What can the employer offer during the special open enrollment?

UnitedHealthcare has extended the COVID-19 Special Enrollment Period (SEP) to April 13, and employers* with multiple plan options also can buy down to a leaner plan. Options include:

Add a special open enrollment for members who previously waived coverage, including dependents, to provide additional access to care. Employers can do this without introducing any new plans from March 23 -April 13 (extended from April 6). Employers will continue to contribute to the cost of the coverage, and coverage will be effective April 1.

1. Buy down to a leaner plan:

• Employers with a single-benefit offering that wish to buy down to a leaner plan may do so between now and May 31. They also can re-enroll their population to the leaner plan design.
• Employers with multi-option plan designs can temporarily buy down to a leaner plan. If employers decide to conduct a SEP when adding the plan, new enrollees who previously waived coverage can select from any of the plans offered by the employer provided they are eligible and the employer contributes to the cost of coverage. Existing members can also move to the lean plan design, but no other benefit changes are permitted.

2. Add a lean plan design but no SEP: Consistent with the buy-down approach, employers will have until May 31 to add a lean benefit. In that instance, existing members can move to the new lean plan design. No other benefit changes are permitted. New enrollees previously waiving coverage are excluded beyond the April 13 cutoff for SEP.

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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.

Can California extend the Open Enrollment for CA HMO products to April 13?

Yes. This date extension only applies to United Healthcare group CA HMO products.

Learn more.

Can a multi-option employer add an additional lean plan design and conduct a Special Open Enrollment?

Yes, between March 23rd and May 31st, UnitedHealthcare will not impose any fully insured policy limitations on employer /plan sponsors who want to:

1. allow new enrollees (i.e. eligible individuals that previously declined group coverage during open enrollment) the opportunity to enroll in any plan option available under the employer/plan sponsor’s benefit offerings, and/or
2. allow existing enrollees (i.e. those who are currently enrolled in a benefit offering) the opportunity to change their prior election and enroll in a newly added leaner plan design. As always, UnitedHealthcare encourage plan sponsors to review any changes to their plan with their employee benefit plan counsel and/or tax advisor. The group’s effective date will not change, and the new plan will become effective between April 1 – June 1, depending on timing of plan change request. Follow standard off-cycle plan change process.

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If an insured employer has only a single benefit plan, but wants to change the plan mid-year to a leaner plan design to save money will UnitedHealthcare allow it?

Yes. Between March 23rd and May 31st, employers have one chance to buy down their benefit plan. The group’s effective date will not change, and the new plan will become effective between April 1 – June 1, depending on timing of plan change request. Follow standard off-cycle plan change process.

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Which products are in scope for the SEP?

The SEP is limited to medical, pharmacy, dental and vision. All other products are not part of the special enrollment program.

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Does UnitedHealthcare cover the test for COVID-19?

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

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

Learn more.

Will drive-up testing be an option?

Get the answer in UnitedHealthcare’s COVID-19 Testing FAQs.

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.

Will pharmacy coverage or treatment be impacted by COVID-19?

Get the answer in UnitedHealthcare’s COVID-19 Pharmacy Coverage FAQs.