Can a group or employee change plans off-anniversary?

CCSB is not allowing groups to drop or downgrade plan offering off-anniversary. However CCSB has indicated that they will work with an employer on a case by case basis for consideration.

Contact Claremont for more information.

Is there any additional grace period for the payment of premiums?

Yes, there’s a 60 day grace period for April and May premium payments.

Contact Claremont for more information.

Can employers use credit cards to pay premiums?

No. The available methods of premium payment have not changed; checks and ACH. No credit card payments.

If employees are required to work a reduced schedule (temporary layoff, furlough, reduction-in-hours, etc) will they remain eligible for coverage?

If employee’s hours are reduced or if they are temporarily furloughed, but still considered employees, then so long as the monthly premium is paid coverage will stay in place.

Employers must ensure that any changes they make in this area of eligibility are equitable across all employees and employee classes. Employers must not make changes that could be considered discriminatory.

If employees are formally terminated, then COBRA is the only group coverage option.

Are there any extensions to new business submission deadlines?

Yes. CCSB is extending new business submission deadlines to provide relief to employer groups and their brokers. See here for the updated deadlines, and the New Business Late Submission Acknowledgement form.

Is there a special open enrollment period for individuals who have previously declined coverage?

Employer groups may enroll new members off-anniversary through a Special Enrollment Period (SEP) through June 30, 2020, with July 1 as the latest effective date. This SEP is for employees who previously declined coverage for themselves or their dependents.

• For an April 1, 2020, effective date, enrollment request must be received no later than April 15.
• For May 1, June 1, and July 1 effective dates, enrollment requests must be received on or before the 1st of the month for which enrollment is being requested.

This applies to all fully insured Small Group (1-100) and Large Group (101+) employers, and includes enrollment for medical plans, dental plans, and vision plans.

See also: Can a group or employee change plans off-anniversary?

Learn more.

Is Blue Shield allowing employer groups to change plan selections off-cycle to accommodate revenue and workforce reduction due to COVID-19?

Small Business (1-100): Blue Shield will allow a one-time buy-down (leaner plan design with lower premiums) change off-cycle for employers and employees to adjust their health plan selection to meet their current needs. Buy-down selections must be consistent with the current plan type offered by the group: PPO plan to PPO plan or HMO plan to HMO plan.

Note: rates for employees who choose a buy-down plan off-cycle will be based on the age of the member at the time of the change.

As a reminder, specialty benefits – dental plans, vision plans, and life insurance – may be added at any time.

Learn more.

If employees are required to work a reduced schedule (temporary layoff, furlough, reduction-in-hours, etc) will they remain eligible for coverage?

Fully insured groups:

Blue Shield will continue to provide coverage through June 30, 2020 as long as premiums are received. Coverage must be offered on a consistent, non-discriminatory basis to all employees, and employee premium contributions must be the same or less as prior to the layoffs, furloughs or reduction of hours.

Options for continuing coverage for laid-off employees:

• Employees can remain on a group plan to keep them covered in the same manner as prior to COVID-19 if premium payments continue for laid-off employees.
• Employees can elect COBRA or Cal-COBRA, if eligible, and will be liable to pay the full cost of coverage (unless their employer chooses to subsidize COBRA premiums).
• Employees can enroll in the individual marketplace. Employees may benefit from government subsidies to help pay premiums.

Learn more.

Are there any extensions to new business submission deadlines?

Yes. Blue Shield will allow new groups to be submitted up to the last business day of each month for effective dates through January 2021. Once approved, the effective date cannot be changed. Please note on the submission cover sheet that the group agrees to the requested effective date and understands the effective date cannot be changed.

Does UnitedHealthcare cover the test for COVID-19?

UnitedHealthcare will waive cost sharing (copayment, coinsurance, and deductible) for COVID-19testing during this national emergency. We are also waiving cost sharing for COVID-19 testing related visits during this same time, whether the testing related visit is received in a health care provider’s office, an urgent care center, an emergency department or through a telehealth visit. This coverage applies to Medicare Advantage, Medicaid and fully insured and self-funded employer-sponsored plans.

Testing must be provided at approved locations in accordance with U.S. Centers for Disease Control and Prevention (CDC) guidelines including FDA approved testing at designated labs around the country.

Learn more.