COVID-19 and Health Benefit Plans

On March 25, 2020, the Department of Labor and Regulation issued Bulletin 20-02, requesting health carriers take certain measures (through June 30, 2020) in light of the unique circumstances impacting individuals due to COVID-19. Highlights include:

  • COVID-19 testing and related visit – whether office, urgent care or emergency room – must be provided at no cost to insured individuals (in conjunction with the Families First Coronavirus Response Act).
  • Any preauthorization requirements should be waived or expedited.
  • Carriers are urged to expand availability of telemedicine and are encouraged to waive cost sharing for telemedicine services.
  • When appropriate, carriers are strongly encouraged to permit early refills on maintenance prescription medication (with no additional authorization requirements).
  • If there is not adequate number of in-network providers, carriers are recommended to allow access to out-of-network provides at in-network cost sharing.
  • Carriers are urged to provide grace periods for premium payments.
  • Health care providers are urged to refrain from balance billing.

Employers should be aware of these developments.

Bulletin 20-02 »