Claremont Insurance Services, Walnut Creek, Californian General Agency

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COVID-19 Carrier FAQs

Covid 19 FAQs

Get carrier answers to Coronavirus questions, including coverage for COVID-19 testing and treatment, expanded access to telehealth, special enrollment periods, relief for employer groups, and more.

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COVID-19 Carrier Frequently Asked Questions


Allied Benefit Suite

Access to Emotional/ Behavioral/ Mental Health

Contract Clarifications

Disability: are there any exclusions for pandemics?

No, there’s no exclusion for pandemics. COVID-19 is evaluated like any other medical condition.

Contact Claremont for more information.

Updated 05/07/2020
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Beam

Relief for Employer Groups

Are there any billing grace periods or extensions available?

To assist employer groups during this time, Beam is offering a 60-day grace period for any premium invoices for the month of March. During the 60-day grace period, Beam will continue to pay claims for active groups and members. Groups will continue to receive invoices for all outstanding premiums due, but payment for the outstanding premium would not be required for those invoices until 60 days past the first missed due date.

The extended 60-day grace period at this time applies only to March premiums. Beam is working diligently with their insurance partners and will continue to evaluate this Policy as they receive more information from NGL (they are underwritten by National Guardian Life) with regards to future premiums.

Contact Claremont for more information.

Updated 04/16/2020
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If employees are required to work a reduced schedule and no longer meet the minimum hours required in the policy, will they remain eligible for coverage?

Beam will allow laid-off employee(s) to retain coverage on an employer’s Policy upon the employer’s request, as long as the laid-off employee(s) was active on the Policy as of 3/1/2020. Please note that the employer will still be responsible for paying premiums for any laid-off employees that are kept on the Policy.

Contact Claremont for more information.

Updated 04/16/2020
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If a small business has to temporarily close due to impacts from COVID-19, will their Beam Dental/Vision coverage remain active?

Any temporarily closed group should fall under 60-day grace period in terms of retaining active coverage.  Please contact Claremont for more information on the proper procedure for temporarily closing businesses.

Updated 04/16/2020
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If there is a reduction in enrollment for a group, what is the minimum number of enrollment/EEs Beam will allow to continue the Dental/Vision coverages, even if on a temporary basis?

As long as one person remains actively employed, eligible employees may elect to continue coverage under COBRA. Beam are not terminating groups who fall below the 2- member threshold at this time.

If the employer would like to keep furloughed or laid off employees on the group plan, that is allowed and is at the discretion of the employer. Beam will continue to invoice the employer for all members that are actively on the plan, therefore the group would be responsible for collecting any individual premiums from their furloughed employees.

Contact Claremont for more information.

Updated 04/16/2020
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Are there any extensions to new group application deadlines?

Yes. Check the Carrier Responses section of our COVID-19 resource page for the latest information.

Updated 04/08/2020
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Blue Shield of California

Keeping Employees Covered

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.

Updated 06/02/2020
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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.

Updated 06/02/2020
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Is Blue Shield enforcing active-at-work and minimum work hours?

The terms of Blue Shield’s group service agreements continue to apply to employee eligibility for coverage. Employers should refer to the agreement and note that there are provisions in most group service agreements that may allow for continued coverage for members who are impacted by a temporary suspension of work or temporary reduction of hours in certain circumstances, such as a layoff, furlough, or approved leave of absence. This may be permitted under the employer’s policies regarding coverage, under the following conditions:

  • If the subscriber ceases active work because of a disability due to illness or bodily injury, or because of an approved leave of absence or temporary layoff, payment of dues for that subscriber shall continue coverage in force in accordance with the employer’s policy regarding such coverage.
  • If the employer is subject to the California Family Rights Act of 1991 and/or the federal Family and Medical Leave Act of 1993, and the approved leave of absence is for family leave pursuant to such Acts, payment of dues for that subscriber shall keep coverage in force for the duration(s) prescribed by the Acts. The employer is solely responsible for notifying employees of the availability and duration of family leaves.

Employees who lose eligibility for coverage due to a reduction of hours or suspension of work may have the right to continue coverage under COBRA or Cal-COBRA. Employers should refer to their group service agreement for additional information.

Learn more.

Updated 06/02/2020
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Relief for Employer Groups

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.

Updated 07/31/2020
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What is the “Premium Payment Plan” Program?

Blue Shield has introduced a flexible payment program for the month of April, May and June for Individual and Family Plan and Medicare Supplemental plan members, and Small Business groups.

Learn more.

Updated 06/02/2020
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Is Blue Shield waiving Recertification for renewing groups?

Yes. Blue Shield has announced that the recertification process is being waived in response to the Coronavirus. All groups with an April through July 2020 renewal date will have recertification waived.

Contact Claremont for more information.

Updated 06/02/2020
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If an employee is laid off and then re-hired, how long is the waiting period before they can join the medical plan?

Blue Shield standard provision allows for waiving of waiting period if rehired within 6 months of cancellation of coverage. Employers should check their contract for further details.

Updated 06/02/2020
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Coverage for Covid-19 Testing and Treatment

Is Blue Shield of California covering the cost of testing and treatment for COVID-19?

Yes. Blue Shield is waiving out-of-pocket costs for co-payments, coinsurance, and deductibles
for COVID-19 testing and treatment through September 30, 2020.

Learn more.

Updated 06/02/2020
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Are at-home Coronavirus test kits covered by Blue Shield and will the copay be waived?

At this time, Blue Shield and Blue Shield Promise will only cover self-administered test kits that are FDA-approved, or emergency use authorized, or authorized under other guidance from the Secretary of the Department of Health and Human Services consistent with the federal CARES Act. Other self-administered tests available on in the market are not covered.

Blue Shield and Blue Shield Promise require self-administered tests be ordered by a healthcare provider, sent to the approved laboratory specified on the kit, and processed in accordance with FDA and other guidance, as applicable. This policy is in accordance with applicable legislation, including the federal CARES Act.

Blue Shield and Blue Shield Promise will not cover self-administered test kits that fail to meet the conditions specified above. Members should call the phone number on the back of their member ID card to confirm coverage.

Learn more.

Updated 06/02/2020
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If a member pays for the co-payment, either through an office visit or Teladoc, because the provider requested payment at time of service, will they be reimbursed?

If a member is improperly charged for a co-payment, the member should call the number on the back of their member ID card and Customer Care will work with them to get a reimbursement issued.

Learn more.

Updated 06/02/2020
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Access to Telehealth/ Virtual Care/ Teladoc

Does the standard employer group plan contract cover telemedicine?

Telemedicine services are covered under Blue Shield’s standard plan designs for fully insured and self funded (ASO and Shared Advantage/Shared Advantage+), as follows:

  • For all plans, telemedicine services are available as a covered benefit through those network providers that offer such services, including Mental Health Service Administrator participating providers.
  • For fully insured plans, telemedicine services are also available through Teladoc and Nurse Help 24/7.
  • For self-funded plans, telemedicine services may also be available through Teladoc and Nurse Help 24/7, if the plan sponsor has elected to offer those programs.

In addition, Blue Shield is expanding access to telehealth services in response to COVID-19 by allowing providers to provide services using an expanded range of telehealth platforms. This applies to all telehealth services, including medical-related and behavioral health services, performed appropriately during the COVID-19 public health emergency.

Learn more.

Updated 06/02/2020
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Will Blue Shield waive copays for calls to Teladoc?

Copays and co-insurance for Teladoc visits, medical and behavioral health, will be waived for members enrolled in all Blue Shield commercial plans through September 30, 2020, whether or not related to COVID-19.

Members enrolled in Blue Shield’s Trio and Tandem plans already enjoy $0 out-of-pocket costs for Teladoc services.

Learn more.

Updated 06/02/2020
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Access to Emotional/ Behavioral/ Mental Health

What emotional, behavioral and mental health services and benefits does Blue Shield provide for employees and their families?

  • Teladoc costs waived, including for tele-behavioral services. 
  • Tele-behavioral benefit the same as in-person visits. 
  • Sanvello, a mental and wellness health app, available in Wellvolution, free to members. 
  • Virtual programs such as nutrition and fitness support also available in Wellvolution. 
  • LifeReferrals 24/7 EAP available to fully insured large groups (101+). 

Contact Claremont for more information.

Updated 06/02/2020
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What services does Blue Shield offer for members with anxiety over this outbreak?

Through September 30, 2020, Blue Shield is making Teladoc health, including behavioral health services, available with no member cost sharing for all members with access, including all Blue Shield fully insured commercial plans.

During this time, all Teladoc behavioral health services will be exempt from copays, regardless of the reason for the visit, including encounters with psychiatrists, psychologists, licensed clinical social workers, and marriage family therapists.

Mental health services also continue to be available from providers other than Teladoc. If the Evidence of Coverage (EOC) or Certificate of Insurance (COI) states that mental health services are available through Mental Health Services Administrator (MHSA) network, members can search for providers in the MHSA network through the provider directory. The standard office visit copay applies to MHSA Tele-behavioral health appointments.

Updated 06/02/2020
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Pharmacy

Are members allowed to fill their prescriptions earlier or have larger fill or refill amounts to offset difficulties with getting medications?

For the duration of the public health emergency, Blue Shield and Blue Shield Promise will
waive early refill limits on prescription medications. Blue Shield does not recommend
stockpiling medications. However, early refill limits have been adjusted so that members
can refill an extended supply of their medication according to their benefit. For any
questions regarding early refills, members may call the Members Services number on the
back of their Blue Shield member ID card.

Learn more.

Updated 06/02/2020
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What is Blue Shield doing to make it easier for members to receive their prescriptions?

  • Early refill limits have been waived.
  • 90-day supplies of maintenance medications are available through mail-service pharmacy CVS Caremark.
  • No fee mail service is available through CVS Caremark.
  • Free home delivery is also available through several pharmacy chains.

Learn more.

Updated 06/02/2020
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General

What Coronavirus resources is Blue Shield making available for brokers, groups, employees and members?

You can find Blue Shield’s Coronavirus resources in the Coronavirus Carrier Resources section of our website. You can also stay up-to-date here with carrier actions in response to the Coronavirus.

Updated 06/02/2020
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Chinese Community Health Plan

General

What Coronavirus resources is Chinese Community Health Plan making available for brokers, groups, employees and members?

You can find Chinese Community Health Plan’s Coronavirus resources in the Coronavirus Carrier Resources section of our website. You can also stay up-to-date here with carrier actions in response to the Coronavirus.

Updated 05/07/2020
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Choice Builder

Keeping employees covered

Will ChoiceBuilder allow employees who are currently furloughed, not working, or whose hours have been reduced below 30 hours per week to keep their insurance?

As long as the group and employees are current on their monthly payments, ChoiceBuilder will allow employees that would otherwise have lost eligibility to remain on the plan. COBRA is available to employees where there is an active employer policy.

Learn more.

Updated 04/21/2020
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Are customers able to continue employee ancillary benefits if the entire workforce is laid off in response to the COVID-19 crisis?

As long as the group and employee are current on their monthly payments, ChoiceBuilder will allow employees that would otherwise have lost eligibility to remain on the plan. COBRA is available to employees where there is an active employer policy.

Learn more.

Updated 04/21/2020
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If an employer wants to reduce their contribution mid-year to save money will you allow it?

Employers may make a one-time, “mid-plan year” change to their contribution or plan to reduce
their premiums and maintain coverage for the balance of the contract year. Employees may also
make a one-time “mid-plan year” change to downgrade from the current plan they are on to a
lower cost plan as long as they remain with the same Ancillary Carrier.

Learn more.

Updated 04/21/2020
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Will you waive any rehire waiting period for re-hired employees who were terminated due to COVID-19?

ChoiceBuilder will allow the group to define the waiting period when the employee returns to work.

Learn more.

Updated 04/21/2020
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What continuation of coverage applies if my plan is fully-insured and one or more employees are terminated as a result of COVID-19?

If an employee loses eligibility and the group will not cover the employer contribution, the employee is encouraged to explore COBRA, their state based individual exchange, or the federally facilitated marketplace, based on a qualifying life event (per existing standard business practices and applicable law).

Learn more.

Updated 04/21/2020
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If I terminate employees in the middle of the month as a result of COVID-19, will my fully-insured coverage extend for the terminated employees until the end of the month?

If premiums have been remitted for the month, coverage will continue through the end of that month (per existing standard business practices and applicable law).

Learn more.

Updated 04/21/2020
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Is there a Special Enrollment Period (SEP) for employees who have previously waived coverage?

Yes:

  1. Open through April 10. 
  2. Individuals who previously declined coverage for themselves or their dependents can enroll for benefits. 
  3. Employers may make a one-time, “mid-plan year” contribution change. Employees may make a one-time “mid-plan year” plan downgrade within the same Health Plan.

Learn more here. 

Updated 04/08/2020
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Relief for Employer Groups

If an employer group cannot make their premium payment due to impacts to their business from COVID-19, will the ChoiceBuilder consider extending the current 30-day grace period prior to termination?

ChoiceBuilder realizes these are unprecedented times and want to help and support their customers where possible. If customers are having trouble making payments they should reach out to their account manager or customer service. ChoiceBuilder will evaluate payment extensions on a case-by case basis.

Learn more.

Updated 04/21/2020
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General

What Coronavirus resources is ChoiceBuilder making available for brokers, groups, employees and members?

You can find ChoiceBuilder’s Coronavirus resources in the Coronavirus Carrier Resources section of our website. You can also stay up-to-date here with carrier actions in response to the Coronavirus.

Updated 05/07/2020
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Covered California for Small Business

Relief for Employer Groups

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.

Updated 06/05/2020
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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.

Updated 06/02/2020
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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.

Updated 06/02/2020
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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.

Updated 06/02/2020
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What is the “Premium Deferral Program”?

Covered California for Small Business has introduced a flexible premium payment plan to employers who have not yet paid their premiums for April or May.

Learn more.

Updated 06/02/2020
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Keeping employees covered

Is there a Special Enrollment Period for individuals who previously waived coverage?

Yes. CCSB is offering a Special Enrollment Period (SEP) for individuals who previously waived coverage:

  • Enrollment period through end of June, 2020
  • Intended for employees and dependents of employees who previously waived coverage.
  • Effective Date of the coverage will be first of the month following the date the enrollment was submitted, ending with July 1st effective date for the SEP.
  • 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.

Learn more.

Updated 06/02/2020
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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.

Updated 06/02/2020
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General

What Coronavirus resources is Covered California for Small Business making available for brokers, groups, employees and members?

You can find Covered California for Small Business’ Coronavirus resources in the Coronavirus Carrier Resources section of our website. You can also stay up-to-date here with carrier actions in response to the Coronavirus.

Updated 06/02/2020
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Health Net

Access to Emotional/ Behavioral/ Mental Health

What emotional, behavioral and mental health services and benefits does Health Net provide for employees and their families?

  • 24/7 access to MHN, Health Net’s behavioral health subsidiary, for referrals. 1-800-227-1060. Available to members. 
  • Teladoc costs waived, including for tele-behavioral services. 

Contact Claremont for more information.

Updated 04/20/2020
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Pharmacy

What is Health Net doing to make it easier for members to receive their prescriptions?

  • Early refill limits waived have been waived.
  • Home and mail delivery restrictions have been relaxed.

Contact Claremont for more information.

Updated 04/20/2020
(view full answer)

General

What Coronavirus resources is Health Net making available for brokers, groups, employees and members?

You can find Health Net’s Coronavirus resources in the Coronavirus Carrier Resources section of our website. You can also stay up-to-date here with carrier actions in response to the Coronavirus.

There may be a more recent answer to this question. Contact Claremont for an update.
(view full answer)

Humana

General

Is Humana extending grace periods for premium payment?

Yes. Humana is extending its usual 30 day premium payment grace period to 60 days for California employers.

Contact Claremont for more information.

Updated 04/23/2020
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Are there any extensions to new group application deadlines?

Yes:
4.10.20 for April effective dates.
5.12.20 for May effective dates.

Updated 04/23/2020
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What Coronavirus resources is Humana making available for brokers, groups, employees and members?

You can find Humana’s Coronavirus resources in the Coronavirus Carrier Resources section of our website. You can also stay up-to-date here with carrier actions in response to the Coronavirus.

Updated 04/16/2020
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Kaiser

Access to Emotional/ Behavioral/ Mental Health

Pharmacy

What is Kaiser doing to make it easier for members to receive their prescriptions?

  • A 3-month supply for most prescriptions is available at 1/3 off regular price.
  • Kaiser is recommending mail delivery to members.

Contact Claremont for more information.

Updated 04/20/2020
(view full answer)

General

What Coronavirus resources is Kaiser making available for brokers, groups, employees and members?

You can find Kaiser’s Coronavirus resources in the Coronavirus Carrier Resources section of our website. You can also stay up-to-date here with carrier actions in response to the Coronavirus.

Updated 05/07/2020
(view full answer)

MetLife

Relief for Employer Groups

Is MetLife issuing premium credits to employer groups?

Yes. 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.

Learn more.

Updated 04/29/2020
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Is MetLife providing any rate passes?

MetLife has announced for groups with fewer than 500 lives and have a renewal June – September of 2020 that they will be having a rate pass. MetLife will be reaching out to employer groups renewing during June – September this week to notify them of the rate pass.

Learn more.

Updated 04/29/2020
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Is there any relief to employers who have furloughed employees or reduced their hours?

Yes.

For group life, dental, AD&D, vision, accident & health and legal coverage, MetLife is willing to allow employees who are furloughed, temporarily laid-off or have reduced hours/salary to continue their coverage for 12 months from the date of the furlough, temporary lay-off or reduced hours/salary (collectively, “temporary salary reductions”). Premiums need to be remitted for coverage to remain active.

For purposes of group life, the coverage amounts will not be reduced as a result of temporary salary reductions and will remain in effect just as they were prior to the furlough, temporary lay-off or reduced hours/salary. Accordingly, premium needs to be remitted based on the volume for the regular (non-reduced) coverage amounts.

For group disability, MetLife is willing to allow employees who experience a furlough, temporary lay-off or have reduced hours/salary between March 1, 2020 and May 31, 2020, to continue their coverage for 60 days from the date of the furlough, temporary lay-off, or reduced hours/salary. Coverage amounts will not be reduced as a result of temporary salary reductions and will remain in effect just as they were prior to the furlough, temporary lay-off or reduced hours/salary. Accordingly, premium needs to be remitted based on the volume for the regular (non-reduced) coverage amounts.

In all instances, if the group policy allows for longer periods of continued coverage under any of the circumstances outlined above, MetLife will honor the longer period of time.

Premiums need to be remitted for coverage to remain active.

Learn more.

 

Updated 04/29/2020
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Is MetLife waiving the usual waiting period requirement for re-hires?

For Group Life, AD&D, Accident and Health, Dental and Vision, if the employee’s employment is terminated and coverage lapses due to non-payment, and they return to work or are re-hired within 6 months, MetLife will reinstate their prior coverage amount without needing to provide evidence of insurability, where applicable, or satisfying benefit eligibility waiting periods. For accident and health coverage, any limitations for pre-ex conditions will be applied from the reinstatement date.

For disability coverage, if the employee’s employment is terminated and coverage lapses due to non-payment, and they return to work or are re-hired within 3 months, MetLife will reinstate their prior coverage amount without needing to provide evidence of insurability, where applicable, or satisfying benefit eligibility waiting periods. In addition, the pre-ex provision will be applied as if there was no interruption in coverage.

MetLife will continue to review the needs of their clients during this time and if additional flexibility is needed based on the duration of this pandemic, they may modify our reinstatement position.

Learn more.

Updated 04/29/2020
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Will MetLife be making any changes or having leniency for premium payments?

MetLife understands these are challenging times for many businesses. As an accommodation to their clients, In the event premiums cannot be paid during the contract grace period, MetLife will be extending grace periods for the lesser of 90 days from premium due date or July 31, 2020, unless a different grace period is required by law.   This policy will be applied for all premiums due 3/1/2020 and forward, as well as apply to any premium within the current 30-day grace period. MetLife will continue to monitor the situation and will provide additional guidance as it becomes available.  MetLife is also monitoring state specific mandates and will comply with those mandates. As the coronavirus situation continues to evolve, MetLife will review this guidance for necessary actions and provide updates where the guidance or process has changed.

Learn more.

Updated 04/29/2020
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Access to Emotional/ Behavioral/ Mental Health

What emotional, behavioral and mental health services and benefits does MetLife provide for employees and their families?

  • COVID-19 Hotline by LifeWorks. 1-866-307-1405. Free for ERs with <500 EEs. 
  • EAP option is available to all MetLife groups. Through LifeWorks. 

Contact Claremont for more information.

Updated 04/29/2020
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Contract Clarifications

Disability: are there any exclusions for pandemics?

No, there’s no exclusion for pandemics. COVID-19 is evaluated like any other medical condition.

Contact Claremont for more information.

Updated 04/29/2020
(view full answer)

General

What Coronavirus resources is MetLife making available for brokers, groups, employees and members?

You can find MetLife’s Coronavirus resources in the Coronavirus Carrier Resources section of our website. You can also stay up-to-date here with carrier actions in response to the Coronavirus.

Updated 04/29/2020
(view full answer)

Oscar

Access to Emotional/ Behavioral/ Mental Health

What emotional, behavioral and mental health services and benefits does Oscar provide for employees and their families?

  • Optum 24/7 emotional support helpline. 1-866-342-6892. Free of charge to anyone, not just members. 
  • Doctor on Demand for in-network virtual mental health services. Optum for in-network mental and behavioral services. 
  • Calm app: 40% member subscription discount.

Contact Claremont for more information.

Updated 04/20/2020
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Pharmacy

What is Oscar doing to make it easier for members to receive their prescriptions?

  • Early refill limits have been waived.
  • No fee mail service is available through CVS Caremark.
  • Free home delivery is also available through several pharmacy chains.

Learn more.

Updated 04/20/2020
(view full answer)

General

What Coronavirus resources is Oscar making available for brokers, groups, employees and members?

You can find Oscar’s Coronavirus resources in the Coronavirus Carrier Resources section of our website. You can also stay up-to-date here with carrier actions in response to the Coronavirus.

Updated 05/07/2020
(view full answer)

Principal

Relief for Employer Groups

Is there any extension available to the grace period for premium payments?

Yes. Principal understand this might be a financially challenging time. So they’re extending grace periods to 60 days for monthly bills through June 1, 2020. Plus, they’re actively monitoring grace period changes at a state level and will implement those requirements that have a grace period longer than 60 days. This is a rapidly changing situation. Principal will continue to monitor and adjust information. Contact Claremont for the latest information.

Updated 04/22/2020
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Are there any rate passes for upcoming renewals?

Yes. For employers with less than 500 employees and policy anniversary dates of May 1, 2020 through Aug. 15, 2020, there won’t be any rate increases at renewal.

Contact Claremont for more information.

Updated 04/22/2020
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Are there any extensions to new group application deadlines?

Yes. Check the Carrier Responses section of our COVID-19 resource page for the latest information.

Updated 04/22/2020
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If an employer group has to temporarily close due to impacts from COVID-19, will its Principal coverage remain active?

Yes, coverage remains active through May 31, 2020, if the employer continues to pay premiums.

Learn more.

Updated 04/22/2020
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If employees are required to work a reduced schedule and no longer meet the minimum number of hours of eligibility in the policy, will they remain eligible for coverage and how long can they be covered?

Principal’s standard practice is to continue coverage until the end of the month. However, as an administrative exception due to impacts from COVID-19, any employee no longer eligible due to reduced hours or furlough/layoff on or after March 1, 2020, through May 31, 2020, may continue coverage for 90 days, provided premiums continue to be paid. For employees whose coverage terminates and are rehired within six months of the termination date, benefits are reinstated without a new hire waiting period..

Learn more.

Updated 04/22/2020
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Can a group downgrade off anniversary?

Please contact Claremont and we can assist with this process. 

Updated 04/22/2020
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Coverage and Benefits Extensions and Clarifications

What support is available for employees feeling overwhelmed or anxious about Covid-19?

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. Employees can contact Magellan Healthcare 24/7 at 800-450-1327 for free, confidential consultation services.

Learn more.

Updated 04/22/2020
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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, one must satisfy the definition of disability and all other provisions outlined in the policy. 

Learn more.

Updated 04/22/2020
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Does Principal have a pandemic-specific exclusion in their insurance policies?

No, Principal evaluates COVID-19 as they would any other medical condition.

Learn more.

Updated 04/22/2020
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Access to Emotional/ Behavioral/ Mental Health

What emotional, behavioral and mental health services and benefits does Principal provide for employees and their families?

  • 24/7 telephonic EAP support by Magellan. 1-800-450-1327. Free to members. 

Contact Claremont for more information.

Updated 04/22/2020
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General

What Coronavirus resources is Principal making available for brokers, groups, employees and members?

You can find Principal’s Coronavirus resources in the Coronavirus Carrier Resources section of our website. You can also stay up-to-date here with carrier actions in response to the Coronavirus.

Updated 04/22/2020
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Reliance Standard

Relief for Employer Groups

Is Reliance Standard providing any relief to employer groups?

Yes. Reliance Standard is providing relief in a number of ways, including temporarily:

  • allowing coverage to continue in the event of a reduction in hours or furlough.
  • maintaining benefit levels in the event of salary reductions
  • adjusting the administration of waiting periods

More information of these new actions can be found on Reliance Standard’s Coronavirus Response page, with links to general FAQs and Dental and Vision FAQs.

Updated 04/23/2020
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Access to Emotional/ Behavioral/ Mental Health

What emotional, behavioral and mental health services and benefits does Reliance Standard provide for employees and their families?

Contact Claremont for more information.

Updated 04/23/2020
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Contract Clarifications

Disability: are there any exclusions for pandemics?

No, there’s no exclusion for pandemics. COVID-19 is evaluated like any other medical condition.

Contact Claremont for more information.

Updated 04/23/2020
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General

What Coronavirus resources is Reliance Standard making available for brokers, groups, employees and members?

You can find Reliance Standard’s Coronavirus resources in the Coronavirus Carrier Resources section of our website. You can also stay up-to-date here with carrier actions in response to the Coronavirus.

Updated 04/23/2020
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How are Coronavirus claims considered across the Reliance Standard Product line?

Short Term Disability

If a person is diagnosed with COVID-19, a claim for fully-insured STD benefits would likely be
payable after the elimination period if the definition of disability has been met. Individuals who
are quarantined without a diagnosis would not have a payable claim.

Long Term Disability

If a person is diagnosed with coronavirus, a claim for fully insured LTD would likely be payable after the elimination period if the definition of disability has been met. As with STD, individuals who are quarantined but not sick generally would not have a payable claim.

Group Term Life Insurance

A life claim following a COVID-19 diagnosis would likely be payable assuming all other provisions of the policy are met.

Accidental Death & Dismemberment

A COVID-19 diagnosis is not a covered condition under Reliance Standard’s Accidental Death & Dismemberment product.

Accident Insurance

Accident insurance does not provide benefits for the diagnosis or treatment of COVID-19.

Critical Illness Insurance

COVID-19 is not a covered condition under Reliance Standard’s Critical Illness product.

Hospital Insurance

Admission/confinement due to a positive diagnosis of COVID-19 may be considered for eligible benefits provided all other provisions of the policy are met.

Wellness Benefits

COVID-19 testing is not a covered test under our Wellness Benefit; however, most major medical plans and many government programs provide free COVID-19 testing.

EAP Services

For any individuals experiencing panic, anxiety or fear, or are in need of community resource referrals for child care or life management needs, an EAP provides work-life referrals that can help. This value-added service is optional on Reliance Standard’s LTD and Group Life contracts. Contact Claremont to confirm coverage.

 

Helpful Resources

Reliance Standard Coronavirus Response page, with links to general FAQs and Dental and Vision FAQs.

Updated 04/23/2020
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Sharp

Pharmacy

What is Sharp doing to make it easier for members to receive their prescriptions?

  • Early refill limits have been waived.
  • No fee mail service is available through CVS Caremark.

Learn more.

Updated 04/20/2020
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General

What Coronavirus resources is Sharp making available for brokers, groups, employees and members?

You can find Sharp’s Coronavirus resources in the Coronavirus Carrier Resources section of our website. You can also stay up-to-date here with carrier actions in response to the Coronavirus.

Updated 05/07/2020
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UnitedHealthcare

Special Enrollment Period

Is there a Dental & Vision Special Enrollment Opportunity?

Yes.

UnitedHealthcare has announced a Dental & Vision Special Enrollment Opportunity to enroll employees who previously did not enroll in Dental and/or Vision coverage. The one-time opportunity will be limited to those employees who previously waived coverage or did not elect coverage for themselves or their dependents (e.g., spouses or children).

  • The enrollment opportunity will extend from May 18, 2020 through May 29, 2020, for a June 1st effective date.
  • Employers are not required to adopt the SEP, so no opt-out action is required.
  • Dependents such as spouses and children, can be added if they are enrolled in the same coverage or benefit option as the employee.
  • This SEP is not intended to allow current members to make a change in plan options.

Get the details.

Updated 05/15/2020
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Relief for Employer Groups

Are there any extensions available to new business submission deadlines?

Yes. Groups with 4/1 effective dates can be submitted in SAM until the last business day of the month. These groups must be clean and complete. Once the group has been approved, the effective date cannot change.

Contact Claremont for more information.

Updated 05/07/2020
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Are there any extensions to new group application deadlines?

Yes. Check the Carrier Responses section of our COVID-19 resource page for the latest information.

Updated 05/07/2020
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Can employers use credit cards to pay premiums?

Get the answer in UnitedHealthcare’s COVID-19 Business Disruption Support FAQs.

Updated 05/07/2020
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Access to Telehealth

Access to Emotional/ Behavioral/ Mental Health

What emotional, behavioral and mental health services and benefits does UnitedHealthcare provide for employees and their families?

  • Optum 24/7 emotional support helpline. 1-866-342-6892. Free of charge to anyone, not just members. 
  • In-network tele-behavioral costs waived. 
  • Free on-demand emotional support mobile app from Sanvello. 

Contact Claremont for more information.

Updated 05/07/2020
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Pharmacy

What is UnitedHealthcare doing to make it easier for members to receive their prescriptions?

  • Early refill limits waived have been waived.
  • No fee mail service is available for Optum Rx members.
  • Free home delivery is also available through several pharmacy chains.

Learn more.

Updated 05/07/2020
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Contract Clarifications

Disability: are there any exclusions for pandemics?

No, there’s no exclusion for pandemics. COVID-19 is evaluated like any other medical condition.

Contact Claremont for more information.

Updated 05/07/2020
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General

What Coronavirus resources is UnitedHealthcare making available for brokers, groups, employees and members?

You can find UnitedHealthcare’s Coronavirus resources in the Coronavirus Carrier Resources section of our website. You can also stay up-to-date here with carrier actions in response to the Coronavirus.

Updated 05/07/2020
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The answers provided are a best interpretation of the information available as of the date posted. The answers are for informational purposes and should not be construed as tax or legal advice.