Claremont Insurance Services, Walnut Creek, Californian General Agency

COVID-19 Ancillary Carrier Responses
claremontcompanies.com


Keeping Employees CoveredAllied Benefit Suite & Delta DentalChoice BuilderHumanaMetLifePrincipalReliance StandardUnited Healthcare
Special Enrollment Periods (SEP) for previous waivers?

Case-by-case basis.

Case-by-case basis.

Yes, open through 4.10.20, 4.1.20 effective date.

No.

Case-by-case basis.

No.

No.

UHC is providing its Fully Insured employer customers with a special COVID-19 dental and vision enrollment opportunity (SEO). From 5.18.20 through 5.29.20. Effective date June 1st.

Coverage in the event of furlough/reduction in hours?

Yes:
– full premium payment by the employer.
– furloughed employee(s) was active on 3.1.20.

Yes:
– full premium payment by the employer.
– only actively-at-work employees may be added to the plan as new enrollees.

Yes:
– full premium payment by the employer.

Yes
– full premium payment by the employer
– effective through 5.31.20.

Yes:
– full premium payment by the employer.
– for 12 months from the date of the furlough
(for group life, dental, AD&D, vision, accident & health, and legal coverage.)

Yes:
– furloughed/ laid-off on or after March 1, 2020, through May 31, 2020, may continue coverage for 90 days
– provided premiums continue to be paid.

Yes:
– full premium payment by the employer for 60 calendar days.

As long as the employer continues to pay premiums on those furloughed employees, coverage will continue.

Waiting period waiver for re-hires?

Case-by-case basis.

Yes, for employees rehired within 6 months.

Yes, waiting period definition at discretion of employer group.

Yes.

Yes:
For Group Life, AD&D, Accident and Health, Dental and Vision: if rehired within 6 months.
For disability coverage: if rehired within 3 months.

No.

No.

Standard waiting periods may be waived for new and rehired; however, existing eligibility and state guidelines will apply.

Relief for Employer GroupsAllied Benefit Suite & Delta DentalChoice BuilderHumanaMetLifePrincipalReliance StandardUnitedHealthcare
Grace period for premium payment?

Yes, 60 day grace period for April and May invoices.

Yes, 60 day grace period.

Case-by-case basis.

Yes, 60 day grace period.

Yes, 90 day grace period.

Yes, 60 day grace period.

Yes, 90 day grace period.

No change, 30-day grace period. Will renew on a case-by-case basis.

Extended new business submission deadlines?

Yes, 15th day of the effective month.

Case-by-case basis.

Yes, the usual 15th day of the effective month.

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

Case-by-case basis.

Contact Claremont.

Case-by-case basis.

Standard deadlines will apply.

Renewal rate pass?

Case-by-case basis.

Two-year rate pass for all small groups renewing from August 2020 through July 2021.

Contact Claremont.

Yes, for dental & vision. Rate pass for 6.1.20 through 9.1.20 renewal dates.

Yes:

For groups <100 employees: Rate pass through 3.31.21 renewal dates.

For groups 100-500 employees: Rate pass for 6.1.20 through 9.1.20 renewal dates.

Yes, for groups <500 employees. Rate pass for 5.1.20 through 4.1.21 renewal dates.

Yes, for groups <500 employees. Rate pass for 5.1.20 through 8.1.20 renewal dates.

UHC will renew at existing rates or better for groups with 2-499 eligible lives until December 31, 2020.

Premium Credits for Employers

Nothing announced.

All small group plans will receive a one-month premium holiday for September 2020. Qualifying groups must be effective on or before July 2020.

Nothing announced.

Nothing announced.

Employers with fully insured dental PPO plans will receive a premium credit on a future bill in the amount of 25% for the months of April and May, 2020.

Fully-insured dental groups (both contributory and voluntary) will receive a 10% premium credit on their June through October 2020 invoices.

Nothing announced.

Reduction in dental premium: UHC Dental is providing a 50%, 1-month premium reduction in July-reflected on June invoices.

Credit card for premium payment?

No.

No.

No.

Yes, for one-time monthly payments. Not for recurring automated payments.

No.

No.

No.

No, UHC is unable to accept credit card payments at this time.

Off-anniversary plan/contribution changes?

Case-by-case basis.

Case-by-case basis.

Yes, for employers a one-time ‘mid-plan year’ change to contribution or plan. For employees, a one-time ‘mid-plan year’ plan downgrade with the same carrier.

Case-by-case basis.

The usual case-by-case basis.

The usual case-by-case basis.

No.

Discussion for a case-by-case basis.Signatures not required through SAM.

Applications in event signatures can't be obtained?

Yes, several options.

Case-by-case basis.

Contact Claremont.

Yes, online.

Yes, eSignatures.

Yes, eSignatures.

Contact Claremont.

Signatures not required through SAM.

Coverage Extensions & ClarificationsAllied Benefit Suite & Delta DentalChoice BuilderHumanaMetLifePrincipalReliance StandardUnitedHealthcare
Disability pandemic exclusion?

N/A

No, COVID-19 evaluated the same as any medical condition.

N/A

N/A

No, COVID-19 evaluated the same as any medical condition.

No, COVID-19 evaluated the same as any medical condition.

No, COVID-19 evaluated the same as any medical condition.

No

Tele-dentistry coverage?

Yes.

Yes.

Ameritas: yes.

Anthem: yes.

Delta Dental: yes.

MetLife: yes.

Yes.

Yes.

Yes.

Yes.

Yes.

Other   

Humana is giving in-network dentists $7 for every Humana member visit they have with their PPO or DHMO DDS, and it’s paid as a stipend vs a claim.

 

A $7 payment for PPE will be paid to in-network providers with each member dentist visit from June 1 through December 31, 2020. This payment will help offset additional COVID-19 expenses for dental offices. Additionally, this payment may help decrease member out-of-pocket costs.

From July 1 through December 31, 2020, Reliance is waiving deductibles and exam/cleaning frequency limitations for all policyholders. Orthodontia claims excluded.

In-network dentists enrolled in electronic payments will receive increases between $5 and $10 for certain services related to routine exams, emergency services and initial evaluations for children and adults.