Kilpatrick

Industry News

COVID-19 Carrier and Industry Resources

This article is a draft. Check back later for more updates.

We are living in unprecedented times. We anticipate prolonged social distancing restrictions impacting all industries.

At Kilpatrick Companies

Beginning Wed, Mar 25, our employees will work from home while the ‘Stay at Home’ orders for Harris County (Houston office) and Galveston County (Santa Fe office) and the state social distancing guidelines are in effect—currently through Apr 3. We anticipate no operational interruptions. Our internal systems and employee desktops run entirely on our servers. Our phone system operates exactly the same. All employees use Slack to collaborate internally.

We will not accept any walk-ins until all social distancing restrictions are lifted. In the interim, we ask brokers to call and email. If a face-to-face meeting is necessary, it must be scheduled in advance.

Upcoming Webinars

We strongly encourage you to attend important upcoming webinars.

WhenHostDescription 
Fri, Mar 20 at 12pm
(1 hour)
Mintz Law FirmCOVID-19 and the Workplace. Mintz attorneys provide guidance on employment and benefits issues.Replay
Tue, Mar 24 at 11am
(1 hour)
UHCCOVID-19 Broker Briefing from UHC national executive leadership with Q&A. For broker audience.Attend
Tue, Mar 24 at 1pm
(1 hour)
UHCCOVID-19 Self-Funded Employer Briefing from UHC national executive leadership with Q&A. For large employer audience.Attend
Wed, Mar 25 at 11am
(1 hour)
UHCCOVID-19 Small Group Employer Briefing from UHC national executive leadership with Q&A. For small employer audience.Attend
Wed, Mar 25 at 12pm
(1 hour)
CignaCOVID-19 Update from national executive leadership. Provides clinical insights.Replay
Wed, Mar 25 at 2pm
(1 hour)
Sun LifeEmployment Law Compliance Issues. Senior counsel discuss employment law and compliance requirements including discrimination, absence management, and the FFCRA law.Replay
Thu, Mar 26 at 12pm
(30 minutes)
PrimePayNavigating the Crisis. PrimePay leadership discuss navigating compliance issues and how they support the key requirements.Register
Thu, Mar 26 at 1:30pm
(1 hour)
Austin AHUCoronavirus CE Webinar presented by Eric Johnson. Sponsored by Kilpatrick Companies. Free for Austin AHU members.Register
Tue, Mar 31 at 11am
(1 hour)
UHCCOVID-19 Broker Briefing from UHC national executive leadership with Q&A. For broker audience.Register
Tue, Mar 31 at 1pm
(1 hour)
MetLifeLegislative Update for the Federal Families First Coronavirus Act.Register
Wed, Apr 1 at 12pm
(1 hour)
NAHUFFCRA Compliance & Employer Actions. Will examine the FFCRA from an HR perspective and what to consider. Limited to 1,000 participants. Register early.Register
Wed, Apr 1 at 1:30pmAustin AHUCoronavirus CE Webinar presented by Eric Johnson. Sponsored by Kilpatrick Companies. Free for Austin AHU members.Register

Plan Coverage Expansions for COVID-19 Testing

The Families First Coronavirus Response Act (FFCRA), enacted Mar 18, mandates that all individual and group fully insured and self-funded health plans cover all costs related to COVID-19 testing at no cost sharing. This includes items and services to test or evaluate the necessity of testing rendered in variety of settings including urgent care visits, in-person or telehealth visits, and emergency room visits that result in an order for in vitro diagnostic products.

On Mar 11, the IRS announced HDHPs can cover COVID-19 testing as preventive care without a deductible.

On Mar 17, the TDI issued an emergency rule requiring fully insured health plans, which are regulated by the state, to cover telehealth services using any platform permitted by the state and pay in-network health professionals at least the same rate for telehealth services as for in-person services. The rule was effective immediately, remains in effect for up to 120 days, and can be extended for an additional 60 days if needed. The rule does not apply to self-funded or level funded plans.

On Mar 27, Congress passed The Coronavirus Aid, Relief and Economic Security Act (CARES). The bill provides $2T in emergency economic stimulus. The expanded accessibility to telehealth and set parameters for insurers to use when paying for COVID-19 testing. If the provider is not in-network, the insurer must pay the provider’s cash price, which must be posted online (subject to a $300/day penalty for noncompliance). Read this article from the Mintz Law Firm for a comprehensive summary of the bill.

Carrier Actions and Accommodations

Carriers are developing plans to provide accommodations to employers. We will publish information we gather it here.

BCBS.

  • BCBS will waive their ‘actively at work’ requirements. As long as premiums are paid, employers can continue to cover employees who were enrolled in coverage as of Mar 20 and no longer meet eligibility definitions through Apr 30, 2020. Coverage availability must be offered on a uniform, non-discriminatory basis.
  • BCBS will allow employers to offer a one-time special enrollment period allowing currently covered employees to select a new plan option among the plans currently offered by the employer. Employees may not term or add dependents during this period. Employees who previously waived are not eligible to enroll during this period. The membership changes must be emailed to BCBS in a census spreadsheet; they cannot be processed online.
  • BCBS committed to not adjust rates or premiums during the plan year if a group’s enrollment decreases by more than 10% due to COVID-19 factors. Rates will adjust at renewal.
  • BCBS allows employers with member-rated billing to make midyear plan changes within six months of the start of the plan year without requiring the plan year to restart. A midyear plan change under these conditions does not trigger an open enrollment opportunity. It only impacts covered employees. A BPA for Amendment must be submitted at least 30 days prior to the change effective date.
  • As a standard practice, BCBS allows groups that do not meet the midyear change conditions to renew early in order to make plan changes. Groups must submit a BPA for Amendment at least 30 days prior to the effective date. The anniversary date will reset to a new 12 month plan year, and the event triggers a true open enrollment opportunity for all employees.
  • BCBS will consider employer requests to extend premium grace periods on a case-by-case basis. Employers need to provide the reason for request and extension date requested.
  • BCBS will not enforce their 30 day renewal paperwork submission deadline for the time being.
  • BCBS has not yet (as of 3/25 at 12pm) made a decision about offering a special enrollment opportunity or waiving rehire waiting periods.

Cigna.

  • On a case-by-case basis at an underwriter’s discretion, Cigna will allow certain employers to offer a special enrollment opportunity for employees who previously waived coverage to enroll. The underwriting team will manage the event and duration. Cigna will not adjust rates as a result of associated membership changes through May 31, 2020. This is not an open enrollment period. Currently enrolled employees cannot change plan elections.
  • Cigna will relax their ‘actively at work’ requirements for employers with medical coverage regardless of funding type. At the request of the employer, Cigna will agree to cover furloughed employees who were enrolled as of Mar 1 through May 31, 2020 as long as premiums are paid. Coverage availability must be offered on a uniform, non-discriminatory basis. See announcement.
  • We will publish additional details when we receive them.

Humana. Read their announcement (Mar 23) for more information.

  • Humana will relax their ‘actively at work’ requirements for fully insured and level funded (LFP) coverage through May 31, 2020. As long as one person remains actively employed and enrolled in coverage, employers may continue covering furloughed employees as long as premiums are paid. Coverage availability must be offered on a uniform, non-discriminatory basis.
  • Humana will provide employers with an option to waive the standard waiting period for rehired employees who were laid off due to COVID-19 factors. True new hires will be subject to the standard waiting period.
  • Humana committed to not adjust rates or premiums during the plan year if a group’s enrollment decreases by more than 10% due to COVID-19 factors. Rates will adjust at renewal.
  • Humana will continue to offer a 30-day grace period for premium payments.
  • Humana will continue to allow employers a 30 day grace period to complete/process open enrollment changes after their effective or anniversary date.

Memorial Hermann.

  • Memorial Hermann will allow employers to renew early to make plan changes. Interested employers must contact their broker for an early renewal offer. They will consider midyear plan buy downs on a special exception request.
  • Memorial Hermann committed to not adjust rates or premiums during the plan year if a group’s enrollment decreases by more than 10% due to COVID-19 factors. Rates will adjust at renewal.
  • Memorial Hermann will continue to offer a 30-day grace period for premium payments with all products.
  • We expect more details by Fri, Mar 27.

National General. Read this FAQ for details.

  • National General will relax their ‘actively at work’ requirements through May 31, 2020. Employers may continue covering furloughed employees as long as premiums are paid. Coverage availability must be offered on a uniform, non-discriminatory basis.
  • National General will provide employers an option to waive the standard waiting period for employees who were laid off and return to work within 90 days of termination. The waiver must be applied uniformly to all previously covered employees who are rehired within 90 days.
  • National General will continue to offer a 30-day grace period for premium payments. They will consider payment plans on a case-by-case basis.
  • National General may consider midyear plan designs changes to buy-down the monthly cost. Remember, the ACA requires employers to give employees 60 days notice of material modification before plan changes can be effective.
  • National General will consider extending the open enrollment period for renewing employers on a case-by-case basis.

Scott & White.

  • Awaiting details.

UHC – Fully Insured Clients. Read the materials available in their broker FAQ page here.

  • UHC will allow employers to offer a special enrollment opportunity for employees and dependents who previously waived coverage to enroll. The special enrollment period will run from Mar 23 to Apr 6. Coverage will be effective Apr 1. This is not an open enrollment period. Currently enrolled employees cannot change plan elections.
  • UHC will relax their ‘actively at work’ requirements for employers with medical coverage. Employers can continue to cover employees furloughed due to COVID-19 through May 31, 2020 as long as premiums are paid. Coverage availability must be offered on a uniform, non-discriminatory basis.
  • UHC will provide employers with an option to waive the standard waiting period for rehired employees who were laid off due to COVID-19 factors. True new hires will be subject to the standard waiting period.
  • UHC committed to not adjust rates or premiums during the plan year if a group’s enrollment decreases by more than 10% due to COVID-19 factors. Rates will adjust at renewal.
  • UHC provides employers with a 30 day grace period for premium payments. They will consider requests for payment extensions on a case-by-case basis. The group must submit the request directly to UHC. They will not accept requests from the broker or GA. For small group (2-50), contact Victoria Vazquez at victoria_vazquez@uhc.com. For 51-100 segment groups, contact Tishanda Onami at tishanda_onami@uhc.com.

UHC – All Savers Clients

  • All Savers will allow employers to offer a special enrollment opportunity for employees and dependents who previously waived coverage to enroll. The special enrollment period will run from Mar 23 to Apr 6. Coverage will be effective Apr 1. This is not an open enrollment period. Currently enrolled employees cannot change plan elections.
  • All Savers will relax their ‘actively at work’ requirements for employers with medical coverage. Employers can continue to cover employees furloughed due to COVID-19 through May 31, 2020 as long as premiums are paid. Coverage availability must be offered on a uniform, non-discriminatory basis.
  • All Savers provides employers with a 30 day grace period for premium payments. They will consider requests for payment extensions on a case-by-case basis. The group must submit the request directly to uhoadminallsavers@uhc.com. They will not accept requests from the broker or GA.

Aetna – AFA Clients. Read their FAQs here.

  • Aetna will relax their ‘actively at work’ requirements for employers with AFA coverage. Employers can continue to cover employees furloughed due to COVID-19 through July 31, 2020 as long as premiums are paid. Coverage availability must be offered on a uniform, non-discriminatory basis.
  • Aetna will provide employers with an option to waive the standard waiting period for rehired employees who were laid off due to COVID-19 factors. True new hires will be subject to the standard waiting period.
  • Aetna will extend payment grace periods and offer payment plans on a case-by-case basis through May 31, 2020.
  • Aetna will allow midyear plan changes through July 31, 2020 to buy down coverage as long as the renewal date is maintained.
  • Remember, the ACA requires employers to give employees 60 days notice of material modification before plan changes can be effective.
  • Aetna committed to not adjust rates during the plan year if a group’s enrollment decreases by more than 10% due to COVID-19 factors. Rates will adjust at renewal.

Principal

  • Principal will not increase rates at renewal for groups renewing in May-Aug. The rate guarantee does not apply if there is a plan change. Additionally, as part of an existing renewal sales promotion, Principal will give a two-year rate guarantee on all existing lines if the group adds a line of coverage at renewal. The promotion is available through Jul 1 renewals, but Principal may extend through Aug.

Economic Hardship and Workforce Reductions

Many businesses will experience extreme economic hardship and are considering a variety of options to weather the storm.

We encourage employers to apply for low-interest disaster loans through the U.S. Small Business Administration.

To date, Congress has not passed legislation to subsidize COBRA premiums—like they did in 2009 during the Great Recession—for employees terminated due to a COVID-19 related factor. We know the topic has been discussed. It may be included in future legislation.

Many employers will have to reduce their workforce. There are a few options and considerations for each. The government has not signaled any intention of subsidizing

  • Furloughs – Employees are required to take unpaid time off but are not terminated from employment. A reduction in hours below 30 hours per week typically causes an employee to lose eligibility as a full time employee. Employees can continue coverage on COBRA or state continuation, depending on employer size. With the exception for variable hour employees in a stability period, employers cannot continue active coverage for a furloughed employee working less than 30 hours a week without amending their health plan (if self-funded) or approval from their insurer (if fully insured or from a stop loss insurer).
  • Layoffs – A termination of employment; separation from payroll. Layoffs typically occur when there is not enough work for an employee to perform and may intend to recall the person when the work again becomes available. Where applicable, the employer offers COBRA or state continuation.
  • Reductions in Force – Occurs when a position is eliminated without the intention of replacing it—a permanent cut in headcount.

For more information about the issues involving furloughed employees, read guidance from Epstein Becker & Green and Ballard Spahr.

Emergency Paid Family Leave Provisions

The FFCRA included provisions applicable to employers with less than 500 employees to expand FMLA and to provide paid sick leave via refundable tax credits. The Act is in effect from Apr 2 to Dec 31, 2020.

  • Emergency Family and Medical Leave Act Expansion – Applies to employees employed for at least 30 days. Employers must provide up to 12 weeks of job-protected FMLA due to leave associated with school closure, child care limitations, or declared emergency. The first 10 days are unpaid. Time remaining must be paid at two-thirds of an employee’s rate of pay up to $200 per day. Job restoration exceptions may be granted to employers with less than 25 employees.
  • Emergency Paid Sick Leave – Applies to all employees regardless of tenure. The act entitles employees to up to 80 hours of sick leave who are quarantined, caring for someone under quarantine, or caring for a child at home due to school or childcare closure. The pay rate depends on the basis for leave.

Read this article from our attorneys at Chamberlain Hrdlicka for a full synopsis.

Carrier Resources

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