carrier guidance for small and large group€¦ · carrier guidance for small and large group...
TRANSCRIPT
COVID-19 (Coronavirus)
Carrier Guidance for
Small and Large Group
COVID-19 (Coronavirus) Response by Carrier Carrier Guidance for Small and Large Group
Updated: 4/2/20 | 11 a.m. (PST)
All responses and information originated from communications from Warner Pacific’s carrier partners. Information is not guaranteed to be accurate and is subject to change at any time. For the most updated information on the coronavirus, visit cdc.gov.
Table of Contents
Aetna ....................................................................................................................................................................................................................................... 2
Anthem Blue Cross .................................................................................................................................................................................................................. 3
Blue Shield of California .......................................................................................................................................................................................................... 4
California Choice ...................................................................................................................................................................................................................... 5
CCHP ........................................................................................................................................................................................................................................ 6
Cigna ........................................................................................................................................................................................................................................ 7
Community Care Health .......................................................................................................................................................................................................... 8
Covered California for Small Business ..................................................................................................................................................................................... 9
Guardian ................................................................................................................................................................................................................................ 10
Health Net ............................................................................................................................................................................................................................. 11
Kaiser Permanente ................................................................................................................................................................................................................ 12
MediExcel .............................................................................................................................................................................................................................. 13
MetLife .................................................................................................................................................................................................................................. 14
National General.................................................................................................................................................................................................................... 15
Oscar Health Plan .................................................................................................................................................................................................................. 16
Principal ................................................................................................................................................................................................................................. 17
The Hartford .......................................................................................................................................................................................................................... 18
Sharp Health Plan .................................................................................................................................................................................................................. 19
Sutter Health Plus .................................................................................................................................................................................................................. 20
UnitedHealthCare .................................................................................................................................................................................................................. 21
Unum ..................................................................................................................................................................................................................................... 22
Western Health Advantage ................................................................................................................................................................................................... 23
Resources .............................................................................................................................................................................................................................. 24
COVID-19 (Coronavirus) Response by Carrier Carrier Guidance for Small and Large Group
Updated: 4/2/20 | 11 a.m. (PST)
All responses and information originated from communications from Warner Pacific’s carrier partners. Information is not guaranteed to be accurate and is subject to change at any time. For the most updated information on the coronavirus, visit cdc.gov.
Aetna
Carrier Responses Resources
Coverage
Aetna will waive copays for all diagnostic testing related to COVID-19. Aetna, a CVS Health company, will waive member cost-sharing for inpatient admissions at all in-network facilities for treatment of COVID-19 or health complications associated with COVID-19. This policy applies to all Aetna-insured commercial plan sponsors and is effective immediately for any such admission through June 1, 2020.
Through Aetna’s Healing Better program, members who are diagnosed with COVID-19 will receive a care package containing CVS over-the-counter medications to help relieve symptoms. The package will also include personal and household cleaning supplies to help keep others in the home protected from potential exposure. Aetna will proactively reach out to members most at-risk for COVID-19. Care managers will walk members through what they can do to protect themselves, where to get information on the virus and where to go to get
tested. CVS Health is implementing the following programs to educate members about COVID-19 and help
address any associated anxiety and stress: Opening Crisis Response Lines for all Aetna (commercial, Medicare, Medicaid) and Caremark members who
may be experiencing anxiety related to COVID-19. Expanding 24x7 access to the Aetna Nurse Medical Line for all Aetna and Caremark members. Providing Aetna plan sponsors with a Resources for Living toolkit with materials specifically developed for
members experiencing anxiety related to COVID-19.
Telemedicine
Until June 4, 2020 Aetna will offer zero copay telemedicine visits — for any reason. For all Aetna plans offering Teladoc® coverage, cost sharing will be waived for all Teladoc® virtual visits. Cost sharing will also be waived
for real-time virtual visits offered by in-network providers (live video-conferencing and telephone-only telemedicine services) for all Commercial plan designs. Members may use telemedicine services for any reason, not just COVID-19 diagnosis.
Includes general medical, behavioral health and dermatology visits.
Self-insured plan sponsors will be able to opt-out of this program at their discretion
Aetna What You Need to
Know (COVID-19)
Resource for Employers CVS Health resources Aetna Teladoc
COVID-19 (Coronavirus) Response by Carrier Carrier Guidance for Small and Large Group
Updated: 4/2/20 | 11 a.m. (PST)
All responses and information originated from communications from Warner Pacific’s carrier partners. Information is not guaranteed to be accurate and is subject to change at any time. For the most updated information on the coronavirus, visit cdc.gov.
Anthem Blue Cross
Carrier Responses Resources
Coverage
Anthem members will not have to pay anything out of pocket if they get care for COVID-19 from doctors, hospitals and other health care professionals in their plan’s network from April 1, 2020 through May 31, 2020. Their COVID-19 testing is also covered. Applies to fully insured business.
Relaxing early prescription refill limits for members who wish to receive a 30-day supply of most maintenance medications, where permissible.
Launching a COVID-19 symptom assessment tool available online and via the Sydney Care mobile app.
Suspending select prior authorization requirements to allow care providers to focus on caring for patients diagnosed with COVID-19. This includes suspension of prior authorization requirements for patient transfers, prior authorization requirements for skilled nursing facilities, along with the suspension of prior authorization requirements for the use of medical equipment critical to COVID-19 treatment.
Special enrollment period for those who previously waived coverage will be allowed between March 23, 2020 through April 3, 2020.
Telemedicine
Anthem will be waiving any member cost share until June 14, 2020 for telehealth visits, including visits for mental health and select Physical, Occupational and Speech therapies, for our fully insured employer plans, Individual plans, Medicare plans and Medicaid plans, where permissible.
Anthem is encouraging its members to use LiveHealth Online to virtually connect to a doctor through a live video chat on their phone, tablet, or computer. The LiveHealth Online doctors can screen for COVID-19 and make recommendations for care. Anthem offers 24/7 NurseLine. With 24/7 NurseLine, members can ask registered nurses a variety of questions,
including how to choose the right level of care. Members can also use Anthem’s Sydney Care mobile app today for a quick and easy way to evaluate your symptoms and see a doctor, again free of charge.
Anthem What you Need to Know (COVID-19)
COVID-19 Symptom Assessment
Find a COVID-19 Testing Site LHO $0 copay flyer NurseLine 24/7
LiveHealth Online app
Sydney Care app
COVID-19 (Coronavirus) Response by Carrier Carrier Guidance for Small and Large Group
Updated: 4/2/20 | 11 a.m. (PST)
All responses and information originated from communications from Warner Pacific’s carrier partners. Information is not guaranteed to be accurate and is subject to change at any time. For the most updated information on the coronavirus, visit cdc.gov.
Blue Shield of California
Carrier Responses Resources
Coverage
Blue Shield of California will cover members’ coinsurance, copayments and deductibles for COVID-19 medical
treatments through May 31, 2020. This includes cost-sharing for hospital, urgent care, emergency room and office visits where the visit is to screen or test for the virus. Blue Shield will also not require prior authorization for medically necessary emergency care, consistent with its current practice. HMO members, must see their
assigned PCP physician, urgent care facility associated with the medical group that they are assigned to, or use Teladoc. PPO members would need to see a licensed health care provider as defined in the EOC, in network or out of network. Special Enrollment Period - Blue Shield is providing a Special Enrollment Period (SEP) through June 30, 2020 for employees who previously declined coverage for themselves or their dependents.
Telemedicine
Blue Shield is waiving Teladoc cost-sharing for all members through May 31, 2020. Blue Shield suggests members and employees reach out to their Teladoc, NurseHelp 24/7 service or to report their condition to their family doctor or urgent care clinic. Teladoc cost share waiver applies to ALL visits during this time, not just those associated with COVID-19 Heal - Cost sharing is waived for remote house calls (telemedicine) for coronavirus screening for members
whose plan benefits include Heal. For cash pay users, a Heal remote house call is $19.
Blue Shield What You Need To Know (COVID-19)
Blue Shield Resources (COVID-19) COVID-19 Teladoc NurseHelp 24/7
Heal
COVID-19 (Coronavirus) Response by Carrier Carrier Guidance for Small and Large Group
Updated: 4/2/20 | 11 a.m. (PST)
All responses and information originated from communications from Warner Pacific’s carrier partners. Information is not guaranteed to be accurate and is subject to change at any time. For the most updated information on the coronavirus, visit cdc.gov.
California Choice
Carrier Responses Resources
Coverage
For details on what California Choice health plan partners are sharing with members, please see below:
Anthem Blue Cross
Health Net
Kaiser Permanente
Oscar Health
Sharp Health Plan
Sutter Health Plus
UnitedHealthcare
Western Health Advantage
Special Enrollment Period - CaliforniaChoice will allow a group special open enrollment for a 4/1/2020
effective date for employees that previously waived coverage. Enrollment applications must be received by 4/10/2020.
Telemedicine Members are advised to contact their enrolled carrier for COVID-19 guidance.
CaliforniaChoice Stay Informed (COVID-19)
Message from the CEO
COVID-19 (Coronavirus) Response by Carrier Carrier Guidance for Small and Large Group
Updated: 4/2/20 | 11 a.m. (PST)
All responses and information originated from communications from Warner Pacific’s carrier partners. Information is not guaranteed to be accurate and is subject to change at any time. For the most updated information on the coronavirus, visit cdc.gov.
CCHP
Carrier Responses Resources
Coverage
Due to new government orders to manage the current outbreak situation, CCHP has modified their services to
better protect everyone’s health and safety. Currently only providing member walk-in service at the following locations: CCHP: 445 Grant Ave., San Francisco Gellert Health Services - 386 Gellert Blvd., Daly City Member Services:
1-888-775-7888 or 1-415-834-2118, TTY 1-877-681-8898 From 8:00 a.m. to 8:00 p.m., 7 days a week. [email protected]
CCHP What You Need To Know (COVID-19)
COVID-19 (Coronavirus) Response by Carrier Carrier Guidance for Small and Large Group
Updated: 4/2/20 | 11 a.m. (PST)
All responses and information originated from communications from Warner Pacific’s carrier partners. Information is not guaranteed to be accurate and is subject to change at any time. For the most updated information on the coronavirus, visit cdc.gov.
Cigna
Carrier Responses Resources
Coverage
Cigna will cover COVID-19 FDA approved testing. Only a health care provider or hospital can administer the test
and send the sample to an approved lab for tests. Cigna is waiving out-of-pocket costs for COVID-19 visits with providers, whether at a provider’s office, urgent care center, emergency room, or via virtual care, through May 31, 2020. For individuals diagnosed with COVID-19, Cigna will ensure all patients receive the care they need. To help fight the spread of COVID-19 (coronavirus disease) in the U.S. and for its globally mobile customers,
Cigna will waive all copays or cost shares for testing prescribed by health care providers. ASO self-funded benefit plans that wish to opt out of this enhanced coverage must submit in writing a request stating the plan does not wish to offer or waive copays, coinsurance, or deductibles for plan participants.
Submission in writing is required within 10 business days of this communication. If a written communication is
not received within that time period, copays, coinsurance, or deductibles will be waived for COVID-19 testing for employees. Telemedicine
Cigna will cover virtual care visits related to screening, diagnosis, or testing for COVID-19, members out-of-pocket costs will be waived. Cigna customers can also receive virtual medical care not related to COVID-19 by physicians and certain providers with virtual care capabilities through May 31, 2020. Out-of-pocket costs may apply.
Cigna Resource Center (COVID-19)
Cigna Resource Center for
Employers (COVID-19) Cigna Telehealth MD Live VirtualCare
COVID-19 (Coronavirus) Response by Carrier Carrier Guidance for Small and Large Group
Updated: 4/2/20 | 11 a.m. (PST)
All responses and information originated from communications from Warner Pacific’s carrier partners. Information is not guaranteed to be accurate and is subject to change at any time. For the most updated information on the coronavirus, visit cdc.gov.
Community Care Health
Carrier Responses Resources
Coverage
Effective immediately, CCH is waiving cost-sharing for medically necessary screening and testing for COVID-19
including, but not limited to, co-pays, deductibles, or coinsurance, including hospital (including emergency department), urgent care visits, and provider office visits, where the purpose of the visit is to be screened and/or tested for COVID-19. CCH customer service reps are prepared to address questions around COVID-19 as they would any other illness, natural disaster, etc. 1-855-343-2247.
Telemedicine
Effective immediately, CCH has waived ALL copayments for ANY telehealth visit, including Teladoc and CMP e-Visits, through May 31, 2020. CCH members have access to Teladocand members assigned to Community Medical Provider (CMP) physicians
can utlize an e-Visit with participationg providers (https://www.communitycarehealth.org/evisits).
CCH Resource Center (COVID-19)
CCH Teladoc
COVID-19 (Coronavirus) Response by Carrier Carrier Guidance for Small and Large Group
Updated: 4/2/20 | 11 a.m. (PST)
All responses and information originated from communications from Warner Pacific’s carrier partners. Information is not guaranteed to be accurate and is subject to change at any time. For the most updated information on the coronavirus, visit cdc.gov.
Covered California for Small Business
Carrier Responses Resources
Coverage
All medically necessary screening and testing for COVID-19 is free of charge (in other words, there’s zero cost-
sharing). This includes emergency room, urgent care, telehealth or doctor’s office visits when the purpose of the visit is to be screened and tested for COVID-19. For details on what our health plan partners are sharing with members, please see below:
Blue Shield of California
Health Net
Kaiser Permanente
Oscar Health
Sharp Health Plan
Special Enrollment Period – CCSB is providing a Special Enrollment Period (SEP) through June 30, 2020.
Details to come. SEP will be offered for any employee or dependent(s) who previously waived coverage. Available through June 30, 2020. Effective date will be first of the month following receipt of the request with the last effective date being July 1, 2020, if submitted by June 30, 2020. Telemedicine
Members are advised to contact their enrolled carrier for COVID-19 guidance.
CCSB Resource Center (COVID-19)
COVID-19 (Coronavirus) Response by Carrier Carrier Guidance for Small and Large Group
Updated: 4/2/20 | 11 a.m. (PST)
All responses and information originated from communications from Warner Pacific’s carrier partners. Information is not guaranteed to be accurate and is subject to change at any time. For the most updated information on the coronavirus, visit cdc.gov.
Guardian
Carrier Responses Resources
Coverage
Currently the direction from California is as follows:
If someone is unable to work due to having or being exposed to COVID-19 (certified by a medical professional), they can file a Disability Insurance (DI) claim. If they’re unable to work because they are caring for an ill or quarantined family member with COVID-19 (certified by a medical professional), they can file a Paid Family Leave (PFL) claim. If their employer has reduced their hours or shut down operations due to COVID-19, they can file an
Unemployment Insurance (UI) claim.
Guardian Resource Center (COVID-19)
COVID-19 (Coronavirus) Response by Carrier Carrier Guidance for Small and Large Group
Updated: 4/2/20 | 11 a.m. (PST)
All responses and information originated from communications from Warner Pacific’s carrier partners. Information is not guaranteed to be accurate and is subject to change at any time. For the most updated information on the coronavirus, visit cdc.gov.
Health Net
Carrier Responses Resources
Coverage
Health Net is waiving cost-sharing (deductibles, copayments and coinsurance) for medically necessary COVID-19
screenings and tests when ordered, referred and/or performed in In-Network. Office visits, urgent care and outpatient hospital (including emergency department) visits for medically necessary COVID-19-related services will also be covered. In addition, Health Net has eliminated prior authorization for lab work for screening and testing, so waivers are not required.
Health Net has waived prescription refill limits for medically necessary COVID-19-related services. In addition, Health Net has relaxed restrictions on home or mail delivery of prescription drugs. Treatment for COVID-19 is a covered benefit under the Health Net plans. For a member admitted to the hospital, the hospital is required to follow standard Health Net prior authorization and notification requirements.
Telemedicine
Health net is waiving Teladoc cost-sharing for all ACA plans.
Health Net What You Need to Know (COVID-19)
Health Net Resource Center
(COVID-19) Health Net Teladoc flyer
COVID-19 (Coronavirus) Response by Carrier Carrier Guidance for Small and Large Group
Updated: 4/2/20 | 11 a.m. (PST)
All responses and information originated from communications from Warner Pacific’s carrier partners. Information is not guaranteed to be accurate and is subject to change at any time. For the most updated information on the coronavirus, visit cdc.gov.
Kaiser Permanente
Carrier Responses Resources
Coverage
Kaiser Permanente is waiving member costs related to COVID-19 screening or testing if referred by a Kaiser
Permanente doctor. Drive up testing is accessible by physician referral/order only. If drive-up testing is available nearby, members will be notified of the appropriate arrangements In the event members are diagnosed with COVID-19, additional services, including hospital admission (if applicable) will be covered and charged according to the normal plan coverage rules. Kaiser Permanente recently created a 5-part Coronavirus and COVID-19 informational video series that members
may find helpful to work together to help prevent the spread of COVID-19. Special Enrollment Period - Kaiser Permanente will allow a special open enrollment for a 4/1/2020 effective date for employees/dependents that previously waived coverage as long as the enrollment application is received by 4/3/2020. Applications that are received between 4/4/2020 and 4/15/2020 may be applied for a 5/1/2020
effective date if the employer agrees.
Kaiser What You Need to Know (COVID-19)
KP Employer FAQ (COVID-19)
KP Virtual Care
COVID-19 (Coronavirus) Response by Carrier Carrier Guidance for Small and Large Group
Updated: 4/2/20 | 11 a.m. (PST)
All responses and information originated from communications from Warner Pacific’s carrier partners. Information is not guaranteed to be accurate and is subject to change at any time. For the most updated information on the coronavirus, visit cdc.gov.
MediExcel
Carrier Responses Resources
Coverage
Effective immediately, MediExcel Health Plan is waiving all cost-sharing for COVID-19 testing prescribed by a
physician for patients who meet CDC guidelines. Excel Hospital in Tijuana has deployed a respiratory triage area to support the potential high demand for screening, while MediExcel’s providers in Mexicali and Tecate are readying their facilities. Special Open Enrollment Period - available to employees and their dependents who previously did not elect coverage or waived coverage. The enrollment period is from March 25, 2020 through April 10, 2020. Coverage will
become effective April 1, 2020. An employee enrollment form must be received before April 1, 2020.
Member notice
Call Your Doctor
MediExcel COVID-19 response
COVID-19 (Coronavirus) Response by Carrier Carrier Guidance for Small and Large Group
Updated: 4/2/20 | 11 a.m. (PST)
All responses and information originated from communications from Warner Pacific’s carrier partners. Information is not guaranteed to be accurate and is subject to change at any time. For the most updated information on the coronavirus, visit cdc.gov.
MetLife
Carrier Responses Resources
Coverage
Under 500 employees: If the new leaves under the Act qualify for a “disability” under your client’s existing STD
program with MetLife, STD will run concurrently with FMLA and offset the federal benefits, subject to the terms and conditions of MetLife’s program. MetLife offers an Employee Assistance Program (EAP) that provides 24/7 confidential access to professional support to help employees manage stress, anxiety, grief, financial concerns and much more. Employees can connect to support by phone, video or chat — anytime, anywhere. And they have access to a vast library of online resources for coping with trauma, building resiliency, self-care and managing change.
MetLife Customer Update (COVID-19)
Federal Legislation > 500
Federal Legislation < 500
COVID-19 (Coronavirus) Response by Carrier Carrier Guidance for Small and Large Group
Updated: 4/2/20 | 11 a.m. (PST)
All responses and information originated from communications from Warner Pacific’s carrier partners. Information is not guaranteed to be accurate and is subject to change at any time. For the most updated information on the coronavirus, visit cdc.gov.
National General
Carrier Responses Resources
Coverage
As part of the effort regarding COVID-19 diagnostic testing, National General will: Waive all member cost-
sharing for COVID-19 diagnostic tests and related services, including the associated office visit, emergency room or urgent care charges. The waiver applies any out-of-pocket costs, including deductibles, copays and co-insurance for diagnostic testing related to COVID-19. Waive all prior authorization requirements as it relates to COVID-19 diagnostic testing. Allow early refills and up to a 90-day supply of a member’s prescription drugs in the event of hardship related to COVID-19.
National General announcement (COVID-19)
COVID-19 (Coronavirus) Response by Carrier Carrier Guidance for Small and Large Group
Updated: 4/2/20 | 11 a.m. (PST)
All responses and information originated from communications from Warner Pacific’s carrier partners. Information is not guaranteed to be accurate and is subject to change at any time. For the most updated information on the coronavirus, visit cdc.gov.
Oscar Health Plan
Carrier Responses Resources
Coverage
Oscar is waiving cost-sharing for COVID-19 diagnostic testing. If your client’s doctor recommends they should be
tested for COVID-19, they will not be charged for the lab test. Telemedicine
Continuing to offer $0 telemedicine services (Doctor on Call). Telemedicine is a great option for people who think they could have COVID-19. Oscar’s telemedicine PCPs can recommend COVID-19 testing and direct your clients to the right place for testing. Oscar members have access to Doctor on Call service 24/7. Concierge team is prepared to support 1-855-672-
2755. Members can secure message Concierge or request a Doctor on Call consultation from their Oscar app or online account (hioscar.com/member) at any time.
Oscar Health Resource Center (COVID-19)
Oscar Q&A (COVID-19)
Oscar Doctor On Call Oscar Concierge flyer Online risk assessment
COVID-19 (Coronavirus) Response by Carrier Carrier Guidance for Small and Large Group
Updated: 4/2/20 | 11 a.m. (PST)
All responses and information originated from communications from Warner Pacific’s carrier partners. Information is not guaranteed to be accurate and is subject to change at any time. For the most updated information on the coronavirus, visit cdc.gov.
Principal
Carrier Responses Resources
Coverage
Group benefits-specific questions:
Will an employee remain eligible for coverage if quarantined due to COVID-19 and unable to work from home? For employees who have not tested positive for COVID-19, the standard continuation language provides coverage to the end of the month. If a quarantine period extends into the next month, Principal will continue coverage until the end of that month, provided premiums continue to be paid. For employees who have tested positive for COVID-19, Principal continues coverage for the duration of the illness, provided premiums
continue to be paid. Is an employee considered disabled if they are quarantined due to COVID-19? Employees under quarantine for COVID-19 that do not have a disabling medical condition do not satisfy the definition of disability under Principal’s policies. Do employees qualify as disabled if they fall ill due to COVID-19? Claims for COVID-19 will be evaluated
the same as any other illness. As with all claims, they must satisfy Principal’s definition of disability and all other provisions outlined in the policy. Does Principal have a pandemic-specific exclusion in its group benefit policies? No, Principal evaluates COVID-19 as it would any other medical condition.
Employee Assistance Program (EAP) for group benefit clients Principal and Magellan are extending telephonic EAP support for all group benefit clients that may have employees who are feeling overwhelmed or anxious about COVID-19. They can contact Magellan Healthcare 24/7 at 800-450-1327 for free, confidential consultation services.
Principal Resource Center (COVID-19)
COVID-19 (Coronavirus) Response by Carrier Carrier Guidance for Small and Large Group
Updated: 4/2/20 | 11 a.m. (PST)
All responses and information originated from communications from Warner Pacific’s carrier partners. Information is not guaranteed to be accurate and is subject to change at any time. For the most updated information on the coronavirus, visit cdc.gov.
The Hartford
Carrier Responses Resources
Coverage
Group benefits-specific questions:
Will The Hartford view a quarantine alone as a disabling condition? A. The Hartford makes coverage determinations based on the specific facts and policy language associated with each claim. Will STD cover coronavirus, and what documentation will be required?
A. The Hartford makes coverage determinations based on the specific facts and policy language associated with each claim. Generally, medical information is required to support an STD claim, including a claim due to coronavirus. Will leave due to coronavirus be approved under FMLA? A: The Hartford reviews each leave request based on the specific facts presented. In order to qualify for leave under FMLA or state leave laws, the claimant must satisfy the requirements as specified under the applicable
federal (or state) regulation. For customers who are STD self-insured, what happens if they choose a plan change or tell us they want to cover something (i.e. quarantine) that is not under their existing coverage?
The Hartford Resource Center (COVID-19)
COVID-19 (Coronavirus) Response by Carrier Carrier Guidance for Small and Large Group
Updated: 4/2/20 | 11 a.m. (PST)
All responses and information originated from communications from Warner Pacific’s carrier partners. Information is not guaranteed to be accurate and is subject to change at any time. For the most updated information on the coronavirus, visit cdc.gov.
Sharp Health Plan
Carrier Responses Resources
Coverage
Sharp covers COVID-19 screening and/or testing when recommended by the member’s healthcare provider as
medically necessary. Sharp Health Plan has reduced the cost-share (or what you pay out of pocket) to $0 for all medically necessary screening and testing for COVID-19. This includes hospital (including emergency department), urgent care, and provider office visits for the purpose of screening and/or testing for COVID-19. Sharp temporarily relaxing early refill limits on 90-day prescriptions for maintenance medications at any in-network pharmacy. The member will need to tell the pharmacist to use the SCC-13 code when processing the order. Standard copayments and deductibles (if applicable) will apply.
Note: This does not apply to refills of controlled substances, such as certain pain medications. A new prescription from the prescriber is required to provide an emergency supply of a controlled substance.
Telemedicine
PlushCare is waiving the fee for Sharp HMO members. Speak with top-trained doctors who diagnose, treat and prescribe medication from the convenience of a phone, computer or tablet. Members can schedule an appointment 24/7 and speak with a doctor. Appointments can be booked Monday to Friday, 6 am to 10 pm and
Saturday and Sunday, 6 am to 6 pm.
Sharp What You Need to Know (COVID-19)
Sharp_PlushCare
COVID-19 (Coronavirus) Response by Carrier Carrier Guidance for Small and Large Group
Updated: 4/2/20 | 11 a.m. (PST)
All responses and information originated from communications from Warner Pacific’s carrier partners. Information is not guaranteed to be accurate and is subject to change at any time. For the most updated information on the coronavirus, visit cdc.gov.
Sutter Health Plus
Carrier Responses Resources
Coverage
Sutter will not collect patient cost shares in advance of providing services for medically-necessary COVID-19
screening and testing administered at Sutter hospitals, emergency departments, Walk-in Care clinics and other medical provider locations. Sutter is offering designated respiratory sites for patients who need to be evaluated by a clinician to see if they meet the criteria for the COVID-19 test. Patients must present identification at the testing site to confirm their appointment.
Telemedicine
Members that may have symptoms of COVID-19, please send a message to your care team or consider a Sutter Video Visit. They’re available 8:00 am – 8:00 pm, seven days a week. The SHP provider may direct
members to a testing site. A member who feels ill may schedule a video visit through My Health Online, call the 24/7 Nurse Advice line at 855-836-3500, or contact their provider to discuss the most appropriate treatment options.
SHP What You Need to Know (COVID-19)
SHP Video Visits
SHP Virtual PCP
COVID-19 (Coronavirus) Response by Carrier Carrier Guidance for Small and Large Group
Updated: 4/2/20 | 11 a.m. (PST)
All responses and information originated from communications from Warner Pacific’s carrier partners. Information is not guaranteed to be accurate and is subject to change at any time. For the most updated information on the coronavirus, visit cdc.gov.
UnitedHealthCare
Carrier Responses Resources
Coverage
UnitedHealthcare is waiving cost sharing for COVID-19 testing during this national emergency. And 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 employer-sponsored plans.
Care or treatment for COVID-19 will be covered in accordance with your health benefits plan. Your deductibles, copays and coinsurance will apply. Eligible UnitedHealthcare and OptumRx members needing help obtaining an early prescription refill can call the customer care number located on the back of their medical ID card for assistance, or contact OptumRx customer
service (800) 788-4863. Special Enrollment effective March 23, 2020 – April 13, 2020 extended to employees who did not elect coverage
for themselves or dependents at the group’s initial enrollment. Telemedicine
UnitedHealthCare is waiving virtual visit fees through June 18, 2020.
UHC Resource Center (COVID-19)
COVID-19 Teladoc
Teladoc FAQ Virtual Visits
COVID-19 (Coronavirus) Response by Carrier Carrier Guidance for Small and Large Group
Updated: 4/2/20 | 11 a.m. (PST)
All responses and information originated from communications from Warner Pacific’s carrier partners. Information is not guaranteed to be accurate and is subject to change at any time. For the most updated information on the coronavirus, visit cdc.gov.
Unum
Carrier Responses Resources
Coverage
Are people quarantined generally considered disabled?
Unum generally does not consider quarantined workers to be disabled unless they have a medical condition that results in restrictions and limitations that satisfy a policy’s definition of disability. However, Unum will evaluate each situation where an individual is quarantined on a case-by-case basis. How will Unum apply leave guidelines to quarantined individuals? When determining whether a quarantine is a qualifying leave event, Unum will consider factors such as the reason the quarantine was ordered, what treatment may have been received during the quarantine period, and
whether an illness was diagnosed at any point. Generally, quarantined employees are not entitled to FMLA, unless they meet the definition of a serious health condition or if they are likely disabled.
UNUM Resource Center (COVID-19)
UNUM flyer
Assist America - FAQ
COVID-19 (Coronavirus) Response by Carrier Carrier Guidance for Small and Large Group
Updated: 4/2/20 | 11 a.m. (PST)
All responses and information originated from communications from Warner Pacific’s carrier partners. Information is not guaranteed to be accurate and is subject to change at any time. For the most updated information on the coronavirus, visit cdc.gov.
Western Health Advantage
Carrier Responses Resources
Coverage
WHA is waiving all cost-sharing for medically necessary screening and testing for COVID-19. This means that all
WHA members will pay $0 for medically necessary screening and testing for COVID-19. Sacramento County Residents: The COVID-19 Program is currently offering access to a free drive-up
coronavirus testing program. Residents who are 18 years of age or older and experiencing mild to moderate symptoms can complete an online screener to determine if they qualify for in-person testing.
Telemedicine
Western Health Advantage covers services provided through telehealth at the same cost sharing that would
apply to those services if they had been provided in person. This means that when a WHA network provider offers telehealth services, such as virtual visits, WHA members will have the same cost-sharing that they would have for an office visit.
WHA Resource Center (COVID-19)
WHA Virtual Visits
COVID-19 (Coronavirus) Response by Carrier Carrier Guidance for Small and Large Group
Updated: 4/2/20 | 11 a.m. (PST)
All responses and information originated from communications from Warner Pacific’s carrier partners. Information is not guaranteed to be accurate and is subject to change at any time. For the most updated information on the coronavirus, visit cdc.gov.
Resources World Health Organization (WHO): https://www.who.int/emergencies/diseases/novel-coronavirus-2019; COVID-19 Pandemic FAQ: https://bit.ly/2IFRtiH Kaiser Family Foundation (KFF): https://www.kff.org/tag/coronavirus/ Centers for Disease Control and Prevention (CDC): https://www.cdc.gov/coronavirus/2019-ncov/index.html California Department of Insurance (CDI): http://www.insurance.ca.gov/0400-news/0100-press-releases/2020/release025-2020-2.cfm http://www.insurance.ca.gov/0250-insurers/0300-insurers/0200-bulletins/bulletin-notices-commiss-opinion/upload/COVID-19-Screening-and-Testing.pdf
Coronavirus Aid, Relief, and Economic Security (CARES) Act
The coronavirus pandemic has created uncertainty and stress for many American small businesses. Part of the government’s response to assist businesses during
this time is the recent passage of the Coronavirus Aid, Relief, and Economic Security Act (CARES Act).With a massive $2 trillion allocated for businesses, individuals, federal agencies, and state and local governments, the CARES Act has been designed to distribute capital quickly and broadly. There are a number of provisions that impact small businesses. See the breakdown of what you need to know: https://www.uschamber.com/co/start/strategy/cares-act-small-business-guide Coronavirus Emergency Loans Small Business Guide and Checklist
Paycheck Protection Program FAQs for Small Business
Families First Coronavirus Response Act: Employer Expanded Family and Medical Leave Requirements
The Families First Coronavirus Response Act (FFCRA or Act) requires certain employers to provide their employees with expanded family and medical leave for specified reasons related to COVID-19.[1] The Department of Labor’s (Department) Wage and Hour Division (WHD) administers and enforces the new law’s paid leave requirements. These provisions will apply from the effective date through December 31, 2020. https://www.dol.gov/agencies/whd/pandemic/ffcra-employer-paid-leave
CDI: 60-Day Grace Period for Insurance Premium Payments Due to the Disruption Caused by the Novel Coronavirus
(COVID-19) Outbreak
Insurance Commissioner Ricardo Lara issued a Notice requesting that all insurance companies provide their policyholders with at least a 60-day grace period to pay insurance premiums. The Commissioner made the request to ensure policies are not cancelled for nonpayment of premium due to the novel coronavirus (COVID-19) public health emergency The Notice follows Governor Gavin Newsom's State of Emergency declaration to make additional resources available, formalize emergency actions already underway across multiple state agencies and departments, and help the state prepare and mitigate against the broader spread of COVID-19. The Commissioner's Notice is directed to all admitted and non-admitted insurance companies that provide any insurance coverage in California including, life, health, auto, property, casualty, and other types of insurance. http://www.insurance.ca.gov/0400-news/0100-press-releases/2020/release030-2020.cfm
IRS: High-deductible health plans can cover Coronavirus costs
The Internal Revenue Service is advising that high-deductible health plans (HDHPs) can pay for 2019 Novel Coronavirus (COVID-19)-related testing and treatment, without jeopardizing their status. This also means that an individual with an HDHP that covers these costs may continue to contribute to a health savings account (HSA).
In Notice 2020-15 (PDF), posted on IRS.gov, the IRS said that health plans that otherwise qualify as HDHPs will not lose that status merely because they cover the cost of testing for or treatment of COVID-19 before plan deductibles have been met. The IRS also noted that, as in the past, any vaccination costs continue to count as preventive care and can be paid for by an HDHP. https://www.irs.gov/newsroom/irs-high-deductible-health-plans-can-cover-coronavirus-costs