CORONAVIRUS (COVID-19)Knowledge Base: Updates & Information
With the extensive amount of concern and the evolving insurance marketplace due to the impact of the Coronavirus pandemic, relevant and timely information will be shared here.
Important Note: As the COVID-19 pandemic continues to evolve at a fast pace, information may get outdated quickly. Please note the date of any materials you are reviewing.
AHT STANDS TOGETHER THROUGH UNCERTAIN TIMES
AUG 12: TRUMP SIGNS EXECUTIVE ORDER PERMANENTLY EXPANDING TELEHEALTH BENEFITS
President Donald Trump recently signed an executive order aimed to improve telemedicine and rural health care access. The order expands telehealth benefits for Medicare recipients past the public health emergency (PHE) declaration for the coronavirus (COVID-19) pandemic, particularly addressing health care access in rural communities.
Previously, Trump had expanded Medicare telehealth coverage, which offered expanded benefits and suspended restrictions on 135 health care services offered via telehealth to Medicare beneficiaries. This temporarily allowed recipients to receive a wider range of services. This executive order extends these flexibilities and moves to expand telehealth benefits permanently and increase access and choices for seniors.
Shortly after the executive order, the CMS issued a press release proposing a rule which reduces the clinician burden in rural areas. The CMS notes that telehealth can help address current health care challenges.
JULY 13: EMPLOYERS MUST REPORT PAY FOR FFCRA LEAVE ON W-2
On July 8, 2020, the Treasury Department and the Internal Revenue Service released Notice 2020-54 guiding employers in their required reporting of the amount of qualified sick leave wages and qualified family leave wages they paid to their employees under the Families First Coronavirus Response Act (FFCRA). Employers will be required to report these amounts either on Form W-2, Box 14, or on a separate statement. This required reporting provides employees who are also self-employed with information necessary for properly claiming qualified sick leave equivalent or qualified family leave equivalent credits under the FFCRA.
JULY 1: DOL ISSUES GUIDANCE ON FFCRA LEAVE FOR SUMMER CAMP CLOSURES
The U.S. Department of Labor (DOL) has clarified when employees may take paid leave under the Families First Coronavirus Response Act (FFCRA) for the COVID-19-related closure of a summer camp, summer enrichment program or other summer program. The clarification appears in Field Assistance Bulletin 2020-4 (Bulletin) issued to field offices of the DOL’s Wage and Hour Division.
The FFCRA allows employees to take leave from work necessitated by the closing of the employee’s child’s place of care—including summer camps and enrichment programs—for COVID-19-related reasons. The Bulletin directs Wage and Hour investigators, in evaluating whether an employer improperly denied FFCRA leave, to consider whether there is evidence of a plan for the child to attend the camp or program, or whether it is more likely than not that the child would have attended the camp or program had it not closed. However, the Bulletin notes that a parent’s mere interest in a camp or program is generally not enough.
The Bulletin says the “multitude of possible circumstances” precludes a one-size-fits-all rule, but it mentions current enrollment in, recent prior attendance at, and acceptance on the waitlist of a camp or program as possible indicators of a plan for a child to attend.
JUNE 29: FEDERAL AGENCIES ISSUE MORE FAQS ON CORONAVIRUS-RELATED CHANGES FOR HEALTH PLANS
On June 23, 2020, the Department of Labor (DOL), the Department of Health and Human Services (HHS), and the Department of the Treasury (collectively, the Departments) jointly prepared answers to a second set of frequently asked questions (FAQs Part 43) about health coverage issues related to COVID-19, including implementation of the Families First Coronavirus Response Act (FFCRA) and the Coronavirus Aid, Relief and Economic Security Act (CARES Act).
The FAQs provide guidance on a variety of topics related to health plan coverage. For example, the FAQs:
- Provide that COVID-19 testing for surveillance or employment purposes is not subject to the coverage mandate under the FFCRA and CARES Act;
- Confirm that the FFCRA and the CARES Act generally prohibit balance billing for COVID-19 diagnostic testing;
- Allow health plans to revoke the temporary COVID-19-related coverage changes without satisfying certain notice deadlines, provided participants are notified within a reasonable time frame in advance of the reversal of the changes; and
- Allow large employers to offer coverage for telehealth and other remote care services to employees who are not eligible for any other group health plan offered by the employer during the public health emergency.
Employers that sponsor group health plans should become familiar with the FFCRA’s and CARES Act’s changes for their health plans. The Departments’ FAQs provide helpful guidance on implementing these changes.
JUNE 29: STATES UPDATE EMPLOYEE LEAVE REQUIREMENTS FOR CORONAVIRUS
In response to the coronavirus (COVID-19) pandemic, states have passed new laws and issued new regulations and guidance about employee leave taken for COVID-19 reasons. These provisions are in addition to the federal Emergency Paid Sick Leave and Emergency Family and Medical Leave Expansion requirements passed on March 18 as part of the Families First Coronavirus Response Act (FFCRA).
In general, employee leave permitted under new state COVID-19 rules and guidance varies with respect to factors like the employers and employees covered by the leave, the length and purpose of the leave, whether the leave is compensated and at what rate, and whether the leave is provided under a new law or rule, or covered under an existing provision.
View a brief description of new state employee leave provisions and guidance enacted or issued in response to the COVID-19 pandemic. Information about similar measures in select major cities is also included. Please note, the information in this document is rapidly changing, but is current as of June 2020.
Employers should also continue to monitor the websites of their state departments of labor for new laws, rules and guidance about COVID-19-related employee leave.
JUNE 29: DOL LAUNCHES EMPLOYEE TOOL FOR ASSESSING FFCRA LEAVE ELIGIBILITY
The U.S. Department of Labor (DOL) has created an online tool to help workers determine whether they qualify for paid sick leave or expanded family and medical leave under the Families First Coronavirus Response Act (FFCRA).
The tool works by posing a series of questions that help employees assess whether the paid leave provisions of the FFCRA apply to their employer. Once employees learn the provisions do apply, the tool then assists them in determining whether they qualify for FFCRA paid sick leave or expanded family and medical leave.
The DOL is also developing a similar tool for employers.
APRIL 2nd: PRESIDENT TRUMP SIGNED THE CORONAVIRUS AID, RELIEF AND ECONOMIC SECURITY ACT (CARES ACT) INTO LAW
On March 27, 2020, President Trump signed the Coronavirus Aid, Relief and Economic Security Act (CARES Act) into law to provide $2.2 trillion in federal funding to address the COVID-19 crisis. The CARES Act makes a variety of changes affecting health plans. These changes include:
- Expanding the types of coronavirus testing that all health plans and health insurance issuers must cover without cost-sharing (such as deductibles, copayments or coinsurance) or prior authorization;
- Accelerating the process that will require health plans and issuers to cover preventive services and vaccines related to COVID-19;
- Allowing telehealth and other remote care services to be covered under a high deductible health plan (HDHP) before the deductible is met, without affecting the HDHP’s compatibility with health savings accounts (HSAs) (applicable for HDHP plan years beginning on or before Dec. 31, 2021); and
- Treating over-the-counter (OTC) medications, along with menstrual care products, as qualified medical expenses that may be paid for using HSAs or other tax-advantaged arrangements, such as health flexible spending accounts (FSAs) or health reimbursement arrangements (HRAs).
MARCH 24th: HSA CONTRIBUTIONS FOR 2019 YEAR MAY BE MADE UP TO JULY 15, 2020
On March 24, 2020, FAQs were released related to Notice 2020-18. Specifically, in Notice 2020-18, the Treasury Department and the Internal Revenue Service (IRS) announced special Federal income tax return filing and payment relief in response to the ongoing Coronavirus Disease 2019 (COVID-19) emergency. Importantly, Question and Answer 21 provided:
Q 21: Does this relief provide me more time to contribute money to my HSA or Archer MSA for 2019?
A 21: Yes. Contributions may be made to your HSA or Archer MSA, for a particular year, at any time during the year or by the due date for filing your return for that year. Because the due date for filing Federal income tax returns is now July 15, 2020, under this relief, you may make contributions to your HSA or Archer MSA for 2019 at any time up to July 15, 2020. For more details about HSA or Archer MSA contributions, see Publication 969, Health Savings Accounts and other Tax-Favored Health Plans.
MARCH 23rd: IRS ISSUES GUIDANCE ON TAX CREDITS FOR CORONAVIRUS PAID LEAVE
On March 20, 2020, the U.S. Treasury Department, Internal Revenue Service (IRS), and the U.S. Department of Labor (DOL) announced that small and midsize employers may begin using two new refundable payroll tax credits to obtain reimbursement for the costs of providing coronavirus-related leave to their employees.
This relief is provided under the Families First Coronavirus Response Act (the Act), which was signed into law on March 18, 2020. The Act provides funds for employers with fewer than 500 employees to provide paid leave, either for their employees’ own health needs or to care for their family members. The Act aims to help employers keep workers on their payrolls while ensuring that workers are not forced to choose between their paychecks and the public health measures needed to combat the coronavirus (COVID-19).
MARCH 19th: FAMILIES FIRST CORONAVIRUS RESPONSE ACT
On March 18, 2020, President Donald Trump signed H.R. 6201, known as the Families First Coronavirus Response Act, into law. The bill provides free coronavirus (COVID-19) testing, paid leave and enhanced unemployment insurance benefits for people affected by the coronavirus. The bill takes effect April 2, 2020, and will expire on December 31, 2020.
With regard to the paid leave provisions, the bill:
- Provides that employers with less than 500 employees and covered public-sector employers must provide up to 12 weeks of job-protected FMLA leave for a qualifying need related to the coronavirus to employees who have been on the payroll for 30 calendar days. The qualifying need is limited to situations where an employee is unable to work or telework due to school or childcare closures related to the coronavirus.
- The first ten days are unpaid unless the employee opts to substitute accrued vacation, personal, or sick leave during this time.
- The remainder of the FMLA leave is required to be paid at 2/3 pay (with the amount not exceeding $200 per day and $10,000 in the aggregate).
- The bill additionally exempts employers with less than 25 employees from the job-protected aspects of the emergency FMLA leave so long as a set of conditions are met.
- Further, the bill permits the Secretary of Labor to exempt employers with less than 50 employees from the emergency FMLA leave requirement if the required leave would jeopardize the viability of their business.
- Employers may also exclude employees who are health care providers or emergency responders from such leave.
- Requires that employers with less than 500 employees and covered public-sector employers provide paid sick time to workers.
- Specifically, paid sick leave is required under the following scenarios:
- When quarantined or isolated subject to federal, state, or local quarantine/isolation order;
- When advised by a health care provider to self-quarantine (due to concerns related to COVID-19);
- When experiencing symptoms of COVID-19 and seeking a medical diagnosis;
- When caring for an individual doing #1 or #2 (2/3 pay);
- When caring for a child whose school or place of care is closed due to COVID-19 (2/3 pay); or
- When the employee is experiencing any other substantially similar condition (2/3 pay).
- The employee is not required to be on the payroll for 30 calendar days for this leave.
- Specifically, the bill provides 80 hours of paid sick leave to full-time employees while part-time employees are entitled to the typical number of hours they are scheduled to work in a two week period.
- As with the FMLA leave, the bill contains language allowing the Secretary of Labor to exempt small businesses with less than 50 employees from the paid sick leave requirement if the required leave would jeopardize the viability of their business. Healthcare providers and emergency responders may also be excluded from paying sick leave.
- The bill limits an employer’s requirement of paid leave to $511 per day ($5,110 in the aggregate) or $200 per day ($2,000 in the aggregate) based upon the reasoning for the sick leave.
In addition, the bill provides funding for economic assistance, requires health plans to cover COVID-19 testing at no charge, and contains a refundable tax credit for employers, including self-employed individuals, that are required to offer paid leave benefits due to the coronavirus pandemic.
We will be following up with additional details.
MARCH 12th: DOL ISSUES GUIDANCE ON COVID-19 & THE FMLA
The U.S. Department of Labor (DOL) has issued Q&As on the federal Family and Medical Leave Act (FMLA) and COVID-19. The Q&As explain that under the FMLA, covered employers must provide eligible employees with job-protected, unpaid leave for specified family and medical reasons, which may include the flu where complications arise. Employees on FMLA leave are entitled to the continuation of group health insurance coverage under the same terms as before they took leave.
The Q&As state, among other things, that the FMLA provides leave for an employee’s serious health condition or to care for a family member’s serious health condition, but does not provide leave for avoiding the workplace out of a fear of contracting a disease. The Q&As also provide information on the application of the Americans with Disabilities Act (ADA) to employee leave.
The Q&As recommend that employers encourage employees who are ill with pandemic influenza or are exposed to ill family members to stay home. They also encourage employees to consider flexible leave policies for their employees in these circumstances.
MARCH 11th: IRS NOTICE 2020-15 - HDHPs & COVID-19 TESTING
Today, the IRS issued Notice 2020-15, advising that high deductible health plans (HDHPs) that are HSA qualified may pay for COVID-19 testing and treatment before they meet their deductible without jeopardizing their HDHP status under the Internal Revenue Code (IRC). Further, an individual covered by an HDHP that pays for those costs may continue to make tax-favored contributions to an HSA.
Significantly, individuals participating in HDHPs or any other type of health plan should contact their medical carrier regarding the health benefits for testing and treatment of COVID-19 provided by the plan, including the potential application of any deductible or cost sharing, as Notice 2020-15 is meant to provide flexibility to plans in that regard, but is not intended as instruction to plans to modify existing cost shares.
Notice 2020-15 “does not modify previous guidance with respect to the requirements to be an HDHP in any manner other than with respect to the relief for testing for and treatment of COVID-19.” As such, vaccinations continue to be considered preventive care for purposes of determining whether a health plan is an HDHP.
For more information, see Notice 2020-15.
STATE INSURANCE COMMISSIONER ORDERS
MARCH 10th: WASHINGTON STATE HEALTH BENEFIT EXCHANGE ANNOUNCES LIMITED SPECIAL ENROLLMENT PERIOD
On March 10, 2020, in response to the potential growth of COVID-19 cases, the Washington State Health Benefit Exchange (Exchange) announced a limited-time special enrollment period for qualified individuals who are currently without insurance. This special enrollment period (SEP) will run through April 8, 2020, and allow uninsured individuals 30 days to enroll in health insurance coverage through Washington Healthplanfinder. The Exchange announced that until April 8, individuals seeking a special enrollment should contact the Customer Support Center between 7:30 a.m. to 5:30 p.m. Monday-Friday at 1-855-923-4633; TTY: 1-855-627-9604, request the SEP, and select a plan by April 8 for a coverage start date beginning April 1, 2020.
Please note that this SEP only applies to the Individual WA State Exchange at this point and does not apply to individual employers and their respective policies.
LIVE & ON-DEMAND WEBINARS
AHT COVID-19 RESOURCES
Travel in the Time of COVID-19 Applying International Travel Risk Management Principles to the COVID-19 World… Even if You’re Not Traveling Internationally - MAY 29
by Joe Gleason, AHT Director of Risk Management – DOWNLOAD HERE
Download Operating Considerations for US Based International NGOs – DOWNLOAD HERE
Brought to you by: International NGO Safety and Security Association, Global Interagency Security Forum, Klamp and Associates and Konterra Group
Download Presentation – Operating Considerations for US Based International NGOs – DOWNLOAD HERE
Brought to you by: International NGO Safety and Security Association, Global Interagency Security Forum, Klamp and Associates and Konterra Group
WHITEPAPER: Impact of COVID-19 Health Plan Use Employer-Sponsored Health Plan Considerations - April 6th
by Steve Uno, AHT Executive Vice President, Shareholder, Member of the Board & Benefits Practice Leader
As questions arise about various insurance coverage and how policies respond in the wake of the Coronavirus outbreak, we compiled this general overview. Contact your service team with industry-specific questions.
In this blog, we review three areas organizations should consider as they manage the risks associated with COVID-19.
EXTERNAL COVID-19 RESOURCES
from The Konterra Group – Take a look at some things people commonly experience during the period of rising uncertainty and pressure surrounding an infectious disease outbreak: VIEW NOW
RETIREMENT SERVICES UPDATES
Insights to help prepare you for inquiries, administration and decisions you might encounter – brought to you by RPAG and the AHT Retirement Services team.
Your AHT team is here to help guide you, answer questions you may have or direct you to the most appropriate resources. Please contact your team directly.