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COVID-19 Group Employee Eligibility Q&A

• BCBS


Q&A
  1. Will you be allowing any extended grace periods for these groups to pay their premiums? The changes in the market are early on and there has already been some discussion by the federal government related to a bailout package. Unclear what this may look like, both at an employer and individual level. Our current contract allows for a 31-day grace period from the due date of the bill. Bills are produced and mailed between the 15th and 20th of the month prior to the due date. This allows the customer 40-46 days for premium payments. We will continue to administer the provisions in accordance with the contract. 
     
  2. If an employer has to layoff some employees for a few weeks, but still want to offer them benefits, what is your stance on this? We are monitoring the legislation passed in the House closely and will comply once passed. Regardless, at this time, we do not intend to terminate employees who are furloughed or have a reduction in work hours as a result of the pandemic, as long as premiums are being paid for the individual(s). This is a temporary situation. ASO groups determine eligibility.
     
  3. How long will you allow employees to be on a leave of absence if they are not FMLA qualified?  We are monitoring what is happening in the Federal Government so this may change, however, per our Underwriting Guidelines for BluePride/BlueFreedom &BlueFlex, Temporary Layoffs, Leaves of Absence, Disability:
    The Group's documented personnel rules regarding sick leave and leaves of absence will determine continued eligibility. As long as the employer considers the employee to still be eligible for fringe benefits according to documented personnel rules, eligibility will be maintained. Once the employment status is terminated, the employee is eligible for any coverage dictated by federal (COBRA or Family Leave Act) or state law. 
    In the absence of documented sick leave or leave of absence policy, continued coverage on an active employee basis for a maximum of six months will be allowed.
     
  4. If an employee is laid off and rehired at some point, would they have to fulfill the company’s waiting period again? That will be up to the group. We have a procedure in place for Waiver of Probationary Period, which includes a form to be submitted.
 
For more information, please visit the BCBS website at BCBSNE COVID-19.

UHC

Furlough & Eligibility

Fully insured clients can continue to offer medical benefits to employees furloughed due to Covid-19 as long as the plan sponsor continues to pay its share of premiums and offers the option to all furloughed employees on an equal basis. 

Employees remain eligible for coverage if they remain an active employee during periods of temporary layoffs or reduction in hours as a result. 
Special Enrollment Opportunity:  The opportunity will be limited to employees who previously did not elect coverage for themselves (spouses, children) or waived coverage. The enrollment opportunity will extend from March 23 to April 6, 2020. The effective date will be April 1st.

Q&A
  1. Will you be allowing any extended grace periods for these groups to pay their premiums? UHC has not made a decision on this and is consulting its leadership.
     
  2. How long will you allow employees to be on a leave of absence if they are not FMLA qualified? LOA is determined by the group at the time of application. Each group should refer to their COC. 
     
  3. If an employee is laid off and rehired at some point, would they have to fulfill the company’s waiting period again? See below.
Rehires: Must be within 6 months of leaving the group. Group has the option of waiving new hire guidelines (we will not waive eligibility completely). Re-hired EE eligible as of 1st of month following re-hire. Per Risk management, rehires are to be treated the same as new hires. Rehires are subject to WP if the group not waiving initial WP. If group wants to shorten its rehire provision from 6 to 3 months, it can be done but Must treat ALL EE’s same and make them aware of this guideline.

Please consult the Frequently Asked Questions (FAQs) to help answer many of the outstanding questions you and your clients may have. For additional information please visit:

Broker FAQ webpage: Broker FAQ
Employer FAQ webpage: Employer FAQ

 National General

Due to the circumstance, it will be up to the group’s discretion on how they would want to handle if employees are being laid off or not working the full 30 hours. If the group chooses to keep the employees on the plan even though they are not working the eligible hours, then we would continue to cover them as long as premiums are being received.  However, if the group submit a termination, then we will process accordingly.

Aetna AFA


Q&A
  1. Our company is reducing hours and/or laying off staff due to the COVID-19 crisis. Are we able to keep our employees covered on our AFA plan? Yes. Your employees can maintain their coverage on your AFA plans so long as (1) the reduction in hours/lay off is a temporary measure resulting from the COVID-19 pandemic; (2) you continue to pay your monthly bill and (3) you do not terminate the employee(s). This option is available to customers until July 31, 2020. Please note the guidelines must be applied uniformly without regard to health status-related factors.
     
  2. If I terminate an employee due to reduction in hours, can I waive the waiting period when the employee resumes working 30+ hours? Yes. We are prepared to support changes to your waiting period rules. Any change in your waiting period rules that extends into the next plan year will be considered in your renewal.
Please download the Frequently Asked Questions (FAQs) to help answer many of the outstanding questions you and your clients may have. Aetna will continue to publish additional questions and responses through: AETNA COVID-19 FAQ
If you have any questions please feel free to contact us at 402-330-8700. 
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