What Insurers, Employers Expect in COVID-19 Aftermath
August 6, 2020
A study has come out predicting that COVID-19, as devastating as it has been, will have little effect on 2021 group health plan rates, as well as offerings.
The study, by eHealth Inc., also found that many insurers have increased utilization of telemedicine and that many of them are extending benefits related to coronavirus testing and treatment.
Here are the main points of the study:
Waiving COVID-19 testing costs ― 97% of insurer respondents say they are waiving out-of-pocket costs for coronavirus testing.
Waiving treatment costs ― 58% of the insurers say they're waiving out-of-pocket costs for COVID-19 treatment. Among insurers who say they have done this, 80% say they have waived all out-of-pocket costs, while 20% say they have waived only a portion of members' out-of-pocket ...
Alternative Group Plan Funding Gets a Second Look
July 28, 2020
Watching their group health plan premiums climb higher with each passing year, some employers start looking into alternative funding strategies in hopes they can get a better handle on their employees' health costs.
While group plans are the standard, larger employers have typically had more options for funding their group health coverage. But now even small and medium-sized employers - even companies with fewer than 100 employees - can benefit from alternative funding approaches.
There are three main types of alternative funding strategies that are available to employers:
Full and partial self-funding.
With a captive, multiple employers pool their resources and share the risk in providing health insurance to their employees. It is essentially a ...
Protecting Your Firm from Employee Benefit Lawsuits
July 21, 2020
Employment practices and employee benefit-related lawsuits are on the rise - and employers have to be eternally vigilant when it comes to meeting their compliance obligations as plan sponsors.
Take the case of Visteon, a global automotive industry supplier, which outsourced its payroll and enrollment/disenrollment functions to outside plan administrators.
But because of internal mistakes at the firms that Visteon outsourced these noncore HR functions to, some of its former employees who should have received COBRA eligibility notices after leaving the firm never received them. At first it was just a handful, but ultimately 741 co-workers signed on to a class-action lawsuit
Visteon argued in court that it was not its own mistakes that had caused the error, and that it had made a ...
Testing Workers for COVID-19 Raises Privacy, Discrimination Issues
July 14, 2020
Employers whose businesses continue to operate are obviously concerned about the coronavirus spreading through their worksites, so many have started testing their workers.
Recent U.S. Equal Employment Opportunity Commission guidance authorized employers to conduct COVID-19 testing and check temperatures of employees. But doing so could expose a business to a number of employee legal actions from invasion of privacy to discrimination and wage and hour charges, say employment law attorneys.
While the EEOC guidance refers to existing Americans with Disabilities Act regulations requiring that any mandatory medical test of employees be "job related and consistent with business necessity," it left many questions unanswered.
So, if you decide to start testing ...
How to Handle Group Health Coverage for Laid-off, Furloughed Staff
July 7, 2020
As the COVID-19 pandemic wears on, many employers have had to lay off or furlough staff due to a tremendous drop-off in business. Besides the loss of income they face, these workers will often also lose their employer-sponsored health insurance.
With this in mind, many employers have been wondering if they can permit coverage to continue during the time the staff is temporarily laid off or furloughed due to the COVID-19 outbreak. If you are looking at options for keeping these employees on your group plan, you'll need to read your policy to see if it's possible and explore all of your options.
Most group health plans will define what constitutes an eligible employee. Typical requirements include working at least 30 hours a week. The policy may also address how long an ...
COVID-19 Changes to Health Plans Must Be Documented, Circulated
July 1, 2020
A number of plan sponsors have made changes to their group health plans in response to the COVID-19 pandemic, such as covering testing and sometimes treatment without any cost-sharing by the plan enrollee.
But any changes that are made must be followed up by amending the plan and communicating the changes to the enrollees.
Under the Employee Retirement Income Security Act, all health plans are required to deliver a Summary Plan Description (SPD) to enrollees to inform them of the full spectrum of coverage and their rights under the plan.
Whenever a plan sponsor makes a material modification to the terms of the plan or the information required to be in an SPD, they must amend the plan and let participants know about the change through a Summary of Material ...