COVID-19 Medical Carrier Responses - Claremont Insurance Services

Keeping Employees Covered	Blue Shield of California	Covered California for Small Business	United Healthcare
Special Enrollment Period (SEP) for previous waivers?	Yes, through 12.31.20. Effective date 1.1.21 latest.	Yes, through 6.30.20. Effective date 7.1.20 latest.	Yes, through 4.13.20. Effective date 4.1.20.
Off-anniversary plan changes?	Yes, through 12.31.20. Effective date 1.1.21 latest.	No.	Yes, separate rules for existing and new members, and for single vs multi-options plan designs.
Add lean plan option?	Yes, through 12.31.20. Effective date 1.1.21 latest. Buy-down plans may be selected from within the current plan type: PPO to PPO or HMO to HMO.	No.	Yes, separate rules for existing and new members, and for single vs multi-options plan designs.
Coverage in event of furlough/ reduction in hours?	Yes, per the terms of the group service agreement.	Yes, temporary as long as premium is paid.	Yes. If the EE is on an ER-approved leave of absence/furlough and the ER continues to pay premium, the coverage will remain in force for: – No longer than 20 consecutive weeks for non-medical leaves (i.e., temporary laid off) – No longer than 26 consecutive weeks for a medical leave Coverage may be extended if required by local, state or federal rules.

Relief for Employer Groups	Blue Shield of California	Covered California for Small Business	UnitedHealthcare
New group submission deadline extensions?	Yes, last business day of effective month. Effective dates 4.1 – 1.31.21.	Yes, 15th of the effective month. Effective dates 4.1 – 12.1.20.	Yes, last business day of effective month. Effective date 4.1.20.
Grace period for premium payment?	No change. 30 day grace period. Premium Payment Plan for April, May, June, July, August and September premium payment. Provides extended grace period. Contact Claremont for assistance in determining group eligibility.	60 day grace period for April and May premium payment. Premium Deferral Program for April and May premium payment. Provides extended grace period.	No change. 30 day grace period. Will review on a case-by-case basis.
Credit card for premium payment?	No.	No.	No.
Renewals & re-certification?	All re-certifications waived for April through December 2020 renewals.	No change. No re-certifications at renewal.	Re-certifications will continue.
Rehires and waiting periods?	Standard rules apply.	No change. Employer specified waiting periods apply.	Waiting periods waived for COVID-19 rehires.
Employee apps in event of no signatures?	Signatures required. E-signatures accepted.	Signatures required. E-signatures accepted.	Signatures not required through SAM.

Coverage Extensions & Clarifications	Blue Shield of California	Covered California for Small Business	UnitedHealthcare
COVID-19 costs waived?	All testing and treatment, physician authorized. No pre-authorization required. Through 12.31.20.	Refer to individual carrier.	Cost share will be waived for COVID-19 testing and testing-related services through 1.20.21. Cost share will be waived for COVID-19 treatment: through 10.22.20 out-of-network through 12.31.20 in-network
Pharmacy	Early refill limits waived. 90-day supplies of maintenance medications available through mail-service pharmacy CVS Caremark. No fee mail service available through CVS Caremark. Free home delivery available through several pharmacy chains.	Refer to individual carrier.	Early refill limits waived. No fee mail service available for Optum Rx members. Free home delivery available through several pharmacy chains.
Telehealth	Teledoc costs waived through 12.31.20. NurseHelp 24/7 always available at no additional cost. Telemedicine through network providers is a covered benefit.	Refer to individual carrier.	Virtual Visit and Telehealth cost-waiving varies by type of provider and type and date of visit. Contact us for specifics.
Emotional/ Behavioral/ Mental Health Services	Tele-behavioral benefits same as in-person visits. Teledoc cost-waiving extended to behavioral health. Sanvello, mental and wellness health app, in Wellvolution. Virtual Wellvolution programs such as nutrition and fitness support. LifeReferrals 24/7 EAP to fully insured large groups (101+).	Refer to individual carrier.	In-network tele-behavioral costs waived. Free 24/7 emotional support line from Optum Health. Free on-demand emotional support mobile app from Sanvello.