Transitional Guidance Issued on Connecticut Family and Medical Leave Act Changes
October 12, 2021
The state Department of Labor recently provided guidance regarding amendments to the Connecticut Family and Medical Leave Act (CT FMLA) scheduled to take effect on January 1, 2022. Specifically, the release is designed to assist employers with administering leave during the transitional period from 2021 to 2022.
Under the current CT FMLA provisions, eligible employees are entitled to 16 weeks of leave in a 24-month period. Effective January 1, 2022, employees will be entitled to 12 weeks of leave in a 12-month period. Employees incapacitated by a serious health condition due to pregnancy may be entitled to an additional 2 weeks of leave.
According to the new guidance, if an employee commences leave in 2021, the duration of their leave as of January 1, 2022, would be limited to 12 weeks in the applicable 12-month measurement period that the employer uses (e.g., calendar year, rolling lookback or other method). This would be the case even if the employee was approved for and had already commenced 16 weeks of leave in 2021. Therefore, in 2022, the employer can look back over the applicable 12-month period to see if the employee has used any leave to determine if they have time available. Examples are provided for each of the four methods that may be used for calculating the 12-month period.
Employers should be aware of this update. However, the guidance does not have the binding force of regulations, which are anticipated to be released later this year. Accordingly, it is advisable for employers to consult with counsel for assistance regarding leave administration during this transition period, and any related updates to employee communications and leave policies.
Guidance concerning the transition to the new FMLA law on 1/1/22 when an employee has an already approved FMLA leave »
New Law Extends Relaxed Telehealth Service Requirements
May 25, 2021
On May 10, 2021, Gov. Lamont signed House Bill 5596 into law. This legislation provides a two-year extension of the relaxed telehealth service requirements that were previously enacted due to the COVID-19 pandemic.
In March 2020, Gov. Lamont enacted emergency Executive Order No. 7G, which suspended certain telehealth limitations to enable more residents to use telehealth services. For example, the order expanded the types of providers and licensed professionals who can provide telehealth services and permitted licensed providers in other states to provide telehealth services to state residents. The order also allowed for the use of audio-only services. For further information on Executive Order No. 7G, please see our March 31, 2020, Compliance Corner article.
In recognition of the benefits of allowing broader access to telehealth services, the recent law extends the relaxed standards through at least June 30, 2023.
Group health plan sponsors may want to be aware of this development.
House Bill 5596 »
Website Offers PFMLA Resources for Employers
November 10, 2020
New resources were recently released on the state’s Paid Family and Medical Leave Act (PFMLA) website. These include materials designed to assist employers with their PFMLA compliance obligations.
As background, in June 2019, Gov. Lamont signed legislation that requires private employers to provide paid leave to eligible employees who work in the state. The leave can be taken for life events covered under the federal FMLA, the state FMLA and the Connecticut Family Violence Leave Act. (The law was covered in our July 9, 2019, edition of Compliance Corner.)
The leave is funded through employee payroll deductions. Accordingly, effective January 1, 2021, employers are required to begin withholding a percentage (up to a maximum of .50%) of employee wages. The withheld amounts must be submitted quarterly to the Connecticut Paid Leave Authority, which is responsible for administering the leave benefits. Eligible employees may begin taking PFMLA leave on January 1, 2022.
The website materials include an employer fact sheet, toolkit and poster. Registration requirements are explained. Frequently asked questions have been updated and address a wide variety of issues regarding the paid leave and an employer’s related responsibilities.
Affected employers should be aware of the website and available PFMLA resources.
PFMLA Website »
Premium Grace Period Required
April 14, 2020
On April 1, 2020, Gov. Lamont issued Executive Order No. 7S, which addressed various health and safety measures related to the coronavirus (COVID-19) pandemic. Amongst other items, the order requires insurers to provide a premium grace period for certain individuals and businesses affected by the COVID-19 emergency.
Following the coronavirus (COVID-19) outbreak, the governor declared a public health emergency on March 10, 2020. With recognition of the worker displacement and business disruption resulting from the disease and mitigation measures, the governor had previously issued a bulletin requesting that insurers take measures to prevent unnecessary policy cancellations or nonrenewals.
Order No. 7S now requires a 60-day grace period (beginning on April 1, 2020) with respect to premium payments and policy cancellations and nonrenewals for certain insureds affected financially by the COVID-19 emergency. The grace period is not a waiver or forgiveness of the owed premium, but rather an extension of time for payment.
The requirement applies to entities licensed or regulated by the Insurance Department that provide any insurance coverage in the state including, life, health, auto, property, casualty and other types. However, the extension is not automatic; eligible individuals or businesses would need to contact their carriers to avail themselves of the temporary relief.
Specifically, insurers must provide the extension to individual policy holders who, due to the COVID-19 pandemic, were laid off, furloughed, fired from employment, or otherwise sustained a significant loss in revenue. Additionally, the grace period must also be extended to businesses that are group policyholders, have group insurance and/or property/casualty insurance, and were required to close or significantly reduce operations or suffered significant revenue loss as a result of the COVID-19 pandemic. Qualifying individuals or businesses may be required to provide a supporting affidavit or other statement acceptable to their carriers.
Although this provision of the order is primarily directed at insurers, employers should be aware of these developments and the available temporary premium relief for qualifying individuals and businesses.
Executive Order No. 7S »
Financial Protections for Health Care Providers and Consumers
April 14, 2020
On April 5, 2020, Gov. Lamont issued Executive Order No. 7U, which aimed to provide financial protections to health care providers and consumers. These measures are intended to ensure the state’s health care workforce and facilities have the necessary capacity to address the coronavirus (COVID-19) pandemic. Additionally, the order seeks to mitigate the adverse financial impacts of COVID-19 treatment on consumers.
As background, the governor had declared a public health emergency due to the COVID-19 crisis on March 10, 2020. In response, the state’s health care workforce was supplemented by professionals who did not maintain liability coverage, including volunteers and out-of-state professionals. Additionally, the state recognized that the unexpected costs of COVID-19 treatment may significantly affect the financial security of the state’s residents.
As a result, the order provides certain protections from civil liabilities for health care professionals and facilities due to acts or omissions that were undertaken in good faith while supporting the state’s COVID-19 response. Included are acts or omissions resulting from a lack of resources that prevented a level or manner of care that would normally be required absent the pandemic.
The consumer financial protections extend to the uninsured and those covered by insurance who receive out-of-network health care services during the emergency. Specifically, if emergency services are provided to an insured out-of-network, the carrier may be billed directly and is only required to pay the in-network rates as payment in full for the services. Additionally, the order specifies that a hospital providing COVID-19 treatment and management services to an uninsured patient may collect no more than the Medicare rate for such services as payment in full. Furthermore, hospitals are prohibited from billing individuals for uncovered COVID-19 treatment and management services pending clarification of the availability of federal funds to cover such services.
The order is primarily directed at health care providers, facilities and hospitals, but employers should be aware of these developments.
Executive Order No. 7U »
Insurance Department Calls for Premium Grace Period
March 31, 2020
On March 24, 2020, the Insurance Department issued Bulletin Number IC-40 regarding insurance premium payments during the coronavirus (COVID-19) pandemic. The bulletin is directed at admitted and non-admitted insurance companies, licensed producers and other interested parties.
Due to the significant economic disruptions and loss of income following the COVID-19 outbreak, consumers and businesses have been substantially impacted. As a result, the bulletin requests insurers providing any coverage in the state, including life, health, auto, property, casualty and other types, to offer a premium grace period.
Specifically, the Department requests that all insurance companies provide their insureds with at least a 60 day grace period to pay insurance premiums and thus avoid cancellation for nonpayment. The request is intended to be applied to premiums due after the initial premium has been made to secure coverage. It is not intended as a forgiveness of the premium, but an extended grace period for payment without penalty or interest. The memo also requests that agents and brokers who accept insurance premium payments on behalf of insureds provide customers with alternative prompt payment options, such as online payments, to eliminate the need for in person payments.
Employer and brokers should be aware of this premium grace period request.
Bulletin Number IC-40 »
Governor Issues Coronavirus Public Health Emergency Response Order
March 31, 2020
On March 19, 2020, Gov. Lamont issued Executive Order No. 7G, addressing various health and safety measures related to the coronavirus (COVID-19) pandemic. Among other items, the order addressed the use of telehealth services during the pandemic.
Following the coronavirus (COVID-19) outbreak, the governor declared a public health emergency on March 10, 2020. With recognition of the benefits of expanded telehealth services during the pandemic, the order includes provisions that suspend existing telehealth limitations and restrictions.
Specifically, the order permits telehealth providers that are in-network providers for fully insured plans to provide covered telehealth services to patients with whom there is an existing provider-patient relationship through the use of audio-only phone. The order also suspends certain licensing requirements for telehealth providers. Additionally, the order requires that a provider who receives payment for telehealth services shall not bill the patient for any additional charges beyond the health plan reimbursement. Any related regulatory requirements that such telehealth services be provided from a provider’s licensed facility are also waived.
The memo is directed at state citizens and covers numerous topics in addition to telehealth services.
Executive Order No. 7G »
Access Health Announces Special Enrollment Period Due to Coronavirus Emergency
March 31, 2020
On March 18, 2020, the state’s health insurance exchange announced a special enrollment period (SEP) available to uninsured residents. During this SEP, eligible individuals will be able to enroll in insurance coverage through Access Health CT.
This measure was taken as a result of the COVID-19 emergency to further protect the public health of state residents. Access Health and the exchange’s insurers, Anthem and ConnectiCare, recognized the need to permit the uninsured to enroll and have access to testing and treatment.
The special enrollment period extends from March 19 through April 2, 2020. Individuals who enroll during this period will generally have coverage effective starting April 1, 2020.
Employers should be aware of this limited enrollment period, which may provide an option for individuals not otherwise eligible to enroll in coverage.
SEP Announcement and FAQs »
Coronavirus Outbreak and Testing Bulletin
March 17, 2020
On March 9, 2020, the Connecticut Insurance Department issued Bulletin No.IC-39 to health insurance companies and health care centers authorized to conduct business in the state. The bulletin provides directions to these entities with respect to the coronavirus (COVID-19) outbreak and related issues.
As background, concerns have arisen that cost sharing may be a barrier to covered individuals seeking COVID-9 testing and treatment. Additionally, it is important that the health care insurers and centers are prepared both to inform individuals of their covered benefits and to address increased COVID-19 cases and claims.
Accordingly, the bulletin encourages these entities to waive cost sharing related to COVID-19 laboratory tests, health care provider visits and telehealth services (including out-of-network services when in-network availability is unreasonable). The Department also urges the insurers and centers to authorize payment to pharmacies for a ninety (90) day supply of maintenance prescription medications for individuals. Furthermore, leniency is encouraged with respect to enforcement of otherwise applicable utilization review penalties and claims filing deadlines.
The bulletin is directed at health care insurers and centers, who are requested to inform the Department of measures taken in response. Employers should be aware of this development.
Bulletin No. IC-39 »
Guidance Regarding Health Insurance Tax Repeal
February 04, 2020
On December 27, 2019, the Insurance Department issued a bulletin to health insurance providers regarding necessary filing and credit adjustments following the Health Insurance Tax repeal. The guidance affects employer groups with plan years beginning between January 1, 2020, and December 1, 2020.
Since 2014, the ACA Health Insurance Tax imposed a sales tax on health insurers, and those insurers generally passed the cost along to consumers and employers by increasing the health plan premium. On December 19, 2019, Congress permanently repealed this tax effective January 2021. However, for plan years beginning after January 1, 2020 (and therefore covering part of 2021), the 2021 portion of the tax was already included in the premium rate charged.
Accordingly, the guidance directs carriers that have approved group rates for plan years beginning in 2020 to refile such rates for the second, third, and fourth quarter of 2020 to remove the fee for the corresponding portion of the plan year in 2021. Filings should be submitted no later than March 1, 2020. For groups with plan years beginning February 1, 2020, through March 31, 2020, carriers are directed to provide a credit or refund of the 2021 fee to the employer group in the 2020 plan year.
Although the bulletin is directed at insurance carriers that deliver or issue group health insurance policies in Connecticut, affected employers should also be aware of the guidance and rate refiling requirements. Additionally, employers with plan years beginning February 1, 2020, through March 31, 2020, should expect a credit or refund of the 2021 health insurance tax fee in the 2020 plan year. They should also analyze any responsibility to return a portion of any such refund to plan participants based on ERISA guidelines.
BULLETIN No. HC-127 »