The Offices of the Insurance Commissioner have provided a number of bulletins addressing the coronavirus and its impact on insurance offered to West Virginia residents.
Bulletin 2020-01, released on March 9, 2020, requests that insurers waive cost sharing for COVID-19 testing in order to reduce or eliminate barriers to ask for testing. Among other things, the bulletin also asks insurers to waive any prior authorization requirements associated with COVID-19 testing or treatment. In the event that an immunization for COVID-19 becomes available, the bulletin also requests that insurers offer the immunization at no cost to participants.
Bulletin 2020-03, released on March 13, 2020, reflects the passage of House Bill 4003, which mandates coverage for telehealth services. Specifically, the bill requires the coverage of telehealth services if those same services are covered through face-to-face consultation. The bulletin also confirms that any such telehealth coverage must be offered with the same cost-sharing amounts that are imposed on other services covered under the policy.
Bulletin 2020-05, released on March 13, 2020, requires insurers to cover a one-time early refill of any necessary prescription to ensure that individuals have access to their necessary medications should they need to limit close contact with others. For maintenance medications, insurers must allow for 90-day supplies upon refill. The bulletin also asks insurers to encourage the use of mail-order prescription benefits and strongly suggests that insurers allow participants to use out-of-network pharmacies at in-network cost-sharing levels.
Insurance Commission Dodrill also declared the coronavirus pandemic an insurance emergency on March 13, 2020. Pursuant to that declaration, the normal time frames for claims handling and settlement are suspended. However, insurers must continue to adjudicate claims as expeditiously as possible.
While these bulletins are not specifically directed to employers, employers should familiarize themselves with this guidance in case employees have questions about insurance coverage amidst the coronavirus crisis.
Bulletin 2020-01 »
Bulletin 2020-03 »
Bulletin 2020-05 »
Emergency Declaration »