Insights

On March 6, 2020, the Commissioner of Insurance issued a Bulletin requesting insurers, self-funded plans, pharmacy benefit managers and cooperative health plans (“Health Plan Issuers”) to remove any barriers to testing and treatment for COVID-19. Specifically, the Office of the Commissioner of Insurance requests Health Plan Issuers providing coverage to Wisconsin residents take the following measures, effective immediately:

• Be readily available to provide accurate information to assist consumers with questions about coverage related to COVID-19.
• Waive any cost sharing for COVID-19 testing, as well as waive any cost sharing for office visits (including provider office visits, urgent care visits, hospital visits or emergency services) when such visit is related to COVID-19.
• Ensure any telehealth programs are robust and able to meet any increase in demand.
• Do not use prior authorization request as a barrier to access to treatment (and should be prepared to expedite prior authorization requests, grievances and appeal processes).
• Cover any immunizations at no cost sharing for all covered individuals in the event an immunization becomes available.

The above requests are not exhaustive. Employers with employees in Wisconsin should consult their carriers, as applicable, and be aware of the Commissioner’s requests when addressing questions regarding health insurance coverage and COVID-19.

Bulletin: Coronavirus (COVID-19) Coverage Request »