Insights

Health Insurance Flexibility Encouraged


On April 17, 2020, the Commissioner Ridling issued Bulletin No. 2020-07 regarding the need for flexibility in health insurance coverage in light of the coronavirus pandemic. The bulletin is directed at all insurers writing health insurance in the state.

The bulletin follows the declaration of a public emergency in the state and the issuance of local “shelter-in-place” orders. The duration of the emergency declaration is unknown at this time.

As a result, the commissioner urges health insurers to consider exercising flexibility with respect to maintaining employee health plan coverage. Specifically, insurers are encouraged to permit employers to continue covering employees under group policies even if the employees would otherwise become ineligible due to a reduction in hours, an “actively-at work” provision, or other eligibility requirements. Insurers are also encouraged not to increase premiums. The commissioner will not take enforcement action with respect to filed forms and rates against insurers that adjust policies and procedures to conform to these suggestions. The bulletin further reminds insurers of their COBRA obligations.

Employers with group policies issued in the state should be aware of these developments, particularly if seeking to continue coverage for employees with reduced hours due to the pandemic. However, it is important to keep in mind that most group health plans are governed by ERISA, which generally requires an amendment to update eligibility requirements. Additionally, notice must be provided to affected individuals. Accordingly, interested employers may want to discuss potential plan eligibility requirement changes with their insurer and document provider.

Bulletin No. 2020-07 »