Keeping Employees Covered | Allied Benefit Suite & Delta Dental | ChoiceBuilder | Humana | MetLife | Principal | Reliance Matrix | United Healthcare | |
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Special Enrollment Periods (SEP) for previous waivers? | Case-by-case basis. | Case-by-case basis. | Yes, open through 4.10.20, 4.1.20 effective date. | No. | Case-by-case basis. | No. | No. | UHC is providing its Fully Insured employer customers with a special COVID-19 dental and vision enrollment opportunity (SEO). From 5.18.20 through 5.29.20. Effective date June 1st. |
Coverage in the event of furlough/reduction in hours? | Yes: | Yes: | Yes: | Yes | Yes: | Yes: | Yes: | As long as the employer continues to pay premiums on those furloughed employees, coverage will continue. |
Waiting period waiver for re-hires? | Case-by-case basis. | Yes, for employees rehired within 6 months. | Yes, waiting period definition at discretion of employer group. | Yes. | Yes: | No. | No. | Standard waiting periods may be waived for new and rehired; however, existing eligibility and state guidelines will apply. |
Relief for Employer Groups | Allied Benefit Suite & Delta Dental | ChoiceBuilder | Humana | MetLife | Principal | Reliance Matrix | UnitedHealthcare | |
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Grace period for premium payment? | Yes, 60 day grace period for April and May invoices. | Yes, 60 day grace period. | Case-by-case basis. | Yes, 60 day grace period. | Yes, 90 day grace period. | Yes, 60 day grace period. | Yes, 90 day grace period. | No change, 30-day grace period. Will renew on a case-by-case basis. |
Extended new business submission deadlines? | Yes, 15th day of the effective month. | Case-by-case basis. | Yes, the usual 15th day of the effective month. | Yes: | Case-by-case basis. | Contact Claremont. | Case-by-case basis. | Standard deadlines will apply. |
Renewal rate pass? | Case-by-case basis. | Two-year rate pass for all small groups renewing from August 2020 through July 2021. | Contact Claremont. | Yes, for dental & vision. Rate pass for 6.1.20 through 9.1.20 renewal dates. | Yes: For groups <100 employees: Rate pass through 3.31.21 renewal dates. For groups 100-500 employees: Rate pass for 6.1.20 through 9.1.20 renewal dates. | Yes, for groups <500 employees. Rate pass for 5.1.20 through 4.1.21 renewal dates. | Yes, for groups <500 employees. Rate pass for 5.1.20 through 8.1.20 renewal dates. | UHC will renew at existing rates or better for groups with 2-499 eligible lives until December 31, 2020. |
Premium Credits for Employers | Nothing announced. | All small group plans will receive a one-month premium holiday for September 2020. Qualifying groups must be effective on or before July 2020. | Nothing announced. | Nothing announced. | Employers with fully insured dental PPO plans will receive a premium credit on a future bill in the amount of 25% for the months of April and May, 2020. | Fully-insured dental groups (both contributory and voluntary) will receive a 10% premium credit on their June through October 2020 invoices. | Nothing announced. | Reduction in dental premium: UHC Dental is providing a 50%, 1-month premium reduction in July-reflected on June invoices. |
Credit card for premium payment? | No. | No. | No. | Yes, for one-time monthly payments. Not for recurring automated payments. | No. | No. | No. | No, UHC is unable to accept credit card payments at this time. |
Off-anniversary plan/contribution changes? | Case-by-case basis. | Case-by-case basis. | Yes, for employers a one-time ‘mid-plan year’ change to contribution or plan. For employees, a one-time ‘mid-plan year’ plan downgrade with the same carrier. | Case-by-case basis. | The usual case-by-case basis. | The usual case-by-case basis. | No. | Discussion for a case-by-case basis.Signatures not required through SAM. |
Applications in event signatures can't be obtained? | Yes, several options. | Case-by-case basis. | Contact Claremont. | Yes, online. | Yes, eSignatures. | Yes, eSignatures. | Contact Claremont. | Signatures not required through SAM. |
Coverage Extensions & Clarifications | Allied Benefit Suite & Delta Dental | ChoiceBuilder | Humana | MetLife | Principal | Reliance Matrix | UnitedHealthcare | |
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Disability pandemic exclusion? | N/A | No, COVID-19 evaluated the same as any medical condition. | N/A | N/A | No, COVID-19 evaluated the same as any medical condition. | No, COVID-19 evaluated the same as any medical condition. | No, COVID-19 evaluated the same as any medical condition. | No |
Tele-dentistry coverage? | Yes. | Yes. | Ameritas: yes. Anthem: yes. Delta Dental: yes. MetLife: yes. | Yes. | Yes. | Yes. | Yes. | Yes. |
Other | Humana is giving in-network dentists $7 for every Humana member visit they have with their PPO or DHMO DDS, and it’s paid as a stipend vs a claim. | A $7 payment for PPE will be paid to in-network providers with each member dentist visit from June 1 through December 31, 2020. This payment will help offset additional COVID-19 expenses for dental offices. Additionally, this payment may help decrease member out-of-pocket costs. | From July 1 through December 31, 2020, Reliance is waiving deductibles and exam/cleaning frequency limitations for all policyholders. Orthodontia claims excluded. | In-network dentists enrolled in electronic payments will receive increases between $5 and $10 for certain services related to routine exams, emergency services and initial evaluations for children and adults. |