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Copywriteroffice - New insurance coverage available because of the pandemic serp result detail
Keyword New insurance coverage available because of the pandemic
Search Urlhttps://www.google.com/search?q=New+insurance+coverage+available+because+of+the+pandemic&oq=New+insurance+coverage+available+because+of+the+pandemic&num=30&hl=en&gl=US&sourceid=chrome&ie=UTF-8
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Search Enginegoogle.com
No. Of Results602000000
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covid-19 covered by insurancehttps://www.google.com/search?num=30&hl=en&gl=US&q=covid-19+covered+by+insurance&sa=X&ved=2ahUKEwj42YPfiZ71AhWUl2oFHY9gC_oQ1QJ6BAhjEAE
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free health insurance for unemployed 2021https://www.google.com/search?num=30&hl=en&gl=US&q=Free+health+insurance+for+unemployed+2021&sa=X&ved=2ahUKEwj42YPfiZ71AhWUl2oFHY9gC_oQ1QJ6BAhmEAE
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affordable care act changes for 2021https://www.google.com/search?num=30&hl=en&gl=US&q=Affordable+Care+Act+changes+for+2021&sa=X&ved=2ahUKEwj42YPfiZ71AhWUl2oFHY9gC_oQ1QJ6BAhhEAE
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Result 1
TitleAffordable Care Act 2022 Plans - Sign Up Before Jan 15 Deadline
Urlhttps://www.google.com/aclk?sa=l&ai=DChcSEwjUo47fiZ71AhUeFtQBHdwCBPwYABAAGgJvYQ&sig=AOD64_3d1Ygsi1y_lqbOXJ4l4TQyv11wLg&adurl&q
DescriptionCoverage in Effect for the Entire Year. Top 2022 Obamacare Plans from $30/Month! See Prices, Plans, and Eligibility. Get a Free Quote. Enroll Today & Save 60%!
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Result 2
TitleFull Coverage from $30/Month - 2022 Open Enrollment Is Here
Urlhttps://www.google.com/aclk?sa=l&ai=DChcSEwjUo47fiZ71AhUeFtQBHdwCBPwYABABGgJvYQ&sig=AOD64_3Tx1kIkj1Her1HZue23sEszrm8fA&adurl&q
DescriptionInstantly See Prices, Plans and Eligibility. 2022 Healthcare Coverage from $30/Month! The Non-Govt Way to Get the Best Health Insurance. Full 2022 Coverage from $30/Month!
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Result 3
TitleCovered California - Enrollment is Open
Urlhttps://www.google.com/aclk?sa=l&ai=DChcSEwjUo47fiZ71AhUeFtQBHdwCBPwYABACGgJvYQ&sig=AOD64_12mo1HmocHeCj0fGJavdSipgeixA&adurl&q
DescriptionCovered CA: Gov't Discounts. American Rescue Plan = More Savings & More Eligible People. Lowest Prices. Top Plans (Kaiser, Anthem, Blue Shield, etc.). View Rates & Enroll...
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Result 4
TitleCOVID-19 & Health Insurance - 2022 CA Health Insurance Plans
Urlhttps://www.coveredca.com/get-started/
DescriptionCovered CA Can Help You Find The Health Insurance Needed To Protect You & Your Loved Ones.
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Result 5
TitleMarketplace Coverage & Coronavirus | HealthCare.gov
Urlhttps://www.healthcare.gov/coronavirus/
DescriptionSee how your Health Insurance Marketplace® coverage is affected by coronavirus (COVID-19). Health plan treatment same as other viral infections. Official HC.gov site
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Organic Position1
H1Marketplace coverage & Coronavirus
H2COVID-19 vaccines
If you paid to get a COVID-19 vaccine
COVID-19 diagnostic testing
If you need medical care
If you lost your job or experienced a reduction in hours
Coverage start dates with a Special Enrollment Period due to loss in coverage
If you can’t pay your premiums because of a hardship due to COVID-19
If your insurance company lowered your premium temporarily in 2020
If you're enrolled in a Marketplace plan and your income has changed
If your child is no longer living with you after their college sent them home early or due to a change in their college residence
If you got or are eligible to get unemployment compensation in 2021
If you have limited Medicaid that covers COVID-19 diagnostic testing only
For the latest COVID-19 information
GET STARTED
H3
H2WithAnchorsCOVID-19 vaccines
If you paid to get a COVID-19 vaccine
COVID-19 diagnostic testing
If you need medical care
If you lost your job or experienced a reduction in hours
Coverage start dates with a Special Enrollment Period due to loss in coverage
If you can’t pay your premiums because of a hardship due to COVID-19
If your insurance company lowered your premium temporarily in 2020
If you're enrolled in a Marketplace plan and your income has changed
If your child is no longer living with you after their college sent them home early or due to a change in their college residence
If you got or are eligible to get unemployment compensation in 2021
If you have limited Medicaid that covers COVID-19 diagnostic testing only
For the latest COVID-19 information
GET STARTED
BodyMarketplace coverage & Coronavirus Begin highlighted textYou can apply for 2022 Marketplace health insurance right now You can apply for the first time, update, or change your plan for 2022. Open Enrollment ends January 15, 2022. Create an account or log in now. Still need health coverage for 2021? See 2 ways to enroll or change. End highlighted text If you already have coverage through the Marketplace, the rules in your Marketplace health plan for treatment for the coronavirus disease 2019 (COVID-19) emergency remain the same as any other viral infection, but your health insurance company may have added benefits. See what Marketplace plans cover. All Marketplace plans cover treatment for pre-existing medical conditions and can’t terminate coverage due to a change in health status, including diagnosis or treatment of COVID-19. Check with your health insurance company for their specific benefits and coverage policy. Log in to update your Marketplace application if COVID-19 impacts your income or household. You may be able to change your plan if certain situations apply. COVID-19 vaccines. Begin highlighted textVaccines to prevent COVID-19 are: Safe and effective Free of charge to everyone living in the United States, regardless of immigration or health insurance status More widely available — anyone 5 years or older can get a COVID-19 vaccine Find COVID-19 vaccinesEnd highlighted text All Marketplace plans cover: Your initial COVID-19 vaccines (two shots for Pfizer & Moderna or one Johnson & Johnson/Janssen dose) An additional third dose of the Pfizer or Moderna COVID-19 vaccine if you’re immunocompromised (like people who have had an organ transplant and are at risk for infections and other diseases). Note: Don’t mix vaccines. If your first two doses were Pfizer, your third dose should also be Pfizer. If your first two doses were Moderna, your third dose should also be Moderna. A COVID-19 vaccine booster shot. Adults 18 years or older can choose which vaccine you receive for your booster – get a booster from the same COVID-19 vaccine series you originally got, or choose a different one. Teens 16-17 years old can only get a booster of the Pfizer COVID-19 vaccine. If you got a Pfizer or Moderna COVID-19 vaccine: You can get a booster shot at least 6 months after you complete your second dose. If you got a Johnson & Johnson/Janssen COVID-19 vaccine: You can get a booster shot at least 2 months after you got your first shot. Learn more about who should get a booster shot at CDC.gov. If you paid to get a COVID-19 vaccine. When you get a COVID-19 vaccine, your provider can’t charge you for an office visit or other fee if the vaccine is the only medical service you get. If you get other medical services at the same time you get the COVID-19 vaccine, you may owe a copayment or deductible for those services. If you paid a fee or got a bill for a COVID-19 vaccine, check this list to see if your provider should have charged you: Check the receipts and statements you get from your provider for any mistakes. Call your provider’s office to ask about any charges you think are incorrect. The person you speak to may help you better understand the services you got, or realize they made a billing error. Review your “Explanation of Benefits.” Report anything suspicious to your insurer. If you think your provider incorrectly charged you for the COVID-19 vaccine, ask them for a refund. If you think your provider charged you for an office visit or other fee, but the only service you got was a COVID-19 vaccine, report them to the Office of the Inspector General, U.S. Department of Health and Human Services by calling 1-800-HHS-TIPS or visiting TIPS.HHS.GOV. COVID-19 diagnostic testing. All Marketplace health plans cover COVID-19 diagnostic tests, even if you don’t have symptoms, or don’t know if you’ve been exposed to COVID-19. For example, if you want to make sure you’re COVID-19 negative before visiting a family member, you pay nothing to get tested. If you need medical care. Call before going to the doctor. Many routine medical visits are being postponed, or done online or by phone. Telehealth services for non-emergency and non-COVID-19-related care may be available to you. If you must visit in-person, you may be asked to do the following to lower exposure risk and protect others: Wait in your car until the start of the visit Use a limited entrance Be screened for COVID-19 by having your temperature checked Avoid waiting rooms and areas Maintain social distancing Wear a face covering, which will be provided to you if you don’t have your own Wash your hands or use hand sanitizer If you’re sick with COVID-19 or think you may have it, visit CDC.gov for steps to help prevent the spread. If you need emergency care, you should go to the closest hospital that can help you. If you lost your job or experienced a reduction in hours. You may qualify for a Special Enrollment Period if you experience certain life changes like: You lost health coverage through your employer in the past 60 days You lost health coverage through a household member’s employer in the past 60 days You expect to lose coverage in the next 60 days (like if you lose health coverage through a parent or guardian because you're no longer a dependent). Note: If you lost coverage or had another life change more than 60 days ago, you may qualify for a Special Enrollment Period if you previously qualified for a Special Enrollment Period, but you missed the 60-day deadline to enroll because you were impacted by the COVID-19 national emergency. Voluntarily dropping coverage doesn't qualify you for a Special Enrollment Period unless you also had a decrease in household income or a change in your previous coverage that made you eligible for savings on a Marketplace plan. If your employer reduced the hours you work and you’re enrolled in a Marketplace plan: Update your application immediately within 30 days to report any household income changes. You may qualify for more savings than you’re getting now. Learn how to report changes and estimate your income. If you were furloughed: In some situations, depending on the status of your health coverage from your employer, you may qualify for a Special Enrollment Period. You may be eligible for a premium tax credit to help pay for Marketplace coverage too. Create an account or log in to start your Marketplace application to find out if you qualify. Need help estimating your income? Use this income calculator to make your best estimate. If you qualify for COBRA continuation coverage: If you’re entitled to COBRA continuation coverage after you lost your job-based coverage, you may still qualify for a Special Enrollment Period due to loss of coverage. You have 60 days after your loss of job-based coverage to enroll in Marketplace coverage. You may also qualify for premium tax credits if you end your COBRA continuation coverage, or if you didn’t accept it to begin with. If you're enrolled in COBRA continuation coverage, you may qualify for a Special Enrollment Period if your COBRA continuation coverage costs change because your former employer stops contributing so you have to pay full cost, or if you get premium assistance to pay for your COBRA premiums and your premium assistance ends. Learn more about COBRA continuation coverage and the Marketplace. If you qualified for COBRA because you or a household member had a reduction in work hours or involuntarily lost a job, you may have qualified for help paying for COBRA premiums. If you qualified, you would have gotten a written notice from your former employer or insurance company and had access to COBRA without having to pay premiums. This help ended on September 30, and so you can enroll in a Marketplace plan with a Special Enrollment Period. To enroll, you can report a September 30 "loss of coverage" on your application. You can’t qualify for a premium tax credit while you’re enrolled in COBRA, so if you want to change to Marketplace coverage, make sure that your COBRA coverage ends on the last day before your Marketplace coverage starts. Learn more about COBRA premium assistance. If you lost your job, but didn’t also lose health coverage, because your former job didn’t offer coverage: You generally won't qualify for a Special Enrollment Period. By itself, a job loss (or a change in income) doesn't make you eligible for a Special Enrollment Period to enroll in Marketplace coverage. Coverage start dates with a Special Enrollment Period due to loss in coverage. If you’ve already lost coverage, your Marketplace coverage can start the first of the month after you apply and enroll. If you know you’ll lose coverage within the next 60 days, you can submit an application on HealthCare.gov before you actually lose your coverage to help make sure there’s no gap in coverage. For example, if you know you’ll lose coverage on August 30, and apply and enroll in a Marketplace plan August 10, your new coverage will start September 1. If you can’t pay your premiums because of a hardship due to COVID-19. Check with your insurance company about extending your premium payment deadline or ask if they will delay terminating your coverage if you can’t pay your premiums. If your household income has changed, update your application immediately. You could qualify for more savings than you're getting now. If you’re getting financial assistance for Marketplace premiums, you have a three-month grace period to catch up on premium payments to avoid having your coverage terminated for non-payment. Most of the time, if you aren’t getting financial help with your premiums, you have a grace period determined by state law (often one month). If your insurance company lowered your premium temporarily in 2020. Due to the COVID-19 emergency, some insurance companies (with prior approval from the Marketplace and their state) may have lowered health plan premiums for a month or more in 2020 (called a “temporary premium reduction”). They were allowed do this as long as it was a fixed percentage off the total premium (like 15%) and was given to all members, regardless of plan type or eligibility for advance payment of the premium tax credit (APTC). If you were newly enrolled in a Marketplace plan with a premium tax credit, any temporary premium reductions that plans may have offered wouldn’t be displayed on HealthCare.gov. If you were already enrolled in a Marketplace plan with a premium tax credit and your insurance company gave you a temporary premium reduction for certain months, the Marketplace may have also lowered your monthly APTC amount so that it didn’t exceed the portion of your monthly premium that counted toward coverage for essential health benefits. You’ll see any adjustments to APTC in Form 1095-A, which you’ll use to reconcile your 2020 taxes that you file in 2021. (You should have received Form 1095-A in the mail. If you haven’t, get help finding Form 1095-A.) If you're enrolled in a Marketplace plan and your income has changed. If you’re enrolled in a Marketplace plan and your household income has changed, update your application immediately. If your income goes down or you gain a household member: You could qualify for more savings than you’re getting now. This could lower what you pay in monthly premiums. You could qualify for free or low-cost coverage through Medicaid or the Children’s Health Insurance Program (CHIP). Need help estimating your new income? Use our income calculator to make your best estimate. If your child is no longer living with you after their college sent them home early or due to a change in their college residence. If you plan to claim your child as a tax dependent on your federal tax return, and you currently have Marketplace savings with your coverage, you can keep your child on your Marketplace application. Read the plan's coverage documents and review the provider network carefully so you know how the plan covers care delivered in the state your child goes to school. When your child moves to or from the place they live and go to school, they may be eligible for a Special Enrollment Period allowing them to enroll outside the yearly Open Enrollment Period if they: Are still enrolled in a student health plan, but the coverage and benefits don’t extend to your area, or if your child’s move home means that they moved to a new ZIP code or county. Had qualifying health coverage or lived in a foreign country or a U.S. territory for at least one of the 60 days before the date of their move. Note: This requirement doesn’t apply to members of a federally recognized tribe or Shareholders of Alaska Native Corporations. If your child is under 26 and you’re already enrolled in Marketplace coverage, you may be able to add your child to your plan. If you have Marketplace coverage with savings and don’t plan to claim your child as a tax dependent on your federal tax return, your child should set up their own Marketplace account and submit a separate application. If you plan to claim your child as a tax dependent on your federal tax return, and you currently have Marketplace savings with your coverage, you can update your Marketplace application and add your child. If you have Marketplace coverage without requesting savings, you can put everyone on one application. Note: If you change plans or add a new household member, any out-of-pocket costs you already paid on your current 2021 Marketplace plan probably won’t count towards your new deductible, even if you stay with the same insurance company. Call your insurance company before changing plans or adding a new household member to find out if you’ll need to start over to meet your new plan’s deductible. If you got or are eligible to get unemployment compensation in 2021. You may be able to enroll now, even if you didn’t experience another life event. (The Marketplace will follow up with you shortly after you submit your application if you’re eligible for this Special Enrollment Period.) If you have limited Medicaid that covers COVID-19 diagnostic testing only. In some states, Medicaid may cover COVID-19 testing if you don’t have other health coverage and don’t qualify for full Medicaid or CHIP coverage. This limited Medicaid benefit only covers COVID testing and doesn’t cover any other health care benefits and services. It doesn’t count as having qualifying health coverage. With limited coverage, you can fill out a Marketplace application to find out if you qualify for comprehensive coverage, including COVID-19 testing, through either Medicaid, CHIP, or the Marketplace with savings based on your income. When you apply, don’t tell us that you have Medicaid. If you enroll in Marketplace coverage and qualify for help paying for that coverage, notify your State Medicaid agency of this new coverage. Note: Like other Medicaid coverage that provides limited benefits, if your COVID-19 testing Medicaid coverage ends, you may not be able to enroll in Marketplace coverage until Open Enrollment for 2022 coverage starting November 1, 2021, unless you have a qualifying event. Learn more about Special Enrollment Periods. Learn more about Medicaid coverage and the Marketplace. For the latest COVID-19 information. CDC.gov/coronavirus has the latest public health and safety information from CDC and for the overarching medical and health provider community on COVID-19. USA.gov/coronavirus to see what the U.S. Government is doing in response to COVID-19. GET STARTED. Preview plans & pricesCreate an accountLog into your account Back to top
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  • premium
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  • health
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  • vaccine
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  • qualify
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  • covid 19 vaccine
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  • 19 vaccine
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  • enrollment period
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  • marketplace plan
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  • insurance
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  • enroll
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  • change
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  • medicaid
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  • health coverage
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  • premium tax credit
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  • cobra continuation coverage
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  • form 1095
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  • booster shot
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  • health insurance
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  • coverage qualify
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  • enroll marketplace coverage
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  • coverage marketplace
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  • health plan
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  • cover covid
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  • lost job
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  • household income
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  • coverage start
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  • marketplace plan cover
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  • moderna covid 19
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  • 19 vaccine booster
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  • vaccine booster shot
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  • covid 19 diagnostic
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  • cover covid 19
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  • coverage 60 day
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  • moderna covid
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  • vaccine booster
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Result 6
TitleHealth Insurance Providers Respond to Coronavirus (COVID-19) - AHIP
Urlhttps://www.ahip.org/health-insurance-providers-respond-to-coronavirus-covid-19/
DescriptionThe health and well-being of millions of Americans remains our highest priority. Health insurance providers are committed to help prevent the spread of COV
DateAug 27, 2021
Organic Position2
H1Issues
H2All Issues
All Research
All News
A | B | C | D | E | F | G | H | I | J | K | L | M | N | O | P | Q | R | S | T | U | V | W | X | Y | Z
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by AHIP
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H3Washington, DC
Las Vegas, NV
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by AHIP
by AHIP
by AHIP
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Issue Briefs Infographics Member Message Guides Sponsored Whitepapers All Research. Reports Gaming the System: How Big Pharma Drives Its Higher Revenues Through Patent... Reports Clinical Appropriateness Measures Collaborative Project Blog Posts Press Releases The Next Big Thing in Health Podcast AHIP SmartBriefs & Newsletters Letters, Testimony, & Comments All News. News Matt Eyles Honored Among Modern Healthcare’s 100 Most Influential People... News AHIP Joins Kidney Care Campaign to Support Access to Home Dialysis Online Learning Online Courses Professional Designations Continuing Education Credits Professional Development Executive Leadership Programs AHIP Career Center Corporate Partnerships Business Memberships Sponsorship Opportunities Advertise with AHIP Online Courses Login Event Calendar Conferences Webinars March 14 – 17, 2022 National Conference on Health Policy and Government Health Programs Washington, DC. June 21 – 23, 2022 AHIP 2022 Las Vegas, NV . Who We Are AHIP Leadership Board of Directors Our Member Organizations AHIP Speakers Bureau Membership Member Organization AHIP Direct Individual Membership AHIP Select Affiliate Organization Associate Affiliate Organization Careers at AHIP Committees Contact Us Corporate Partnerships search Health Insurance Providers Respond to Coronavirus (COVID-19) Blog Health Insurance Providers Respond To Coronavirus (COVID-19) posted by AHIP on August 27, 2021 share. f l i & The health and well-being of millions of Americans remains our highest priority. Our member health insurance providers are committed to help prevent the spread of COVID-19. We continue to take action to ensure that Americans have access to the prevention, testing, and treatment needed to handle the current situation. Health insurance providers are also focused on improving COVID-19 vaccine acceptance and access. Learn more about health insurance providers actions on COVID-19 vaccines here. Here are some ways our member health insurance providers are taking action: A | B | C | D | E | F | G | H | I | J | K | L | M | N | O | P | Q | R | S | T | U | V | W | X | Y | Z. A. Aetna Aetna, a CVS Health company, is waiving member cost-sharing related to the COVID-19 vaccination for Commercial and Medicaid members. For Medicare, CMS has indicated it will cover the full cost of the vaccine for all Medicare beneficiaries, including those in a Medicare Advantage plan, in 2020 and 2021. Additionally, Aetna is extending a number of cost-sharing waivers, including: Waiving member cost-sharing for inpatient admissions for treatment of COVID-19 or health complications associated with COVID-19 for Commercial insured and Medicare Advantage plan members, through January 31, 2021. Waiving member cost-sharing for covered in-network telemedicine visits for outpatient behavioral and mental health counseling services for Commercial insured plan members, through January 31, 2021. Waiving member cost-sharing for covered in-network telemedicine visits for medical and behavioral health services for Aetna Student Health plan members through January 31, 2021. Waiving member cost-sharing for in-network telemedicine visits for Medicare Advantage members for specialist visits, which includes mental and behavioral health providers, through January 31, 2021. Waiving Medicare Advantage member cost-sharing for all in-network primary care visits, whether done in-office and via telehealth, for any reason, through January 31, 2021. Aetna, a CVS Health company, has extended cost-share waivers for its fully insured members through December 31, 2020. The extensions include: Waiving member cost-sharing for inpatient admissions for treatment of COVID-19 or health complications associated with COVID-19 for Commercial and Medicare Advantage plan members, through December 31, 2020. Waiving member cost-sharing for covered in-network telemedicine visits for outpatient behavioral and mental health counseling services for Commercial plan members, through December 31, 2020. Waiving member cost-sharing for in-network telemedicine visits for Medicare Advantage members for specialist visits, which includes mental and behavioral health providers, through December 31, 2020. Waiving Medicare Advantage member cost-sharing for all in-network primary care visits, whether done in-office and via telehealth, for any reason, through December 31, 2020. Waiving early refill limits on 30-day prescription maintenance medications for all members with pharmacy benefits administered through CVS Caremark, through December 31, 2020. Aetna, a CVS Health company, will ship boxes of specially curated, over-the-counter items to all its Medicare Advantage members across the country. As the COVID-19 pandemic continues and flu season begins, these Caring for You kits contain several items to help support Medicare members with simple self-care at home. Kits include a thermometer, hand sanitizer and two Aetna-branded face masks, among other items. The Caring for You kits are a one-time liberalization of an Aetna Medicare Advantage member over-the-counter benefit. Kits will be sent to members who were enrolled on or before August 1, 2020. The kits began shipping last week and will continue throughout the fall. Aetna has launched a new initiative as part of the Aetna Maternity Program. Building on a long-standing commitment to connect expectant moms with care that meets their unique needs, this initiative is focused specifically on preventing preeclampsia. By leveraging data analytics, the Aetna Maternity Program identifies pregnant women with risk factors for developing the condition for individualized outreach and education. Women at high risk are sent a personalized prenatal care kit that contains educational materials along with an 81-mg bottle of low-dose aspirin, a low-cost intervention that may reduce the risk for developing the condition. Members receive an appointment reminder card encouraging them to speak with their pregnancy care provider about the potential benefits of low-dose aspirin and whether it is right for them. All pregnant members are also mailed information developed by the Society for Maternal-Fetal Medicine on preeclampsia and prevention steps. The COVID-19 pandemic has presented new challenges, as many expectant moms may be attending fewer in-person prenatal care visits. In turn, they may increase their risk of developing complications that go undetected. Texas Health Aetna and MAP Health Management have collaborated to expand telehealth support services for individuals and families struggling with substance abuse. All of the more than 110,000 people insured by Texas Health Aetna are eligible for the telephone-based service, which connects members in recovery with peer specialists who know the challenges of addiction deeply because they have faced them personally as well. The support specialists all have been trained and certified to help guide others through recovery. Aetna has launched Time for Care, a campaign that reinforces the importance of accessing primary health care. Throughout the COVID-19 pandemic, many Americans have appropriately focused on staying home to keep themselves and others healthy. Although this kind of physical distancing is still an essential component of preventing the spread of COVID-19, it is critical for people to continue prioritizing health care needs. Time for Care includes a national television ad, which launched July 15, along with a microsite, digital content, and Aetna member program components that address concerns for people with chronic health conditions, including diabetes, high blood pressure and heart disease, as well as specific health issues such as high-risk pregnancies due to preeclampsia. Aetna and Morning Consult initiated a national survey among 4,400 Americans to identify barriers to accessing care amid COVID-19. Key findings include: Nearly 60% of Americans said they have canceled or delayed a health care appointment due to concerns about exposure to COVID-19 since the crisis began Half of Americans have concerns the crisis has negatively affected their own health or the health of someone in their household Nearly 60% of people with chronic conditions are concerned the crisis has negatively affected their own health or the health of someone in their household 50% of pregnant mothers are not confident their primary care physicians have put the necessary measures in place to prevent the spread of COVID-19 Aetna, a CVS Health company, will waive out-of-pocket costs for in-network primary care and specialist telehealth visits for all Individual and Group Medicare Advantage plan members through September 30, 2020. Aetna is extending all member cost-sharing and co-pay waivers for inpatient admissions for treatment of COVID-19 or health complications associated with COVID-19. Additionally, given the escalating mental health crisis resulting from or amplified by the pandemic, Aetna is extending all member cost-sharing waivers for in-network telemedicine visits for outpatient behavioral and mental health counseling services. These actions, which were scheduled to expire on June 1, 2020, have been extended through September 30, 2020. Aetna will continue working with self-funded plan sponsors to provide options. Aetna is also taking additional steps to eliminate out-of-pocket costs for primary care services for Medicare Advantage members. Effective from May 13, 2020 through September 30, 2020, Aetna is waiving member out-of-pocket costs for all in-network primary care visits, whether done in-office and via telehealth, for any reason, and encourages members to continue seeking essential preventive and primary care during the pandemic. Aetna has also extended the following actions, which were scheduled to expire on May 15, 2020, through September 30, 2020: Waiving early refill limits on 30-day prescription maintenance medications for all members with pharmacy benefits administered through CVS Caremark. Continuing to encourage all members of Commercial, Medicare and Medicaid plans to take advantage of plan benefits for 90-day maintenance medication prescriptions. The Aetna Foundation is donating $500,000 to the Americares COVID-19 Mental Health and Psychosocial Support project to help frontline health care workers, particularly those who serve low-income populations, improve their mental health awareness, knowledge and resiliency, and understand the mental health concerns impacting their patients. The Aetna Foundation is also making a $300,000 grant to the Crisis Text Line, which provides 24/7 confidential direct mental health support for those on the frontlines, including health care workers dealing with the stress, anxiety, fear, depression and/or isolation associated with COVID-19. Aetna, a CVS Health company, is streamlining its provider credentialing process so there can be more health care professionals caring for patients. Aetna is also paying the amount of the cost-sharing the member would have ordinarily paid related to COVID-19 testing or inpatient treatment so there is no financial impact on the provider. Additionally, Aetna is reimbursing all providers for telemedicine at the same rate as in-person visits for applicable telehealth codes, including for mental health care services. Aetna is also waiving member cost-sharing for inpatient admissions at all in-network and out-of-network facilities for treatment of COVID-19 or health complications associated with COVID-19. This policy applies to all Aetna Individual and Group Medicare Advantage members and is effective March 25, 2020 for any such admission through June 1, 2020. Aetna is also offering its Resources For Living®, its employee assistance program, to individuals and organizations who have been impacted by COVID-19, whether or not they have RFL included as part of their benefits. Aetna is working closely with partner hospitals to help transfer and discharge members with issues unrelated to COVID-19 from hospitals to safe and clinically appropriate care settings where they can continue to have their needs addressed. This will help hospitals and emergency rooms make room for more patients, especially those suffering from 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. Aetna will waive co-pays for all diagnostic testing related to COVID-19, according to CVS Health. That includes all member costs associated with diagnostic testing for Commercial, Medicare, and Medicaid lines of business. Self-insured plan sponsors will be able to opt-out of the program at their discretion. Aetna is also offering zero co-pay telemedicine visits for any reason, and it is extending its Medicare Advantage virtual evaluation and monitoring visit benefit to all fully insured members. People diagnosed with COVID-19 will receive a care package. CVS Health is also offering several programs to help people address associated anxiety and stress. AFLAC AFLAC is making a $1 million donation to Crisis Text Line, a global, not-for-profit organization that specializes in mental health intervention. Crisis Text Line provides free, 24/7, confidential support to people in crisis via SMS texting. Aflac’s donation will help fund the organization’s new campaign, For the Frontlines, aimed at helping individuals battling the COVID-19 crisis in the U.S. AFLAC has made a $5 million donation to two organizations that are providing assistance for health care workers on the front lines of the COVID-19 pandemic. AFLAC is donating $2 million to the Global Center for Medical Innovation (GCMI), a comprehensive innovation center using innovative 3D printing to help support medical device shortages, particularly as it relates to ventilators and protective masks.  GCMI works in collaboration with Children’s Healthcare of Atlanta Pediatric Technology Center. The additional $3 million is going to Direct Relief, a humanitarian aid organization providing personal protective equipment (PPE) and essential medical items to health workers responding to the coronavirus. Direct Relief is active in all 50 states. Alignment Healthcare Alignment Healthcare has launched two signature programs to address critical medical and social challenges Americans are now facing. The first is the AVA™ Personalized COVID-19 Risk Assessment tool, which provides personalized results and is now available to the public at www.alignmenthealthcare.com. The other is a crisis meal delivery program, providing two weeks of meals to members who cannot otherwise access food. Alignment is also waiving Alignment Health Plan member cost-sharing (including, but not limited to, copays, deductibles or coinsurance) to zero for medically necessary screening and testing for COVID-19. Members may receive medically necessary services from any available Medicare-certified provider or facility without prior authorization from their medical group or Alignment Health Plan. Alignment is making sure plan benefits are available to its members from their homes such as mail-order delivery of prescription drugs. Members with a monthly over-the-counter allowance can order their items for mail delivery by phone or online. Alignment expanded access to certain telehealth services so members can connect with a doctor by phone or video in the safety and comfort of their own home. Additionally, Alignment offers a variety of at-home video workouts through Peerfit Move at no extra cost to its Alignment Health Plan members. Additional resources and information are available for members at www.alignmenthealthplan.com. AllWays Health Partners AllWays Health Partners is removing cost-sharing (copayments, deductibles, or coinsurance) for testing and copayments for treatment at in-network facilities; ensuring access to out-of-network providers for the initial COVID-19 test or treatment when no in-network providers are available; and removing all cost-sharing for telemedicine services, including virtual visits with primary care providers and specialists, and through Partners HealthCare On Demand, to enable members to seek COVID-19-related care without the need to go to medical offices. AlohaCare AlohaCare will fully cover medically-necessary diagnostic tests for COVID-19, according to the Centers for Disease Control and Prevention (CDC) guidelines. Prior authorization is not needed for diagnostic tests and covered services that are medically-necessary and follow COVID-19 CDC guidelines. AlohaCare is donating $150,000 to local non-profit organizations that are helping at-risk families and individuals impacted by the COVID-19 pandemic. The donation includes monetary contributions to food banks across the state; 28,800 KN95 masks for health care workers at community health centers; and a grant for a new online platform to help identify areas of need in Hawaii. AmeriHealth Caritas AmeriHealth Caritas will cover and waive cost-sharing for testing and in-network, inpatient, acute care treatment of COVID-19. AmeriHealth Caritas has also expanded access to telehealth services by video and phone. In several markets, to aid in the enhancement of telemedicine visits, AmeriHealth Caritas plans are also providing blood pressure monitors to persons diagnosed with hypertension, including expectant mothers. AmeriHealth Caritas is focused on improving the health and wellbeing of underserved communities at this time of crisis and is conducting “well-check” outreach to vulnerable members and helping connect them to their providers and community resources. In select communities, AmeriHealth Cartas has also expanded the delivery of medically tailored and ready-to-eat meals and groceries to the homes of members who have been confirmed to have COVID-19 and to members at highest risk for COVID-19 complications. AmeriHealth Caritas Louisiana AmeriHealth Caritas Louisiana is helping its members stay healthy while gyms are operating at reduced capacity by providing them with a Fitbit at no cost. By giving enrollees the devices, AmeriHealth Caritas Louisiana aims to help members at particular health risk from lack of exercise continue efforts to improve their health and wellness. AmeriHealth New Jersey  AmeriHealth New Jersey has launched a collaboration with Quartet  to address members’ behavioral health needs. The collaboration with Quartet will help AmeriHealth New Jersey focus on behavioral health needs magnified by the COVID-19 crisis and will help providers easily refer their patients for care, and help patients easily access appropriate care for their needs. AmeriHealth New Jersey has extended the cost-sharing waiver for in-network, acute in-patient COVID-19 treatment through March 31, 2021. AmeriHealth New Jersey is also waiving prior authorizations for acute inpatient admissions for any COVID-19 diagnosis from the emergency room through March 31, 2021. The waiver applies to commercial group and individual members. AmeriHealth New Jersey will waive members’ cost for in-network, acute in-patient treatment of COVID-19 through December 31, 2020. Cost sharing will be applied to post-acute care (e.g. skilled nursing, rehabilitation and long-term acute care facilities), outpatient treatment, prescription drugs, ambulance transportation to a post-acute setting, and out of network care. Pre-authorization is currently not required for acute, in-network, in-patient admissions from the emergency department. Pre-authorization is also being waived for transfers from an in-patient facility to long-term ambulatory care, rehabilitation, or skilled nursing facilities, and transportation between facilities. These temporary changes to our pre-authorization policy are in effect until July 31, 2020. Facilities are still required to notify AmeriHealth New Jersey. AmeriHealth New Jersey is expanding its temporary suspension of prior authorization for acute in-network from the emergency department to include all diagnoses (including COVID-19) and for in-network transfers and transportation between facilities. The prior authorization expansion will stay in place until June 4. AmeriHealth New Jersey is also offering members free access to Stop, Breathe & Think, an emotional wellness app. The free access will run until June 14. AmeriHealth New Jersey will waive cost-sharing for COVID-19 testing performed at a hospital or approved laboratory. This includes members in fully insured, employer-sponsored plans and the individual  and family plans available through the Affordable Care Act. Self-funded plans will be able to opt-out of the program. The company is also waiving cost-sharing for telemedicine visits available through members’ plans for the next 90 days. Anthem The Anthem Blue Cross Foundation awarded $465,000 to the Foundation for California Community Colleges to help address students’ abilities to meet their basic needs amid lost wages and the transition to virtual learning as a result of the COVID-19 crisis. Grant funds will be used by community colleges to distribute emergency financial aid to respiratory therapy and nursing students, as well as to expand FoundationCCC’s CalFresh Outreach Project and Fresh Success Employment and Training programs. Anthem Blue Cross and Blue Shield in Connecticut and the Anthem Blue Cross and Blue Shield Foundation are committing volunteer hours and donating nearly $90,000 to address hunger in local Connecticut communities. These activities are part of a $1.4 million total commitment Anthem has made in Connecticut so far this year, with more activity to come. Nearly 12 percent of people in Connecticut experience food insecurity, which includes 16 percent of children in Connecticut, and these numbers are likely on the rise given the impact of challenges COVID-19 has introduced. Anthem’s commitment will support a national partnership with Feeding America, as well as sponsorships with local organizations including the Connecticut Food Bank, Foodshare and Massaro Community Farm. MATTER, Anthem, Inc., and Blue Cross and Blue Shield of Illinois have launched the Pandemic Response Innovation Challenge. The challenge is a global call to innovators to develop creative solutions aimed at supporting the health care needs of those impacted by the COVID-19 pandemic. The challenge is part of Anthem and BCBSIL’s broader efforts to help reduce the strain on the health care system today, while preparing consumers and health care providers for a stronger post-COVID-19 world. Innovators can submit their solutions to either of two tracks. The first track is seeking solutions that empower people to address their behavioral health needs, such as depression, anxiety, and substance abuse, which can be exacerbated in times of uncertainty. The second track focuses on leveraging data from Anthem’s Digital Data Sandbox, one of the largest certified de-identified health data sets in the U.S., to improve patient care and outcomes during COVID-19 and in the future. The Anthem Blue Cross and Blue Shield Foundation has granted $100,000 to Community Shelter Board, which drives strategy, accountability, collaboration, and resources to achieve the best outcomes for people facing homelessness in Columbus and Franklin County, Ohio. The grant will accelerate CSB’s rapid re-housing efforts in Central Ohio and is part of a $2 million overall commitment from Anthem Foundation to support Ohio communities through COVID-19. Rapid rehousing has emerged as an effective solution to homelessness in cities across the country. Anthem Blue Cross and Blue Shield of Ohio is giving $100,000 to the Ohio Association of Community Health Centers, who will disperse the funds to member health centers across the state. Community health centers have been at the forefront of the COVID-19 pandemic, providing healthcare to medically undeserved populations in rural and urban settings. The health centers will use the funding to support COVID-19 testing in ways as varied as the regions and populations they serve. Funds will be used to secure items such as portable generators, signage, personal protective equipment, materials for mobile testing, test kits, tents, portable hand washing stations, automated temperature monitoring systems and much more. Anthem has launched a suite of digital tools that provide in-depth, trusted, and aggregated information for multiple stakeholders to use in making informed, data-driven decisions during the COVID-19 crisis. Led by Anthem, Inc.’s new C19 Explorer and C19 Navigator, these decision support tools are also designed to assist public health officials and business leaders as they plan for re-opening and returning to the office. Anthem is providing $2.5 billion of financial assistance to ease the burden COVID-19 is placing on affiliated health plans’ consumers and employer customers, care providers and nonprofit partners across the country. Anthem affiliated health plans are supporting customers by providing a one-month premium credit to members enrolled in select Individual plans and fully insured employer customers ranging from 10 to 15%. In addition, individuals in stand-alone and group dental plans will also receive a 50% credit. Consumers and employer customers will receive the premium credit in July. Anthem’s health plan affiliates are also working with some employer groups on special payment arrangements as a bridge to continue to provide insurance for their employees during this difficult time. Anthem’s health plan affiliates will continue to waive cost sharing for in-network COVID-19 related treatment for members enrolled in fully insured employer plans, Individual plans and Medicare Advantage plans through December 31, 2020. Self-insured employers who previously chose to adopt cost sharing waivers for treatment can choose to extend the waivers. Until September 30, 2020, Anthem’s health plan affiliates will continue to allow expanded telehealth coverage, including some physical, occupational and speech therapy, and will continue to waive cost shares for in-network telehealth visits, including telephonic visits, for medical and mental health or substance abuse disorders, for fully insured employer plans, Individual plans, Medicare Advantage plans, group retiree plans and Medicaid plans, where permissible. This will also include waiving cost shares when utilizing TeleDentists®, an in-network provider with Anthem offering online and mobile-app enabled teledentistry solutions for dental care. Anthem and its affiliated health plans are working with state partners to accelerate funds to care providers who treat the most vulnerable, particularly those with chronic conditions, behavioral health, and other special healthcare needs. Anthem’s health plan affiliates are also reaching out to Medicaid beneficiaries to facilitate connections with state and social services, helping newly eligible and at risk members enroll in the Supplemental Nutrition Assistance Program (SNAP) and Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). Health plan affiliates are directly contacting hundreds of thousands of Medicare Advantage and Medicaid consumers to make sure they have necessary medications on hand, their nutritional needs are being met and critical health needs are addressed during this time of social distancing and isolation. Anthem will continue to make a difference in improving health across the nation, including addressing health disparities facing minority and underserved communities disproportionally impacted by this pandemic and other health inequities. Anthem is focused on empowering individuals to understand and take action on the health risks that affect them, including racial and ethnic risk factors, social drivers of health and pre-existing conditions. Through efforts to collaborate with care providers, health advocates and community leaders Anthem is working to address gaps in care and provide data and resources to effect positive health outcomes for members and communities at large. Anthem is providing funding to support care providers’ telehealth capabilities, quality-based programs and PPE, and extending additional funding to provide critical support to targeted independent primary care physician organizations and multispecialty groups who are facing financial pressure during this crisis. Additionally, Anthem is actively working with care providers to accelerate claims processing for outstanding accounts receivables, resolving claims where possible and appropriate, as well as accelerating payments to support state specific Medicaid programs. Anthem will provide in-network dental providers a PPE Credit of $10 per patient, per visit, from June 15th through the end of August. Anthem is simplifying access to care by temporarily suspending prior authorization requirements for respiratory services and medical equipment critical to COVID-19 treatment including Durable Medical Equipment such as oxygen supplies, respiratory devices, continuous positive airway pressure, or CPAP devices, non-invasive ventilators, and multi-function ventilators. Anthem’s health plan affiliates are temporarily extending prior authorizations on elective inpatient and outpatient procedures, issued before May 30, 2020. This will allow more flexibility in scheduling these procedures. Anthem launched [email protected], a teledentistry and at-home orthodontia program. The services are part of Anthem’s continuing commitment to providing access to affordable services that meet a person’s whole health needs, while also providing safe, remote-care during this pandemic. The service integrates seamlessly with orthodontic network provider options and includes discounts of up to $200 off retail pricing. Anthem has launched a virtual dental care program through a partnership with The TeleDentist, an in-network provider of virtual dental services from board-licensed dentists. The partnership provides consumers with timely access to dental care that is available 24/7, 365 days a year in the event of an emergency, with virtual exams covered at 100% with no deductibles, copays, paperwork, or claims to file through June 30. The Anthem Foundation has distributed more than $200,000 to local organizations across Georgia that are responding to the COVID-19 crisis. These contributions are part of a nearly $2 million commitment recently made by the Foundation as Anthem continues to support relief efforts for communities and families as they respond to the many emerging challenges associated with this public health emergency. The Foundation has also made $260,000 in grants to Ohio-based Boys & Girls Clubs, Feeding America organizations and the Children’s Hunger Alliance to address food insecurity in the wake of COVID-19. Anthem has donated $200,000 to United Way and Feeding America, two organizations that are crucial frontline responders to the coronavirus pandemic in California. Funds will be cascaded to food banks, shelters and other resource centers across the state that are helping struggling individuals and families access necessities amid the pandemic. Anthem Blue Cross’s $100,000 contribution to the Feeding America COVID -19 Response Fund is helping Feeding America’s network of 17 food banks throughout California to secure resources, meet increased demand and implement extra social distancing precautions as they continue to serve the most vulnerable members of the community. This includes families dealing with school closures, those experiencing job disruptions, the elderly and disabled, people with low-incomes, those struggling with homelessness and other challenges. Anthem Blue Cross’s $100,000 contribution to the United Way’s COVID-19 Response Fund is supporting California’s low income and vulnerable populations by ensuring families stay fed and housed amid the economic shutdown. Contributions are being used to provide food assistance, cash to pay for necessities such as rent and utilities, and even broadband access to help school children continue their education from home. Funds are also supporting the United Way’s 2-1-1 programs, which connect people with needed resources and supports. Additionally, the fund is helping many of the state’s agricultural workers, many of whom are undocumented and not eligible for federal financial relief or other resources to support their families. Anthem’s affiliated health plans and Beacon Health Options have joined with Psych Hub, mental health advocates and other national health insurers to develop a free digital resource site to help individuals and care providers address behavioral health needs resulting from the COVID-19 pandemic. This COVID-19 Mental Health Resource Hub provides a range of resources designed to help people, their families and care providers cope with pandemic-related stress brought on by social isolation, job loss and other challenges. Anthem has also partnered with Aunt Bertha, a leading social care network, which helps connect individuals and families to free and reduced-cost social services in their communities. These programs include COVID-19-specific assistance, such as food delivery and help paying for bills. All consumers can access the more than 350,000 programs, which are available in every zip code across the U.S. Anthem is waiving cost sharing payments for COVID-19 treatment. The expansion covers the waiver of cost share for COVID-19 treatment received through May 31, 2020. Anthem is contributing $1 million to the Rapid Response Loan Fund, which was established by the Indy Chamber. The loan fund is intended to help the roughly 43,000 small business in central Indiana. Anthem has launched the Anthem Medical Associate Volunteer Program, which is designed to allow associates with professional medical training volunteer and assist in their local community’s response to COVID-19. In addition, Anthem suspended prior authorization requirements for patient transfers as well as for the use of medical equipment critical to COVID-19 treatment. On March 17, Anthem also announced new resources for its members. First, it is working to accelerate the availability of a Coronavirus Assessment tool on the Sydney Care mobile app, which members can download at no cost. Second, Anthem’s affiliated plans will continue to waive copays, coinsurance and deductibles for diagnostic tests for COVID-19, and extending this to include waiver of copays, coinsurance, and deductibles for visits associated with in-network COVID-19 testing, whether the care is received in a doctor’s office, urgent care center or emergency department. Third, Anthem is relaxing early prescription refill limits for members who wish to receive a 30-day supply of most maintenance medications, where permissible. Fourth, for 90 days, Anthem plans will waive any cost sharing for telehealth visits, including visits for mental health care, for fully insured employer plans, individual plans, Medicare plans, and Medicaid plans, where permissible. This includes visits using Anthem’s telemedicine service, as well as care received from other telehealth providers delivering virtual care. The Anthem Foundation continues to support the Red Cross, Direct Relief, Americares, and Feeding America, and has committed $50 million for COVID-19 response and recovery efforts to help areas of greatest need, including care provider safety, food insecurity, and mental and behavioral health resources. The company is also matching employee donations to the Anthem Foundation’s program. Anthem is increasing physician availability through its telemedicine service, LiveHealth Online (LHO), including encouraging in-network doctors to join the platform, given the surge in demand. LHO is a safe and helpful way to use Anthem benefits to see a doctor and receive health guidance related to COVID-19, without leaving home or work. Anthem will cover the cost of coronavirus testing with no out-of-pocket cost. Anthem also confirms that prior authorization is not required for diagnostic services related to COVID-19 testing. The company recommends using telehealth when possible to help prevent the spread of a virus. It is also encouraging its members to talk to their doctor about whether it is appropriate for them to change from a 30-day supply of their regular medications to a 90-day supply. Arkansas Blue Cross and Blue Shield and Health Advantage Arkansas Blue Cross and Blue Shield is waiving cost-sharing for medical services for fully insured members whose primary diagnosis is COVID-19 until the public health emergency declaration is terminated by the federal government. Arkansas Blue Cross and Blue Shield is also waiving cost-sharing for virtual health visits for fully insured members through September 30, 2021. Arkansas Blue Cross and Blue Shield is waiving cost-sharing for medical services for fully insured members whose primary diagnosis is COVID-19 through April 21, 2021. Arkansas Blue Cross and Blue Shield has expanded COVID-19 related benefits for fully insured and individual health plans through January 21, 2021. The extension includes: Covering COVID-19 diagnostic tests at no cost to members, if ordered by a health care provider Waiving cost-sharing payments for medical services for members whose primary diagnosis is COVID-19 Enhancing access to maintenance prescription medication and extending prior authorizations on many medications for 90-day supplies The voluntary, expanded COVID-19-related benefits announced for certain Arkansas Blue Cross and Blue Shield and Health Advantage fully insured health plans and individual policies will be extended to align with the federally mandated COVID-19 coverage provisions as specified in the FFCRA (Families First Coronavirus Response Act) and CARES (Coronavirus Aid, Relief and Economic Security) Act. The federal mandate currently runs through October 23, 2020. Temporary benefit changes include: Covering COVID-19 diagnostic tests ordered by healthcare providers at no cost to members. Arkansas Blue Cross and Health Advantage will cover, with no cost share to the member, the diagnostic testing services that meet primary coverage criteria for COVID-19 as defined by the CDC and ordered by the member’s healthcare provider. Currently, the only recommended screening test for COVID-19 is the RT-PCR Test, which involves swabbing the nose and/or mouth. Arkansas Blue Cross and Health Advantage will also ensure patient testing is done in close coordination with federal, state and public health authorities. Waiving the cost-sharing for medical services for fully insured members whose primary diagnosis is COVID-19.This includes COVID-19-specific visits to an in-network medical clinic, urgent care center and/or emergency room, and inpatient treatment where COVID-19 is the primary diagnosis. Temporarily enhancing access to maintenance prescription medications and extending prior authorizations on many medications for 90-day supplies. Arkansas Blue Cross and Health Advantage will also work to implement prescription drug formulary flexibility to respond to medication shortages or access issues. Encouraging members to access virtual health and nurse/provider hotlines. Given the nature of the COVID-19 outbreak, seeking in-person medical care may lead to further spreading of the virus. Usual member costs (copays, coinsurance and deductibles) are temporarily being waived for telemedicine visits with in-network physicians (M.D.s, D.O.s), advance practice nurse practitioners and physician assistants. This includes wellness/preventative visits. To schedule a telehealth visit with a physician, members should contact the physician office to see if she/he is seeing patients via telemedicine. Members who do not have a physician may visit arkansasbluecross.com and select Find Care to choose a physician. Similarly, Arkansas Blue Cross and Health Advantage has added coverage (without copays, deductibles and coinsurance) for teledentistry. Arkansas BlueCross BlueShield has extended its temporary COVID-19 benefits until at least August 17. The benefits include waiving member cost sharing payments for COVID-19 treatment, covering diagnostic COVID-19 testing at no cost to members, and waiving out-of-pocket costs for telemedicine counseling from in-network behavioral health professionals. Arkansas Blue Cross and Blue Shield and Health Advantage has extended the waiver on telehealth out-of-pocket costs through July 25, 2020. The waiver for cost-sharing payments for medical services for fully insured members whose primary diagnosis is COVID-19 has also been extended to July 25, 2020. Arkansas Blue Cross and Blue Shield and Health Advantage are covering any illness related to the coronavirus that results in a need for standard covered medical treatment. There will be no prior authorizations for COVID-19 diagnostic tests and for covered services that meet primary coverage criteria and are consistent with CDC guidance. They will cover COVID-19 diagnostic testing and testing services at no cost to members. They are waiving early medication refill limits on 30-day prescription maintenance medications and encouraging members to use their 90-day mail-order benefit. Arkansas Blue Cross will also ensure formulary flexibility if there are shortages or access issues. Members are encouraged to use virtual health and nurse/provider hotlines. Arkansas Blue Cross and Blue Shield and Health Advantage are waiving costs their fully insured members would normally have to pay for telehealth services related to physical and/or behavioral health when received from an in-network provider. The waivers will be in place through at least May 15, 2020. The Blue & You Foundation for a Healthier Arkansas is donating $500,000 in support of immediate needs around food insecurity in the state and opening the “Rapid-Response COVID Relief” grant process to award up to $1.7 million in grants supporting nonprofit organizations that have experienced the consequences of COVID-19. The Rapid-Response COVID Relief Grants program is designed to help eligible organizations lessen the impact of the Covid-19 virus on the individuals, families, and communities they serve. Aspire Health Plan Aspire Health Plan is waiving all co-pays related to COVID-19 testing. Aspire is also making its telehealth benefit available for no copay. Avera Health Plans Avera Health Plans is extending a waiver of members’ cost-share related to the treatment of COVID-19 when seeking care from an in-network provider through April 20, 2021. Avera Health Plans will waive members’ cost-share related to the treatment of COVID-19 (co-pay, coinsurance and deductible) when seeking care from an in-network provider through January 21, 2021. Avera Health Plans has extended its waiver of member cost-share payments related to COVID-19 treatment when seeking care from an in-network provider through October 23, 2020. Avera Health Plans has extended its waiver of member cost-share payments related to COVID-19 treatment when seeking care from an in-network provider through Sept. 30, 2020. Avera Health Plans is waiving the member cost for all applicable telehealth services through December 31, 2020. Members receiving applicable telehealth services from participating providers during this period will have their normal cost-share waived regardless if the telehealth visit is directly related to COVID-19 or not. Avera Health Plans will waive members’ cost-share related to the treatment of COVID-19 (co-pay, coinsurance and deductible) when seeking care from an in-network provider through June 30, 2020. Avera Health Plans is waiving member costs for all telehealth benefits through June 14. Avera is also waiving early refill limits on maintenance drugs to allow access to an additional 30-day supply. AvMed AvMed is waiving out-of-pocket costs for all COVID-19 treatment until May 31, 2021. AvMed will also administer a waiver for self-funded group health plans at their request. The treatments covered at no out-of-pocket cost for COVID-19 are those covered under Medicare or other applicable state regulations. AvMed is waiving out-of-pocket costs for all COVID-19 treatment until February 28, 2021. AvMed is extending COVID-19 benefits and coverage, beyond testing and medication requirements, to the end of the year. Benefits that will be extended through December 31, 2020 include zero cost diagnostic testing, zero cost treatment, zero cost virtual visits, and the waiving of specialist referral requirements related to COVID-19 testing and treatment. AvMed is extending its waivers of out-of-pocket costs for all COVID-19 treatment until Sept. 30, 2020. AvMed will also administer a waiver for self-funded group health plans at their request. The treatments covered at no out-of-pocket cost for COVID-19 are those covered under Medicare or other applicable state regulations. AvMed is also offering zero copays and cost share for any and all types of virtual visits until Sept. 30, 2020. Additionally, where applicable, copays and cost share will be waived for telehealth visits, as well as telephone visits, members may need from their traditional healthcare providers. AvMed is extending COVID-19 benefits and coverage until July 31, 2020. That includes zero-cost diagnostic testing, zero-cost treatment, and zero-cost virtual visits AvMed is waiving out-of-pocket costs for COVID-19 treatments for its fully-insured commercial and Medicare Advantage members through May 31, 2020. In addition, AvMed will continue to provide its members with zero-dollar diagnostic testing, zero-dollar virtual visits, including behavioral health, and waiver of specialist referral requirements. AvMed will cover diagnostic testing for COVID-19 at no cost-sharing if it is determined that test is needed. AvMed, in partnership with CVS Health, will also be waiving early refill limits on 30-day prescriptions for maintenance medications and providing home delivery of all prescription medications free of charge. It is also encouraging the use of telehealth services. Back to top B. Blue Cross Blue Shield Association Blue Cross Blue Shield Association’s network of 35 independent and locally operated Blue Cross and Blue Shield companies and the Blue Cross and Blue Shield Federal Employee Program® have committed more than $7 billion to help the nation address the COVID-19 outbreak by providing premium relief, enhancing access to telehealth and investing to support people in need.   Blue Shield of California Blue Shield of California is waiving cost-sharing payments for COVID-19 treatment through February 28, 2021. Blue Shield of California is waiving out-of-pocket costs for COVID-19 treatment through January 31, 2021. Blue Shield of California also said COVID-19 vaccines will provided at no out-of-pocket cost to members. Blue Shield of California Promise Health Plan is providing $950,000 to two nonprofit organizations that aim to improve health outcomes for children in Compton and Antelope Valley by developing innovative programs that support behavioral health and well-being. Blue Shield Promise is providing $900,000 to ScaleLA Foundation to fund a two-year initiative to destigmatize challenges associated with behavioral health; help school officials, families and teens identify key indicators to better support youth mental health; and improve care coordination and service delivery for families affected by trauma. Blue Shield Promise is providing an additional $50,000 to the Center for Youth Wellness (CYW) to work with Blue Shield Promise clinics in Lancaster and Palmdale. CYW is part of a national effort to change pediatric medicine and transform the way society responds to kids with significant adverse childhood experiences and stress. Blue Shield of California Foundation has made a grant to a new initiative by the Public Health Institute (PHI) to fight coronavirus in at-risk communities. The effort, called Together Toward Health, is launching with $20 million, which includes a contribution from Blue Shield’s foundation. The PHI will coordinate Together Toward Health, which will connect with community based organizations to expand workforce development opportunities for Californians most impacted by COVID-19, and create and amplify public outreach efforts to reduce its spread. Blue Shield of California is providing more than $50 million in premium credits for its customers facing economic hardship caused by the COVID-19 pandemic. Blue Shield is applying a one-time premium credit to bills issued for the month of November or December for its fully insured employer customers. Premium credits will also be applied to November bills for people enrolled in Blue Shield dental and/or vision plans, plus those enrolled in Blue Shield’s Medicare Supplement plans. The credit, which will vary by customer, will appear on their November or December billing statement. Blue Shield of California Promise Health Plan and L.A. Care have begun reopening their jointly-operated Community Resource Centers that were closed earlier due to the COVID-19 pandemic. Select services are available by appointment only in a safe environment. The four centers – located in Pomona, Lynwood, East L.A. and Palmdale –will have staff on-site to help with member services support, enrollment in local and state assistance programs and support finding a range of resources such as food and housing assistance. The centers also have a newly added feature: free Wi-Fi for anyone needing telehealth services. Given the significant increase in demand for telehealth appointments during the pandemic – and the reality that many low-income individuals lack robust mobile data plans – L.A. Care and Blue Shield Promise are enhancing community members’ access to high-quality health care through telehealth hubs at each resource center location. Blue Shield of California announced a new “Primary Care Reimagined” program that provides in-network physician groups access to an array of latest technologies to enhance their delivery of care, and new reimbursement models that provide more predictable cash flow for the physician practices. The program was spurred by the COVID-19 crisis that has placed significant challenges on physician practices while the health care delivery system is experiencing changes including expanded telehealth and virtual care. The program is initially being offered to select physician groups throughout California. The reimbursement model includes set monthly payments per member as well as additional financial incentive payments for achieving quality outcomes and positive member experiences. The new services offered to participating physician practices will include shared decision-making, virtual care, community health advocates, real-time claims payment initiative, and practice-level consulting services. These services are part of Blue Shield’s Health Reimagined initiative that seeks to transform the healthcare system with innovative ideas and technologies by working with medical providers, employers and community leaders. Blue Shield of California has announced the “Neighborhood Health Dashboard,” an online tool to advance public health services, increase transparency around community health, and help address health disparities in California. The Neighborhood Health Dashboard uses data intelligence from dozens of sources to create a comprehensive picture of a community’s health including: health outcomes, preventative health care, utilization and access, health behaviors, social risk factors, and environment and economic health conditions. Most recently, the platform was used to produce California’s Vulnerability Index, which focuses on social and economic vulnerability of communities to start conversations about equitably prioritizing the allocation of resources for COVID-19 recovery efforts. In addition to the health impact of the COVID-19 crisis on different communities, the report also considers which areas are likely to have a more difficult time recovering from the coronavirus-related shutdowns, job reductions and layoffs. Blue Shield of California’s  BlueSky Initiative, in partnership with DoSomething.org – the largest organization for young people and social change – has launched a first-of-its-kind digital mental health guide for youth, created for students by students. The guide provides young people with peer-to-peer tips on self-care, managing stress from digital learning, and supporting the mental health of fellow classmates. With COVID-19 disrupting schooling for more than 55 million students across the United States, DoSomething.org, and the BlueSky initiative called on their members to submit advice to help students during these difficult times. Blue Shield of California is teaming up with artists in nine counties to create original artwork as part of an education and awareness campaign that offers support and encouragement during the COVID-19 crisis to members who face health-related challenges. More than 200,000 Blue Shield members, ages 35 to 64, will receive customized-art postcards over the next two weeks that encourage them to build healthy habits, especially during the COVID-19 crisis. For example, taking advantage of the nonprofit health plan’s Wellvolution program to better manage stress, treat existing conditions, and improve mental and physical health. Wellvolution offers members more than 50 digitally driven health programs to choose from, which address specific health goals, conditions and health risks, and the program is available to most Blue Shield members at no additional cost. This outreach campaign is the latest example of Blue Shield’s efforts to help members prioritize their health from the convenience and safety of their homes to prevent, treat or even reverse chronic conditions. Blue Shield of California will waive copays, coinsurance, and deductibles for COVID-19 treatments received between March 1 – December 31, 2020. Blue Shield will also continue to cover costs for virtual care (medical and behavioral) services provided by Teladoc Health through December 31, 2020. Blue Shield of California is extending its commitment to waive co-payments, coinsurance, and deductibles for treatment for COVID-19. It will also continue to cover costs for virtual care (medical and behavioral) services provided by Teladoc Health through Sept. 30, 2020. The plan will also continue to waive cost-sharing for COVID-19 screening and testing in accordance with applicable state and federal law. Blue Shield of California has provided $300,000 in grants to nonprofit organizations providing mental health supports in San Diego and Alameda counties. This builds on the company’s multi-year, $10 million investment in youth mental health. The $300,000 will be divided into 18 different grants – nine each in Alameda and San Diego counties. Blue Shield of California has teamed up with DoSomething.org, the largest organization for young people and social change in the nation, to develop a first-of-its-kind mental health guide to help youth cope with stress and anxiety during the COVID-19 crisis. The three-month digital campaign, will include text, email, and social media activations to DoSomething.org’s millions of members, encouraging young people across the U.S. to share their tips to help combat anxiety, especially during COVID-19.The idea is to reduce stigma, raise awareness, and encourage youth to seek help. The campaign is in addition to the resources developed and offered by Blue Shield of California’s BlueSky initiative, a multi-year effort to enhance awareness, advocacy, and access to mental health support for middle and high school students in California and beyond. Blue Shield of California is providing $100,000 support to MedShare, a San Francisco Bay area nonprofit organization that donates personal protective equipment (PPE) supplies to nonprofit community healthcare providers. Blue Shield of California is offering a digital tool at no additional cost for its nearly 350 in-network hospitals to help them triage the influx of patients seeking advice on coronavirus or other medical care via their websites. Blue Shield is also donating $500,000 to the Oakland COVID-19 Relief Fund to support, among its projects, pop-up coronavirus testing sites organized by Brown & Toland Physicians that will prioritize medical providers and first responders. Blue Shield of California Promise Health Plan, which serves Medi-Cal and Medicare beneficiaries, is giving $100,000 sponsorship funds to community health providers in Los Angeles and San Diego counties. Blue Shield of California is providing up to $200 million in direct support to health care providers and hospitals through financing guarantees, advance payments, and restructuring of contracts. Blue Shield is working with two financial institutions to help providers with guaranteed loans and to make advanced payments to them on anticipated healthcare costs. The plan is to offer favorable repayment terms to help providers get through the next six months. Blue Shield of California will cover members’ coinsurance, copayments and deductibles for COVID-19 medical treatments through May 31, 2020. Blue Shield of California will waive all cost-sharing and any prior approval for COVID-19 testing for fully insured commercial and Medi-Cal plans. 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 also will not require prior authorization for medically necessary emergency care. Blue Shield is working closely with self-funded plan sponsors to confirm coverage levels for their employees. Blue Shield is closely monitoring impact to prescription drug supply and will take immediate steps to ensure members have access to medications. It is encouraging use of telehealth services. Blue Shield of California also announced it will waive out-of-pocket costs for most members to use Teladoc Health’s virtual care service. Costs will be waived until May 31 in Individual & Family and employer-sponsored plans that offer Teladoc. Members enrolled in Blue Shield’s Trio, Tandem and Medicare Advantage plans, plus Blue Shield of California Promise Health Plan enrollees, already enjoy $0 out-of-pocket costs for Teladoc Health services. Blue Cross of Idaho Blue Cross of Idaho is waiving cost-sharing payments for COVID-19 treatment through 60 days after the end of the Health and Human Services COVID-19 Public Health Emergency. Blue Cross of Idaho members on Medicare Advantage, DSNP, and Idaho Medicaid Plus plans will continue to have their telehealth cost sharing waived through March 31, 2021, in order to support easier access to care during the COVID-19 crisis. Blue Cross of Idaho is also waiving member cost-sharing payments for COVID-19 treatment after a confirmed diagnosis through March 23, 2021. Blue Cross of Idaho is waiving member cost-sharing payments for COVID-19 treatment after a confirmed diagnosis through December 31, 2020. Blue Cross of Idaho is extending telehealth services for its members throughout the state until December 31, 2020. Members may continue to receive telehealth services via phone or video call from all in-network providers throughout Idaho. Additionally, Blue Cross of Idaho members can access MDLIVE, the company’s telehealth partner. MDLIVE provides a primary care platform via mobile device or computer for Blue Cross of Idaho members to access convenient, secure and cost-effective options for accessing preventive, chronic and other primary care services. Blue Cross of Idaho has processed more than 90,500 telehealth claims since expanding telehealth access on March 19, 2020. During the week of January 27-February 2, 2020, Blue Cross of Idaho processed 108 telehealth claims. That number increased to 10,718 telehealth claims between April 6-April 19, 2020 – 118 times more than the weekly average for the first 3 months of the year. Blue Cross of Idaho has created a program to allow independent providers, such as private-practice physician groups, an opportunity to receive advance payments to cover monetary shortfalls due to the COVID-19 pandemic. Blue Cross of Idaho will make advance payments to the provider once per month in April, May and June. The company will recover the interest-free payments during the fourth quarter of 2020. Blue Cross of Idaho is also waiving all member cost-sharing for treatment of COVID-19. Members will not pay anything out-of-pocket – including copays, deductibles or coinsurance – for testing for COVID-19, for the medical visits related to testing, or treatment of COVID-19. Waiving of cost-sharing for coverage of treatment for COVID-19 applies through June 30, 2020. Blue Cross of Idaho has waived all cost-sharing for doctor’s office and urgent care visits related to testing for COVID-19. This decision applies to individual and fully insured members on employer plans. Blue Cross of Idaho has also expanded access to MDLIVE, the company’s telehealth partner. The new telehealth benefits are being offered at no additional premium cost to those members. Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Illinois has opened an additional round of quick-release funding to support community-based organizations supporting five focus areas – access to care, hunger, shelter and behavioral health, and COVID-19 health education and vaccine access.  This grant cycle will again offer 75 grants of $20,000 and is open to prior recipients of BCBSIL’s COVID-19 Community Collaboration funding. However prior grantees are not guaranteed a second award. Blue Cross and Blue Shield of Illinois awarded $1.5 million to 75 organizations during the first round of the COVID-19 Community Collaboration Fund in May 2020. Blue Cross and Blue Shield of Illinois is waiving cost-sharing payments for in-network COVID-19 treatments through December 31, 2020. Blue Cross and Blue Shield of Illinois is also waiving cost-sharing payments for telehealth visits through December 31, 2020. Blue Cross and Blue Shield of Illinois is partnering with the provider community on additional programs aimed at improving health care outcomes in minority groups, increasing the diversity and cultural competency of the physician workforce and advancing awareness on implicit bias — the unconscious attitudes and stereotypes that can influence behavior. The COVID-19 crisis has shone a spotlight on the significant health disparities impacting BCBSIL members and communities across the state. This concerning trend led BCBSIL to develop the Health Equity Hospital Quality Incentive Pilot Program. The Program’s immediate objective is to support hospitals serving the highest concentrations of BCBSIL members in Illinois communities who are often most at risk of contracting COVID-19 and, in the long term, improving the quality of care by elevating a focus on health equity and reducing racial and ethnic disparities in care. Blue Cross and Blue Shield of Illinois is providing roughly $108 million in relief to fully insured employer customers in the form of a premium credit. Eligible customer will see the premium credits reflected in their November statement under a line item called COVID Relief Premium Credit. Blue Cross and Blue Shield of Illinois is waiving cost-sharing payments for COVID-19 treatment through October 23, 2020. The waiver applies to members in fully-insured group, individual, Medicare (excluding Part D), Medicare Supplement, or Medicaid health plans. MATTER, Anthem, Inc., and Blue Cross and Blue Shield of Illinois have launched the Pandemic Response Innovation Challenge. The challenge is a global call to innovators to develop creative solutions aimed at supporting the health care needs of those impacted by the COVID-19 pandemic. The challenge is part of Anthem and BCBSIL’s broader efforts to help reduce the strain on the health care system today, while preparing consumers and health care providers for a stronger post-COVID-19 world. Innovators can submit their solutions to either of two tracks. The first track is seeking solutions that empower people to address their behavioral health needs, such as depression, anxiety, and substance abuse, which can be exacerbated in times of uncertainty. The second track focuses on leveraging data from Anthem’s Digital Data Sandbox, one of the largest certified de-identified health data sets in the U.S., to improve patient care and outcomes during COVID-19 and in the future. Blue Cross and Blue Shield of Illinois has extended cost-sharing waivers for COVID-19 treatment for members of all fully insured group, individual, Medicare (excluding Part D), Medicare Supplement, and Medicaid plans through August 31, 2020. Blue Cross and Blue Shield of Illinois has selected 75 organizations to receive $1.5 million in funding as part of the BCBSIL COVID-19 Community Collaboration Fund. The Fund supports organizations that are providing critical services in the areas of access to health care, hunger and shelter. Of the 75 grant recipients, 25 represent and address each focus area: hunger, shelter and access to health care. Blue Cross and Blue Shield of Illinois has opened a $1.5 million funding program to support community-based organizations with missions focused on access to health care, hunger and shelter. The BCBSIL COVID-19 Community Collaboration Fund will release $20,000 grants to organizations around the state. The program is designed to distribute the funds quickly to respond to the current health crisis. BCBSIL is also supporting non-profit organizations that serve our most vulnerable neighbors through a $1 million donation to Governor J.B. Pritzker’s Illinois COVID-19 Response Fund and $500,000 to the Chicago Community COVID-19 Response Fund. BCBSIL has also purchased and donated 150,000 KN95 masks, to meet the urgent need for personal protective equipment. The masks were donated to the Illinois Emergency Management Agency for distribution to providers most in need. Blue Cross and Blue Shield of Illinois is temporarily lifting cost sharing payments for medically necessary health services delivered through telehealth. This applies to all fully insured members whose benefit plan included telehealth benefits. Blue Cross and Blue Shield of Illinois has also added 18 additional telehealth procedure codes that health care providers may use when billing Blue Cross and Blue Shield of Illinois for medically necessary health care services, including codes for behavioral health therapy. Blue Cross and Blue Shield of Illinois also launched a dedicated microsite with information for members, providers on COVID-19.     Blue Cross Blue Shield of Michigan Blue Cross Blue Shield of Michigan and Blue Care Network will continue to waive cost sharing for members who are diagnosed and treated for COVID-19 through September 30, 2021. This extension of a temporary benefit ensures members will not pay out-of-pocket costs – copays, deductibles, or coinsurance – for the medical care associated with COVID-19. The temporary waiver applies to all commercial and Medicare Advantage plans offered by Blue Cross and Blue Care Network. Blue Cross Blue Shield of Michigan will continue to waive cost-sharing for members who are diagnosed and treated for COVID-19 through March 31, 2021. This extension of a temporary benefit, originally set to expire on Dec. 31, ensures members will not pay out-of-pocket costs – copays, deductibles or coinsurance – for the medical care associated with COVID-19. The temporary waiver applies to all commercial and Medicare Advantage plans offered by Blue Cross and Blue Care Network. Blue Cross Blue Shield of Michigan is donating $1 million for the procurement and distribution of emergency personal protective equipment (PPE) to support dentists and patients statewide amid the ongoing COVID-19 crisis. The funds will be used to acquire $1 million worth of PPE for the assembly and distribution of safety kits to help protect dentists, dental staff and patients against the transmission of COVID-19 while dental care services are being performed. Each kit will contain NIOSH-approved KN-95 masks, disposable isolation gowns with cuffs and bouffant hair caps.  The kits will be shipped to dentists who practice and primarily serve patients throughout Michigan. Blue Cross Blue Shield of Michigan will waive 30% of one month of health and dental plan premiums for more than 180,000 active, commercially insured individual health plan subscribers this fall.  Totaling more than $21 million, the refunds will be delivered in the form of premium credits on November invoices, pending approval of plans filed with state regulators this week.  The credits are a response to lower than expected health care claims resulting from the disruption in the delivery of health and dental services caused by the COVID-19 crisis. Blue Cross Blue Shield of Michigan and Blue Care Network will provide their members no-cost treatment for COVID-19 disease through Dec. 31, 2020. The cost share waivers apply to members in fully insured commercial PPO and HMO plans, as well as individuals in fully insured Medicare Advantage plans. BCBSM will work with employer group customers that are self-insured to make decisions regarding their own benefits. BCBSM estimates that it will spend between $23 million to $43 million in providing these additional benefits – bringing the company’s total investment in additional benefits for members to nearly $150 million during the pandemic. Blue Cross Blue Shield of Michigan and Blue Care Network will be returning more than $100 million to many fully insured customers this year. The refunds are in addition to $494 million that BCBSM has invested in expanding the availability of no-cost benefits for members and to support health providers in response to COVID-19 – bringing the BCBSM enterprise’s commitment in response to the crisis to nearly $600 million. BCBSM will be providing the following relief to customers and members with Blue Cross and Blue Care Network health plans: Fully insured small group customers with 50 or fewer employees will receive a 30% credit on their July premium invoice. All told, BCBSM is providing about $37 million back to small group customers for their medical plans. Low rate adjustments for small group customers. BCBSM filed 2021 small group rates last week with state regulators that average 0.9% more for PPO plans and 1.95% more for HMO plans. Blue Dental and Blue Vision employer group customers will be sharing a total refund of about $10.5 million. All fully insured groups with dental and vision coverage will receive a one-month premium refund to be credited on their July invoice. BCBSM also will not increase rates for fully insured customers renewing dental and vision plans for 2021. Individual health plan members from 2019 will receive a one-time rebate resulting from lower than expected health care claims. Altogether, about $45 million will be paid directly to these 2019 individual plan subscribers in September. Rebates are determined based on each subscriber’s plan and premiums paid in 2019. Rebate amounts will vary by subscriber. Medigap (Medicare Supplement) and individual Medicare Advantage members in a plan with a premium above $0 will receive a 15% premium refund for the months of March and April to be applied to their July premium bill. This refund totals about $15 million to Medigap and Individual Medicare Advantage members. For Individual Medicare Advantage members this includes their Optional Supplemental Buy-up (if applicable). BCBSM is also providing $494 million in additional support to members and providers: Medicare Advantage member cost share waivers will be provided through December 31 for BCBSM and BCN Medicare Advantage members. On May 7, BCBSM became the first health plan in Michigan to announce that it would waive cost sharing for Medicare Advantage members for all services provided during in-person primary care visits, for in-person behavioral health services and for telemedicine access. The projected value of these no-cost services will save BCBSM and BCN Medicare Advantage members $10 million. COVID-19 testing and treatment cost share waivers and no-cost telehealth services will continue to be provided through June 30 to enable free access to physician-directed COVID-19 testing and treatment for commercially insured members. The projected value of these no-cost services will save members $97 million. BCBSM was the first health plan in Michigan to announce testing and treatment for COVID-19 at no cost, along with no-cost telehealth access for both medical and behavioral health services during the first wave of the pandemic period. Advance funding for health providers. BCBSM pulled forward $87 million in earned incentive payments to Michigan physicians to enable them to operate, purchase testing supplies, enhance treatment services for COVID-19 patients and expand telehealth services. BCBSM also decided to continue planned payments to health systems, totaling about $300 million, despite disruptions in claim volume. This enabled Michigan health systems to continue operating with a stable revenue stream during a time of significant disruption in their ability to deliver services. Blue Cross Blue Shield of Michigan and Blue Care Network are launching new telehealth programs with behavioral health providers, so Blue members who are interested in participating in group sessions to discuss the impacts of the COVID-19 pandemic on their mental health can share their experiences with others under the guidance of a trained therapist.  The programs are available for free to members with Blue Cross and Blue Care Network behavioral health coverage through June 30. Blue Cross Blue Shield of Michigan and Blue Care Network of Michigan will waive cost-sharing for Medicare Advantage members through December 31 for certain specific services that enable seniors to consult with their doctors and therapists about their health needs, both in-person and virtually.  Members in BCBSM and BCN Medicare Advantage plans will be assured of no copays, coinsurance or deductibles for the following in-network services, from May 1 through Dec. 31, 2020: In-person primary care services Behavioral health office visits Telehealth services for both medical and behavioral health Blue Cross Blue Shield of Michigan is offering full salary and benefits to employees with medical backgrounds who volunteer to work in the coronavirus field hospital being constructed at the TCF Center in Detroit. Blue Cross Blue Shield of Michigan is accelerating payments to Michigan-based physician organizations and practices to support their efforts for treating patients with COVID-19.  Additionally, BCBSM is relaxing some of its administrative requirements to allow Michigan’s physician organizations and health systems to spend more time treating patients and hasten their diagnoses and treatment. The accelerated funding is available to the more than 40 physician organizations that are a part of Blue Cross’ Physician Group Incentive Program (PGIP), including over 20,000 primary care and specialist physicians throughout Michigan. Blue Cross Blue Shield of Michigan and Blue Care Network are waiving all member copays, deductibles and coinsurance for COVID-19 testing and treatment. The coverage applies to commercial PPO, Medicare Advantage PPO and HMO plans. Blue Cross Blue Shield of Michigan and Blue Care Network of Michigan will further expand access to prescription drug refills for members in order to comply with an executive order issued by Gov. Gretchen Whitmer to expand access to prescription drug refills during the COVID-19 public health crisis. Governor Whitmer’s executive order expands BCBSM and BCN efforts by requiring all insurance providers to waive any limits on early refills, so Michigan residents can obtain a 90-day supply of prescription drugs necessary to manage their medical conditions during the COVID-19 crisis. Blue Cross Blue Shield of Michigan will waive prior authorizations for diagnostic tests and covered services for COVID-19, cover those tests at no cost share to members, waive prescription refill limits on maintenance medications, and expand access to telehealth and nurse/provider hotlines. This applies to fully insured and Medicare Advantage plan members. Blue Cross Blue Shield of Michigan will also work to support self-insured customers who choose to take similar actions. Blue Cross and Blue Shield of New Mexico  Blue Cross and Blue Shield of New Mexico is waiving cost-sharing payments for COVID-19 treatment through the end of the HHS public health emergency for individual plans. The waiver covers fully insured group, individual, Medicare (excluding Part D), Medicare Supplement, or Medicaid plan member. Blue Cross and Blue Shield of New Mexico is waiving cost-sharing payments for COVID-19 related treatments through December 31, 2020. The waiver applies to all Medicare (excluding Part D) and Medicare Supplement members. Blue Cross and Blue Shield of New Mexico is providing approximately $4 million in relief to fully insured employer customers in the form of a premium credit. Blue Cross and Blue Shield of New Mexico has waived cost-sharing for COVID-19 treatment through October 23, 2020 for Medicare (excluding Part D) and Medicare Supplement members. Blue Cross and Blue Shield of New Mexico has made a $20,000 grant to the Adelante Development Center, a nonprofit that supports people with disabilities and seniors across New Mexico. The grant will help Adelante’s direct support professionals meet the increased demands of delivering personal care to vulnerable populations during the COVID-19 crisis. Blue Cross and Blue Shield of New Mexico is waiving cost-sharing for COVID-related treatment for Medicare (excluding Part D) and Medicare Supplement members, through August 31, 2020. For fully insured and Interagency Benefits Advisory Council members, there is no projected end date for the cost-sharing waivers for COVID-19 related testing and treatment. Blue Cross and Blue Shield of New Mexico is contributing $1 million to address the needs of New Mexicans impacted by the COVID-19 pandemic. The BCBSNM COVID-19 Community Collaborative Grant Fund will help support the health and wellness of our communities by focusing on areas where communities need it the most, including aid for food security, child and senior care, providers, and health care access. Blue Cross and Blue Shield of New Mexico will waive co-pays and deductibles for COVID-19 testing and will not require prior authorization. It is working with self-insured plans on their decisions. Blue Cross and Blue Shield of New Mexico also launched a dedicated microsite with information for members, providers on COVID-19. BlueCross BlueShield of North Carolina  Blue Cross and Blue Shield of North Carolina (Blue Cross NC) announced its expanded telehealth policy will remain in place through March 31, 2022. The telehealth policy covers doctor visits by video or phone the same as face-to-face visits. In 2020, Blue Cross NC saw members’ telehealth usage increase by more than 7,500%. The policy applies to all Blue Cross NC commercial plans and Medicare Advantage plans offered and administered by Blue Cross NC, including the State Health Plan. Members of the Federal Employee Program have telehealth covered at parity with in-person visits until further notice. The extended policy does not apply to Blue Cross NC members getting care from out of state providers. COVID-19 is driving long-term changes in how doctors and patients use and value telehealth. In 2020, 92% of Blue Cross NC members’ telehealth visits were primary care or behavioral health services, compared to 8% for specialist visits, despite coverage and payment parity. Blue Cross and Blue Shield of North Carolina is extending telehealth coverage through December 31, 2021. Blue Cross NC will cover all telehealth visits at the same cost as face-to-face visits. Virtual (or telehealth) visits can be used with primary care doctors, specialists, and behavioral health providers. Blue Cross and Blue Shield of North Carolina is extending its cost-sharing waiver for COVID-19 treatment through March 31, 2021. Blue Cross and Blue Shield of North Carolina will also continue to waive prior authorization requirements through March 31, 2021. An expanded reimbursement policy for virtual doctors visits will also be extended through June 30, 2021, and will cover telehealth visits the same as face-to-face visits. BlueCross BlueShield of North Carolina is waiving cost-sharing payments for all COVID-19 related treatments through December 31, 2020 for both in-network and out-of-network providers. All doctors providing COVID-19 care will be paid as in-network – whether they are or not. Blue Cross and Blue Shield of North Carolina has teamed up with North Carolina State University’s Nonwovens Institute, Freudenberg Performance Materials, UNC Health, the NC Healthcare Association Strategic Partners, and NC Medical Society to manufacture and distribute N95 respirators that will serve the needs of North Carolina health care workers during the COVID-19 pandemic and increase equity in access to personal protective equipment (PPE) in communities that need them most. The Made in NC collaboration will produce an initial 100,000 to 200,000 N95 respirators per month with plans to quickly ramp up, right here in North Carolina, providing a more consistent and affordable source of PPE for local health care providers. Blue Cross and Blue Shield of North Carolina will issue $200 million in health and wellness retail cards to more than 600,000 eligible subscribers, or households, across the state. The cards will be pre-loaded with funds that will help many North Carolinians pay for health, wellness, and household expenses, including food, during the ongoing COVID-19 pandemic. Eligible subscribers are those enrolled in individual under 65 and fully insured employer plans, including vision and dental plans. These customers can expect to receive their cards in the mail between Oct.19 and Nov. 7. Blue Cross and Blue Shield of North Carolina has invested $400,000 in the American Red Cross’ Sound the Alarm program for home fire prevention, preparedness, and recovery, and to help create disaster-ready kits for its shelters in the wake of the COVID-19 pandemic. National Preparedness Month is recognized each September to promote disaster planning, and this year Blue Cross NC has committed $100,000 to support the Red Cross’ efforts to create 10 pandemic-ready shelter kits to keep residents and volunteers safe as they navigate disasters during the evolving public health crisis. Each kit includes enough PPE and other essential supplies to enable 150 workers and residents (and those seeking safe shelter from threats such as hurricanes and flooding to monitor and address basic health and wellness and social distancing needs for up to two weeks. Blue Cross and Blue Shield of North Carolina and the Charlotte Hornets are teaming up to support Project BOLT, a nonprofit whose mission is to enhance the quality of life for marginalized citizens of the Charlotte community. The Hornets and Blue Cross NC are committing to a weekly donation of 300 meals for children in Charlotte over the next six weeks, along with a $10,000 donation to Project BOLT. Since the COVID-19 crisis began in March, Project BOLT has been delivering food and school supplies to children ages 2-18 across seven neighborhoods to ensure that children who normally get their primary meals and basic nutrition covered through school were fed and had the necessary supplies to do their school work at home. BlueCross BlueShield of North Carolina is waiving cost-sharing for all COVID-19 related treatments for both in-network and out-of-network providers through October 31, 2020. All doctors providing COVID-19 care will be paid as in-network – whether they are or not. BlueCross BlueShield of North Carolina is also waiving all copays for in-network primary care and behavioral health visits for Medicare advantage members through the end of 2020. Blue Cross and Blue Shield of North Carolina is lowering how much members pay for a 90-day supply of maintenance medications through the end of 2020. The move is designed to help ease financial burdens caused by COVID-19, and help people stay home by encouraging them to order 90-day supplies of their medications. Effective July 15, all Blue Cross NC commercial, fully insured customers will receive up to a 33% discount on their copays for maintenance medications. The company will only require the equivalent of two copays versus three for a 90-day supply. This benefit will be available at both retail and mail-order pharmacies. Members on an individual under-65 health plan will receive the discount immediately. Fully insured group members who get a 90-day fill between July 15, 2020 and Sept. 1, 2020 will receive a check for refunded amounts in October. Group members will get the discount at their retail or mail-order pharmacy starting Sept. 1, 2020. Blue Cross and Blue Shield of North Carolina is expanding its support of primary care by creating Accelerate to Value, a program to help independently owned primary care physician practices remain financially viable and move to value-based care. The program helps ensure long-term access to high-quality care for Blue Cross NC members while enabling primary care practices across the state to weather the financial crisis created by the COVID-19 pandemic. The program, open to independently owned primary care practices in North Carolina, includes: Financial stabilization: Blue Cross NC will provide significant financial support by making payments to participating practices, based on 2019 revenue, to improve financial stability in 2020 and 2021. These payments will begin by September. Transition to value-based care: Participating practices will commit to joining Blue Premier, Blue Cross NC’s value-based care program, by the end of 2020. Practices will have the option of joining an existing accountable care organization through a Blue Premier clinically integrated network or through Aledade, a company that helps primary care practices move to value-based care. Blue Premier jointly holds providers and Blue Cross NC accountable for meeting quality and cost standards. Capitated payments: Under a payment model known as capitation, beginning in 2022 the practices will be eligible to receive fixed monthly payments for meeting the health needs of their entire patient population. This replaces the fee-for-service method of getting paid for each patient encounter. Capitation encourages doctors to spend as much time as they need with each patient, helping them to improve their health. Blue Cross and Blue Shield of North Carolina will speed up payments to providers as they deal with potential short-term cash flow challenges from COVID-19. The company is also fast-tracking proactive steps to support hospitals, physicians, nurses and thousands of other health care providers across North Carolina. Blue Cross NC is enhancing claims payment processes to speed payments to providers to help alleviate revenue and potential short-term cash flow challenges during the pandemic. These measures mean that 90 percent of claims will be paid within 14 days. A significant portion of these will be paid in seven days or less. Blue Cross NC is also speeding up its credentialling process to help meet the demand for clinicians related to the COVID-19 pandemic. Blue Cross NC will credential physicians and physician assistants applying due to COVID-19 treatment needs within 72 hours of receipt of the necessary application, consistent with the North Carolina Medical Board’s processes. Commitments made by Blue Cross and Blue Shield of North Carolina to provide financial support to members, employers, providers, and community organizations to address the COVID-19 pandemic are projected to reach up to $593 million with $318 million in projected costs to improve access to care and $275 million projected to address cash flow challenges facing members, employers and providers. BlueCross and BlueShield of North Carolina is waiving member cost-sharing – including deductibles, co-payments, and coinsurance – for treatments related to COVID-19 if a member is diagnosed with the virus. Blue Cross NC will waive member cost-sharing for COVID-19 related treatments for both in-network and out-of-network providers. BlueCross BlueShield of North Carolina will cover members’ cost for COVID-19 testing and will not require prior approval for COVID-19 testing. The company is also expanding virtual access to doctors and will waive early medication refill limits. These changes apply to fully insured, Medicare Advantage and Federal Employee Program members. Self-funded employer groups will be given the option to apply these changes to their employees’ plans. BlueCross BlueShield of North Carolina also announced that it will cover virtual doctor visits, including those done by phone, the same as face-to-face visits according to a member’s health plan. This is an expansion of the telehealth benefits Blue Cross NC has previously offered.   Blue Cross and Blue Shield of Oklahoma  Blue Cross and Blue Shield of Oklahoma is waiving cost-sharing payments for in-network COVID-19 treatments through December 31, 2020. Blue Cross and Blue Shield of Oklahoma is also waiving cost-sharing payments for telehealth visits through December 31, 2020. Blue Cross and Blue Shield of Oklahoma is providing approximately $20 million in relief to fully insured employer customers in the form of a premium credit. The company has worked with regulators to obtain necessary approvals. Blue Cross and Blue Shield of Oklahoma is extending cost-sharing waivers for COVID-19 treatment through October 23, 2020. The waivers are offered for members of all fully insured group, individual, Medicare (excluding Part D), Medicare Supplement, and Medicaid plans. Blue Cross and Blue Shield of Oklahoma is waiving cost-sharing for COVID-19 treatment for members of all fully-insured group, individual, Medicare (excluding Part D), Medicare Supplement, and Medicaid plans through August 31, 2020. Blue Cross and Blue Shield of Oklahoma will authorize any member who was receiving treatment outside of Oklahoma prior to March 15 to continue receiving care closer to home if they prefer not to travel during the COVID-19 crisis through July 31. This date is an extension from the original end date of June 30. Members can transition to an in-network provider in Oklahoma or BCBSOK will cover the costs to see an out-of-network provider in Oklahoma at the in-network rate. Blue Cross and Blue Shield of Oklahoma will authorize any member who was receiving treatment outside of Oklahoma prior to March 15 to continue receiving care closer to home if they prefer not to travel during the COVID-19 crisis. Members can transition to an in-network provider in Oklahoma, or BCBSOK will cover the costs to see an out-of-network provider in Oklahoma at the in-network rate. MyHealth Access Network is providing its secure health records portal to all qualified providers in Oklahoma. These services are being made available to all qualified Oklahoma providers through September 1, 2020, thanks to a grant from Blue Cross and Blue Shield of Oklahoma. The new program will enable front line health care providers to use MyHealth to reference patient health data, including any test results for COVID-19, in real-time. Qualified providers for this program will include the first responders, doctors, hospitals, agencies and long-term care providers who come into contact with patients before their COVID-19 status is known or who may encounter these patients later and need to verify testing status. Blue Cross and Blue Shield of Oklahoma will temporarily lift cost-sharing for medically necessary medical and behavioral health services delivered via telemedicine in response to the COVID-19 public health emergency. Blue Cross and Blue Shield of Oklahoma also launched a dedicated microsite with information for members, providers on COVID-19. Blue Cross and Blue Shield of Oklahoma has partnered with DispatchHealth, a mobile medical care unit, to deliver on-demand health care services at members’ homes. The service is intended to prevent overcrowding at emergency rooms and other health care facilities during the COVID-19 pandemic. Blue Cross and Blue Shield of Oklahoma will waive co-pays and deductibles for COVID-19 testing and will not require prior authorization. BlueCross BlueShield of Tennessee BlueCross BlueShield of Tennessee Foundation is giving a total of $1.75 million to 6 Tennessee food banks to help meet the needs of community members affected by the COVID-19 crisis. These additional food bank gifts are the latest in a series of contributions the BlueCross Foundation has made to help Tennesseans throughout the COVID-19 crisis. The foundation has given a combined $1.5 million for COVID testing in underserved areas, flu vaccine education efforts, and community organizations. BlueCross BlueShield of Tennessee is waiving member costs for COVID-19 treatment from in-network providers, including hospitalizations, through the end of the COVID-19 National Emergency. BlueCross BlueShield of Tennessee will continue waiving Medicare Advantage member copayments for visits with in-network primary care and behavioral health care providers through December 31, 2020. This includes in-person and telehealth visits. BlueCross BlueShield of Tennessee Foundation is investing $1 million in the HCS EdConnect initiative, which will provide no-cost internet access to 28,500 students in the Chattanooga area. Students who qualify for the program will receive 100 Mbps home internet service with symmetrical speeds and no data caps, and a WiFi router. In Hamilton County, approximately 28,500 students qualify for free and reduced lunch assistance, a measure the school system uses to determine financial need. Many of these students also don’t have internet access in their homes, which makes learning challenging, and COVID-19 has made it even more so. While many students are participating in virtual learning and online classes to keep up with their schoolwork, those without internet access risk falling behind. BlueCross BlueShield of Tennessee will waive Medicare Advantage member costs for doctor’s office and virtual visits to in-network primary care and behavioral health care providers from May 19 through September 30, 2020. BlueCross BlueShield of Tennessee has made permanent its coverage of virtual visits with in-network providers. BlueCross BlueShield of Tennessee began covering telephone and video visits with in-network providers in March.  The change initially included primary care providers, specialists and behavioral health providers and was later expanded to include occupational, physical and speech therapy as well as ABA therapy services. All of these services will now be covered on an ongoing basis. BlueCross BlueShield of Tennessee is offering enhanced support for its members by: Waiving all member cost-sharing for COVID-19 treatments, including hospitalizations, from in-network providers through May 31, 2020 Waiving member costs for any appropriate, FDA-aligned COVID-19 testing Adapting prior authorization requirements and billing processes for emergency care through May 31, 2020 Allowing early prescription refills and 90-day prescriptions to avoid increased risk of exposure Expanding access to telehealth services by making PhysicianNow visits available at no cost and by covering virtual visits with other network providers for many services Sharing key public health information, such as promoting social distancing and warning of potential scam activity Working with community news partners to help educate on and address health care disparities In addition, the BlueCross BlueShield of Tennessee Foundation donated a total of $3.25 million to six food banks across the state to help them meet increased community needs. And the foundation has provided grants to support testing for uninsured residents in partnership with local governments. BlueCross has also made donations of personal protective equipment (PPE) to some Tennessee health systems. Blue Cross and Blue Shield of Texas Blue Cross and Blue Shield of Texas is awarding $1.8 million in Healthy Kids, Healthy Families® grants to 28 community-based organizations statewide to help target the socio-economic and social determinants of health impacts associated with the COVID-19 crisis. Blue Cross and Blue Shield of Texas has extended cost-sharing waivers for in-network COVID-19 treatment through December 31, 2020. Blue Cross and Blue Shield of Texas has also extended cost-sharing waivers for telehealth visits with in-network providers through December 31, 2020. Blue Cross and Blue Shield of Texas is providing approximately $104 million in relief to fully insured Texas employer customers in the form of a premium credit. Blue Cross and Blue Shield of Texas has extended cost-sharing waivers for COVID-19 treatment through Oct. 23, 2020. The waivers are offered for members of all fully insured group, individual, Medicare (excluding Part D), Medicare Supplement, and Medicaid plans. Blue Cross and Blue Shield of Texas has launched a home screening initiative that has the potential to reach thousands of members who may not otherwise get screened for colorectal cancer this year because of disruption caused by the COVID-19 crisis. About 8,000 eligible members in Texas soon will receive a free home test, a fecal immunochemical test (FIT), to screen themselves for colorectal cancer. Blue Cross and Blue Shield of Texas is extending cost-sharing waivers for COVID-19 treatment for members of all fully insured group, individual, Medicare (excluding Part D), Medicare Supplement, and Medicaid plans through Aug. 31, 2020. Blue Cross and Blue Shield of Texas made a $1 million grant to the Texas Restaurant Association’s TX Restaurant Relief Fund. Established in response to the COVID-19 pandemic, the TX Restaurant Relief Fund provides immediate financial support to Texas’ independent restauranteurs and their employees. This grant will be used to keep restaurant operations open and employees working, while also providing first responders across Texas with meals to show appreciation for all they are doing during this unprecedented crisis. In addition to providing more than 150,000 meals to first responders, the BCBSTX grant will provide support to more than 100 independently owned restaurants, 670 Whataburger, and more than 220 Chipotle stores across Texas. Blue Cross and Blue Shield of Texas has made a $1 million donation to the Communities Foundation of Texas to help with COVID-19 relief efforts. The donation will support nonprofits statewide providing critical services such as: personal protective equipment (PPE) for first responders, childcare for first responders and healthcare professionals, and services for senior adults, including meal and grocery delivery. Blue Cross and Blue Shield of Texas is waiving member cost-sharing, including deductibles, copayments and coinsurance, related to treatment for COVID-19. The waiver applies to costs associated with COVID-19 treatment at in-network facilities and treatment for out-of-network emergencies. The policy is effective for treatment received April 1 through May 31, 2020. Blue Cross and Blue Shield of Texas will offer a special enrollment period (SEP) for its insured group customers. Employees of fully insured group customers who did not opt in for coverage during the regular enrollment period will have an opportunity to get coverage for their health care needs. The SEP launched April 1 and will conclude April 30, 2020. Blue Cross and Blue Shield of Texas as is temporarily lifting cost sharing for medically necessary medical and behavioral health services delivered through telemedicine. This applies to all fully insured members who receive covered in-network telemedicine services. Blue Cross and Blue Shield of Texas also launched a dedicated microsite with information for members and providers on COVID-19. Blue Cross and Blue Shield of Texas will not apply co-pays or deductibles for testing to diagnose COVID-19, and will not require preauthorization. Bright Health  Bright Health will cover COVID-19 diagnostic test and associated office as a preventive care service, so it is available at no cost to members, regardless of network. The company is also authorizing early medication refills for members who might be impacted by the outbreak. Non-emergency transportation is being made available to all members, and ride limits are being waived for non-emergency visits to and from their doctor. All telehealth services (online and virtual care) obtained in connection with COVID-19 testing and diagnosis is now covered, at no cost to members. Back to top C. CalOptima The CalOptima Board of Directors has approved $45.6 million in funding and programs in response to the ongoing COVID-19 crisis  and start of vaccination efforts. The increased support will reach health networks, providers, and nursing homes, and offer incentives to members who receive the COVID-19 vaccine once it is available to them. Vaccine distribution will follow a federally approved phased approach that prioritizes high-risk groups first, followed by the general public later in the year. The actions include: Increasing contracted health networks’ Medi-Cal capitation rate by 5% for the period January 1–June 30, 2021, totaling approximately $9 million. Eleven health networks representing thousands of contracted doctors will receive the increase, which is designed to address higher COVID-19-related costs. Launching a Vaccination Incentive Program to offer two $25 nonmonetary gift cards to CalOptima Medi-Cal members who get both required doses of the COVID-19 vaccine, subject to state regulatory approval. CalOptima plans a multipronged member outreach program to promote vaccination and will work with the Orange County Health Care Agency (HCA) on the administration of the incentive program, which is approved to spend up to $35 million. Creating a Vaccination Intervention and Member Incentive Strategy to promote vaccination of members experiencing homelessness. Medi-Cal members who are homeless and age 14 or older will be eligible for two $25 nonmonetary gift cards for receiving both required doses of the COVID-19 vaccine, subject to state regulatory approval. CalOptima will coordinate with community health centers, shelter operators and others to reach homeless members and promote vaccine access in the $400,000 program. Expanding and extending the Orange County Nursing Home COVID-19 Infection Prevention Program, totaling $1.2 million. A partnership with UC Irvine infectious disease experts, the program will support urgent educational webinars to increase vaccine uptake among nursing home staff and extend the infection prevention training that began in May 2020. CalOptima is collaborating with the Orange County Health Care Agency to ensure that communications to key groups reinforce the benefits of the COVID-19 vaccine for individuals and the community. CalOptima will engage community-based organizations to reach out low-income members so they have trusted information in multiple languages that builds their confidence and offers direction on obtaining COVID-19 vaccines at no cost. CalOptima has committed more than $629,000 in a grant for a new program that improves infection control training. The Orange County Nursing Home COVID-19 Prevention Team program is a collaborative effort by UC Irvine, the Orange County Health Care Agency (HCA) and CalOptima. The new COVID-19 program will operate concurrently with other infection control efforts by HCA and CalOptima. HCA’s public health team responds with a targeted intervention when a cluster of COVID-19 cases is identified in a nursing home. Separately, CalOptima’s Post-Acute Infection Prevention Quality Initiative (PIPQI) reduces the impact of multi-drug resistant organisms, such as MRSA, among nursing home residents. CalOptima has committed more than $629,000 in a grant for a new program that improves infection control training. The Orange County Nursing Home COVID-19 Prevention Team program is a collaborative effort by UC Irvine, the Orange County Health Care Agency (HCA) and CalOptima. Cambia Asuris Northwest Health is covering the cost of FDA-approved treatment for COVID-19 at in-network facilities with no out-of-pocket costs for members through 2021. Asuris Northwest Health is covering the cost of treatment at in-network facilities and inpatient medications for COVID-19 without any out-of-pocket costs through March 31, 2021. Out-patient medications treating COVID-19 are covered at the normal member cost share. Asuris Northwest Health is providing up to $1.4 million in financial relief to commercial health plan customers through a premium credit. Select fully insured group and individual Asuris health plan customers will receive a credit for a portion of their health care premium on upcoming bills. Cambia has extended coverage for COVID-19 treatment without any out-of-pocket costs for fully insured Asuris Health Northwest members through Dec. 31, 2020. In addition, Asuris will continue paying providers for virtual care services at the same rate as in-person visits through Sept. 2020 to help ease member access and support providers experiencing financial challenges. Diagnostic testing also remains covered at no cost to members. Cambia Health Foundation has invested more than $3 million to meet emerging needs created by the COVID-19 crisis. The investments will go to four community health associations that support the work of Federally Qualified Health Centers across Idaho, Oregon, Utah, and Washington. The new funding also supports the development of tools and resources for health care providers on the front-lines of the pandemic. Cambia is fully covering the cost of testing and associated office visits for COVID-19, and also covering the cost of COVID-19 treatment at no cost to members through June 30. Cambia is also supporting early refills of needed medication and ensuring that care related to COVID-19 is not restricted by preauthorization requirements. Cambia is promoting telehealth options, and in-network providers can provide telehealth services at the same cost as an in-person visit.   Capital District Physicians’ Health Plan Capital District Physicians’ Health Plan will continue its support for local not-for-profit organizations and communities hit hard by the effects of the COVID-19 crisis by extending weekly lunch deliveries. Over the last month, CDPHP was able to distribute 2,000 lunches to those in need. Capital District Physicians’ Health Plan, MVP Health Care, CDPHP, and Quick Response have partnered to provide the cities of Albany, Schenectady, and Troy with essential sanitation equipment to protect local first responders from COVID-19. Each city will receive two Defense Soap Cordless Electrostatic Hand or Backpack Sprayers for use by the police and fire departments. Each sprayer provides up to 23,000 square feet of disinfectant in a single tank. Capital District Physicians’ Health Plan has partnered with Brook Health to offer the Brook Personal Health Companion to members and non-members for free during the COVID-19 crisis. The Health Companion is a smartphone app that can provide patient support in areas including healthy meal ideas, blood pressure management, and sleep support. Capital District Physicians’ Health Plan Patient Care Team, which moved into a virtual setting as a result of the COVID-19 pandemic, is reaching out to patients and their family members to assist with the following: Providing emotional support to members, families, and caregivers; Providing daily communication updates between hospital staff, patients, and families; Collaborating with hospital care teams to customize discharge planning; Identifying any barriers to care, such as access to food, medication, and transportation; Identifying any community resources/support services needed post-discharge; and Facilitating post-discharge phone calls and support. Capital District Physicians’ Health Plan is waiving cost sharing (copays, coinsurance, and deductibles) for all coronavirus (COVID-19) related treatment with in-network providers. This change is retroactive for all COVID-19 treatment, including hospitalizations, testing, and office visits with in-network providers. Capital District Physicians’ Health Plan is also providing members access to telemedicine services with no cost sharing. Members have access to ER Anywhere and Doctor on Demand. CareFirst BlueCross BlueShield CareFirst BlueCross BlueShield will fully cover all member costs associated with all FDA-approved COVID-19 vaccines, including for members in self-insured plans. CareFirst is also working with state and local leaders across the region to help support coordinated community vaccination efforts related to communication and distribution processes but cautions patience. CareFirst BlueCross BlueShield is extending cost-sharing waivers for COVID-19 testing and treatment into 2021. The waivers were scheduled to end December 31, 2020. CareFirst BlueCross BlueShield has extended cost-sharing waivers for COVID-19 treatment through December 31, 2020. Cost-sharing waivers were also extended through December 31, 2020 for diagnostic tests for COVID-19, FDA-authorized antibody tests for COVID-19, and visits, regardless of the setting, associated with diagnostic testing. CareFirst BlueCross BlueShield has invested $1 million in the distribution of care packages including masks, hand sanitizer and no-touch tools for high-risk members in Maryland, the District of Columbia and Northern Virginia. This initiative is one of several actions CareFirst is taking to provide ongoing coronavirus (COVID-19) relief to the communities it serves. As restaurants, shops, workplaces and other services reopen, CareFirst recognizes the importance of providing its members with resources that enhance their safety during the pandemic. To alleviate this concern, CareFirst will distribute over 100,000 care package items to its most vulnerable member populations including Medicaid members, individuals over 65-years-old, individuals under 65-years-old with underlying medical conditions and student health plans. CareFirst BlueCross BlueShield has launched a $5 million public-private sector philanthropic endeavor, “Care, delivered”, that will distribute personal protective equipment at no-cost to healthcare and social service organizations on the front lines of the pandemic. This initiative is part of CareFirst’s ongoing commitment to support the communities it serves as they navigate the complexities of this public health crisis. CareFirst will distribute 1.6 million gowns, gloves, masks and face shields to community-based organizations, federally qualified health centers and independent primary care providers in Maryland, the District of Columbia, and Northern Virginia who are on the front lines of the COVID-19 crisis. CareFirst will provide premium credits to many fully insured customers as a result of treatment disruptions related to the COVID-19 crisis, extend the waiver of cost sharing for telehealth services and COVID-19 testing and treatment, and return rebates from 2019 as a result of lower than expected use of medical care by its members. These latest benefits, combined with other relief CareFirst has offered, result in over $300 million made available to CareFirst’s members, providers, and communities during the COVID-19 crisis. CareFirst will provide the following relief: Premium credits totaling $25 million for fully insured small and large group customers, to be reflected on their August premium invoice; Premium credits totaling over $4 million for small and large group fully insured dental customers, to be reflected on each group’s August premium invoice; Rebates totaling over $80 million for individual members and fully insured small and large group customers who had CareFirst coverage in 2019 due to lower utilization of medical care than anticipated; and, Extension of waiver for cost share expenses related to telehealth services to July 24, 2020, and extension of waiver for cost share expenses related to COVID-19 testing and treatment through September 30, 2020, reflecting in total an anticipated $45 million commitment to our members. CareFirst and the Maryland State Medical Society (MedChi) announced a partnership to provide MedChi independent physician practices with five or fewer members, a year of complimentary access to DrFirst’s Backline Telehealth platform for physicians who enroll between March 1st and December 31st of 2020. DrFirst is a Maryland-based company that offers secure telehealth services. This partnership will equip additional Maryland physicians with the technology they need to provide needed virtual care during the COVID-19 pandemic and beyond. CareFirst BlueCross BlueShield will offer a new accelerated payment program to an array of healthcare providers experiencing financial strain due to the coronavirus (COVID-19) pandemic. This initiative is part of CareFirst’s ongoing commitment to support the communities it serves as they navigate the complexities of this public health crisis. CareFirst’s combined provider-focused efforts will result in over $170 million in direct support of the healthcare delivery system during the pandemic. CareFirst is accelerating funds that would otherwise not be available during the pandemic or have been paid later in 2020 and 2021. CareFirst will offer a combination of: Advance lump-sum payments, increased fee schedules and monthly cash advances for qualifying PCMH panels; Monthly cash advances for pediatricians and rural primary care physicians who need additional assistance, independent practices in certain specialty areas, and dentists; and, Cash advances to select hospitals demonstrating need in Maryland, the District of Columbia, and Northern Virginia. CareFirst BlueCross BlueShield is offering financial flexibility for members and groups that are experiencing economic hardship. Customers can request a deferral of up to two months of premium with due amounts carried forward with no interest or penalty. The deferred premium would be satisfied over time through scheduled periodic payments. CareFirst also created a volunteer program available for the company’s licensed clinicians in response to the coronavirus (COVID-19) pandemic. This initiative offers CareFirst employees, who are licensed nurses and behavioral health practitioners, the opportunity to volunteer their time, resources and expertise during this public health crisis. CareFirst BlueCross BlueShield is offering employees who are licensed nurses and behavioral health practitioners the opportunity to volunteer their time, resources and expertise during the COVID-19 pandemic. CareFirst BlueCross BlueShield will waive prior authorizations for diagnostic tests and covered services for COVID-19, cover those tests at no cost share to members, waive early medication refill limits, and encourage alternative sites of care if a member’s primary care doctor is not available. CareFirst is waiving cost sharing for in-network or out-of-network visits to a provider’s office, lab fees or treatments related to COVID-19. It is eliminating prior authorization requirements for medically necessary diagnostic tests and covered services related to COVID-19 diagnosis. It is also waiving early medication refill limits on 30-day maintenance medications, encouraging the use of its 24/7 nurse phone line, and encouraging the use of telemedicine and virtual sites of care. For telemedicine accessed through a CareFirst Video Visit, copays, coinsurance, and deductibles will be waived for the duration of this public health emergency—including behavioral health, lactation support, nutrition counseling and urgent care services. CareFirst has also rapidly expanded the scope of its contracted lab partners to support access to testing as it becomes available. CareFirst Community Health Plan of DC CareFirst Community Health Plan of DC (formerly Trusted Health Plan) will cover all medically necessary services required to facilitate testing and treatment of COVID-19 for its eligible enrollees, in accordance with federal and state guidance. No prior authorization is required for COVID-19 testing. CareOregon CareOregon is strategically reallocating $1.5 million of funding through its Community Giving Grant program to assist local organizations and help them continue to offer food security, shelter and rental assistance to our communities. CareOregon is also expediting approvals for temporary housing support for members suspected to have COVID-19, including helping secure hotel/motel stays for houseless members who are at risk for virus transmission. CareOregon is also working with providers to supply flip phones and simple smartphones to members. With many providers moving to delivery of services via telehealth, CareOregon wants to ensure that members have access to a phone so they can still get the care they need. CareOregon is also taking actions to support providers during the COVID-19 crisis, expediting $25 million in payments to support provider operations including: Offsetting lost revenue by paying providers a lump sum advance for visits that would have been conducted in March, April, May and June 2020. Releasing the majority of state incentive payments earlier than normal to give clinics needed access to money for COVID-19 mitigation. Delaying the implementation of new alternative payment methodology (APM) contracts and maintaining PMPM payments at current respective clinic levels. CareSource CareSource is committing $50 million in investments to affordable housing projects across the United States. All of the investments in the portfolio will be focused in locations with either a high density of CareSource members, underserved populations, or hard to serve geographies. In the U.S. on average, for every 100 extremely low-income people searching for affordable housing, there are only 36 affordable units available. The COVID-19 pandemic has only worsened the number of families who are housing insecure. CareSource is partnering with The Foodbank, Inc., as part of its response to COVID-19. CareSource is committing up to $128,000 to allow The Foodbank to prepare 1,200 supplemental food boxes to distribute to seniors who live with an income below 200% of the poverty line. Each home will be provided with a 14-day supply of food, covering three meals per day for a total of 50,400 meals. Centene  Centene is working with Samsung Electronics America to expand access to telehealth for individuals living in rural and underserved communities. The initiative will supply providers with Samsung Galaxy A10e smartphones to disseminate to patients who would not otherwise have the ability to receive their health care virtually. Additionally, some providers will receive Samsung Galaxy tablets to use to conduct telehealth visits. With this initiative, Centene and Samsung will deploy 13,000 Galaxy A10e smartphones, with 90 days of free wireless service, to approximately 200 federally qualified health centers (FQHCs), other providers and community support organizations throughout Centene’s markets, with a particular focus on rural and underserved areas. The providers and organizations will then determine which of their patients need the devices and distribute them accordingly. Centene previously announced the creation of a Medicaid Telehealth Partnership with the National Association of Community Health Centers (NACHC) to help FQHCs quickly ramp-up their capacity to provide telehealth solutions to meet the needs created by the COVID-19 crisis. As of mid-July, a CDC survey found that 44.4 percent of respondents reported delaying or not receiving care for various reasons, including concerns and challenges around COVID-19. Meanwhile, prior to the COVID-19 outbreak, rural residents already exhibited higher mortality rates and higher incidences of preventable inpatient and emergency room admissions than their counterparts in urban areas. Centene and Quartet Health have expanded their existing partnership to help members quickly and easily access the behavioral health care they need. The nationwide expansion will enable members to seamlessly access quality behavioral health care from providers located in their areas who serve their unique clinical needs. To support members who want access to care from their homes during the COVID-19 crisis, all scheduled appointments will be with providers who support virtual care. Centene has formed a research partnership with the National Minority Quality Forum to assess the impact of COVID-19 on racial minorities and underserved communities across the country. The Minority and Rural Health Coronavirus Study will examine the risk factors associated with the disproportionate impact that coronavirus is having on racial minorities and rural communities. Centene has donated $500,000 to the National Domestic Violence Hotline, which aims to support and advocate for those affected by relationship abuse. The shelter-in-place orders across the country during the COVID-19 crisis have led to an increase in incidents of domestic violence. Centene is waiving all cost sharing for in-network primary care, behavioral health, and telehealth visits for the remainder of the calendar year for Medicare Advantage members. Medicare Advantage members may also be eligible for the following expanded benefits for the remainder of 2020: Extended Meal Benefits – Members eligible for meal benefits due to a chronic condition or recent discharge may receive an additional 14 meals delivered to their home at no cost. Annual Wellness Visit Incentives – Members will be eligible for an increased incentive for completing their Annual Wellness Visits, a benefit offered at no cost to the member. Additional Over-The-Counter (OTC) Benefits – Plans with an OTC benefit may now receive additional allowance dollars in monthly or quarterly increments, adding up to as much as $150 for the remainder of 2020, depending on plan. Centene has convened a group of medical, non-profit and community leaders to form the Centene Health Disparities Task Force. The task force will further enhance Centene’s leadership and commitment to ensuring underserved populations have access to quality health care. The Task Force will meet on a regular basis to provide advice and recommendations to Centene through the pandemic and beyond. Centene is making three investments to support communities that are experiencing elevated levels of stress and mental strain caused by an increase in grief, loss, economic pressure, unemployment and social isolation due to the COVID-19 crisis. Centene is partnering with Allegheny Health Network and the CARES Institute at Rowan University to fund 25 virtual Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) training cohorts, which will enable up to 600 clinicians nationally to receive this highly effective training. TF-CBT is an evidence-based treatment for the impact of traumatic experience on child and adolescent mental health. Centene is also directing funds to the Crisis Text Line to support their ‘For the Frontlines’ initiative. For the Frontlines provides fast, free, text-based crisis support to individuals on the frontlines of the COVID-19 pandemic response, including doctors, nurses, pharmacists, and other essential workers. Additionally, Centene is partnering with peer warmlines, which are dedicated call centers for mild to moderate behavioral health needs, in states hardest hit by COVID-19, including California, Michigan, New York, New Jersey, Louisiana, Illinois, and Florida. As part of this partnership, Centene will allocate funds to assist warmlines in meeting the demand for increased capacity brought on by the pandemic. Centene is also donating to the National Council for Behavioral Health’s COVID-19 Relief Fund, specifically for the provision of Mental Health First Aid. Mental Health First Aid teaches citizens to recognize signs that someone might be experiencing a mental health crisis, suicidal thinking, or abusing substances. Advancing States, in collaboration with Centene, is releasing www.ConnectToCareJobs.com for wide dissemination and use in all 56 states and territories. This new website serves as a tool to solve the critical problem many healthcare facilities face during the COVID-19 crisis – how to fill critical staffing gaps in a timely fashion. The first release allows nursing homes, assisted living facilities, residential care facilities, and long-term acute care hospitals to identify gaps in specific staffing needs they have on particular days. At the same time, healthcare professionals who are licensed and/or trained for the various roles needed by these facilities can register their availability and willingness to fill shifts. An algorithm then matches the workers to the facilities – in real time. States and territories have the ability to manage which facilities are included (to enable preference for those in crisis) as well as to monitor the matching process. Centene is collaborating with Quest Diagnostics to increase access to real-time reverse transcription polymerase chain reaction (rRT-PCR) COVID-19 testing in critical areas of need across the country. Through this collaboration, Centene will facilitate the distribution of 25,000 Quest COVID-19 test kits each week to Federally Qualified Health Centers in ten states or districts across the country. Centene has created a Medicaid Telehealth Partnership with the National Association of Community Health Centers to help Federally Qualified Health Centers quickly ramp-up their capacity to provide telehealth solutions to meet the needs created by the COVID-19 crisis. Centene is dedicating $5 million to the partnership’s efforts, which will be used to purchase equipment and provide training and technical assistance to FQHCs. Centene has expanded membership access via Telehealth and has been supportive of provider practices to ensure care continuity during the COVID-19 crisis. Centene has created a provider support program to assist its network providers who are seeking benefits from the Small Business Administration (SBA) through the CARES Act. As part of the provider program, the company has launched a dedicated online portal where providers can research benefits they may be eligible for and work directly with experts to apply for them. The company will provide resources to aid providers in grant writing and business loan applications, among other key activities. The program will help providers apply for various benefits including small business loans, a paycheck protection plan and various grants they may be eligible for. In addition to the online portal, the Company will provide partners with access to webinars and one-on-one consulting with key experts. Centene has also made a series of investments to address the social determinants of health for vulnerable populations during the COVID-19 crisis. Centene is partnering with Feeding America’s network of food banks to donate1 million meals a month for 12 months to feed communities all over the country. Centene is also purchasing 50,000 gift cards for use on essential items. The cards will be delivered to local providers and other community resources for distribution to individuals in need. The gift cards, which will have $35 of value each, can be used to purchase essential healthcare and educational items including diapers, over-the counter medicines, cleaning supplies, and books. Centene has released resources on improving health care access for people with disabilities during the COVID-19 pandemic, as well as maintaining their access to personal attendants. Centene is supporting the disability community affected by the COVID-19 pandemic by: Establishing an emergency registry for members with long-term services and supports. Centers for Independent Living partners will recruit, train, and deploy a specialized emergency in-home care workforce for members with disabilities who self-direct their personal attendants. Establishing onsite disability liaisons at COVID-19 super sites. Disability liaisons provided by local CILs within treatment facilities will advocate for and assist with functionality for patients with physical disabilities. Addressing social determinants of health to support the unique needs of members with disabilities by: Augmenting service coordination activities through peer supports and skills training for members with disabilities provided by the CILs. Supports include personal protective equipment distribution, multiple weekly contacts for problem solving, and sourcing Providing grants to Area Agencies on Aging for groceries and meal deliveries for members with disabilities who have had a disruption of natural supports Matching funds in partnership with organizations, such as, workforce development boards and other safety net organizations, to train the direct care workforce and support unemployed individuals by preparing them for a career in health care Offering access to the Provider Accessibility Initiative COVID-19 Web Series to provide timely recommendations from experts with disabilities on how providers and organizations can deliver disability-competent care during the pandemic and future emergencies Centene has created a provider support program to assist its network providers who are seeking benefits from the Small Business Administration (SBA) through the CARES Act. As part of the provider program, the company has launched a dedicated online portal where providers can research benefits they may be eligible for and work directly with experts to apply for them. The company will provide resources to aid providers in grant writing and business loan applications, among other key activities. The program will help providers apply for various benefits, including small business loans, a paycheck protection plan and various grants for which they may be eligible. Centene has also created a comprehensive financial aid package in response to the unprecedented needs of safety net providers including Federally Qualified Healthcare Centers, behavioral health providers and community-based behavioral health organizations, and long-term service and support organizations operating on the front lines of the pandemic. Centene is creating a Medical Reserve Leave policy to support clinical staff who want to join a medical reserve force and serve their communities during the COVID-19 pandemic. The new policy will provide paid leave and benefits for up to 3 months of volunteer service. Centene will cover the cost of COVID-19-related treatments for Medicare, Medicaid and Marketplace members. Centene is also eliminating the need for providers to collect co-pays and removing authorization requirements for COVID-19 related treatment. Centene will cover COVID-19 testing and screening services for Medicaid, Medicare and Marketplace members and is waiving all associated member cost share amounts for COVID-19 testing and screening. The company will not require prior authorization, prior certification, prior notification or step therapy protocols for these services. Cigna Cigna Medical Group (CMG) in Arizona is among the first in the country to provide the monoclonal antibody infusion therapy to high-risk COVID-19 patients in a non-hospital setting. This is part of CMG’s ongoing and proactive efforts to support patients and the community with COVID-19 prevention and treatment solutions. CMG has continued to provide testing and has administered over 4,000 COVID-19 vaccines as of mid-February to patients and qualified members of the community through drive-thru vaccine clinics and in its 21 health care centers. Cigna is covering the cost of approved vaccines without any cost share. The vaccine is currently purchased by the federal government and provided free of cost to individuals. Cigna covers the cost of administering the vaccine at 100% without any out-of-pocket costs when done by any in-network or out-of-network provider. Cigna is also waiving out-of-pocket costs for all COVID-19 treatment through February 15, 2021. Cigna is waiving out-of-pocket costs for COVID-19 visits with in-network providers, whether at a provider’s office, urgent care center, emergency room, or via virtual care, through January 21, 2021. Cigna is waiving out-of-pocket costs for all COVID-19 treatment through December 31, 2020. The treatments that Cigna will cover for COVID-19 are those covered under Medicare or other applicable state regulations. The company will reimburse health care providers at Cigna’s in-network rates or Medicare rates, as applicable. Cigna is also waiving out-of-pocket costs for COVID-19 visits with in-network providers, whether at a provider’s office, urgent care center, emergency room, or via virtual care, through January 21, 2021. Cigna has extended member cost-sharing waivers and other enhanced benefits through Oct. 31, 2020. The extension includes: Cost share waivers for COVID-19 diagnostic testing, related visit and treatment Cost share waivers for COVID-19 related virtual medical visits Cigna Dental will reimburse contracted network dentists for PPE when providing dental services for Cigna customers. In addition, Cigna is helping dental providers overcome the stress and anxiety of returning to work by offering mental health resources and support for in-network dental office employees. Network dentists and office staff can speak to a qualified representative 24 hours a day, seven days a week through July 31 by calling 1.855.287.8400. Cigna group dental clients will also receive a one-month premium credit applied in July for clients who were active in May 2020. The employer can pass through the premium credit to employees if they are responsible for their dental premiums. No action is required by clients to receive this credit. In addition to the one-month premium credit for eligible clients and customers, Cigna Dental has implemented dental care solutions to assist employers and their employees during the COVID-19 pandemic, including no-cost virtual dental care for employees through July 31, 2020. The Cigna Foundation is inviting nonprofits working to create greater access to mental health services to apply for funding through its Healthier Kids For Our FutureSM grant program. The program will provide up to a total of $5 million in grants to community organizations over the next year. Healthier Kids For Our FutureSM is a five-year, $25 million global initiative to improve the health and well-being of children that launched in 2019. Phase I focused on reducing childhood hunger and improving nutrition, awarding more than $4.5 million in grants to-date. In Phase II, the program will add an additional focus area, addressing the mental health and well-being of children. Nonprofits working to improve childhood hunger can still apply as well. Many families across the country are facing increased stress and anxiety right now. Prior to COVID-19, up to 20 percent of children and adolescents worldwide experienced mental illness, and the crisis is shedding light on a worsening mental health crisis – as both children and adults are struggling with anxiety, loneliness, and isolation. Cigna is expanding its support for customers during the COVID-19 crisis by eliminating cost-sharing for all primary care, specialty care and behavioral health care in-office or telehealth visits for COVID-19 and non-COVID-19 care. This expansion applies to all U.S. customers enrolled in Cigna’s Medicare Advantage and Individual and Family Plans, including those sold on the Individual Marketplace. Additionally, Cigna is making enhancements to its Medicare Advantage meal plan benefits to further protect customers during the crisis and underscore the company’s continued commitment to enabling access to simple, affordable and predictable health care. Cigna has launched the Cigna Care Card to help clients provide financial assistance to keep employees healthy and supported during the COVID-19 crisis. The new offering will make it easier for employers to support the well-being and peace of mind of employees and their families by designating a tax-free dollar amount to cover expenses incurred as a result of COVID-19. The Cigna Care Card is a debit card powered by Alegeus that allows clients to pre-load funds that employees can use for qualified disaster relief payments, such as medical payments, groceries, child care, and wellness services. Payments are tax-free to employees and fully deductible to the employer. Cigna is adding Talkspace to its behavioral provider network for customers seeking a more convenient therapy option. With private messaging (text, voice, and video), Talkspace connects Cigna customers to dedicated licensed therapists who engage daily through a secure app. Customers can also schedule live video sessions based on personal preference. Cigna is expanding its digital capabilities to help customers with COVID-19 by providing real-time, personalized support. These new virtual solutions will help rapidly identify and assist Cigna customers who arrive in emergency room settings with COVID-19 symptoms, and support those who are actively recovering at home. Cigna has partnered with Collective Medical to identify customers, in real-time, checking into emergency care settings with COVID-19 symptoms. With this information, Cigna Care Advocates can quickly engage these customers and connect them with programs to support whole person health, such as care management, remote patient monitoring and behavioral health support. Customers with mild to moderate COVID-19 symptoms can now access an interactive digital tool while they safely shelter and recover at home. Cigna has partnered with Medocity to create a simple solution, Medocity for Cigna, which allows customers to track their symptoms, connect with care advocates and access behavioral and emotional supportive resources. Cigna Foundation and New York Life Foundation have partnered to launch the Brave of Heart Fund to help the spouses, domestic partners, children, and parents of the frontline healthcare workers who gave their lives in the fight against COVID-19. Cigna Foundation and New York Life Foundation will make initial seed contributions of $25 million each and both CEOs will work to garner additional support from other corporate and private citizens. In addition to the financial assistance, Cigna will provide behavioral and emotional health support to the families to help them cope. These offerings are an expansion of Cigna’s efforts to support both front-line healthcare workers and the general public during the ongoing COVID-19 outbreak. Cigna has launched Dental Virtual Care, which will be available through Cigna’s growing network of dental providers who offer teledentistry. Cigna Dental Virtual Care will be available this month to over 16 million dental customers enrolled in Cigna’s employer-sponsored insurance plans at no cost through May 31, 2020. Cigna is also partnering with The TeleDentists, a national virtual care dental provider with more than 300 dentists. Through a video consultation, licensed dentists can triage urgent situations such as pain, infection, and swelling and guide the customer on next steps. If necessary, the dentist will prescribe medications, such as antibiotics and non-narcotic pain relievers. Cigna is providing medications to Washington University School of Medicine in St. Louis to initiate a clinical trial that will evaluate antimalarial and antibiotic treatments for COVID-19. The researchers plan to enroll 500 patients, over the course of the study, hospitalized with the novel coronavirus at Barnes – Jewish Hospital in St. Louis, MO. Cigna is launching a pilot program to increase social connectivity among its Medicare Advantage (MA) customers during the COVID-19 pandemic. Through the pilot, Cigna is reaching out proactively to many of its Medicare customers to monitor their general health and well-being as well as daily needs during COVID-19, including food, housing and transportation. Customers will be able to opt-in to receive follow-up calls from the same Cigna representative to help cultivate meaningful connections. Cigna will also leverage its comprehensive data and analytics to identify MA customers who may be at higher risk for health issues and complications for additional proactive outreach to help answer questions about COVID-19, conduct regular health checks and triage care to a medical professional, if necessary. The pilot program will initially reach 24,000 customers with plans for rapid expansion. Cigna and Express Scripts are working with Buoy Health to provide an early intervention screening tool to help customers and members understand their personal risks for COVID-19. The digital tool immediately triages symptoms and recommends next steps for care, while also relieving demand on an over-burdened health care system. Cigna is waiving customer cost-sharing and co-payments for COVID-19 treatment through May 31. The policy applies to customers in the U.S. who are covered under Cigna’s employer/union sponsored insured group health plans, insured plans for U.S. based globally mobile individuals, Medicare Advantage, and Individual and Family Plans. Cigna will also administer the waiver to self-insured group health plans. Cigna will waive prior authorizations for the transfer of its non-COVID-19 customers from acute inpatient hospitals to in-network long term acute care hospitals to help manage the demands of increasingly high volumes of COVID-19 patients. Cigna announced it will waive customers’ out-of-pocket costs for COVID-19 testing-related visits with in-network providers, whether at a doctor’s office, urgent care clinic, emergency room or via telehealth, through May 31, 2020. This includes customers in the United States who are covered under Cigna employer/union sponsored group insurance plans, globally mobile plans, Medicare Advantage, Medicaid and the Individual and Family plans. Employers and other entities that sponsor self-insured plans administered by Cigna will be given the opportunity to adopt a similar coverage policy. The company is making it easier for customers with immunosuppression, chronic conditions or who are experiencing transportation challenges to be treated virtually by in-network physicians with those capabilities, through May 31, 2020. Cigna’s Express Scripts Pharmacy offers free home delivery of up to 90-day supplies of prescription maintenance medications. Additionally, Cigna will offer a webinar to the general public raising awareness about tools and techniques for stress management and building resiliency, along with the ability to join telephonic mindfulness sessions. Cigna is covering the cost of coronavirus testing, waiving all co-pays or cost-shares for fully insured plans, including employer-provided coverage, Medicare Advantage, Medicaid, and individual market plans available through the Affordable Care Act. Organizations that offer Administrative Services Only (ASO) plans will also have the option to include coronavirus testing as a preventive benefit. Recognizing that health outbreaks can increase feelings of stress, anxiety and sleeplessness and sometimes loss. Cigna is also staffing a second phone line for customers. CVS Health CVS Health has formally launched its COVID-19 vaccination program for long-term care facilities, whose residents have been disproportionality impacted by the pandemic. CVS Pharmacy teams will administer the first dose of the Pfizer vaccine in facilities across 12 states this week, and the company expects to vaccinate up to four million residents and staff at over 40,000 long-term care facilities through the program. CVS Pharmacy teams will make three visits to each long-term care facility to ensure residents and staff receive their initial shot and critical booster. The majority of residents and staff will be fully vaccinated three to four weeks after the first visit, depending on which vaccine they receive. CVS Health expects to complete its long-term care facility vaccination effort in approximately 12 weeks. CVS Health will administer COVID-19 vaccinations starting this week in the following states: Connecticut, Florida, Kentucky, Maine, Maryland, Nevada, New Hampshire, New York, Ohio, Oklahoma, Oregon, and Vermont. Vaccinations will begin in 36 more states, as well as the District of Columbia, on December 28. Puerto Rico will activate on January 4. CVS Health and the CVS Health Foundation are making nearly $1.25 million in grants to help underserved communities in Ohio increase access to food and health care. CVS Health will provide $1 million to free and charitable clinics in Ohio to increase access to telehealth services in coordination with the National Association of Free and Charitable Clinics. Funds will help clinics add technology solutions, including software and hardware, increase training and staffing needs and secure internet services to support the practice of telemedicine. The company will also work with Feeding America to provide nearly $100,000 in grants to local food banks across Ohio to provide meal kits for seniors, school-aged children, and those who have had to shelter in place as a result of the COVID-19 crisis. Separately, the CVS Health Foundation will invest $150,000 over two years to support Cleveland Clinic and their full-service school-based health mobile unit. CVS Health will administer COVID-19 vaccinations to the public when authorized and available. CVS Health already announced it would provide COVID-19 vaccinations to long-term care facilities when the vaccine become available. CVS Health is expanding COVID-19 testing services currently offered at select CVS Pharmacy locations to include rapid-result testing at nearly 1,000 sites by the end of the year. Rapid-result COVID-19 diagnostic tests are available at no cost to patients who meet Centers for Disease Control and Prevention criteria. In addition, rapid-result tests may also be available as a testing option for eligible employees or students affiliated with an organization that has adopted CVS Health’s Return Ready™ return-to-work COVID-19 testing solution. To date, CVS Health has administered more than 5 million COVID-19 tests since March, and currently manages more than 4,000 drive-thru test sites at CVS Pharmacy locations in 33 states and Washington, D.C. Most results from these existing test sites are generally available within 2 to 3 days. CVS Health announced new and expanded programs to help prevent opioid misuse, which come as the COVID-19 crisis has presented challenges to delivering traditional drug abuse prevention programs for young people. The company’s newest initiative increases access to digital prevention education resources tailored for the current learning environment. Working with Discovery Education, CVS Health has launched a suite of no-cost digital resources that empower educators to discuss the facts about prescription and illicit drug misuse with students in either a classroom or virtual learning setting. The standards-based curriculum, called Dose of Knowledge, features Chicago Bears wide receiver Allen Robinson and U.S. Women’s National Soccer goalkeeper Adrianna Franch. The CVS Health Foundation, a private charitable organization created by CVS Health, has also committed nearly $3 million in new grants to address opioid misuse and support treatment in local communities. CVS Health is planning to add more than 2,000 new COVID-19 drive-thru test sites at select CVS Pharmacy locations across the country to support the company’s ongoing efforts to increase access to testing and help slow the spread of the virus. CVS Health currently manages the largest number of independently run COVID-19 test sites in the country, and with these new locations the company expects to have more than 4,000 operating by mid-October. The new locations will open in waves over the next several weeks and build on the company’s ability to support testing in 33 states and Washington, DC, beginning with the opening of more than 400 sites this Friday. CVS Health has announced that children 12 years and older are now eligible for COVID-19 testing at more than 2,000 drive-thru testing sites. In recent weeks, CVS Health has expanded its network of independent third-party lab partners in an effort to help improve turnaround time for the delivery of test results. As a result, the majority of test results from specimens collected at CVS test sites across the country will generally be available within 2 to 3 days. CVS Health has expanded its COVID-19 testing program by deploying 77 additional test sites at select CVS Pharmacy drive-thru locations across Florida. The opening of these new test sites on Friday, August 21 add to the 221 locations previously opened in Florida. The 77 additional test sites opening across the state this week are among the more than 1,900 locations CVS Health has opened since May and expand the company’s overall testing capacity. In addition to increasing the number of drive-thru sites, CVS Health has expanded its network of independent third-party lab partners in an effort to help improve turnaround time for the delivery of test results. Given the steps CVS Health has taken, the majority of test results across the country will generally be available within 2 to 5 days. CVS Health has launched Return Ready™, a comprehensive, customizable COVID-19 testing solution for employers and universities. The solution helps return employees to worksites and students, faculty and staff to campuses, and integrates COVID-19 testing for ongoing business continuity. With flexible technology options for on-site testing and/or drive-thru testing at CVS Pharmacy locations, organizations can design a customized testing strategy to meet their unique needs. Return Ready builds on CVS Health’s commitment to helping the country on its path forward by making COVID-19 testing available to consumers, the business community, universities and vulnerable populations impacted by the virus. CVS Health opened additional COVID-19 test sites at select CVS Pharmacy drive-thru locations on Friday, May 29 to establish a total of 1,000 sites across more than 30 states and Washington, DC. More than half of the company’s 1,000 test sites will serve communities with the greatest need for support, as measured by the Centers for Disease Control and Prevention (CDC) Social Vulnerability Index. CVS Health is working with Piedmont Healthcare in Georgia to support their solutions for increasing hospital bed capacity. This expands a recently launched strategy of Coram, the company’s infusion care business, to help transition eligible IV-therapy patients to home-based nursing care in response to COVID-19. Specifically, Coram has enhanced its clinical monitoring, virtual support and oversight through telehealth to complement existing personalized in-home support, coordination and administration of medications and supplies. The CVS Health MinuteClinic, the company’s retail medical clinic, is now offering expanded telehealth options to help patients access safe, affordable and convenient non-emergency care. In addition to traditional in-clinic patient visits, patients are now able to select a virtual E-Clinic visit with a local MinuteClinic provider for a wide variety of routine health care needs. This new telehealth option is available in Washington, D.C. and the 33 states where MinuteClinic currently operates, and is contracted with most health insurance plans. CVS Health is working with hospitals and providers, including UCLA Health, to support solutions for creating much-needed hospital bed capacity during the COVID-19 crisis. Coram, CVS Health’s infusion care business, has enhanced its existing home infusion capacity and capabilities to help transition eligible IV-therapy patients to home-based care. This includes enhanced clinical monitoring, virtual support and oversight through telehealth to complement existing personalized in-home support, coordination and administration of medications and supplies. Back to top D. Dean Health Plan Dean Health Plan will cover in-network inpatient hospitalizations for COVID-19 treatment with no copayment, coinsurance or deductible for the duration of the Public Health Emergency. Dean Health Plan will cover in-network hospitalizations for COVID-19 treatment with no copayment, coinsurance or deductible through Dec. 31, 2020. Dean Health Plan is covering in-network hospitalizations for COVID-19 treatment with no member cost sharing. Dean Health Plan is waiving in-network cost-sharing, including copayments, coinsurance and deductibles, for COVID-19 diagnostic testing. Dean Health Plan will cover the test and doctor visit at no cost to members when the basis for the visit is related to testing for COVID-19. Delta Dental Delta Dental of Iowa and the Delta Dental of Iowa Foundation have committed $10.5 million in grants to COVID-19 relief programs to help Iowa dentists and nonprofits. Delta Dental of Arizona Delta Dental of Arizona has also partnered with the Arizona Department of Administration to provide 30,000 toothbrushes and 30,000 tubes of toothpaste to homeless shelters and organizations serving vulnerable populations. Delta Dental of Arizona’s Interim PPE Support Program is designed to help offset the cost of PPE supplies, equipment and technology needed to safely reopen and scale up practices to provide dental services to Delta Dental of Arizona members amid COVID-19. A $10 PPE support payment will be calculated for all Delta Dental of Arizona member claims paid to a dental office from April 1 through July 31, 2020, with a maximum of one PPE support payment per patient per day. PPE support payments will be made as separate, monthly lump-sum payments that reflect the total number of Delta Dental of Arizona claims paid to the dental office for the period. Claims paid during the timeframe of the program are the only claims eligible for the PPE support payment. Delta Dental Plan of Arizona, through its foundation, is donating $500,000 to the 23 federally qualified health centers (FQHCs) across the state. Delta Dental of Arizona plans to provide a 25% premium credit to its fully-insured group dental clients. The move provides more than $3 million in relief to more than 2,900 companies statewide. Delta Dental of Arizona has also frozen rates for clients with 2-199 enrolled employees that renew PPO dental and/or vision plans May 1 through August 1, 2020. As a result, approximately, 650 small- to medium-sized businesses will not get an increase in rates and will continue to benefit from the same competitive premium rate for another 12 months. Delta Dental of Arizona is offering claims advances to network dentists affected by the novel coronavirus (COVID-19). The newly launched Advance Claim Payment Program will allow Arizona dental offices to receive an advance of up to $50,000 from the dental insurance company. Delta Dental of Arkansas Delta Dental of Arkansas provided $27.4 million in direct COVID-19 relief funding in 2020 while also enacting rate holds, offering grace periods for premium payments, easing eligibility requirements for coverage, retaining its full workforce and facilitating telecommuting for most of its employees. The beneficiaries included network group clients and members, dentists, Arkansas non-profit and community organizations as well as company employees. Delta Dental of Arkansas is providing financial assistance to its business clients and network dentists as Arkansans continue to feel the impact of COVID-19 on their businesses. The Pandemic Relief Credit gives a credit in the amount equal to 100% of the monthly premium billed to Delta Dental’s commercial business clients with dental and/or vision insurance. This premium “holiday” amounts to almost $15 million in credits to over 4,000 Arkansas business clients. Delta Dental of Arkansas has committed a total of $6.5 million in emergency financial assistance to dental practices in Arkansas. The new program – the Delta Dental of Arkansas Advance Receipts Program – will provide financial support to dental practices, who are limited to providing only emergency services during the COVID-19 outbreak. In addition, the Delta Dental of Arkansas Foundation, which is the organization’s charitable giving arm, will offer a total of $500,000 in grants to community organizations for projects directly related to COVID-19. Delta Dental of California The Delta Dental Community Care Foundation is donating $2.5 million to 39 food banks in 15 states and the District of Columbia. The COVID-19 crisis has elevated food insecurity rates across the country and increased the need for fully stocked food banks. Dental caries, a disease that causes tooth decay, has also been linked to food insecurity and the disruption of regular eating patterns. Delta Dental of California is making available an additional $100 million in loan funding to its independent provider network across 15 U.S. states and the District of Columbia for economic assistance and COVID-19-related relief. The increase in financial support brings to $300 million the total amount of the loan program, which is administered by Lendeavor, a leading digital lender that provides financial solutions to healthcare practices. The additional loan funding offers expanded ways for providers to use the funds, including practice acquisitions, new-location expansions, commercial real estate and equipment purchases, practice buildouts – which may include investment to support new health and safety standards – and refinancing existing practice and commercial real estate debt. This second phase also offers favorable loan terms including the first 12 months of interest covered by Delta Dental. Delta Dental of California is establishing a $200 million loan program to provide economic assistance and post-COVID-19 pandemic relief for its independent provider network across 15 U.S. states and the District of Columbia. As part of this aid, Delta Dental’s co-sponsored loan program will include interest subsidies, principal deferment and enable providers to refinance other business loans and get working capital. Delta Dental Community Care Foundation is providing $2 million funding for organizations in New York state helping vulnerable populations affected by COVID-19. The funding will be in the form of unrestricted grants for organizations that provide critical services to underserved individuals, including medical clinics and community service organizations. Delta Dental Community Care Foundation is making $5 million in funding available to organizations across its 15-state service area that are at the forefront of helping the communities most impacted by COVID-19. Funds will support a variety of response activities for at risk populations. Of the $5 million total, $3.5 million will support increasing access to care across the Foundation’s 15-state area. The majority will be provided to federally qualified health centers, which are government-funded clinics that provide primary care services in underserved areas and must offer a sliding fee scale based on a patient’s ability to pay, and other community health centers that serve on the front lines of this public health crisis and are working tirelessly to protect and treat those affected by the COVID-19 virus. The Delta Dental Community Care Foundation will make $1 million of this funding available to organizations responding to the unparalleled public health emergency and to current partners experiencing significant increases in expenses and/or budget shortfalls as a result of the COVID-19 pandemic. The Delta Dental Community Care Foundation will also be providing $500,000 in disaster response funding to California organizations that provide assistance to seniors, those living with food insecurity, those experiencing homelessness and homebound individuals. Delta Dental of Colorado Delta Dental of Colorado and the Delta Dental of Colorado Foundation (DDCOF), have collectively committed $30 million in the form of billing and premium credits, loans, relief funds, and grants to customers, oral health care providers, and local community organizations. Delta Dental of Illinois Delta Dental of Illinois Foundation, in partnership with Illinois Children’s Healthcare Foundation, awarded over $3 million in grants to 36 Illinois Federally Qualified Health Centers and other public health clinics that deliver vital health care services. The Foundations developed the grant opportunity to help offset costs associated with reopening and continuing operations during the COVID-19 crisis. Grants were focused on these health centers and clinics because they offer crucial services to Illinois residents who are underserved and may face obstacles to receiving needed care. The Foundations are committed to eliminating health disparities and recognize the important role these organizations have in providing care. The Delta Dental of Illinois Foundation has provided $1.5 million to help ensure Illinoisans continue to receive vital health services during the COVID-19 pandemic. The Foundation has provided $500,000 to support the Illinois State Dental Society Foundation and is also launching a $1 million emergency grants program to Federally Qualified Health Centers in Illinois. Delta Dental of Iowa Delta Dental of Iowa will provide a 25% premium relief credit for employer customers offering fully-insured dental and vision plans. The credit will cover April and May premiums and be applied to July premiums. A $10 payment will also be applied to claims for Delta Dental of Iowa members who have services between May 1 through August 31, 2020. In total, more than $4 million in additional support has been dedicated to Delta Dental network dentists through this program. Delta Dental of Iowa DeltaVision members with individual and family plans will also receive a 25% premium relief credit for April and May premiums. Members can choose to donate their premium relief credit to the Iowa Food Bank Association, which serves food banks in all 99 Iowa counties and Delta Dental will match members’ donations up to $250,000. Delta Dental of Iowa and the Delta Dental of Iowa Foundation have committed $10.5 million in grants to COVID-19 relief programs to help Iowa dentists and nonprofits. Delta Dental of Kentucky Delta Dental of Kentucky’s new Provider Advance Payment Program is making approximately $5 million available to help supplement Kentucky dental practices that have lost income following Gov. Andy Beshear’s March 18 executive order stopping all non-emergency medical and dental procedures. Delta Dental of Massachusetts Delta Dental of Massachusetts is providing $12 million more in relief to its fully insured clients, individual members, and independent dentists and oral surgeons working in DDMA network practices across the state, as the latest step in its comprehensive COVID-19 relief and recovery program. The new relief package will include credits to support Massachusetts fully insured clients and individual members as well as payments to eligible dental practices in DDMA’s network to help mitigate costs associated with new pandemic-related safety measures. The company previously announced $35 million in support for employers, individual members, and dentists during the first few months of the pandemic. Delta Dental of Massachusetts has donated $2 million to the Massachusetts Dental Society Foundation COVID-19 Recovery Fund, established to support the continued viability of community dental offices and dentists across the state following the extended COVID-19 shutdown. Delta Dental of Massachusetts will provide a 30% credit on premiums paid for April and May coverage, following approval by the Massachusetts Division of Insurance for individual subscribers who signed up directly and through the Massachusetts Health Connector. Additionally, DDMA will provide free access to its Delta Dental Patient Direct® card discount plan from June 1 through the end of the year for employees of DDMA’s clients, who have been furloughed or laid-off and lost their dental insurance coverage. For patients who choose to return to the dentist for preventive cleanings, DDMA will provide each member of a fully insured group plan who completes a preventive cleaning visit between June 1 and August 31 with a free electronic toothbrush. Delta Dental of Massachusetts has made three contributions totaling $200,000 to support Massachusetts non-profits in their response to community needs during the COVID-19 outbreak. Delta Dental of Michigan, Ohio, and Indiana Delta Dental of Michigan, Ohio, and Indiana will provide every licensed dentist in the three-state region a $1,000 credit for dental products and services beginning May 26, 2020 so they can maintain care and keep their communities healthy as patients begin seeing their dentists again. Since March, Delta Dental of Michigan, Ohio, and Indiana along with the Delta Dental Foundation, the philanthropic arm of the company, have committed about $88 million to assist local communities and partners through the pandemic. Delta Dental of Missouri Delta Dental of Missouri’s Land of Smiles® program, known for visiting hundreds of elementary schools throughout Missouri each year to teach grade-school children good dental health habits, has launched a new virtual experience in response to the continuing impact of COVID-19. The age-appropriate online program features a 30-minute video with brand-new Land of Smiles superhero characters, which can be used for students in the classroom and for those involved in partial or full-time virtual learning. More than 60 Missouri schools have already signed up to take advantage of this free virtual program. Delta Dental of Missouri is donating $500,000 to organizations providing COVID-19 relief efforts in Missouri, and in South Carolina, where the company does business as Delta Dental of South Carolina. Delta Dental of New Mexico Delta Dental of New Mexico donated $75,000 to support UNM Hospital crisis relief funds. A majority of the donation, $50,000, will support the UNM Hospital Crisis Relief Fund, which provides funds for equipment, supplies and other needed resources to care for patients and protect healthcare workers during the COVID-19 health emergency. The remaining $25,000 will support the UNM Hospital Employee Crisis Relief Fund, which provides funds for food and lodging for healthcare workers during this time of crisis. Delta Dental of Rhode Island Delta Dental of Rhode Island is providing $1 million in financial support to help participating dental practices meet the unforeseen expense of acquiring personal protective equipment (PPE). The amount of support is based on Delta Dental patient volume in each practice. Delta Dental of Tennessee Delta Dental of Tennessee has announced more than $325,000 in collective donations to the state’s seven children’s hospitals as part of Delta Dental’s ongoing COVID-19 response initiative, Operation #SmilesMatter. As the COVID-19 crisis hit, children’s hospitals suspended elective care, stockpiled supplies, and developed contingency surge plans to support their adult counterparts. Many children’s hospitals are nonprofit organizations and rely heavily on fundraising events to further their missions. With a large number of these events cancelled due to the pandemic, donations from the community have been crucial during this time. Delta Dental of Tennessee made a $50,000 commitment to support COVID-19 relief efforts across Tennessee through The Salvation Army Nashville Area Command and Second Harvest Food Bank of Middle Tennessee. The nonprofits will receive $25,000 each to distribute across the state based on need. Delta Dental of Tennessee also announced a commitment of more than $3.3 million for Operation #SmilesMatter, a grant program to help Tennessee dentists acquire much-needed supplies, equipment, and technology as they prepare to reopen their practices following COVID-19-related closures. Delta Dental will be funding a $1,000 “allowance” or credit available to all dentists in Tennessee, regardless of whether they participate in Delta Dental’s network, to purchase dental products. Delta Dental of Virginia Delta Dental of Virginia and the Delta Dental of Virginia Foundation have donated $3 million to help alleviate the financial burden on practices and their patients and to increase patients’ confidence in seeking oral health care. The funds will be distributed to the more than 4,500 dentists in the Delta Dental of Virginia network. Dental practices may use these donated funds to cover operating expenses associated with safety guidelines, including acquiring personal protective equipment. Delta Dental of Virginia has made a $1 million contribution to support Virginia’s dental practices and their patients, provide financial assistance for safety net dental clinics, and support local non-profits working to meet needs in their communities. Delta Dental of Wisconsin Delta Dental of Wisconsin Foundation Cool Water Program has awarded $100,000 to 27 schools in Wisconsin for water bottle filling stations this year. Traditionally, the Cool Water Program grant has covered the installation cost of new filling stations at 20 schools and provided toothbrushes and dishwasher-safe water bottles for all students and staff. This year, though, the Wisconsin Department of Public Instruction recommended that schools discontinue the use of shared drinking fountains. So, the Foundation decided to forego the water bottles and toothbrushes and fund seven more schools instead. The Delta Dental of Wisconsin Foundation has provided $800,000 in grants to safety-net clinics in Wisconsin as well as an additional $100,000 for food security programs. Delta Dental of Wyoming Delta Dental of Wyoming has committed more than $300,000 for Operation #WyomingSmiles, a grant program to help Wyoming dentists acquire much needed supplies, equipment and technology as they reopen their practices following COVID-19-related closures. Delta Dental will fund a $1,000 “allowance,” or credit, available to all participating dentists in Wyoming, to buy dental products and services. DentaQuest DentaQuest has contributed $300,000 to the OneStar Foundation Texas COVID Relief Fund, which is raising and distributing funds to eligible organizations working to support the economic recovery of Texas communities impacted by the coronavirus. The DentaQuest donation is the largest received to date. The Fund will provide grants of up to $150,000 to support projects that address the unmet needs of vulnerable populations and underserved communities in the areas of community and economic development, healthcare, and education. DentaQuest is also committing an additional $100,000 to support dentists throughout the state with contributions to Dentists Who Care, Texas Dental Association Smiles Foundation and Texas Academy of Pediatric Dentistry. The DentaQuest Partnership for Oral Health Advancement is offering free online continuing education credit courses for dentists, hygienists, dental assistants and other dental care team members, including a COVID-19 Education Series designed to help educate in the areas of infection control and other best practices for the re-opening of dental clinics. The DentaQuest Partnership’s online learning center offers engaging resources – free of charge – for dentists and other healthcare providers looking to implement practice improvement initiatives and prevention-focused care. All courses are designed and delivered by expert faculty members, including clinicians, academics, data scientists, government and nonprofit leaders and oral health educators. Back to top E. Empire BlueCross BlueShield Empire BlueCross BlueShield has donated funds to the Joint Council for Economic Opportunity of Clinton and Franklin Counties to support the Backpack Program. The program provides a weekly bag of food to students from 4 local elementary schools. These funds come at a time when fundraising events have been cancelled due to the COVID-19 crisis, and the need for the programs has been growing due to COVID-19 and its impact on families in the local communities. Empire BlueCross BlueShield will cover COVID-19 treatments for enrollees with individual and family plans with no copays or cost-sharing through December 31, 2020, as long as members receive treatment from doctors, hospitals, and other health-care professionals in their plan’s network. Costs are also waived for Medicare Advantage enrollees seeking COVID-19 treatment through December 31, 2020, including inpatient and outpatient services, respiratory services, durable medical equipment, and skilled-care needs. Empire BlueCross BlueShield has launched [email protected], a teledentistry and at-home orthodontia program. The services is part of Empire’s continuing commitment to providing access to affordable services that meet a person’s whole health needs, while also providing safe, remote-care during the COVID-19 crisis. Consumers with orthodontic benefits will have access to at-home clear aligner therapy, remote oversight of care, teeth whitening, and retainers at completion of treatment with an average cost up to 60% less than traditional orthodontia and three times faster. This offering helps improve member access to orthodontic care – especially in rural areas where over half of the counties in the United States do not have access to orthodontists’ offices. The Empire BlueCross BlueShield Foundation has committed more than $200,000 to organizations on the frontlines of providing New Yorkers with critical access to food during the ongoing COVID-19 pandemic. Of the $200,000 dedicated to fighting food insecurity, Empire has made contributions of $50,000 each to City Harvest and Food Bank for New York City, which will support local families during the COVID-19 outbreak.   Back to top F. Florida Blue Florida Blue is waiving the cost share for covered services for the treatment of a positive COVID-19 diagnosis through Aug. 31, 2021. Florida Blue is waiving cost-sharing payments for covered services for COVID-19 treatment through December 31, 2020. Additionally, all general medicine visits through Teladoc, Florida Blue’s telehealth partner, will continue to have a $0 cost share through December 31, 2020. Florida Blue is more than tripling its COVID-19 community investments to over $7 million. In March, the insurer provided an initial $2 million to organizations across the state to address urgent health and safety needs. Florida Blue will invest an additional $2.5 million to provide access to testing and health care, food security and other essential needs for Floridians. Additionally, the insurer plans to contribute more than $2.6 million to United Way organizations across Florida. More than $1 million of the additional funding is dedicated to providing COVID-19 testing and access to health care for underserved Floridians. Florida Blue will work with its partners at organizations such as the Florida Association of Free and Charitable Clinics, Federally Qualified Health Centers and others to identify opportunities across the state to address areas in need. A three-year grant of $220,000 to UF Health will help provide necessary technology for the development of a model for COVID-19 diagnostic tests called pooled testing. The model allows more people to be tested at a substantially reduced cost and will be exportable to other labs with similar technology. Over $1.3 million will also address food security for seniors, children and disadvantaged families, support the mental health of those impacted by the COVID-19 crisis and provide essential needs to those struggling due to the pandemic. Florida Blue is extending the premium due date through the end of June for customers who needed extra time to pay premiums as a result of the COVID-19 health crisis and would otherwise have been subject to termination of coverage. The payment extension applies to Individual – Affordable Care Act (ACA) and non-ACA – plans, Fully Insured Employer Group health plans and Medicare Supplement plans. Additionally, all member cost sharing payments for in-network primary care office and telehealth visits, as well as behavioral health-related office, outpatient and telehealth visits, will be waived for Florida Blue’s Medicare Advantage plan members through December 2020. Florida Blue will also waive cost-sharing for its members who must undergo testing and treatment for COVID-19, including in-patient hospital admissions, through August 1, 2020. Florida Blue is offering a dedicated COVID-19 virtual assistant on its public websites at www.FloridaBlue.com and www.FloridaBlue.com/COVID19, free and available to anyone. The assessment function of the new virtual assistant pops up automatically on the websites, and guides users through educational content or through a series of questions to check for COVID-19 symptoms and related risk factors. Based on the assessment results, the tool directs users to contact their primary care provider for next steps, to the Florida Blue Center nurses for answers to commonly asked questions about COVID-19 and connection to community resources, or to immediate care options as needed. Florida Blue will waive cost-sharing through June 1 for its members who must undergo treatment for COVID-19, including in-patient hospital admissions. The announcement impacts all Florida Blue members with Affordable Care Act, Medicare Advantage (excluding Part D drug plans) and other individual plans, as well as all fully insured employer group health plans. Florida Blue is allowing groups and individual members more time to pay through May 31, 2020 for customers unable to pay premiums as a result of the COVID-19 health crisis that would otherwise have been subject to termination of coverage. Florida Blue is adding a free-to-member virtual care partner, Teladoc, for seniors and others on its Medicare Advantage plans, and waiving the virtual care copay for many commercial and Affordable Care Act members to encourage use of Teladoc if it is offered as part of their plan. Additionally, during this pandemic, Florida Blue’s network of primary care doctors and specialists will be able to treat patients virtually at their normal office visit rates. Florida Blue will waive all copays and deductibles for the medical testing for COVID-19 for members who are part of its commercial insurance plans, including the Affordable Care Act (ACA) Individual and Medicare Advantage plans. The company is waiving early medication refill limits on 30-day prescriptions, is encouraging the use of virtual care, and is offering mental health support for experiencing stress from COVID-19. First Choice Health First Choice Health is covering the cost of telehealth services for its self-funded employer customers via on-demand primary care service 98point6. First Choice Health will provide its employer customers complimentary access to 98point6 for 60 days. Back to top G. Gateway Health Gateway Health is committing more than $1 million to support non-profit organizations, community partners and social determinants of health causes in 2020. Many of the areas where Gateway Health members live have been hit especially hard by the economic challenges associated with COVID-19, including food insecurities. Gateway Health’s donation to this important relief effort will assist communities across Pennsylvania. They will be able to expand access to much needed heathy food options in light of the ongoing COVID-19 crisis. The donation also supports ongoing nutrition education and resources in these areas. Gateway Health is waiving all member co-payments, co-insurance and deductibles associated with COVID-19 testing and medical treatment. This applies to in-network and out-of-network inpatient, outpatient and emergency department services related to COVID-19 treatment. The decision to waive member cost-sharing affects all Gateway members participating in Pennsylvania Medicaid HealthChoices and Medicare Assured Part C plans. Back to top H. Harvard Pilgrim Health Care Harvard Pilgrim Health Care is waiving cost-sharing payments for COVID-19 treatments from in-network providers and for emergency services related to COVID-19 treatment from out-of-network providers if the policy was purchased in Massachusetts. Cost-sharing payments for COVID-19 telehealth treatments are also being waived if the policy was purchased in Massachusetts. Harvard Pilgrim Health Care is waiving member cost-sharing payments for COVID-19 treatments provided by in-network providers through March 31, 2021. Cost-sharing for emergency services related to COVID-19 treatment administered by out-of-network providers will also be waived. Harvard Pilgrim Health Care has waived member cost sharing (deductibles, copays, coinsurance) for COVID-19 treatment provided by in-network providers through January 31, 2021. Cost-sharing for emergency services related to COVID-19 treatment administered by out-of-network providers will also be waived. This enhanced policy applies to all Harvard Pilgrim fully insured commercial, Medicare Advantage and Medicare Supplement members. Harvard Pilgrim Health Plan has waived all cost-sharing payments for COVID-19 treatment provided by in-network providers through December 31, 2020. The waiver applies to all Harvard Pilgrim fully insured commercial, Medicare Advantage, and Medicare Supplement members. Telemedicine service will stay covered in full for Medicare Advantage members through December 31, 2020. Harvard Pilgrim Health Care is providing 120 Connecticut independent primary care practices with $10,000 each to assist with providing safe access to care for patients including the purchasing of necessary personal protective equipment (PPE), reconfiguring facilities to assist with physical distancing guidelines, supporting telehealth infrastructure, and other important necessary measures.  Harvard Pilgrim has committed $3 million to support independent primary care practices in Massachusetts, New Hampshire, Connecticut and Maine. The independent primary care practices Harvard Pilgrim is supporting are, on average, small and physician-owned, many with limited access to capital or other external support to assist them during the pandemic. While shortages of PPE have eased since the start of pandemic, many of these practices are forced to explore expensive avenues or use multiple vendors to purchase PPE, as the supply chain typically favors large health care systems with significant buying power. Additionally, many practices, especially those in rural communities, lack the resources and infrastructure to fully integrate telehealth into their practices. Harvard Pilgrim Health Care will be providing $32 million in premium credits to all its fully-insured employer groups, as well as to Medicare Supplement members. Harvard Pilgrim is awaiting regulatory approval for this action in Connecticut which it expects to receive shortly. Additionally, the nonprofit health plan announced it will provide $3 million in financial support to independent primary care physicians, $3 million to support community health centers, and the insurer will waive all primary care and specialty care copays for office visits for Medicare Advantage members through the end of the year. Harvard Pilgrim will be providing the following relief and support to members, customers, independent primary care physicians and community health centers: Fully-insured Employer Groups regardless of size or location, will receive a 15% credit on their September premium invoice ($30 million total). Medicare Supplement Members will receive a 15% credit on their September invoice ($2 million total). Medicare Advantage members copays for all primary and specialty care office visits will be waived starting July 1stuntil the end of 2020. Independent Primary Care Practices will have access to $3 million in financial support to assist with aspects of reopening their practices. To support the provider community, Harvard Pilgrim provided over $40 million in financial advances to providers throughout the region. Community Health Centers, focusing on those providing care to predominately black and brown communities, as well as centers that provide care for vulnerable populations, will receive $3 million to support equity and equality in accessing health care, and address health disparities. COVID-19 testing and treatment cost-share waiving and no out-of-pocket expense for telehealth services will continue to be provided through September 30, 2020. Harvard Pilgrim will reassess these policies as circumstances warrant. Harvard Pilgrim Health Care Foundation and Convenient MD have partnered to open a drive-thru COVID-19 testing site at Harvard Pilgrim Health Care’s Quincy headquarters’ parking lot, located at 1600 Colony Drive. Harvard Pilgrim Health Care is waiving member cost-sharing related to treatment for COVID-19. The waiver applies to medical costs associated with COVID-19 treatment at in-network facilities and out-of-network emergencies. Harvard Pilgrim has also donated over $3 million to COVID-19 relief efforts by supporting community organizations in Connecticut, Maine, Massachusetts, and New Hampshire. The money will help select restaurants throughout the region to provide and deliver take-out meals to families in need and help to put people back to work. Additionally, these resources will assist communities in facilitating access to COVID-19 testing. Harvard Pilgrim Health Care will cover the costs of diagnostic testing for COVID-19, waive cost sharing for all telemedicine visits and allow early refills for prescription medications. Self-insured groups will have the ability to opt-in at their discretion. Health Care Service Corp. (HCSC)  Heath Care Service Corp. is providing approximately $240 million in relief to fully insured employer customers in the form of a premium credit. The company has obtained all necessary approvals. The premium credits are the latest relief action HCSC through its health plans have taken, totaling more than $930 million, in response to the global health crisis. Health Care Service Corp. will launch the Employed Clinician Volunteer Program for more than 3,000 doctors, pharmacists, nurses, behavioral health specialists and other clinicians with varied specialty backgrounds. Through this program, HCSC will pay eligible and approved HCSC employees, who are medical clinicians, to volunteer for patient care in their field for up to 80 hours of paid time during their regular scheduled work hours. HCSC is waiving member cost-sharing, including deductibles, copayments, and coinsurance related to treatment for COVID-19. The waiver applies to costs associated with COVID-19 treatment at in-network facilities and treatment for out-of-network emergencies. HCSC will also offer a special enrollment period for its insured group customers. Employees of fully insured group customers who did not opt in for coverage during the regular enrollment period will have an opportunity to get coverage for their health care needs. The special open enrollment period begins April 1 and will end April 30, 2020. Health Care Service Corp. (HCSC) will waive co-pays and deductibles for COVID-19 testing and will not require prior authorization for those tests. This applies to all members they insure; the company is working with self-insured plans on their decisions. Healthfirst, Inc. Healthfirst, Inc. is waiving co-pays for all diagnostic testing and evaluations related to coronavirus. This means that if a primary care physician or in-network provider orders a coronavirus test, the person’s Healthfirst health plan will cover the cost for the test and the in-network provider visit related to the coronavirus evaluation. Members will not be subject to any cost sharing for the test or the in-network provider visit. HealthPartners HealthPartners is waiving cost-sharing payments for COVID-19 treatment through December 31, 2021. The waiver applies to fully insured employer and individual members. For Medicare and Medicaid members, the cost-sharing waiver extends until the federal government declares an end to the public health emergency. HealthPartners is waiving cost-sharing payments for COVID-19 treatment through March 31, 2021. The waiver applies to fully insured employer and individual members. For Medicare and Medicaid members, the cost-sharing waiver extends until the federal government declares an end to the public health emergency. HealthPartners is providing premium credits totaling more than $40 million to many of its individual commercial insurance purchasers and fully-insured employer group purchasers. The credit will be applied to December premiums. HealthPartners is waiving the cost for fully insured members for the treatment of COVID-19 when getting care from an in-network provider, through December 31, 2020. HealthPartners is also waiving the cost for fully insured members for the treatment of COVID-19 when getting care from an in-network provider, effective March 1 through September 30, 2020. This includes copays, coinsurance and deductibles. HealthPartners is waiving Medicare member cost-sharing for all in-network primary care and behavioral health visits, effective July 1-Dec. 31, 2020. This will provide members with financial relief and encourage members to seek important and necessary care during the COVID-19 crisis. Cost-sharing will be waived for in-person, phone and video primary care and behavioral health visits, including visits for substance abuse when services provided are in-network. This applies to all HealthPartners Medicare Advantage, Cost and group retiree plans in Minnesota, North Dakota, South Dakota, Iowa, Illinois and Wisconsin. HealthPartners is offering an innovative solution to provide consultation and direct support for businesses as they work to reopen, safely return workers and welcome back customers during the COVID-19 pandemic. The new “Back to Business” COVID-19 employer preparedness solution is based on medical expertise and the latest scientific evidence and offers personalized support to businesses, including: COVID-19 preparedness planning. An employer assessment with personalized recommendations and best practices that support COVID-19 preparedness plan requirements Medical consultation on business preparedness. Medical expertise on how to safely resume business operations Absence policies consultation. Recommendations and best practices for employer absence policies regarding Family and Medical Leave Act expansion and Emergency Paid Sick Leave legislation related to COVID-19 Employee communications consultation. Support for communicating employer preparedness plans to employees and customers Employee screening. Recommendations and implementation of COVID-19 screening best practices such as temperature, questionnaire or attestation screening as appropriate Employee testing. Recommendations and implementation of COVID-19 testing best practices for both symptomatic and asymptomatic employees Follow-up care support. Support for employees who screen at-risk of COVID-19 or test positive, connecting them to available resources Absence management. Case management for various leave types to keep employers compliant with regulations, minimize risk and reduce costs associated to employee leaves The HealthPartners Dental Plan will provide monetary relief to network providers as they face the cost of acquiring PPE to care for patients. Beginning June 17th the HealthPartners Dental Plan will reimburse network providers the amount of $10 per visit through the use of the CDT code “D1999 – unspecified preventive procedure, by report” to document and report the use and cost of additional PPE. Dentists can use this code once per patient visit/claim/day to attempt to offset the heightened cost of PPE. HealthPartners Institute and researchers at the University of Minnesota have teamed up with developers to create a mobile app that provides users with data about the health of their neighborhood, helping them avoid potential COVID-19 hotspots. The SafeDistance app crowdsources data down to the level of people’s census block groups. These census block groups usually contain around 1,500 people and most accurately reflect neighborhoods. HealthPartners is providing coverage with no cost share for the administration of the COVID-19 laboratory test (regardless of where the test is performed). It is also providing coverage with no cost share related to an in-network office visit or urgent care visit associated with the test. HealthPartners will waive fully insured members’ cost-share for the treatment of COVID-19 – including copays, coinsurance and deductibles–when getting care from an in-network* provider, effective March 1 through May 31, 2020. Health Plan of San Joaquin Health Plan of San Joaquin worked with the San Joaquin County Medical Society to plan for the distribution of medical-grade PPE from California Medical Association. Over 140 local small and medium-sized practices were able to safely receive boxes of medical-grade PPE, including N95 and surgical masks, gowns, gloves and face shields. There is no cost to Health Plan of San Joaquin members for receiving medically-needed screening, testing, and treatment for COVID-19. Highmark Most Highmark members who need in-network, inpatient hospital care for COVID-19 won’t have to pay for things like deductibles, coinsurance, or copays through December 31, 2021. Highmark is waiving all cost-sharing payments for COVID-19 hospital treatment through March 31, 2021. Highmark is also waiving all copays and deductibles for telemedicine through March 31, 2021. Highmark is donating over 100,000 masks to community organizations in need throughout Pennsylvania, West Virginia, and Delaware. Across the three states, 145 community organizations received the bulk-quantities of face masks including more than 90,000 adult-size face masks and 4,300 youth-size face masks. In Southwestern Pennsylvania specifically, over 21,500 masks were donated to 72 community organizations. Highmark is extending a waiver of cost-sharing – such as deductibles, coinsurance and copays — for members who require in-network, inpatient hospital care for COVID-19 through Dec. 31. Highmark is also extending a waiver of telehealth services through Dec. 31. The waiver for in-network telehealth visit cost-sharing will also be extended through Dec. 31.  As with COVID-19 treatment, self-funded employer groups for which Highmark administers benefits may also opt-out of this waiver. Highmark’s Medicare Advantage members will have no cost-sharing for inpatient hospital care for COVID-19 and telehealth visits for both in- and out-of-network care through Dec. 31. Highmark is donating Back-to-School Toolkits containing personal protective equipment and resources to school districts across Pennsylvania and Delaware. School districts with Highmark coverage will receive adjustable face coverings to fit a wide age range of students, face shields for teachers and staff members, disinfectant hand wipes, large one-gallon pumps of hand sanitizer, signage containing best practices, and resource guides to assist with the transition to the new school year, courtesy of Highmark. Signage and resource guides are also available for download on the Highmark Employer Back-to-School Toolkit website. School districts will be given the option to schedule when and where they will receive the supplies to align with their current and future reopening plans. In addition to supplies and resources, Highmark hosted a Back-to-School webinar in collaboration with clinical leaders from Allegheny Health Network (AHN) on August 5 for school districts to provide current information on COVID-19 to school decision-makers. Highmark Blue Cross Blue Shield, Latino Connection, the Pennsylvania Department of Health, and the Independence Blue Cross Foundation have partnered to create the first-in-the-nation COVID-19 Mobile Response Unit to provide testing and education targeting minority and underserved communities throughout Pennsylvania. In total, this testing effort costed $498,000. The department Epidemiology and Laboratory Capacity Enhancing Detection fund contributed a $331,000 grant. In addition, specimens will be collected and taken to the Pennsylvania Bureau of Laboratories for testing after each event. Known as CATE, Community-Accessible Testing & Education, the unit is equipped to conduct COVID-19 testing on-site through a mobile RV vehicle while also educating the public on how to stay healthy and safe. The mobile response unit’s tagline is “Sharing knowledge to erase fear,” which it intends to do through widespread community healthcare and health education offered with no insurance required. Highmark is sending cloth face coverings to Direct Pay Medicare members in Pennsylvania and West Virginia as part of its 1 million face covering initiative. Members who have individual Highmark Medicare Advantage plans can expect to receive one face covering per member at their residence through the remainder of August and early September. In total, nearly 150,000 face coverings will be distributed across both states. Highmark is waiving all virtual medicine and telehealth costs through Sept. 30, 2020. Highmark is also waiving all costs for care if a patient is in the hospital being treated for COVID-19 through Sept. 30, 2020. Highmark is joining forces with four small and diverse Pittsburgh-based businesses to design, manufacture and donate over 1 million cloth face coverings throughout the summer months. The face coverings will be distributed to at-risk and vulnerable Highmark members, community organizations in need, health care professionals, and employer groups across Pennsylvania, Delaware and West Virginia. Highmark has collaborated with the CDC Foundation and Microsoft to develop and launch the COVID-19 Symptom Checker Healthbot. Anyone can use the Healthbot to check their symptoms, which will then provide guidance on seeking appropriate medical care when necessary during the COVID-19 pandemic. Highmark has announced that its commercial, Affordable Care Act and Medicare Advantage members in Pennsylvania and Delaware now have access to a comprehensive, technology-enabled opioid use disorder (OUD) program. The program, which was first rolled out to Highmark’s West Virginia members in January of 2020, will help preserve treatment access and promote recovery during the COVID-19 pandemic and beyond. Highmark is waiving deductibles, co-insurance, and copays for members who require in-network, inpatient hospital care for COVID-19. The waiver will continue through May 31 as Highmark continues to monitor and evaluate the rapidly changing nature of this crisis. Highmark has also introduced an additional 30-day grace period on late premium payments allowing members the ability to maintain their coverage and avoid cancellation for a more extended period of time. Highmark will assist local primary care physicians by advancing payments made through the True Performance reimbursement program. The reimbursement payments would have been made in June, but will begin going out the week of April 6 as many physician practices are being affected financially by stay-at-home orders and other COVID-19 related issues. More than 1,700 primary care practices or associated entities in Pennsylvania, West Virginia and Delaware will receive the advanced payments based on achievement in the True Performance program. More than $30 million in advanced payments will be made during this extremely challenging time. Highmark will cover coronavirus testing, when recommended by a medical professional, for members of its fully insured group customers, as well as members of its Medicare Advantage and ACA plans. Self-insured health plan sponsors will be able to opt-out of the program. Highmark has also waived member cost sharing for all covered telehealth services for 90 days and expanded access to telehealth vendor platforms for Medicare Advantage and Medicaid members. Highmark Health Highmark Health has expanded coverage for telehealth to all members, including self-funded customers who had previously opted out of telehealth coverage. Highmark Health is also covering COVID-19 testing, both in-network and out-of-network, up to charges for out-of-network providers. Highmark Health is ensuring access to teleaddiction services for members in PA, WV and DE who are in addiction treatment and need immediate help, but may not be able to access their regular provider during this time. These services are covered for both in- and out-of-network without cost sharing for members for 90 days. Horizon Blue Cross Blue Shield of New Jersey Through June 30, 2021, most Horizon members will not pay any cost share (copay, coinsurance, deductibles) for covered services related to inpatient or outpatient treatment when the primary diagnosis is COVID-19 Horizon Blue Cross and Blue Shield of New Jersey has extended its member cost-sharing waiver for COVID-19 treatment through March 31, 2021. Horizon Blue Cross Blue Shield of New Jersey has extended through December 31, 2020 the cost-sharing waiver for covered services related to inpatient or outpatient treatment when the primary diagnosis is COVID-19. The waiver applies to all fully insured members, including those covered through Medicaid, Medicare Advantage, Individual and Small Group policies, as well as members covered by the State Health Benefits Program (SHBP) and the School Employees’ Health Benefits Program (SEHBP). Horizon Blue Cross Blue Shield of New Jersey has extended the waiver of member cost sharing for treatment of COVID-19 through August 31, 2020. This means that members will pay no deductible, copay or coinsurance for inpatient and outpatient care when claims indicate treatment was directly related to treatment of COVID-19 as the primary diagnosis. Horizon Blue Cross Blue Shield of New Jersey has launched Horizon Neighbors in Health, a comprehensive program to address social determinants of health. The state’s largest health insurer is investing $25 million and partnering with some of New Jersey’s most respected health organizations over the next three years on a model that employs local Community Health Workers to connect members with a wide-array of services that make good health more possible. Addressing social determinants of health has become even more critical in light of the COVID-19 pandemic. Individuals whose access to services and care was challenging in the best of circumstances, now face even greater challenges. Horizon Blue Cross Blue Shield of New Jersey has partnered with AbleTo to offer its members free access to AbleTo’s individual teletherapy services. This partnership builds on Horizon BCBSNJ’s larger initiative to provide in-network telemedicine services to members with zero out-of-pocket costs until at least June 30, 2020. Horizon Blue Cross Blue Shield of New Jersey has donated $2 million to The New Jersey Pandemic Relief Fund, the response and support organization established by Tammy Murphy, New Jersey’s First Lady. With the donation, Horizon has contributed $4.35 million for protective equipment for health care workers, food, and social services in response to the COVID-19 outbreak. Horizon has also expanded paid-time-off for volunteer service to provide those employees answering New Jersey Governor Phil Murphy’s Healthcare Professionals Call to Serve with 40 hours of compensated volunteer time. 72 doctors, nurses, pharmacists, and clinicians from Horizon have volunteered and are awaiting deployment. Horizon Blue Cross Blue Shield of New Jersey is extending its previously announced waiver of all member cost-sharing obligations to include all covered benefits associated with treatment for COVID-19. The policy, retroactive to March 1, 2020 and in place through at least June 30, 2020, means that members will pay no deductible, co-pay, or coinsurance for inpatient and outpatient care when their claim indicates treatment was related to COVID-19. Horizon Blue Cross Blue Shield of New Jersey is also is spending $2.35 million to donate 500,000 N95 respirator masks and 81,000 face shields to Governor Murphy’s coordinated response effort. Horizon Blue Cross Blue Shield of New Jersey will waive prior authorizations for diagnosis of COVID-19, cover the full cost of diagnostic testing for COVID-19, waive early medication refill limits for 30-day prescription medications, and provide access to telehealth services at no cost. Humana For the 2021 plan year, Humana will cover out-of-pocket costs for COVID-19 treatment for all Humana Medicare Advantage medical plan members.  Humana Medicare Advantage members will have no copays, deductibles, or coinsurance out-of-pocket costs for covered services for treatment of confirmed cases of COVID-19, regardless of where the treatment takes place. This could include telehealth, primary care physician visits, specialty physician visits, facility visits, labs, home-health and ambulance services. For Medicaid plans, members are encouraged to check their plan documents for details about their 2021 coverage. Medicaid plans will continue to follow state requirements for COVID-19 treatment and cost-share waivers. Effective January 1, 2021, employer group members’ standard benefits and cost sharing will apply for COVID-19 treatment. This does not apply to Part D-only plan members. Part D-only plan members continue to be eligible for prescription benefits. Regarding COVID-19 testing, members with medical coverage through Humana can receive no-cost COVID-19 diagnostic tests, including Medicare Advantage, Medicare Supplement, commercial (fully insured and self-funded plans), and Medicaid members. Humana has partnered with several of Ohio’s leading community service organizations to address social factors that can significantly impact individual and community health, including food insecurity and housing insecurity. Both of these social determinants of health are even more acute today in light of the COVID-19 pandemic and the related economic downturn. These latest community investments total nearly $500,000 and build on an earlier Humana initiative to provide more than $1.6 million in COVID-19 relief and recovery assistance in Ohio. Humana has delivered more than $1.6 million in financial grants in Ohio for COVID-19 relief and economic recovery efforts. The Humana Foundation has issued more than $1 million in direct relief to Ohio non-profits organizations fighting the community impact of COVID-19, while Humana Regional COVID-19 Relief and Investment funds have contributed roughly $400,000 to community organizations, including the Ohio Association of Food Banks and the Coalition on Homelessness and Housing in Ohio. Humana’s Rapid Response initiative has facilitated the delivery of more than 20,000 meal kits throughout Ohio. Humana and the Humana Foundation have committed more than $1 million in COVID-19 relief for communities in Georgia to date. Support from The Humana Foundation includes a $500,000 commitment to the Community Foundation for Greater Atlanta’s COVID-19 Response and Recovery Fund. Additionally, Humana has contributed to health and housing initiatives in the state, including: $25,000 to the Atlanta Volunteer Lawyers Foundation for eviction rental assistance and utility support; $15,000 to the ARCHI Diabetes Telephonic Coaching Line; $10,000 for personal protective equipment provided to several rural hospitals in Georgia, in partnership with HomeTown Health; $8,000 to HOPE Atlanta’s COVID-19 response housing initiative; and $4,000 to the American Diabetes Association’s Virtual Diabetes Forum. Humana will mail more than 1 million in-home preventive care screening kits to members in 2020, helping increase access to routine screenings that many members have put off during the COVID-19 crisis. Humana’s new initiative, which triples the number of screening kits sent to members, comes as many people have postponed all but the most necessary health procedures during COVID-19, limiting doctors’ appointments and emergency room visits. Humana announces at-home and drive-through COVID-19 testing: Humana is proud to be the first insurer to offer LabCorp® at-home COVID-19 test kits and drive-thru COVID-19 testing at hundreds of Walmart Neighborhood Market pharmacies across the country. Testing is available for all eligible medical plan members, including Medicare Supplement. If testing is recommended, members can opt to have a testing kit mailed to their homes within one business day. If members prefer a drive-thru test, Humana has teamed up with Walmart, Quest Diagnostics, and PWNHealth to offer drive-thru testing at Walmart Neighborhood Market pharmacies. The pharmacy staff will give members a test kit and help complete the process correctly. Humana is continuing to waive all member costs related to covered COVID-19 testing and treatment. The Humana Foundation has awarded $2.2 million to nonprofit organizations in Louisville as part of its ongoing Community Partners Program. The initiative began in 2018 and has since awarded more than $6 million to local nonprofits addressing social determinants of health and creating greater health equity in Humana’s corporate hometown. The most vulnerable are disproportionately experiencing the economic and health implications of COVID-19. These challenges are compounding issues many were dealing with before the pandemic, including hunger and financial instability. As of June 1, Humana will pay an additional $7 per Humana member dental claim – for all fully insured Humana dental members. At the end of each month, Humana will send a stipend to its dental provider partners, based on the total number of claims for Humana members that month. In addition to this financial support, Humana is also offering 24/7 access to its EAP and Work-Life Services to providers in its dental networks. These actions are a part of the company’s wide-ranging proactive approach to supporting a better health care experience for its members, especially during this unprecedented health crisis. Humana is eliminating out-of-pocket costs for office visits so that Medicare Advantage members can reconnect with their healthcare providers. To reduce barriers, Humana is waiving in-network primary care costs, not only for COVID-19 costs, but all primary care visits for the rest of 2020. In addition, the company is waiving member costs for outpatient, non-facility based behavioral health visits through the end of year. Humana is also extending telehealth cost share waivers for all telehealth visits—PCP and specialty, including behavioral health, for in-network providers through 2020. The Humana Foundation will deploy $50 million in immediate short-term and long-term relief and partner with national and community service organizations to help those disproportionately impacted by the COVID-19 health crisis. The commitment will be split between organizations that support essential workers, food security, behavioral health and community-based organizations. The Humana Foundation will distribute $34 million of the $50 million commitment to the immediate short-term response efforts of service organizations on the frontlines of the COVID-19 health crisis. The remaining $16 million will go toward long-tern recovery and rebuilding support for service organizations that are fighting COVID-19. Humana is providing financial and administrative relief for the health care provider community facing unprecedented strain during the coronavirus pandemic. Humana is also expanding its policy of suspending prior authorization and referral requirements, instead requesting notification within 24 hours of inpatient (acute and post-acute) and outpatient care. Humana is waiving consumer costs for treatment related to COVID-19-covered services. Costs related to treatment for COVID-19, including inpatient hospital admissions, will be waived for enrollees of Medicare Advantage plans, fully insured commercial members, Medicare Supplement, and Medicaid. The waiver applies to all medical costs related to COVID-19 treatment, as well any FDA-approved medications or vaccines. There is no current end date for the waiver. Humana is waiving member cost share for all telehealth services delivered by participating/in-network providers, including telehealth services delivered through MDLive to Medicare Advantage members and to commercial members in Puerto Rico, as well as all telehealth services delivered through Doctor on Demand to commercial members. Humana will waive out-of-pocket costs associated with COVID-19 testing. This applies to Medicare Advantage, Medicaid, and commercial employer-sponsored plans. Self-insured plan sponsors will be able to opt-out. The company is also waiving telemedicine costs for all urgent care for the next 90 days, and is allowing early refills on regular prescription medications. Back to top I. Independence Blue Cross Independence Blue Cross has waived member cost-sharing for in-network, acute in-patient treatment of COVID-19 through December 31, 2021. Cost-sharing will be applied to post-acute care (e.g. skilled nursing, rehabilitation and long term acute care facilities), outpatient treatment, prescription drugs, ambulance transportation to a post-acute setting, and out-of-network care. Independence will waive members’ cost for in-network, acute in-patient treatment of COVID-19 through October 31, 2021. Cost sharing will be applied to post-acute care (e.g. skilled nursing, rehabilitation and long term acute care facilities), outpatient treatment, prescription drugs, ambulance transportation to a post-acute setting, and out of network care. Independence Blue Cross is waiving all cost-sharing for the administration of the COVID-19 vaccine to commercial group and individual members. For Medicare Advantage members, the cost of the COVID-19 vaccine and its administration will be covered by Medicare. Independence Blue Cross is covering consumer grade pulse oximeters that are prescribed by an in-network doctor and purchased through an in-network supplier. Member cost sharing will be waived through March 31, 2021. Pulse oximeters are small, portable devices that monitor oxygen levels in the blood and pulse rate, and can help monitor members who have a COVID-19 diagnosis or are recovering from COVID-19. Independence Blue Cross is waiving cost-sharing payments for COVID-19 related telemedicine services through January 21, 2021. Independence is also waiving members’ cost-sharing payment for in-network, acute in-patient COVID-19 treatment through March 31, 2021. Independence is waiving pre-authorizations for acute, in-network, in-patient admissions from the emergency department for a COVID-19 diagnosis, and for transfers from an in-patient facility to long-term ambulatory care, rehabilitation, or skilled nursing facilities, and transportation between facilities, through March 31, 2021. Independence Blue Cross is offering medical and dental premium credits to fully insured employers, as well as providing premium rebates due to the effective management of medical costs. The premiums being returned to Independence employers total nearly $120 million. Independence is also extending payment options for certain fully insured employers. Independence will give its fully insured group employers a one-time premium credit in their September invoices totaling more than $35 million. The medical premium credit is calculated using member enrollment figures as of July 1, 2020. In addition, in partnership with United Concordia Dental (UCD), a one-time dental premium credit will be issued to fully insured, small group clients with Blue-branded stand-alone dental coverage and fully insured, large group, UCD-branded dental plan clients. The dental credit will be issued with September invoices. Independence will also be issuing premium rebates exceeding $84 million to many of these same customers due to the effective management of medical costs. Independence will extend its payment flexibility and continue to accept credit card payments from fully insured employers with up to 500 enrolled employees through September 30, 2020. Independence’s credit card flexibility option was originally announced in April in tandem with the company’s Deferred Payment Plan. The program provided an extended period for customers to pay their April or May invoice with no interest and no penalty. Independence Blue Cross Foundation, Highmark Blue Cross Blue Shield, Latino Connection, and the Pennsylvania Department of Health have partnered to create the first-in-the-nation COVID-19 Mobile Response Unit to provide testing and education targeting minority and underserved communities throughout Pennsylvania. In total, this testing effort costed $498,000. The department Epidemiology and Laboratory Capacity Enhancing Detection fund contributed a $331,000 grant. In addition, specimens will be collected and taken to the Pennsylvania Bureau of Laboratories for testing after each event. Known as CATE, Community-Accessible Testing & Education, the unit is equipped to conduct COVID-19 testing on-site through a mobile RV vehicle while also educating the public on how to stay healthy and safe. The mobile response unit’s tagline is “Sharing knowledge to erase fear,” which it intends to do through widespread community healthcare and health education offered with no insurance required. Independence Blue Cross is waiving member cost sharing payments for in-network, acute in-patient treatment of COVID-19 through Dec. 31, 2020. Independence Blue Cross is also waiving cost sharing payments for telemedicine services with a primary care doctor or specialists through Dec. 31, 2020, as well telemedicine visits for behavioral health. In addition, Independence Blue Cross will cover consumer grade pulse oximeters that are prescribed by an in-network doctor and purchased through an in-network supplier. Member cost sharing will be waived through July 31, 2020. Independence Blue Cross recently launched a comprehensive COVID-19 Provider Hub website. The site provides information on clinical and business initiatives taken by Independence to support doctors, hospitals, health systems, and other health care professionals during the pandemic. Independence Blue Cross has developed a new initiative called “Calls of Kindness.”  The initiative involves Independence employee volunteers making proactive check-in calls to Medicare members. The purpose of the calls is to give comfort and support to those who need it during the COVID-19 crisis. So far volunteers have made “Calls of Kindness” to more than 2,000 Medicare members. Independence Blue Cross and Philadelphia-based United By Blue, a sustainable outdoor apparel and accessories brand, today announced the launch of a new program that offers four weekly grocery deliveries at no cost to Independence Medicare Advantage members. Each delivery contains fresh, local, and organic groceries, homemade soups, and household supplies. The program is targeting 7,700 Medicare Advantage members who are enrolled in Independence’s Keystone 65 Individual HMO plans and have chronic obstructive pulmonary disease (COPD) and at least one of the following diagnosis: hemoglobin A1c level greater than 9, asthma, hypertension, congestive heart failure, end-stage renal disease, or ischemic heart disease. Independence Blue Cross is expanding its temporary suspension of prior authorization for acute in-network inpatient admissions from the emergency department to include all diagnoses (including COVID-19) and for in-network transfers and transportation between facilities. The change, which is for fully insured members, takes effect immediately and will remain in effect until June 4, 2020. Independence Blue Cross is offering members access to an emotional wellness app, Stop, Breathe & Think, at no cost until June 14, 2020. The app provides effective ways to alleviate feelings of anxiety, reduce stress, and find peace of mind. Independence Blue Cross is offering a comprehensive COVID-19 preparedness tool developed by Quil to some Independence members at no cost. Quil, the digital health joint venture of Independence Health Group and Comcast, is updating content in the tool daily based on new information and best practices. The tool includes resources for ways to support healthy living at home and help individuals adjust to new work/life balance realities. Independence Blue Cross is waiving member cost-sharing for in-network, inpatient, acute care treatment for COVID-19. This means members will pay no co-pay, co-insurance or deductible in this scenario. Independence is also waiving cost-sharing for emergency department visits when members are admitted to the hospital under these same conditions. These changes are effective March 30, 2020 and will extend through May 31, 2020. Independence is also temporarily suspending prior authorizations for acute inpatient admissions from an emergency department at all in-network facilities for members with a COVID-19 diagnosis through April 30. In addition, prior authorization requirements are temporarily suspended for transfers from acute in-network inpatient facilities to post-acute in-network facilities (long-term acute care hospitals, rehabilitation or skilled nursing facilities) for any diagnoses. Notification from facilities is still required. Independence is waiving cost sharing payments for all primary care telemedicine visits through June 4. Independence is also expanding coverage for telemedicine services to reimburse visits with specialists and ancillary service providers and expanding existing behavioral health telemedicine coverage to ensure that members with autism spectrum disorder receive Applied Behavior Analysis support. Independence Blue Cross will cover and waive cost-sharing (such as co-pays and coinsurance) for the COVID-19 test when performed at a hospital or an approved laboratory. This includes members enrolled in fully insured plans, employer-sponsored plans, Medicare Advantage and the individual and family plans available through the Affordable Care Act. Self-funded plans will be able to opt-out of this program. Independence has lifted prescription refill restrictions, such as the “refill too soon” limit, for members in states that have declared a state of emergency because of the virus, and is encouraging the use of telemedicine. Independence Blue Cross is also supporting the new PHL COVID-19 Fund, which will provide grants to Greater Philadelphia nonprofit organizations that serve vulnerable populations. Independent Health Independent Health is expanding its partnership with Brook, a Seattle-based health-technology company that helps individuals take better care of their health. The new feature will allow members to log their meals, instantly receive detailed nutrition information about their food, and get expert advice from registered dietitians, certified diabetes educators, and nutritionists. Independent and Brook also confirmed that they will continue to provide the Western New York community with free access to the Brook Personal Health Companion app during the COVID-19 crisis. Independent Health is expanding its partnership with Brook, a Seattle-based technology company, to offer the Western New York community free access to the Brook Personal Health Companion App for the duration of the COVID-19 health emergency. Independent Health has waived copayments and cost-sharing for COVID-19 medical testing, diagnosis and treatment for its fully insured employer groups, Medicare Advantage, Medicaid and individual plan members. In addition, Independent Health is covering in-network telehealth/telemedicine services, whether or not COVID-19 related, to encourage social distancing and help reduce the risk of spreading the coronavirus. There will be $0 copay or cost-sharing for these services as well. Independent Health implemented a global payment reimbursement model to help primary care practices during the pandemic. By compensating practices through an all-encompassing global payment, Independent Health helped keep cash flow similar to a “typical” month prior to the pandemic. This way, practices were not solely dependent on office or telehealth visits for reimbursement to stay afloat. For its members who do not have a primary care physician, Independent Health partnered with several primary care practices to connect these members with a doctor right away. Independent Health is also allowing members who are considered to be at higher risk as defined by CDC guidelines to obtain an early refill of their medication if needed. Indiana University Health Indiana University Health is accelerating payments for purchased products and services. The initiative aims to boost cash flow for the many Indiana-based businesses that supply needed goods and services to health care providers and other Central Indiana companies during the global COVID-19 crisis. IU Health is expediting the processing of over $5 million a week in billings into the accounts of its in-state vendors. The dozens of Indiana vendors who will see expedited payments from IU Health include many small businesses and women- and minority-owned enterprises. Indiana University Health is expanding testing for the SARS-CoV-2 virus, which causes COVID-19, to any health care worker or first responder in Indiana who may have been exposed to the virus. This includes health care workers serving at non-IU Health facilities. Indiana University Health provides free screening for COVID-19 via its virtual visits app where Indiana residents of any age are able to review symptoms with a health care provider. The team will recommend and facilitate appropriate pathways for care and will provide direct access and communication with local hospitals as medically appropriate. Inland Empire Health Plan  Inland Empire Health Plan and Loma Linda University Children’s Hospital teamed up to create a webinar helping expectant mothers understand the issues surrounding pregnancy during COVID-19. The webinar discussed risks, symptoms, and possible complications of COVID-19 during pregnancy. Inland Empire Health Plan is on track to have distributed more than $1.3 million in food and groceries to Inland Empire residents since June. The need for food has increased due to the COVID-19 crisis. Inland Empire Health Plan and Molina Healthcare of California are joining forces to lead a new healthcare initiative called “Together4IE.” This collaboration will raise awareness about available coverage through Medi-Cal and the health insurance marketplace (Covered California) to support Californians affected by income or employment changes during the COVID-19 crisis. Working together to support this population, the “Together4IE” initiative connects qualified residents to resources and works to reduce any stigma around government-sponsored health care. In addition to the resources made available, partnering organizations are actively engaging with individuals and families, as well as communities, to ensure that those interested in affordable health care are fully aware of the available options. Inland Empire Health Plan has awarded Rolling Start Inc., a non-profit organization serving people with disabilities, with a $5,000 sponsorship to support its new Digital Access Pilot Program. In addition to the sponsorship, IEHP will encourage interested employees to volunteer for the program, launching September 1. Aiming to reduce the digital divide and social isolation experienced by seniors and persons with disabilities in the face of COVID-19, Rolling Start Inc.’s Digital Access Pilot Program will provide eligible individuals who have restricted or no internet access with paid access for up to three months, a Chromebook and instructional courses. Program participants will be required to complete all instructional courses within a designated time to keep their devices. IEHP team members will use this training as a tool to teach program participants how to navigate social media websites, access telehealth benefits, and how to use the tool to improve communication with their medical providers. Inland Empire Health Plan has housed 164 homeless members who have chronic health conditions and are high utilizers of health services. The innovative program also assigns members to case managers who provide benefit education and preventative health support. Inland Empire Health Plan has provided more than 2.4 million units of personal protective equipment (PPE) to Inland Empire government agencies, medical societies, associations, and hospitals during the COVID-19 pandemic. To date, the plan has provided over 1.9 million disposable masks, 145,000 N95/KN95 respiratory masks, 80,000 surgical gowns, 130,000 isolation gowns, 43,000 boxes of gloves, 150,000 containers of sanitizing wipes and 48,000 wipe refills. Inland Empire Health Plan is amending its contracts to include a capitation feature that will pay a facility the hospital’s expected net patient revenue for IEHP Medi-Cal members or their monthly claims’ average for calendar year 2019, whichever is greater. IEHP is expecting to provide more than $90 million in support to providers during their pandemic response efforts. Inland Empire Health Plan has joined with local organizations to create several innovative initiatives, including: COVID-19 testing and lifted pharmacy restrictions for members; personal protective equipment and adjusted financial support for health workers; and resource support to the greater community. IEHP has secured and distributed much-needed PPE to local hospitals and providers. They have also increased financial support for skilled nursing facilities to provide care for COVID-19 patients, when clinically appropriate. Dedicated IEHP webpages for COVID-19 information for providers, members, and community were developed and are updated daily with testing information, changes in county restrictions, and safety information. Inland Empire Health Plan’s provider payment initiative compares the average claim payments in 2019 to what a physician specialist received during the COVID-19 crisis in 2020. The difference, up to 90%, is paid to the physician so they can keep their practice and employees intact. All provider claims are also being processed in under 30 days to make sure critical cash flow is available to physicians, hospitals, clinics, and other providers. Inland Empire has also provided $100,000 grants to Federal Qualified Health Centers who have begun testing for COVID-19 in their clinics. Inland Empire is also providing 17 skilled nursing facilities in the area with increased rates to provide care to COVID-19 patients to lower the number of patients transferred to hospital emergency rooms. Uninsured Inland Empire residents now have access to medical advice 24/7 through the Inland Empire COVID-19 Medline, due to a collaboration between Inland Empire Health Plan, 211 Riverside and San Bernardino County, Riverside and San Bernardino County Public Health, and Carenet Health. This free resource is accessible to uninsured residents in Riverside and San Bernardino counties who call 211’s social service line with COVID-19 related health questions. In addition to community resources, 211 can route callers to a health professional, staffed by Carenet Health. Inland Empire Health Plan has sourced and donated more than 221,000 units of personal protective equipment supplies to local government agencies, medical societies, associations and hospitals in Riverside and San Bernardino counties during the COVID-19 pandemic. Inland Empire Health Plan’s (IEHP) response to COVID-19 includes collaborative efforts with counties, county hospitals, public health, local medical associations, providers, and partners to coordinate efforts to serve the plan’s members, providers and community. To ensure members continuity to access routine and COVID-19 related care, IEHP has partnered with county public health, county health systems, and one of the nation’s largest Federally Qualified Health Centers, SAC Health System, to administer tests to members locally. The health plan has also expanded telehealth services to include both new and established patients for an array of services. To support health care workers and providers in care delivery, IEHP has increased rates for Skilled Nursing Facilities so they may provide care for COVID-19 patients (when clinically appropriate) to lower the number of patients transferred to hospital emergency rooms. In addition, IEHP has also organized the procurement and distribution of personal protective equipment for hospitals and providers. To address food and resource insecurity for the greater community, IEHP has provided sponsorships, donations of goods and volunteers to local food banks. To ensure the continuity of services from additional community-based-organizations, technology sponsorships have also been awarded to transition their critical services to digital platforms. Inter Valley Health Plan Inter Valley Health Plan is treating COVID-19 diagnostic tests as covered benefits, and is waiving all cost sharing for members for screening and testing of COVID-19. It has also provided more flexibility for Part D refill restrictions to allow members to receive their needed medications. InnovaCare Health InnovaCare Health is fully compensating primary care physicians for April and May. Through its subsidiary, MSO of Puerto Rico, InnovaCare will also compensate specialists, dentists, hospitals and hospitalists to ease the financial stress from reduced patient volumes. Hospitals are receiving payments based upon average monthly billings while hospitalists are receiving full payment based on their contractual agreements. InnovaCare expects to disburse more than $100 million in advanced payments to providers by the end of May. InnovaCare has also implemented expedited claims processing, ensuring claims are processed within five days or sooner, allowing providers to be reimbursed as quickly as possible for the care they’re providing. At the onset of this pandemic, InnovaCare’s plans were first in their markets to announce they would cover patients’ healthcare usage related to COVID-19, ultimately waiving copays and deductibles during this time. Through subsidiary Orlando Family Physicians, InnovaCare has expanded its telehealth offerings to help patients access the care they need and maintain important relationships with their physicians. The expanded capabilities have allowed OFP to handle an increased number of visits during the COVID-19 pandemic and also to be one of Central Florida’s only provider groups to continue accepting new patients. Back to top J. N/A Back to top K. Kaiser Permanente Kaiser Permanente has created guidance that can be widely adopted across the health care industry for assessing COVID-19 patients’ need for social resources that will allow them to safely recover and reduce community spread of the virus. The Kaiser Permanente COVID-19 Social Health Playbook provides clinical care teams with guidance and tools for screening patients for social needs, connecting them to help, and following up to ensure their needs are met. The initial release of the playbook has a strong focus on addressing COVID-19 patients’ social needs to improve their health outcomes and to prevent further transmission of the virus. It is publicly available as a free resource for care providers across the industry. Kaiser Permanente is committing $63 million to support California’s contact-tracing work in order to reduce the number of Californians who contract COVID-19. This support, in the form of charitable grant funding to the Public Health Institute, will create agile community health teams hired from within communities that have been disproportionately affected by COVID-19 to support the critical work of local public health departments. The support teams will be embedded in clinical settings to rapidly respond to COVID-19 hot spots and support ongoing contact-tracing efforts while ensuring high levels of privacy and security. This funding will also connect Californians in self-imposed isolation and quarantine with supportive services to assist with food, housing, child care, and other needs. The work is being undertaken in collaboration with Gov. Gavin Newsom’s administration, with the aim of reducing the number of Californians who contract COVID-19. The effort will add up to 500 people in clinical settings to support the state’s contact-tracing effort, which will help facilitate safe reopening for businesses and schools. Kaiser Permanente and its employees will donate $500,000 to the Colorado COVID Relief Fund, $300,000 of which will be restricted to organizations applying to do contact tracing, specifically organizations focused on cultural competency within Colorado communities. The remaining $200,000 will come through Kaiser Permanente’s employee donation matching campaign, ending on September 30, 2020. Kaiser Permanente is joining with nonprofit Civica Rx in its mission of assuring that health providers nationally have access to stable and affordable supplies of essential generic medications throughout the COVID-19 crisis and beyond. Kaiser Permanente joins Civica as a governing member with a seat on the board of directors and as an integrated health system with 12.4 million members will provide an important voice in designing Civica’s future strategy. The addition of Kaiser Permanente comes at a time when Civica is already delivering 20 essential generic medications, 10 of which are currently being used to treat COVID-19 patients. Civica is also working to significantly boost generic drug production within the United States. Kaiser Permanente will extend its waiver for most member out-of-pocket costs for inpatient and outpatient services related to the treatment of COVID-19 through December 31, 2020. This waiver, put into effect on April 1 and originally set to expire on May 31, is intended to alleviate the cost burden and stress of paying for care, allowing members to focus on recovery. Kaiser Permanente’s elimination of member out-of-pocket costs applies to all fully insured benefit plans, in all markets, unless prohibited or modified by law or regulation. It will apply for all dates of service from April 1 through December 31, 2020, unless superseded by government action or extended by Kaiser Permanente. Kaiser Permanente has released a playbook, “Planning for the Next Normal at Work,” to guide employers and businesses through health considerations they will need to address as they safeguard workplaces during the COVID-19 pandemic and prepare to bring employees back to traditional work environments. Examples of recommended safety modifications to the workplace include: Re-configuring office space to allow at least 2 arms’ length of space between workstations and providing hand sanitizer in multiple locations. Limiting meetings and gatherings to 10 people or fewer. Creating processes for potential employee diagnoses, including evaluating leave-of-absence policies. Reinforcing a psychologically healthy workplace where employees feel safe, respected, and empowered. Kaiser Permanente members can now download Calm Premium on their smartphone, computer, or tablet through their kp.org account. Kaiser Permanente members will have unlimited access to Calm content, including an ever-growing library of guided meditations, sleep stories for deeper and better sleep, and video lessons on mindful movement and gentle stretching. The availability of the Calm app is part of Kaiser Permanente’s continued commitment to provide its members with new ways to support emotional wellness anytime and anywhere, particularly during times of increased stress and anxiety. Kaiser Permanente and Dignity Health will partner with California and Los Angeles County to open the Los Angeles Surge Hospital, a temporary facility in Los Angeles that will expand access to additional beds and expand ICU capacity for patients who contract COVID-19. The facility will be located on the campus of the former St. Vincent Medical Center in central Los Angeles. The Los Angeles Surge Hospital is expected to open April 13. Futuro Health, a California-based nonprofit established by Kaiser Permanente and the Service Employees International Union-United Healthcare Workers West (SEIU-UHW) to address the nation’s allied health worker shortage, has expanded its education offerings to prepare front-line health care workers for an expected surge in COVID-19 cases, committing $1 million to launch a new pandemic-readiness program. Kaiser Permanente will waive all member out-of-pocket costs for inpatient and outpatient services related to the treatment of COVID-19. Kaiser Permanente’s elimination of member out-of-pocket costs will apply to all fully insured benefit plans, in all lines of business, in all markets, unless prohibited or modified by law or regulation. It will apply for all dates of service from April 1 through May 31, 2020, unless superseded by government action or extended by Kaiser Permanente. Kaiser Permanente is contributing $1 million to 10 leading public health organizations and collaborating with CDC Foundation to strengthen the United States’ public health infrastructure and response systems to stop the spread of COVID-19. Kaiser Permanente has more information about how its medical centers continue to prepare to contain and treat the disease. Kaiser Permanente is not requiring members to pay any costs related to COVID-19 screening or testing when referred by a Kaiser Permanente doctor. Back to top L. L.A. Care L.A. Care is launching a Gratitude Project to thank frontline providers for their work during the COVID-19 crisis. For the next few months, L.A. Care is going to be conducting a series of activities that will show immense appreciation to these tireless healthcare warriors. The health plan is dedicating a web page to this project that will include a video with L.A. Care leaders sending their personal messages of thanks. L.A. Care social media channels and external newsletters will have a special focus on providers. Additionally, each of L.A. Care’s providers will receive personalized thank you notes from the health plan. The Gratitude Project will culminate in February with a weeklong Provider Recognition Awards celebration. There will be a recorded virtual celebration, a social media campaign, and top providers will be recognized on billboards in the neighborhoods where they practice. L.A. Care Health Plan has awarded $1 million in Equity and Resilience Initiative grants to community-based organizations that are working to mitigate the impact of COVID-19 on racially marginalized communities. Each organization will receive up to $125,000 and organizational coaching from a capacity building consultant firm. L.A. Care Health Plan and Blue Shield of California Promise Health Plan (Blue Shield Promise) have begun reopening their jointly-operated Community Resource Centers that were closed earlier due to the COVID-19 pandemic. Select services are available by appointment only in a safe environment. The four centers – located in Pomona, Lynwood, East L.A. and Palmdale –will have staff on-site to help with member services support, enrollment in local and state assistance programs and support finding a range of resources such as food and housing assistance. The centers also have a newly added feature: free Wi-Fi for anyone needing telehealth services. Given the significant increase in demand for telehealth appointments during the pandemic – and the reality that many low-income individuals lack robust mobile data plans – L.A. Care and Blue Shield Promise are enhancing community members’ access to high-quality health care through telehealth hubs at each resource center location. L.A. Care Health Plan, the California Endowment, Blue Shield of California Promise Health Plan, and the Los Angeles County Department of Public Health are hosting a second COVID-19 Disparities Leadership Summit.  The summit will bring together dozens of health care and community leaders to strategize on how to address the devastating disproportionate impact on Black and Latino communities. The summit leaders will learn more about what fellow community partners are doing to assist residents, and explore ways to combat persistent disparities. L.A. Care has announced 29 awardees in its seventh round of Elevating the Safety Net Provider Recruitment Program grants. The 29 grants will bring more physicians into the safety net, helping to relieve the strain that has worsened during the COVID-19 crisis. The grants are worth nearly $4.3 million, bringing the total award amount from all six rounds to nearly $19 million. Newly recruited physicians to the safety net are eligible for the Provider Loan Repayment Program, another part of Elevating the Safety Net. Under the program, physicians receive loan repayments of up to $5,000 per month for up to 36 months, as long as they continue to work within the safety net. Sixty-seven physicians have been approved for loan repayment grants. L.A. Care is committing $750,000 to help fight evictions that have been exacerbated by the COVID-19 crisis. Six legal aid agencies that have long been fighting to protect low-income and under resourced individuals and families who are often from communities of color, will receive the funding. While California Governor Newsom has extended authorization allowing local governments to delay evictions through the end of September, UCLA researchers found that 365,000 renter households in Los Angeles County are in imminent danger of eviction once eviction orders are lifted. L.A. Care has awarded the United Way of Greater Los Angeles two grants worth $975,000 to support workers on the frontline during the COVID-19 crisis as well as those experiencing homelessness. One grant commits $475,000 to provide personal protective equipment (PPE) for up to 5,000 frontline workers in the COVID-19 crisis. United Way will also use the funding to procure and distribute food, tents, sleeping bags, or other shelter in place equipment to as many as 10,000 individuals who are living on the streets during this crisis. They will also provide essential supplies such as masks, health kits, and hygiene kits. L.A. Care has awarded nearly $1.5 million to 10 grantees through the Robert E. Tranquada, MD Safety Net Initiative XI. Health care centers and community clinics across Los Angeles County will receive between $100,000 and $150,000 to conduct projects that will primarily help communities of color, which have been harder hit by COVID-19. The various projects involve combatting diabetes, hypertension, periodontal disease, and more, while tailoring their clinical services to meet COVID-19 demands. Total funding for the Tranquada Initiative is $1,425,000. In some cases, the funding will support hiring of nurses and support personnel who are members of the community they will serve. Other funding covers equipment, software, and renovations that will help the centers meets their goals. L.A. Care has committed grant funding of up to $550,000 to Project Angel Food. Project Angel Food provides medically tailored meals and nutritional counselling to 2,000 low-income individuals in Los Angeles County affected by life threatening illnesses each week. L.A. Care is helping Project Angel Food reducFe their waiting list. Food insecurity has long been a major deterrent to good health outcomes for low-income individuals, and the COVID-19 pandemic has exacerbated the problem. The 151 people on the Project Angel Food waiting list were part of a rush that applied for help in the wake of the COVID-19 outbreak. For a year, these clients will receive medically tailored meals based upon their personal health conditions. L.A. Care is moving to accelerate claims payments and provide other financial support to many providers in its provider network to help address the financial pressure caused by the COVID-19 pandemic. L.A. Care will be accelerating more than $7 million in grant payments to 138 clinics and community-based organizations. The health plan is also committing more than $6 million in targeted grant support for its most vulnerable members and communities, including some who are experiencing homelessness. L.A. Care is providing up to $35 million in accelerated claims payments to hospitals, and more than $21 million in advanced incentive payments for individual primary care physicians and FQHC clinics. L.A. Care is waiving all costs associated with screening, testing and medically necessary treatment for COVID-19. Lighthouse Health Plan Lighthouse Health Plan is waiving all co-payments for COVID-19 related services. Back to top M. Magellan Health Magellan Health has launched a free crisis texting service for anyone who needs help during the COVID-19 crisis. Individuals can connect with a certified, licensed mental health clinician who will provide confidential mental health services. This service supports Magellan’s crisis telephone hotline, offering another way to access mental health services. Magellan’s confidential mental health crisis text line is offered free-of-charge to the community to assist individuals as they try to cope with feelings of fear, sadness, anger and hopelessness. Individuals may also seek information and guidance to other available resources, such as community-based support. Magellan Health has opened a free national 24-hour crisis line for all first responders and healthcare workers who are serving on the front lines battling the coronavirus pandemic. These critical workers who call the hotline will speak directly to a certified licensed mental health clinician. The hotline is being operated by Magellan Healthcare, the behavioral and specialty healthcare segment of the company. Magellan Health has expanded telehealth services to help support clients during the COVID-19 pandemic. Magellan will permit all credentialed and contracted behavioral health providers to conduct telehealth video sessions for all routine services and certain psychological testing, applied behavior analysis (ABA), intensive outpatient programs (IOP) and partial hospitalization program (PHP) services. Magellan Health is providing free access to one of its digital cognitive behavioral therapy, RESTORE®, for members who are experiencing sleep difficulty and insomnia related to the COVID-19 pandemic. Martin’s Point Health Care Martin’s Point Health Care donated $5,000 to help address food insecurity among students at the University of Southern Maine. The donation enabled the USM to open a new food pantry where students can pre-order online and pick up their food and supplies in person. The COVID-19 crisis has impacted the economic security of many USM students. Martin’s Point Health Care has received the first Maine shipment of newly developed rapid COVID-19 tests. The new test offers results in minutes, rather than the days required by current tests. Medica Health Plan Medica Prime Solution and Advantage Solution individual plans will cover the cost of COVID-19 treatment at no cost to members through October 31, 2021 in these situations: In a hospital participating with their Medica network When accessing extended absence and travel benefits, or in an emergency (i.e. admission through an emergency room) If the provider/hospital is Medicare eligible Medica Advantage Solution group retiree plans will cover the cost of COVID-19 treatment if the provider/hospital is Medicare eligible, at no cost to members. Medica is waiving cost-sharing for in-network COVID-19 hospital treatment through March 31, 2021. This applies to all fully insured groups, individual, Medicare, and Medicaid members. Medica is waiving members cost-sharing payments for in-network COVID-19 inpatient hospital care for fully insured group, individual and family, and Medicare members through December 31, 2020. Medica Health Plan has extended the waiver for copays, co-insurance and deductibles for in-network COVID-19 inpatient hospital care for fully insured group members. These changes will extend through September 30, 2020. Medica Health Plan has waived in-person, in-network primary, specialty and behavioral care office visit copays for all Medica Advantage members for appointments completed between June 1, 2020 through September 30, 2020.  Medica will continue to suspend prior authorization for admission to a post-acute care setting, also through September 30, 2020. Medica Health Plan is distributing more than 200,000 disposable protective masks to members who are at the greatest risk for experiencing complications related to COVID-19. Medica is also donating an additional 150,000 masks and other personal protection equipment to community organizations and its skilled nursing partners. Medica Health Plan is donating $200,000 to nine Nebraska non-profit organizations and community health centers that play important roles in addressing the needs of the most vulnerable people in communities statewide, especially during the coronavirus pandemic. Funding is being made available through the Medica Foundation. The organizations include the United Way of the Midlands, the Nebraska Farm Bureau, and the Charles Drew Health Center. Medica Health Plan is waiving copays, co-insurance, and deductibles for COVID-19 in-patient hospital care. The waiver will extend through May 31. Prior authorization will not be required for admissions to long-term care facilities, acute in-patient rehabilitation, or skilled nursing and home health care facilities. This change will extend through May 31. Medica has donated $1 million to Minnesota non-profits to address the health needs of the most vulnerable people in the state during the COVID-19 pandemic. Medica’s funding is targeted to support key focus areas including child and family support, clinics and shelters, food security, mental health / telehealth services and general disaster relief. Medica Health Plan will waive co-pays, co-insurance and deductibles related to COVID-19 testing for all fully insured group, individual and Medicare members. Self-insured employers will have an opportunity to also waive fees related to the testing of COVID-19. To help limit the spread of COVID-19, Medica provides coverage for virtual care or telehealth services. Medical Mutual of Ohio Medical Mutual of Ohio has extended the cost sharing waivers for all COVID-19-related treatment through December 31, 2020. Treatment includes hospitalizations and ground ambulance transfers for individuals with a positive COVID-19 diagnosis. In addition, Medical Mutual will permanently cover FDA-approved medications and vaccines when they become available. Medical Mutual is waiving member cost sharing associated with COVID-19 testing and treatment. This applies to services provided by both in-network and out-of-network providers. For testing, this covers the cost of the test, as well as the cost of the provider visit, which could include a telehealth (telemedicine), urgent care or emergency room visit, to determine whether the COVID-19 testing is required, and the visit to administer the test. This is effective through the end of the national public health emergency declared by the U.S. Department of Health and Human Services. Medical Mutual has extended the period during which cost sharing for all treatment related to COVID-19 will be waived to now go through July 24, 2020. Treatment includes hospitalizations and ground ambulance transfers for individuals with a positive COVID-19 diagnosis. In addition, Medical Mutual will permanently cover FDA-approved medications and vaccines when they become available. MeridianHealth Meridian Health is supplying local healthcare providers with Samsung Galaxy A10e smartphones to distribute to patients who would not otherwise have access to healthcare services virtually. Meridian will deploy 425 Samsung Galaxy A10e smartphones, with 90 days of free wireless service, to select federally qualified health centers (FQHCs), health systems, other healthcare providers, and community support organizations. Many of the selected providers will be in rural and underserved communities, where there can be barriers to receiving in-person healthcare. The providers and organizations will then determine which of their patients need the devices and then distribute them accordingly. A CDC survey found that 44.4% of respondents reported delaying or not receiving care for various reasons, including concerns and challenges around COVID-19. MeridianHealth will waive all out-of-pocket costs for COVID-19 testing treatments through the end of 2020, including copays, deductibles, and coinsurance. MeridianHealth is partnering with Aunt Martha’s Health and Wellness to offer COVID-19 PCR tests and antibody testing at no cost in the Chicago Heights and Kankakee communities. MeridianHealth has donated more than 130,000 units of PPE to help protect Michigan’s first responders and essential workers on the front lines of the coronavirus (COVID-19) pandemic. MeridianHealth, a subsidiary of Centene, has identified four organizations serving as either Federally Qualified Health Centers and/or Community Mental Health Centers  to receive $500,000 in total funding to continue their work during the COVID-19 crisis, including providing shelter or secure housing for those who have been exposed to COVID-19 and must be quarantined or those who have tested positive, but do not need hospitalization. In addition to this funding, Meridian has recently provided 100,000 protective masks to the Westside Homeless COVID-19 Response Workgroup. MHS Health Wisconsin MHS Health Wisconsin, a subsidiary of Centene, has donated $45,000 to food banks in Milwaukee, Eastern Wisconsin and Western Wisconsin. Additionally, a partnership with Feeding America, Centene and MHS Health will coordinate a donation of 1 million meals a month for the next 12 months to feed those in Wisconsin and across the country. MHS Wisconsin is also coordinating with Centene to purchase 500 gift cards for use on essential items. MHS Wisconsin will deliver the cards to FQHCs and a local pharmacy for distribution to individuals in need. The gift cards will have a value of $35 and can be used to purchase essential health care and educational items, including diapers, over-the-counter medicines, cleaning supplies, and books. MHS Health has made several additional donations, including: $5,000 to Discovery World to support the museum’s online free, hands-on educational opportunities. $500 to Healthy Eats for Hospital Heroes. This organization prepares and delivers healthy meals to health care providers who are treating coronavirus patients at Froedtert Hospital in Milwaukee. 100 canvas bags filled with children’s supplies donated to Milwaukee Health Services Community Health Center (FQHC) for patients at their COVID-19 testing tents. In partnership with Log Cabin Sewing Company, MHS Health will mail 300 masks to high-risk members. Minnesota Council of Health Plans Minnesota Council of Health Plans announced that Minnesota’s nonprofit health plans are voluntarily waiving cost-sharing for COVID-19 testing and in-patient treatment for enrollees as part of a framework to support and protect the health of Minnesotans amid the COVID-19 crisis. Minnesota’s nonprofit health plans that have committed to this framework include: Blue Cross and Blue Shield/Blue Plus of Minnesota HealthPartners Hennepin Health Medica PreferredOne UCare Minnesota Council of Health Plans announced that Minnesota’s nonprofit health plans are voluntarily extending cost-sharing waivers for in-patient COVID-19 treatment through the end of 2020. The Minnesota Council of Health Plans announced that Minnesota’s nonprofit health plans are enhancing support for enrollees impacted by the COVID-19 pandemic by extending cost-sharing waivers for in-patient treatment. To the extent permitted by law, health plans are extending waivers for cost sharing for in-network COVID-19 hospitalization on fully insured, individual and group health plans until Sept. 30, 2020. Plans that have committed to this extension include: Blue Cross and Blue Shield/Blue Plus of Minnesota HealthPartners Hennepin Health Medica PreferredOne UCare Moda Health For members covered on a Moda Individual or Family plan or fully-insured Employer Group, cost-sharing is also waived for other in-network medical treatment of COVID-19, both inpatient and outpatient, and FDA-approved medications administered inpatient for the treatment of COVID-19, for services received April 1, 2020 – July 31, 2021, or the end of the Federal Emergency Order. Moda Health has extended cost-sharing waivers through December 31, 2020 for the in-network treatment of COVID-19, both inpatient and outpatient. The waiver applies to Oregon members covered on Individual or Family plans or fully-insured employer group members. Moda Health has extended cost sharing waivers for in-network treatment of COVID-19 for Oregon members on individual and family plans and employer group plans through Aug. 31, 2020. Moda Health is waiving cost sharing for Oregon and Alaska Individual and Family plans and fully-insured employer groups plans for in-network medical treatment of COVID-19, both inpatient and outpatient, and FDA-approved medications administered inpatient for the treatment of COVID-19, until May 31. Alaska Moda is waiving cost sharing payments for all commercial medical members for respiratory diagnostic testing needs, including respiratory syncytial virus, influenza, and COVID-19 lab tests. This includes office visits, urgent care visits, telehealth visits, or emergency room visits when the purpose or outcome of the visit is to be tested for respiratory illness. The waiver applies to in-network and out-of-network providers, facilities, and laboratories. Oregon Moda is waiving cost sharing payments for commercial health members for COVID-19 testing needs, including: a telehealth visit to be evaluated for COVID-19 testing; a provider office visit, urgent care center visit, or emergency room visit to be tested for COVID-19; COVID-19 lab test for all testing facilities; and other testing received during a COVID-19 testing visit, when administered to determine if there is a need for COVID-19 testing. Oregon Moda is waiving all cost sharing payments for Medicare Advantage members, including: a telehealth visit to be evaluated for COVID-19 testing; a provider office visit, urgent care center visit, or emergency room visit to be tested for COVID-19; COVID-19 lab tests for all testing facilities; and other testing received during a COVID-19 testing visit, when administered to determine if there is a need for COVID-19 testing. Molina Healthcare Molina Healthcare of California and Inland Empire Health Plan are joining forces to lead a new healthcare initiative called “Together4IE.” This collaboration will raise awareness about available coverage through Medi-Cal and the health insurance marketplace (Covered California) to support Californians affected by income or employment changes during the COVID-19 crisis. Working together to support this population, the “Together4IE” initiative connects qualified residents to resources and works to reduce any stigma around government-sponsored health care. In addition to the resources made available, partnering organizations are actively engaging with individuals and families, as well as communities, to ensure that those interested in affordable health care are fully aware of the available options. Molina Healthcare has launched the MolinaCares Accord, which will channel investments into solving the many gaps that exist in the access to, and delivery of, health care, particularly for disadvantaged populations. While the COVID-19 crisis isn’t directly responsible for the gaps, it has highlighted them. The Accord will use Molina’s clinical and community resources and an initial $150 million funding commitment to address the many social issues that afflict the delivery of health care today, including racial disparities, rural access to care, and health care for the elderly, infirmed, and frail. The Accord will use Molina’s clinical and community resources and an initial $150 million funding commitment to address the many social issues that afflict the delivery of health care today, including racial disparities, rural access to care, and health care for the elderly, infirmed, and frail. Molina Healthcare will waive all out-of-pocket costs associated with COVID-19 testing and treatment for its Medicare, Medicaid, and Marketplace members nationwide through Dec. 31, 2020. Molina Healthcare of Washington has committed over $1 million in donations and relief efforts to local communities and organizations in the state as part of its comprehensive COVID-19 Community Response Plan. This initiative focuses on reducing disparities in access to care through the following: the provision of personal protective equipment (PPE) donations; telehealth support to various health care providers; and reducing food insecurity through charitable contributions to food banks and meals delivered directly to members’ homes. To increase access to telehealth services, Molina is providing more than 20 behavioral health provider organizations with technological support and resources, such as computers and cell phones. Molina is also offering cell phones and data plans to its Medicaid members who do not otherwise have the capabilities to contact their provider via virtual visits. This effort focuses primarily on smaller behavioral health organizations in rural and remote areas of the state. Molina Healthcare of Ohio has committed over $1.5 million to support innovative programs across Ohio. The Molina Community Innovation Fund will provide grants and sponsorships to various partners launching innovative programs designed to increase access to care, provide unique approaches to reinforce health and wellness, and support integrated care services. The funding also supports organizations helping to fill community needs around social determinants of health, which can have a lasting effect on the health outcomes of women, children, and vulnerable seniors. Through Molina’s efforts with partner organizations, Ohioans will be provided with additional access to resources that support their physical and behavioral health, especially amid the COVID crisis. Molina Healthcare of Texas has contributed $20,000 to the North Texas Food Bank to help replenish necessary food supplies for area residents experiencing high levels of unemployment or reduced income due to the current pandemic. Molina Healthcare of Illinois has donated $40,500 to an array of community-based organizations across the state. The grants and supply donations will help the nonprofits provide hygiene essentials, food, financial support, and other resources to help vulnerable communities during the COVID-19 pandemic. Molina Healthcare of Utah is donating $15,500 to relief efforts in the wake of COVID-19. Molina will provide funds to food banks and other community-based organizations across the state that are working to provide for the communities most in need. Molina Healthcare of New York is donating over $38,000 to community-based organizations that are providing support and essentials during the COVID-19 crisis. Molina Healthcare of Mississippi is committing nearly $50,000 for the purchase of personal protective equipment to help protect health care professionals and those in need during the coronavirus pandemic. Molina is aiding its provider partners most impacted by low and in some cases, depleted, PPE supply by donating more than 17,000 3-ply masks, 4,000 N95 masks, and 7,000 nitrile medical gloves. This contribution will support small clinics, federally qualified health centers, rural health clinics, and larger health systems. Molina Healthcare of Ohio has partnered with the Make-A-Day Foundation and former Ohio State University Football Coach Urban Meyer to provide 20,000 nutritious meals to Ohioans experiencing homelessness or financial distress during the COVID-19 pandemic. Molina Healthcare has accelerated $150 million in payments to providers. Additionally, Molina has extended all previously approved prior authorizations until September 1, 2020. Molina has also enabled providers to be paid the same amount for servicing members via telehealth as they would have for in-person service, and has expedited credentialing to ensure providers are able to see members for any health care reason. Molina has also provided personal protective equipment in many markets and continues efforts to seek and provide PPE where it is most needed. Molina Healthcare of Ohio is committing $150,000 for the purchase of personal protective equipment, COVID-19 test kits, as well as other needed essentials to help protect providers, health care professionals, and those in need during the coronavirus pandemic. Molina Healthcare is waiving all COVID-19-related out-of-pocket expenses for its Medicare, Medicaid, and Marketplace members nationwide, following up on its previous announcement last month about waiving all member costs associated with testing for the coronavirus, which causes COVID-19. Molina Healthcare of New Mexico is donating a relief package that includes medical supplies for families, Indian Health Services, and 638 facilities across the Navajo Nation that are experiencing hardships as a result of the coronavirus pandemic. The relief package includes 5,000 rapid test kits, 240 N95 masks, 200 first aid kits, cleaning supplies, and $25,000 for food supplies. Molina Healthcare has launched a Coronavirus Chatbot, an enhanced digital tool for members seeking information about COVID-19 risk factors and their own personal risk profile. This new self-appraisal feature is available for members looking for current insight, risk factors, live help, and appropriate action to take if symptoms are present. Molina Healthcare will waive all member costs associated with testing for COVID-19. Any related visit to a primary care doctor, urgent care or emergency care does not require prior authorization. MVP Health Care MVP Health Care, CDPHP, and Quick Response have partnered to provide the cities of Albany, Schenectady, and Troy with essential sanitation equipment to protect local first responders from COVID-19. Each city will receive two Defense Soap Cordless Electrostatic Hand or Backpack Sprayers for use by the police and fire departments. Each sprayer provides up to 23,000 square feet of disinfectant in a single tank. MVP Health Care and Media Logic have launched a new website, trytelemedicinefirst.com, that serves as a directory of available telemedicine services, and can be searched by health insurance company name or by zip code – the latter of which will provide information on hospitals and providers that offer telemedicine services. MVP Health Care is making COVID-19 screening and testing free for all MVP members. Patients are not responsible for any co-payments, other cost-share, or fees associated with: an emergency room visit or visit to an in-network health care provider for the purpose of getting tested for COVID-19; drive-thru specimen collection sites; and telemedicine services, like MVP’s myERnow virtual emergency room and myVisitNowonline doctor visits. Back to top N. Neighborhood Health Plan of Rhode Island Neighborhood Health Plan of Rhode Island is waiving requirements for health care providers to seek prior authorizations for all behavioral health and all inpatient medical services regardless of whether they are COVID-19 related or not. Neighborhood is also waiving prior authorizations and all members’ out-of-pocket fees for treatment related to COVID-19, including copays, deductibles and co-insurance. Neighborhood Health Plan of Rhode Island will not require pre-authorization for COVID-19 testing and they will cover the cost if a doctor believes a patient needs testing and the patient meets testing guidelines from the CDC. There will be no cost sharing for those patients. Northeast Delta Dental Northeast Delta Dental will provide relief totaling $18.8 million in returned and reduced premiums to individual and group customers by: extending rate holds for fully insured individual and group customers renewing July through December, 2020; crediting all fully insured individual and group customers with a one-month dental premium in July based on June’s billed amount; and crediting all self-insured group customers for the July administrative fee. It will help the producers and consultants who market its dental insurance by providing relief payments totaling $700,000 for the premium/administrative credit period based on commissions paid for the previous month. Back to top O. Oscar Oscar waived cost-sharing payments for COVID-19 treatment for Oscar Individual and Oscar for Business plan members through August 31, 2021. Oscar has waived the cost of COVID-19 treatment delivered by in-network providers through September 30, 2020. If members are treated at an out-of-network facility, Oscar will also waive the cost through September 30, 2020, as long as members have received prior-authorization. Oscar is also waiving the cost of all COVID-19 care delivered through telemedicine for our members. Oscar Health will offer zero dollar Virtual Primary Care in 10 markets in 2021: Miami, FL, Fort Lauderdale, FL, Palm Beach, FL, Houston, TX, Dallas, TX, Austin, TX, Los Angeles, CA, Orange County, CA, Denver, CO, and New York, NY, pending regulatory approval. The COVID-19 pandemic is transforming how Americans access health care and accelerating demand for virtual services. The new service will include unlimited virtual visits with a dedicated team of Oscar primary care providers. Oscar Primary Care also will bring some care directly to members in their homes, by offering $0 vitals monitoring kits and in-home lab draws when ordered by an Oscar Primary Care provider. Oscar will waive cost-sharing for the treatment of COVID-19 for its Individual and Small Group members through July 31, 2020. If you’re treated at an out-of-network facility, Oscar also will waive the cost through July 31, 2020, as long as the patient has received prior-authorization. Oscar and Uno Health are partnering to help Oscar Medicare Advantage members unlock financial assistance, providing critical relief during the COVID-19 pandemic. Uno has helped Oscar Medicare Advantage members achieve an average financial assistance of more than $5,000 per member. 30-50% of Medicare members are eligible for financial assistance through government programs, but have not enrolled in them – often because they don’t know they exist or how to navigate complex signup processes. Oscar and Uno are helping more Medicare Advantage members tap into this government support. Oscar has also launched the first testing center locator for COVID-19 in the United States. It is free and accessible to the general public, and it is being updated daily to reflect both in-network and out-of-network facilities in the 29 markets that Oscar operates in. The tool builds on its  at-home risk assessment survey. Oscar will waive cost-sharing for the treatment of COVID-19 for its Individual and Small Group members through July 31, 2020. If you’re treated at an out-of-network facility, we’ll also waive the cost through July 31, 2020, as long as you’ve gotten prior-authorization. Oscar is waiving cost-sharing for diagnostic testing for COVID-19, including the cost of the test and administration of the test, at both in-network and out-of-network facilities when recommended by a health care provider. Oscar is offering telemedicine services at no cost to most members through its Doctor on Call service. Back to top P. PacificSource PacificSource is waiving all out-of-pocket costs for coronavirus (COVID-19) testing, diagnosis and treatment for its fully insured commercial, Medicare Advantage, and health savings accounts members. This waiver will apply to those members who have received or will receive care between Jan. 31 through June 30, 2020, regardless of place of care. The organization’s self-funded businesses will have the option to adopt these provisions. PacificSource is waiving out-of-pocket costs for COVID-19 testing and diagnosis-related office visits, urgent care visits, telemedicine visits, ER visits, testing and radiology if billed with one of the COVID DX codes. PacificSource providers are instructed to not collect copay/coinsurance or deductibles for visiting and testing. PacificSource is also increasing access to prescription medications by waiving early medication refill limits on 30-day prescription maintenance medications, consistent with a member’s benefit plan. Passport Health Plan Passport Health Plan is providing Medicaid members with virtual recovery support services for substance use disorders during the COVID-19 pandemic. Passport Health Plan will not charge any copays for COVID-19 screening and testing. This includes: Any related hospital emergency visit, urgent care visit, provider office visit, lab testing, telehealth, and immunizations (shots). Passport also will not require any prior authorizations. Physicians Health Plan of Northern Indiana PHP will cover the COVID-19 test and the visit where the test takes place at 100%, with no deductible, copay, or coinsurance. If a patient is diagnosed with COVID-19, PHP benefit plans coverage applies to treatment. This applies to all plan types, including self-funded plans. Employers may not opt-out. Physicians Health Plan of Northern Indiana is covering the cost of the COVID-19 screening test for members at no out-of-pocket expense. PHP will waive co-pays, co-insurance, deductibles, and prior authorization, when the test is medically necessary, for members of its fully insured health plans. PreferredOne PreferredOne will waive cost-sharing for in-network COVID-19 hospitalization for fully insured, Simplicity employer, and individual plan members through September 30, 2021. PreferredOne will waive cost-sharing for in-network COVID-19 hospitalization for fully insured, Simplicity employer, and individual plan members through March 31, 2021. PreferredOne is extending the cost-sharing waiver for in-network COVID-19 hospitalization through December 31, 2020. The waiver applies to fully-insured, Simplicity employer, and individual plan members. PreferredOne is extending its cost-sharing waiver for in-network COVID-1 hospitalization through December 31, 2020. The waiver applies to fully-insured, Simplicity employer, and individual plan members. PreferredOne is extending cost-sharing waivers for in-network COVID-19 hospitalization for fully-insured employer and individual plan members through September 30, 2020. Previously, the waivers were set to last through May 31, 2020. PreferredOne is waiving cost-sharing for in-network COVID-19 hospitalization for fully-insured employer and individual plan members effective March 1st through May 31st, 2020. PreferredOne will cover medically necessary COVID-19 laboratory testing without cost sharing for fully insured employer group and individual plan members. The tests will be available without prior authorization. PreferredOne is working with self-insured clients on their approaches. Prominence Health Plan Prominence Health Plan is providing members telehealth services through Teladoc with zero-dollar copays. Providence Health Plan Providence Health Plan is waiving all member cost-sharing payments for COVID-19 treatment through March 31, 2021. The waiver applies to in-network, inpatient, outpatient, facility, and professional visits, and is applicable for all members on an individual and family plan, small group fully insured plan, and large group fully insured plan. Providence Health Plan has extended the cost sharing waiver for COVID-19 treatment through December 31, 2020. This applies to in-network inpatient, outpatient, facility, and professional visits. This change is applicable for all members on an individual and family plan, small group fully insured plan and large group fully insured plan. Providence Health Plan has extended the waiver for all cost sharing payments for COVID-19 treatment through Aug. 31, 2020. Providence Health Plans has extended the waiver for all member cost sharing for COVID-19 treatment until June 30. This applies to in-network inpatient, outpatient, facility and professional visits. This change is applicable for all members on an individual and family plan, small group fully insured plan and large group fully insured plan. Providence Health Plans is waiving cost sharing for commercial insured members for COVID-19 treatments for in-network inpatient, outpatient, facility, and professional visits. Providence is taking the initiative to help ensure healthcare workers have the necessary personal protective equipment (PPE), and to provide vulnerable populations with soap and disinfectant to help Providence expanded its health plan premium payment grace period for commercial groups so members can continue to receive care and medications during this time of uncertainty. Providence is also allowing commercial groups to maintain coverage for their furloughed employees at the group premium rate. Providence has waived all cost sharing for testing services related to COVID-19, such as copays, coinsurance, and deductibles. Providence significantly expanded telehealth provider policies to reduce barriers to care and to encourage the use of telehealth services by members and provider partners. Providence has also added virtual capacity so that more providers can be seen quickly. Providence’s clinical pharmacists are monitoring the supply chain to anticipate and address any potential drug shortages, and are promoting 90-day supply of maintenance medications, early refills when appropriate,  and mail delivery to support staying at home as well as extending prior authorization approval dates up to 90 days to enhance access to medication when appropriate. Providence quickly developed and implemented a coronavirus assessment tool to help communities assess their symptoms in real time. Providence’s labs began testing for coronavirus early on, becoming the first hospital system in the state to offer in-house lab analysis and increasing the community’s testing capacity. Providence Health Plan is waiving cost sharing for COVID-19 treatment for service dates beginning April 1 through May 31, 2020. This applies to in-network inpatient, outpatient, facility and professional visits. This change is applicable for all members on an individual and family plan, small group fully insured plan and large group fully insured plan. Providence Health Plan is proactively taking action to ensure continuity of coverage – so members can continue to receive care and medications during this time of uncertainty. If an employer group has furloughed or laid off employees, Providence will continue to cover those employees contingent on payment of premium by the employer. This means that normal minimum hour requirements will be waived. COBRA may be an option for some of those employees, but this “premium continuation” approach may provide additional stability in the event employers are willing to participate in hopes that they may be able to resume business in the near term. People who purchase individual plans through the federal marketplace and who receive an advance premium tax credit will continue to receive a 90-day grace period, established by federal law that we will continue to follow without adjustment. Providence will grant a 30-day extension for the following people that are unable to pay some or all of their premium: People who purchase individual plans through the federal marketplace and who do notreceive an advance premium tax credit People who purchase individual plans direct (not through the federal marketplace) Fully-insured employer group plans (small and large) Providence Health Plan is waiving all cost sharing for testing services related to COVID-19, such as copays, coinsurance, and deductibles. Back to top Q. Quartz Health Solutions Quartz Health Solutions has waived out-of-pocket costs for testing related to COVID-19. Office visits and services associated with testing for COVID-19 will be covered with no out-of-pocket costs. Quartz is offering telehealth, video visits, virtual visits, and e-visits with Quartz providers with no out-of-pocket costs. These benefit enhancements are being offered through December 31, 2020 and apply to Quartz’s Commercial lines of business and members enrolled in a HDHP or HSA plan. Note: Self-insured plan sponsors may opt-in to these enhancements at their discretion. Quartz has waived cost-sharing for inpatient hospitalizations at all in-network facilities for treatment related to COVID-19. This benefit enhancement is being offered through October 22, 2020 and applies to Quartz’s Commercial lines of business. These services are also covered for both in and out-of-network providers for Quartz Medicare Advantage members as directed by CMS through the Public Health emergency. Quartz is allowing earlier access to prescription drugs. For non-maintenance prescriptions, members can refill prescriptions 22 days before they should be needed based on the date of their last claim. For maintenance prescriptions eligible for a 90-day supply, members can refill prescriptions 30 days before they should be needed based on the date of their last claim. These benefit enhancements are being offered until further notice and apply to Quartz’s Commercial lines of business. Quartz’s Medicare Advantage members also have access to early refills, without limits, through the duration of the public health emergency. Please visit Quartz’s dedicated COVID-19 page for updates to benefits, FAQ documents, and more. Quartz has waived out-of-pocket costs for testing related to COVID-19. Office visits and services associated with testing for COVID-19 will be covered with no out-of-pocket costs. Quartz is offering telehealth, video visits, virtual visits, and e-visits with Quartz providers with no out-of-pocket costs. These benefit enhancements are being offered through July 31, 2020 and apply to Quartz’s Commercial lines of business and members enrolled in a HDHP or HSA plan. Note: Self-insured plan sponsors may opt-in to these enhancements at their discretion. Quartz has waived cost-sharing for inpatient hospitalizations at all in-network facilities for treatment related to COVID-19. This benefit enhancement is being offered through July 31, 2020 and applies to Quartz’s Commercial lines of business. These services are also covered for both in and out-of-network providers for Quartz Medicare Advantage members as directed by CMS through the Public Health emergency. Quartz is allowing earlier access to prescription drugs. For non-maintenance prescriptions, members can refill prescriptions 22 days before they should be needed based on the date of their last claim. For maintenance prescriptions eligible for a 90-day supply, members can refill prescriptions 30 days before they should be needed based on the date of their last claim. These benefit enhancements are being offered until further notice and apply to Quartz’s Commercial lines of business. Quartz’s Medicare Advantage members also have access to early refills, without limits, through the duration of the public health emergency. Back to top R. Regence BlueShield of Idaho will cover the cost of FDA-approved treatment for COVID-19 at in-network facilities with no out-of-pocket costs for members through 2021. Regence BlueShield of Idaho Employers with Regence health insurance will be able to access Fitbit’s Ready for Work program that helps employees with early illness detection and improves workplace safety for businesses. Offered through Fitbit Health Solutions, Fitbit’s Ready for Work program aims to help employees and employers make informed decisions on returning to work safely and confidently and combat workplace spread of COVID-19. The solution provides access to key health metrics from a Fitbit device (resting heart rate, heart rate variability and breathing rate), along with exposure, symptom and temperature logging. Regence is also providing a special offer on Fitbit smartwatches, trackers, accessories and Fitbit Premium programming, providing members with the ability to track activity, sleep, heart rate and access to audio workouts and meditation tracks. A partnership between Regence BlueShield of Idaho and health solutions provider Papa Inc. offers companionship and support to older adults enrolled in a Regence Medicare Advantage plan with coverage in 2021. The Papa Pals program pairs qualifying Regence members with ‘pals’ – non-clinical, trained companions who are often college students – to provide companionship and assistance with everyday tasks, such as grocery shopping, pharmacy pickup and technology support. Members with qualifying Medicare plans across Regence’s four-state footprint – Idaho, Oregon, Utah and Washington – can access up to four hours of virtual Papa Pal support each month at a $0 copay. Developed in response to the COVID-19 pandemic, Papa’s virtual ‘Assistance from a Distance’ program allows older adults to safely connect with their pal over the phone or through video chat. To foster deeper connections, members can select the same Papa Pal for each virtual visit or find a pal that speaks their primary language. Regence BlueShield of Idaho is providing up to $35 million in financial relief to commercial health plan customers in its four-state footprint through a premium credit. Select fully insured group and individual Regence health plan customers across Idaho, Oregon, Utah and Washington will receive a credit for a portion of their health care premium on upcoming bills. Regence BlueShield of Idaho’s telehealth claims are up 4900 percent during the COVID-19 crisis. In January, Regence saw an average of 1,000 telehealth visits a week. In May, that average was more than 50,000 visits a week. Primary and specialty care are making up half of all telehealth utilization for Regence members, up from about 20% in January. Members across Regence’s four-state region who received behavioral health care before the COVID-19 crisis successfully switched to virtual care options to ensure their continued care from the earliest days of physical distancing. This included 87% of members in Washington, 85% in Oregon, 85% in Idaho, and 82% in Utah, averaging to 85% across the four states. Regence has also extended coverage for coronavirus (COVID-19) treatment without any out-of-pocket costs for fully insured members through December 31, 2020. In addition, Regence will continue paying providers for virtual care services at the same rate as in-person visits through September 2020 to help ease member access and support providers experiencing financial challenges. Diagnostic testing also remains covered at no cost to members. Regence is offering health plan members free access to COVID-19 and mental wellness resources powered by myStrength, a digital behavioral health app, through the end of the year. MyStrength from Livongo for Behavioral Health provides interactive, activity-based modules designed to manage heightened stress and feelings of social isolation stemming from the current COVID-19 crisis. Through year-end, Regence’s fully-insured and self-funded members will have complementary access to myStrength’s COVID-19 and Mental Wellness resources, which include stress-management strategies, tips for parenting during challenging times, ideas to manage feelings of social isolation, and other emotional support tools. Regence BlueShield of Idaho will cover treatment for coronavirus (COVID-19) without any out-of-pocket costs for fully insured members through June 30, 2020. Regence BlueShield of Idaho will cover the cost of coronavirus testing without any out-of-pocket costs for fully insured members. Regence is working with federal officials to ensure coordination of benefits for Medicare members and those with health savings accounts (HSA). Regence is also easing access through virtual care, as well as access to regularly prescribed medications. Regence BlueCross BlueShield of Oregon   Regence BlueCross BlueShield of Oregon will cover the cost of FDA-approved treatment for COVID-19 at in-network facilities with no out-of-pocket costs for members through 2021. Employers with Regence health insurance will be able to access Fitbit’s Ready for Work program that helps employees with early illness detection and improves workplace safety for businesses. Offered through Fitbit Health Solutions, Fitbit’s Ready for Work program aims to help employees and employers make informed decisions on returning to work safely and confidently and combat workplace spread of COVID-19. The solution provides access to key health metrics from a Fitbit device (resting heart rate, heart rate variability and breathing rate), along with exposure, symptom and temperature logging. Regence is also providing a special offer on Fitbit smartwatches, trackers, accessories and Fitbit Premium programming, providing members with the ability to track activity, sleep, heart rate and access to audio workouts and meditation tracks. A partnership between Regence BlueCross BlueShield of Oregon and health solutions provider Papa Inc. offers companionship and support to older adults enrolled in a Regence Medicare Advantage plan with coverage in 2021. The Papa Pals program pairs qualifying Regence members with ‘pals’ – non-clinical, trained companions who are often college students – to provide companionship and assistance with everyday tasks, such as grocery shopping, pharmacy pickup and technology support. Members with qualifying Medicare plans across Regence’s four-state footprint – Idaho, Oregon, Utah and Washington – can access up to four hours of virtual Papa Pal support each month at a $0 copay. Developed in response to the COVID-19 pandemic, Papa’s virtual ‘Assistance from a Distance’ program allows older adults to safely connect with their pal over the phone or through video chat. To foster deeper connections, members can select the same Papa Pal for each virtual visit or find a pal that speaks their primary language. Regence BlueCross BlueShield of Oregon is providing $2 million in financial relief through a one-time premium credit to its members enrolled in a Medicare Advantage (MA) PPO plan. The credit amount will either be applied to eligible members’ October premium bill or sent as a printed check in September. This follows a one-time credit totaling $35 million that Regence health plans issued in August 2020 to select fully insured group and individual customers across Washington, Oregon, Idaho and Utah. Regence BlueCross BlueShield of Oregon is providing up to $35 million in financial relief to commercial health plan customers in its four-state footprint through a premium credit. Select fully insured group and individual Regence health plan customers across Idaho, Oregon, Utah and Washington will receive a credit for a portion of their health care premium on upcoming bills. Regence BlueCross BlueShield of Oregon’s telehealth claims are up 4900 percent during the COVID-19 crisis. In January, Regence saw an average of 1,000 telehealth visits a week. In May, that average was more than 50,000 visits a week. Primary and specialty care are making up half of all telehealth utilization for Regence members, up from about 20% in January. Members across Regence’s four-state region who received behavioral health care before the COVID-19 crisis successfully switched to virtual care options to ensure their continued care from the earliest days of physical distancing. This included 87% of members in Washington, 85% in Oregon, 85% in Idaho, and 82% in Utah, averaging to 85% across the four states. Regence has also extended coverage for coronavirus (COVID-19) treatment without any out-of-pocket costs for fully insured members through December 31, 2020. In addition, Regence will continue paying providers for virtual care services at the same rate as in-person visits through September 2020 to help ease member access and support providers experiencing financial challenges. Diagnostic testing also remains covered at no cost to members. Regence is offering health plan members free access to COVID-19 and mental wellness resources powered by myStrength, a digital behavioral health app, through the end of the year. MyStrength from Livongo for Behavioral Health provides interactive, activity-based modules designed to manage heightened stress and feelings of social isolation stemming from the current COVID-19 crisis. Through year-end, Regence’s fully-insured and self-funded members will have complementary access to myStrength’s COVID-19 and Mental Wellness resources, which include stress-management strategies, tips for parenting during challenging times, ideas to manage feelings of social isolation, and other emotional support tools. Regence BlueCross BlueShield of Oregon will cover treatment for coronavirus (COVID-19) without any out-of-pocket costs for fully insured members through June 30, 2020. Regence BlueCross BlueShield of Oregon is covering COVID-19 testing at no cost, easing access to virtual care, easing access to regular prescription drugs, and proactively reaching out to high-risk members. Regence BlueCross BlueShield of Utah Regence BlueCross BlueShield of Utah will cover the cost of FDA-approved treatment for COVID-19 at in-network facilities with no out-of-pocket costs for members through 2021. Employers with Regence health insurance will be able to access Fitbit’s Ready for Work program that helps employees with early illness detection and improves workplace safety for businesses. Offered through Fitbit Health Solutions, Fitbit’s Ready for Work program aims to help employees and employers make informed decisions on returning to work safely and confidently and combat workplace spread of COVID-19. The solution provides access to key health metrics from a Fitbit device (resting heart rate, heart rate variability and breathing rate), along with exposure, symptom and temperature logging. Regence is also providing a special offer on Fitbit smartwatches, trackers, accessories and Fitbit Premium programming, providing members with the ability to track activity, sleep, heart rate and access to audio workouts and meditation tracks. A partnership between Regence BlueCross BlueShield of Utah and health solutions provider Papa Inc. offers companionship and support to older adults enrolled in a Regence Medicare Advantage plan with coverage in 2021. The Papa Pals program pairs qualifying Regence members with ‘pals’ – non-clinical, trained companions who are often college students – to provide companionship and assistance with everyday tasks, such as grocery shopping, pharmacy pickup and technology support. Members with qualifying Medicare plans across Regence’s four-state footprint – Idaho, Oregon, Utah and Washington – can access up to four hours of virtual Papa Pal support each month at a $0 copay. Developed in response to the COVID-19 pandemic, Papa’s virtual ‘Assistance from a Distance’ program allows older adults to safely connect with their pal over the phone or through video chat. To foster deeper connections, members can select the same Papa Pal for each virtual visit or find a pal that speaks their primary language. Regence BlueCross BlueShield of Utah is providing up to $35 million in financial relief to commercial health plan customers in its four-state footprint through a premium credit. Select fully insured group and individual Regence health plan customers across Idaho, Oregon, Utah and Washington will receive a credit for a portion of their health care premium on upcoming bills. Regence BlueCross BlueShield of Utah’s telehealth claims are up 4900 percent during the COVID-19 crisis. In January, Regence saw an average of 1,000 telehealth visits a week. In May, that average was more than 50,000 visits a week. Primary and specialty care are making up half of all telehealth utilization for Regence members, up from about 20% in January. Members across Regence’s four-state region who received behavioral health care before the COVID-19 crisis successfully switched to virtual care options to ensure their continued care from the earliest days of physical distancing. This included 87% of members in Washington, 85% in Oregon, 85% in Idaho, and 82% in Utah, averaging to 85% across the four states. Regence has also extended coverage for coronavirus (COVID-19) treatment without any out-of-pocket costs for fully insured members through December 31, 2020. In addition, Regence will continue paying providers for virtual care services at the same rate as in-person visits through September 2020 to help ease member access and support providers experiencing financial challenges. Diagnostic testing also remains covered at no cost to members. Regence is offering health plan members free access to COVID-19 and mental wellness resources powered by myStrength, a digital behavioral health app, through the end of the year. MyStrength from Livongo for Behavioral Health provides interactive, activity-based modules designed to manage heightened stress and feelings of social isolation stemming from the current COVID-19 crisis. Through year-end, Regence’s fully-insured and self-funded members will have complementary access to myStrength’s COVID-19 and Mental Wellness resources, which include stress-management strategies, tips for parenting during challenging times, ideas to manage feelings of social isolation, and other emotional support tools. Regence BlueCross BlueShield of Utah will cover treatment for coronavirus (COVID-19) without any out-of-pocket costs for fully insured members through June 30, 2020. Regence BlueCross BlueShield of Utah will cover the cost of coronavirus testing without any out-of-pocket costs for fully insured members. Regence is working with federal officials to ensure coordination of benefits for Medicare members and those with health savings accounts (HSA). Regence is also easing access through virtual care, as well as access to regularly prescribed medications. Regence BlueShield of Washington Regence BlueShield of Washington will cover the cost of FDA-approved treatment for COVID-19 at in-network facilities with no out-of-pocket costs for members through 2021. Employers with Regence health insurance will be able to access Fitbit’s Ready for Work program that helps employees with early illness detection and improves workplace safety for businesses. Offered through Fitbit Health Solutions, Fitbit’s Ready for Work program aims to help employees and employers make informed decisions on returning to work safely and confidently and combat workplace spread of COVID-19. The solution provides access to key health metrics from a Fitbit device (resting heart rate, heart rate variability and breathing rate), along with exposure, symptom and temperature logging. Regence is also providing a special offer on Fitbit smartwatches, trackers, accessories and Fitbit Premium programming, providing members with the ability to track activity, sleep, heart rate and access to audio workouts and meditation tracks.  A partnership between Regence BlueShield of Washington and health solutions provider Papa Inc. offers companionship and support to older adults enrolled in a Regence Medicare Advantage plan with coverage in 2021. The Papa Pals program pairs qualifying Regence members with ‘pals’ – non-clinical, trained companions who are often college students – to provide companionship and assistance with everyday tasks, such as grocery shopping, pharmacy pickup and technology support. Members with qualifying Medicare plans across Regence’s four-state footprint – Idaho, Oregon, Utah and Washington – can access up to four hours of virtual Papa Pal support each month at a $0 copay. Developed in response to the COVID-19 pandemic, Papa’s virtual ‘Assistance from a Distance’ program allows older adults to safely connect with their pal over the phone or through video chat. To foster deeper connections, members can select the same Papa Pal for each virtual visit or find a pal that speaks their primary language. Regence BlueShield of Washington is providing $2.4 million in financial relief through a one-time premium credit to its Washington members enrolled in a Medicare Advantage (MA) PPO plan. The credit amount will either be applied to eligible members’ October premium bill or sent as a printed check in September. This follows a one-time credit totaling $35 million that Regence health plans issued in August 2020 to select fully insured group and individual customers across Washington, Oregon, Idaho and Utah. Regence BlueShield of Washington is providing up to $35 million in financial relief to commercial health plan customers in its four-state footprint through a premium credit. Select fully insured group and individual Regence health plan customers across Idaho, Oregon, Utah and Washington will receive a credit for a portion of their health care premium on upcoming bills. Regence BlueShield of Washington’s telehealth claims are up 4900 percent during the COVID-19 crisis. In January, Regence saw an average of 1,000 telehealth visits a week. In May, that average was more than 50,000 visits a week. Primary and specialty care are making up half of all telehealth utilization for Regence members, up from about 20% in January. Members across Regence’s four-state region who received behavioral health care before the COVID-19 crisis successfully switched to virtual care options to ensure their continued care from the earliest days of physical distancing. This included 87% of members in Washington, 85% in Oregon, 85% in Idaho, and 82% in Utah, averaging to 85% across the four states. Regence has also extended coverage for coronavirus (COVID-19) treatment without any out-of-pocket costs for fully insured members through December 31, 2020. In addition, Regence will continue paying providers for virtual care services at the same rate as in-person visits through September 2020 to help ease member access and support providers experiencing financial challenges. Diagnostic testing also remains covered at no cost to members. Regence is offering health plan members free access to COVID-19 and mental wellness resources powered by myStrength, a digital behavioral health app, through the end of the year. MyStrength from Livongo for Behavioral Health provides interactive, activity-based modules designed to manage heightened stress and feelings of social isolation stemming from the current COVID-19 crisis. Through year-end, Regence’s fully-insured and self-funded members will have complementary access to myStrength’s COVID-19 and Mental Wellness resources, which include stress-management strategies, tips for parenting during challenging times, ideas to manage feelings of social isolation, and other emotional support tools. Regence BlueShield of Washington will cover treatment for coronavirus (COVID-19) without any out-of-pocket costs for fully insured members through June 30, 2020. Regence BlueShield of Washington is covering COVID-19 testing at no cost, easing access to virtual care, easing access to regular prescription drugs, and proactively reaching out to high-risk members. Back to top S. Sanford Health Plan Sanford Health Plan is waiving cost-sharing for all Telehealth/Virtual Care services – even those unrelated to COVID-19 – through the end of the COVID-19 National Emergency. Sanford Health Plan is waiving all cost-sharing payments for COVID-19 treatment through Sept. 30, 2020. Sanford is also waiving all co-pays for telehealth care through Sept. 30, 2020. Sanford Health Plan has deployed a test for COVID-19 that can deliver results within 90 minutes. These rapid tests will be used for the highest priority patients, including those who are hospitalized, health care workers and elderly adults living in long-term care facilities, and are available in Sioux Falls, South Dakota, and Fargo, North Dakota. Sanford Health Plan will cover 100% of the cost of specimen collection and testing for COVID-19. Testing is covered when indicated as medically necessary by a qualified practitioner. Sanford will also cover office visits and ER visits at 100% when related to COVID-19 testing. Sanford Health Plan is also extending prior authorizations an extra 90 days for all existing maintenance prescriptions with prior authorizations that will expire in 90 days or fewer. SCAN Health Plan SCAN Health Plan is waiving copayments for visits with primary care doctors, or members of their staff, through June 30, 2021. This includes in-person visits, as well as those done over the telephone or via computer. SCAN is also waiving copayments for outpatient visits with behavioral health professionals through June 30, 2021. SCAN Health Plan is making grants to community organizations and developing new partnerships with the Mizell Center in Palm Springs and Janet Goeske Center in Riverside in order to provide critically needed social services to adults in the Inland Empire. The funding and collaborations, which are being made through Independence at Home (IAH), a SCAN community service, will be used to improve the health and social engagement of older adults, many of whom have become isolated and cut off from services during the COVID-19 crisis. Through almost $210,000 in direct grants, SCAN has provided funding this year to 15 local non-profits in the Inland Empire, supporting their efforts to meet the needs of older adults and their caregivers. The grants are being used to provide seniors with groceries, home-delivered meals and essential household items, as well as assistance with expenses including prescriptions, rent and utilities. SCAN Health Plan has introduced several benefits to help seniors navigate the ongoing impacts of the coronavirus, including a technology support line, online memory and brain health exercise platform, and ensuring members maintain access to benefits when out of town or sheltering in place with loved ones. The 2021 health plan benefits will be available to those eligible for Medicare in the Northern California communities of San Francisco, Santa Clara, Napa, Sonoma and Stanislaus counties, as well as Medicare-eligible seniors in Los Angeles, Orange, San Bernardino, Riverside, San Diego and Ventura counties. In addition to having access to $0 telehealth services, an important element in maintaining health remotely, starting Jan. 1, 2021, SCAN benefits include: HEALTHtech—SCAN’s technology support line that helps members use a computer, tablet or smartphone to access healthcare and health-related information and services BrainHQ—Provides online exercises at no cost to enhance memory, brain speed and other functions to boost brain health SCAN on the go—Ensures members are aware of the benefits available to them when out of town, helping them stay healthy and safe while away from home SCAN Health Plan has launched the first phase of artificial intelligence (AI) based predictive models designed to improve health outcomes and inform benefit and service design. This implementation will improve SCAN’s ability to identify high-needs members and provide tailored interventions to help avoid or reduce hospitalizations. SCAN Health Plan has launched Rally®, an interactive member engagement platform from digital health company Rally Health, Inc. Working in collaboration with Rally, SCAN is offering its members a digital solution that enables them to engage in online social communities, set and meet wellness goals, and get information about the health topics of interest to them. The introduction of an online interactive experience for health, wellness, and social connectivity comes as seniors’ lives have been impacted significantly by the COVID-19 pandemic. Sheltering in place has forced many to become more familiar with tech platforms for everything from doctor’s appointments to ordering groceries to staying in touch with loved ones. SCAN Health Plan is waiving copayments for primary care doctor visits, or members of their staff like a physician assistant or nurse practitioner, through Dec. 31, 2020. This includes in-person visits, as well as those done over the telephone or virtually through a computer or smart phone. SCAN is also waiving copayments for outpatient visits with behavioral health professionals through Dec. 31, 2020. SCAN Health Plan is committing $5.1 million to address a variety of needs for vulnerable seniors and others at risk due to the effects of the COVID-19 pandemic. The emergency funding will address: Delivery of additional services to seniors in need of nutritious meals and other essential supplies; Additional financial support to non-profit, senior-focused organizations and provider groups in addition to the nearly $350,000 in COVID-19-related funding SCAN has already provided to such groups; and Assistance for SCAN employees most impacted by current circumstances. SCAN Health Plan is supporting California Governor Gavin Newsom’s “Stay Home. Save Lives. Check In.” campaign, which is aimed at combatting social isolation and food insecurity among those 65 and older. SCAN has launched an employee “all hands” effort, proactively calling members to make sure they have what they need to stay healthy at home, focusing first on those who are: High-risk, such as those on oxygen or who are homebound Socially isolated, because they live alone or don’t have a support system SCAN is also providing emergency funding for nonprofits serving seniors, including, to date, an additional $330,000 to 14 organizations—most of which are delivering meals and other necessary supplies. SCAN Health Plan has provided $200,000 in emergency funding for nonprofits to help them respond to demand for their services due to the COVID-19 pandemic. SCAN has also adapted many of their community services from in-person to telephonic, including clinical programs for seniors and caregivers and many volunteer efforts. Security Health Plan Security Health Plan is covering in-patient and observation treatment related to COVID-19 at 100% through the end of the National Public Health Emergency for members with large employer group, small employer group, Medicare Advantage, Medicare Supplement, and Medicaid plans. Security Health Plan is covering in-patient and observation treatment related to COVID-19 at 100% through April 20, 2021 for members with large employer group, small employer group, individual and family, Medicare Advantage, Medicare Supplement, and Medicaid plans. Security Health Plan is covering in-patient and observation treatment related to COVID-19 at 100% through January 21, 2021 for members with large employer group, small employer group, Medicare Advantage, Medicare Supplement, and Medicaid plans. Security Health Plan is issuing premium rebates to its fully insured employer clients and waiving cost sharing for its individual consumer clients. These efforts are in response to the historic reductions in people seeking medical care in April and May due to the COVID crisis. Security Health Plan will refund 10% of the April premium and 5% of the May premium to fully insured employer customers. Security Health Plan will also waive cost sharing for Medicare Advantage and Affordable Care Act Individual and Family Plan primary and specialty office visits beginning August 1 and continuing through the end of 2020. Sentara Healthcare Sentara Healthcare is partnering with local health departments, Urban League and NAACP chapters, community organizations and faith groups to provide free coronavirus testing in minority communities Sentara serves across Virginia and in northeast North Carolina. These may include African-American and Hispanic neighborhoods, LGBTQ persons, homeless persons and others without ready access to testing. Sentara Healthcare has started providing drive-thru screening and testing at three locations for those who are concerned they may have coronavirus (COVID-19). Sharp Health Plan Sharp Health Plan is waiving out-of-pocket costs for all COVID-19 diagnostic treatment through June 30, 2021. Sharp Health Plan is waiving out-of-pocket costs for all COVID-19 diagnostic treatment through March 31, 2021. Sharp Health Plan is waiving members’ out-of-pocket costs for inpatient and outpatient services related to the treatment of COVID-19. This policy applies to Sharp Health Plan members who are diagnosed with COVID-19 and who are enrolled in a fully insured benefit plan, and is effective from April 1 through December 31, 2020. Sharp Health Plan is waiving members’ out-of-pocket costs for inpatient and outpatient services related to COVID-19 treatment through October 31, 2020. Sharp Health Plan has extended its waiver for out-of-pocket costs for all COVID-19 diagnostic treatment through September 30, 2020. Sharp Health Plan has also waived out-of-pocket costs for all COVID-19 treatment received Apr. 1 through May 31, 2020 for members diagnosed with COVID-19. Sharp Health Plan will waive the cost-share for all medically necessary screening and testing for COVID-19. This includes hospital (including emergency department), urgent care, provider office visits, and telehealth appointments for the purpose of screening and/or testing for coronavirus. SummaCare SummaCare is waiving any co-pays and deductibles related to provider-ordered testing of COVID-19 for Medicare Advantage, Individual and Commercial members regardless of where the test is ordered and performed. Self-insured plans will determine how their coverage will apply. Sutter Health Plan Sutter Health Plus will waive the cost-share for telehealth visits for covered services from April through the end of December 2020. Sutter Health Plus will waive the cost-share for covered services related to COVID-19 treatment from February through the end of September 2020. This includes, but is not limited to, PCP office visits, urgent care visits, emergency department visits, inpatient hospital stays, telehealth visits, and lab tests. Members are responsible for the appropriate cost-shares for outpatient prescription drugs. Sutter Health Plus will waive the cost share for covered services related to screening and testing for COVID-19. Back to top T. TakeCare TakeCare is waiving cost-sharing payments for telehealth services related to COVID-19 through January 21, 2021. TakeCare has also expanded its telehealth benefit coverage to include audio and video services using a computer, tablet, or smartphone, in addition to phone consultation for primary and specialist consultation. TakeCare is providing coverage for the COVID-19 test and associated visit under the preventive care benefit, at no cost to members, when using in-network providers provided these tests and visits are not covered by the Public Health System. TakeCare is also allowing for early medication refills for an additional 30 days for members who meet criteria. Trillium Health Plan Trillium Health Plan will cover the cost of COVID-19 tests and the associated physician’s visit when medically necessary diagnostic testing or medical screening services are ordered and/or referred by a licensed health care provider. If applicable, your plan’s copayment, coinsurance and/or deductible cost-sharing will be waived for medically necessary COVID-19 diagnostic testing and/or medical screening services. Tufts Health Plan Foundation Tufts Health Plan Foundation announced 64 community organizations will share $900,000 in funding to help in on-going COVID-19 response efforts. The nonprofit organizations focus on urgent needs in communities, especially those disproportionately affected by the virus. The funding, first announced in June, is in addition to the $1 million in COVID-19-related grants awarded earlier this year. The grants support organizations working to address basic needs like food access, housing assistance, and other fundamental supports to help people stay safe and healthy. The funding will go to organizations in Massachusetts, Rhode Island, New Hampshire and Connecticut. Tufts Health Plan Foundation board has approved an additional $900,000 to support recovery and rebuilding efforts addressing the effects of the coronavirus pandemic in Massachusetts, Rhode Island, New Hampshire and Connecticut. The Foundation’s commitment to COVID-19 response now reaches nearly $2 million. Tufts Health Plan Foundation announced $170,000 in grants to 10 nonprofit organizations, part of the $1 million it committed to support community efforts addressing coronavirus in Massachusetts, Rhode Island, New Hampshire and Connecticut. In total, 49 organizations on the front lines of the pandemic have received funding. This funding goes to organizations working to improve access to food and respond to inequities in housing and services. It bolsters collaborative regional responses, particularly in communities reporting the highest rates of COVID-19 infection. Tufts Health Plan has launched an Employee Relief Fund to support employees who have been affected by the coronavirus pandemic and are experiencing financial hardship, including the loss of a job by someone in their household. Eligible employees can apply for $1,000 grants to cover essential living expenses, such as rent or mortgage, utilities and certain medical costs. Tufts Health Plan Foundation has made grants to five diverse community organizations to help them address the COVID-19 crisis. The organization range from helping the homeless to supporting veterans and LGBTQ+ youths. Each organization will receive $10,000. Tufts Health Plan Foundation is providing funding to 18 additional nonprofit organizations as part of the $1 million it has committed to support community efforts on behalf of older people affected by the coronavirus. This second wave of funding, totaling $345,000, focuses on housing and equity efforts in Massachusetts, Rhode Island, New Hampshire and Connecticut. The organizations include housing providers, those working with people experiencing homelessness and immigrant communities, and several serving as hubs for collaborative regional responses. Tufts Health Plan is waiving treatment costs for its members suffering from the coronavirus, including copays, deductibles and coinsurance. This coverage applies at in-network providers, urgent care centers, emergency rooms and other facilities, and at out-of-network providers in the event a member cannot easily find an in-network provider to provide timely services. Tufts has also eliminated out-of-pocket costs for telehealth visits and removed prior authorization requirements for providers as it relates to treatment and care of coronavirus. Tufts Health Plan Foundation is donating $1 million to efforts driven by community and nonprofit organizations supporting older people affected by the coronavirus outbreak in Massachusetts, Rhode Island, New Hampshire and Connecticut. Back to top U. UCare  UCare is waiving all copays, coinsurance and deductibles when patients receive in-network observation and inpatient hospital services to treat COVID-19 through December 31, 2021. UCare is waiving cost-sharing payments for in-network observation and inpatient hospital services to treat COVID-19 through June 30, 2021. UCare is waiving cost sharing for COVID-19 observation or inpatient hospitalization for all members through March 31, 2021. As vaccines for COVID-19 become available, UCare will cover them without charge for members through 2021. UCare has extended copay waivers on telehealth for primary and mental health care for Medicare members through the end of the year. UCare is also waiving copays for COVID-19 telehealth visits for all members through the end of the year. UCare is waiving copays, coinsurance and deductibles when members receive in-network, inpatient hospital services to treat COVID-19 through September 2020. UCare is reducing member premium payments by 20% in July and August of 2020. UCare is also: Removing copays for Medicare primary care and mental health clinic services – including telehealth – during the COVID-19 public health emergency Continuing to waive copays, coinsurance and deductibles for COVID-19 tests and associated clinic, urgent care and emergency room visits Continuing to waive copays, coinsurance, deductibles for COVID-19 inpatient hospitalizations through September 2020 Supplying health care providers, group homes, nursing homes, assisted living facilities, social service organizations and vulnerable members with telehealth home kits, masks, healthy snack boxes and iPads Offering $25,000 grants to small provider groups and community clinics to build infrastructure during COVID-19 The UCare Foundation is providing $500,000 in short-and long-term assistance to benefit Minnesotans impacted by COVID-19. The funds support needs related to social isolation, telehealth, food insecurity and personal protective equipment. The UCare Foundation is a community-directed initiative focused on supporting innovative services, education, community outreach, and research that improve health. UCare is covering coinsurance, copays, and deductibles for members who receive in-network hospital services to treat COVID-19 through May 31, 2020. UCare will continue to track the situation and determine whether to extend this coverage beyond May 31. UCare will waive all copays, coinsurance or deductibles for doctor-ordered COVID-19 testing in all of its plans. UCare is also covering copays, coinsurance or deductibles for medically necessary clinic and urgent care services received at the visit when a COVID-19 test is administered at an in-network clinic, and at out-of-network clinics if in-network alternatives are not available. UniCare UniCare will cover COVID-19 treatment with no copays or cost-sharing through December 31, 2020, as long as members receive treatment from doctors, hospitals, and other health-care professionals in their plan’s network. UniCare is also covering telehealth visits with doctors and health-care professionals at no cost to members through Sept. 13, 2020. UniCare Health Plan of West Virginia UniCare Health Plan of West Virginia and its Foundation announced $134,000 in grants to community-based organizations to support health care workers and first responders, access to food and shelter for the homeless, and other vital community needs and resources. The grants are being provided to several community-based organizations in West Virginia, and are part of UniCare Health Plan of West Virginia and its Foundation’s commitment to the whole health of individuals and families. These efforts are part of UniCare’s coordinated response to COVID-19 for members, local community organizations, health care workers, and frontline responders. UniCare Health Plan has also provided ongoing member support for those that may have an increased need during this crisis, including those high-risk members impacted by immunosuppression, chronic conditions, or social isolation. These virtual check-ins assess if members need assistance addressing areas such as medical attention, telehealth access, medications, food insecurity, or isolation. University Health Alliance University Health Alliance is waiving copays, coinsurance, and deductible coinsurance for medically necessary hospitalizations at related to COVID-19 through December 31, 2020. The waiver applies to hospitalizations at UHA participating facilities. University Health Alliance is covering 100% of the cost for all services related to the diagnosis of COVID-19.  For inpatient hospitalizations, UHA is paying 100% of the UHA eligible charge.  Member co-pays, coinsurance and deductibles will be waived. University Health Alliance is also covering all telehealth access at 100% of eligible charges with no copay for any telehealth service for the duration of the COVID-19 state of emergency—regardless of the primary purpose of the visit. UPMC and UPMC Health Plan UPMC Health Plan is waiving all member cost sharing (such as deductibles, copays, and coinsurance) for in-network inpatient treatment of COVID-19 through January 20, 2022. Now through October 20, 2021, UPMC Health Plan is waiving all deductibles, coinsurance, and copays for in-network, inpatient COVID-19 treatment for Medicare Advantage members. UPMC Health Plan is waiving all member cost sharing, including deductibles or copayments, for virtual health care visits with our network providers through February 28, 2021. Additionally, UPMC Health Plan is waiving all deductibles, coinsurance, and copays for in-network, inpatient COVID-19 treatment for members through February 28, 2021. UPMC Health Plan will continue to waive all deductibles, coinsurance, and copays for in-network, inpatient COVID-19 treatment for its members enrolled in its Medicare Advantage plans, fully-insured employer group and individual ACA plans, as well as in self-insured employer group plans that opt into this coverage. This policy change is effective immediately and will stay in effect through December 31, 2020, so long as permitted under current state and federal emergency declarations. UPMC Health Plan will also continue to waive deductibles, copayments and cost-sharing for all in-network virtual visits (telehealth) with a health care provider, including through UPMC AnywhereCare, until December 31, 2020, so long as permitted under current state and federal emergency declarations. UPMC Health Plan is providing parents with increased flexibility to meet the physical and emotional health care needs of their children as the new school year begins. UPMC Health Plan encourages parents to resume routine well-visits for their children’s’ annual physicals and checkups, and is working with the pediatricians in its network to ensure that they are prepared to provide well-visits during the COVID-19 crisis in three ways: i) in-person visits, ii) virtual well-visits, and iii) split visits, with the first visit being a virtual well-visit and the second visit being an in-person visit, primarily for flu shots and immunizations. By providing this flexibility, UPMC Health Plan is ensuring that children are receiving continued care with their existing providers. UPMC Health Plan encourages members to reach out to their providers to discuss the availability of virtual well-visits at each site. For individuals enrolled in UPMC Health Plan’s fully-insured commercial group coverage, UPMC for Kids, UPMC for You, and individual ACA Marketplace plans, virtual pediatric well-visits are being offered through December 31, 2020.  Well-visits are always no cost for individuals enrolled in UPMC Health Plan’s fully-insured commercial group coverage, UPMC for Kids, UPMC for You, and individual ACA Marketplace plans. UPMC Health Plan is waiving all deductibles, coinsurance, and copays for in-network, inpatient COVID-19 treatment for members through September 30. UPMC Health Plan has launched a new initiative—Pathways to Work—that aims to increase access to employment through training, education, and dedicated support from UPMC staff. This program is administered through the UPMC Center for Social Impact, and it aggregates UPMC Health Plan’s existing workforce development and employment efforts, creates and scales new partnerships and programs, and connects individuals to employment opportunities at UPMC and other Pennsylvania employers. The program has taken on a new urgency because of the COVID-19 pandemic. According to the Pennsylvania Department of Labor and Industry, more than 2 million Pennsylvanians have filed initial jobless claims since the pandemic began in March. To meet the increased need for employment services, human resource professionals are available to support UPMC Health Plan members who have lost their jobs and are seeking new career opportunities. Members can contact a talent acquisition specialist who can connect them with resources and opportunities through UPMC Health Plan customer service, or they can email [email protected]  and receive a response within two days. UPMC Health Plan is extending $0 cost-sharing for all covered telehealth services through September 30, 2020. With UPMC Health Plan’s commitment to remove financial barriers that could discourage members from seeking telehealth services, including through UPMC AnywhereCare, members will not face deductibles, copayments, or cost-sharing of any kind for in-network virtual visits with a health care provider, including primary care physicians, specialists, and both physical and occupational therapy. This extension until September 30, 2020, applies to individuals enrolled in UPMC Health Plan’s fully-insured commercial group coverage, individual ACA Marketplace plans, and UPMC for Life Medicare Advantage plans, as well as self-insured employer group plans that opt into this coverage. UPMC is waiving all deductibles, co-insurance and co-pays for all in-network, inpatient COVID-19 treatment for its members enrolled in fully-insured group, ACA and Medicare Advantage plans, as well as in self-insured employer group plans that opt in to this coverage. This policy change is effective immediately and will stay in effect through June 15, 2020. UPMC and UPMC Health Plan will waive any applicable deductibles, copayments, or other cost-sharing for COVID-19 testing when ordered by a member’s treating medical provider. This no-cost coverage of COVID-19 testing as a preventive service will apply for members in all of UPMC’s commercial UPMC Advantage group and individual products, UPMC for Life Medicare Advantage plans, and UPMC for You Medical Assistance plans. Self-insured or administrative services only (ASO) employer groups will be permitted to opt-out of preventive coverage at their discretion. UPMC Health Plan is waiving all member cost sharing payments for all in-network virtual health care visits with UPMC telehealth providers. The waiver lasts until June 15, 2020. UPMC is also waiving early refill limits on medications filled at retail and specialty pharmacies until June 15, 2020. UPMC is also working with a bank to help small businesses find available loans from state or federal programs. Back to top V. Viva Health Viva Health will cover 100% of inpatient hospital treatment for COVID-19, through December 31, 2020. Viva is also waiving copayments for telehealth visits for Medicare patients with their in-network provider through December 31, 2020. Viva Health announced that if a member requires hospitalization for the treatment of COVID-19, inpatient hospital treatment will be covered at 100% on all Viva Health fully insured plans through September 30, 2020. Viva Health will cover FDA-approved lab testing from a participating/in-network reference lab (Labcorp or Quest), as well as the Alabama Department of Public Health. No deductible, copayment, or coinsurance will apply to the lab test, and prior authorization is not required. Members can have telehealth visits from any location with any in-network physician, nurse practitioner, or physician assistant who offers this service. Members will not have a copayment for telehealth visits with their local provider for the next 30 days. If a member requires hospitalization for the treatment of COVID-19, inpatient hospital treatment will be covered at 100% on all Viva Health fully insured plans through September 30. Back to top W. WEA Trust WEA Trust will waive cost sharing, including co-pays, coinsurance and deductibles, for the COVID-19 test. In addition, it will not require pre-authorization for medical services related to the testing for COVID-19. WellCare WellCare has partnered with Shipt, a same-day delivery service, to help Medicare Advantage members safely and conveniently access groceries and everyday essentials throughout 2020, providing them with a critical service during the COVID-19 crisis. WellCare is providing low-income and special needs plan members in select WellCare, WellCare TexanPlus and ‘Ohana Medicare Advantage plans with free, monthly Shipt memberships for the remainder of 2020. With this benefit, members can have groceries and essentials delivered from a number of retailers directly to their homes through their Shipt account, which not only helps them easily obtain the essentials they need, but also helps reduce possible exposure to the virus by eliminating their need to go to the grocery store. The benefit, which is subject to availability, is being offered to more than 200,000 members across 23 states. WellCare of North Carolina, a subsidiary of Centene Corporation, is partnering with community-based organizations and other programs across the state to provide access to food and other essential supplies. WellCare of North Carolina has donated $40,000 directly to local food pantries and community partners across the state. The donation will help increase access to food support initiatives that serve vulnerable populations in high-need areas due to the COVID-19 pandemic. WellCare also purchased nearly $35,000 worth of Walmart gift cards to support vulnerable populations in the community who are in need of food, supplies and support during the COVID-19 pandemic. Each gift card holds a value of $35 and can be used to purchase essential items like diapers, over-the-counter medicines, and cleaning supplies. WellCare of South Carolina will award grants up to $1,500 to local community partners through its Community Connections Resource Grant (CCRG) process to help support those affected by the novel coronavirus (COVID-19). The goal of the grant process is to identify local, community-based organizations that are creating innovative solutions to address social service barriers affecting vulnerable populations due to the COVID-19 pandemic. To qualify, an organization must address the following social service areas: Food access Financial assistance Transportation Medication assistance Homelessness/housing WellCare of Georgia will award grants up to $1,500 to local community partners through its Community Connections Resource Grant process to help support those affected by the novel coronavirus (COVID-19). The goal of the grant process is to identify local, community-based organizations that are creating innovative solutions to address social service barriers affecting vulnerable populations due to the COVID-19 pandemic. WellCare, which was acquired by Centene on Jan. 23, is covering Medicaid, Medicare and Marketplace members’ coronavirus testing, screening and treatment. Western Health Advantage Western Health Advantage is waiving all treatment costs associated with COVID-19 care in an effort to alleviate any unnecessary stress or out-of-pocket costs to impacted members. This financial assistance will apply to treatment through March 31, 2021. This includes copayments and deductibles, if applicable, for office visits and hospitalization, and for services related to the treatment of COVID-19. Western Health Advantage is waiving all treatment costs associated with COVID-19 care through January 31, 2021. This includes copayments and deductibles, if applicable, for office visits and hospitalization, and for services related to the treatment of COVID-19. Western Health Advantage is waiving all treatment costs associated with COVID-19 care through December 31, 2020. The waiver includes copayments and deductibles for office visits and hospitalization for services related to COVID-19 treatment. Western Health Advantage is waiving all treatment costs associated with COVID-19 care in an effort to alleviate any unnecessary stress or out-of-pocket costs to impacted members. This includes copayments and deductibles, if applicable, for office visits and hospitalization, for services related to the treatment of COVID-19. This relief will apply for any treatments from February 2020 until the end of September 2020. Western Health Advantage will waive all cost-sharing for medically necessary screening and testing for COVID-19, including hospital/emergency room, urgent care, and provider office visits where the purpose of the visit is to be screened and/or tested for COVID-19. West Virginia Association of Health Plans The West Virginia Association of Health Plans announced that managed care organizations that manage West Virginia’s Medicaid program will temporarily remove all prior authorization/service authorization requirements for all covered medical services for out-of-network and in-network providers. An additional measure will extend the time period for patients to remain in residential substance abuse disorder treatment facilities. WPS Health Insurance WPS Health Insurance is waiving copays for telehealth services provided by Teladoc providers for customers with health plans that are not HSA-qualified High Deductible Health Plans through March 13, 2021. WPS Health Insurance is waiving copays for telehealth services for any condition provided by Teladoc providers and other preferred providers. The waiver will go through Dec. 31, 2020, but does not apply if a customer has an HSA-qualified HDHP. WPS will waive any cost-sharing for laboratory tests related to COVID-19. WPS will waive prior authorization requirements, and cover with no out-of-pocket costs to the customer, COVID-19 diagnostic laboratory testing and health care costs associated with provider visits for testing (e.g., office visits, urgent care visits, hospital visits, emergency room visits, etc.) for all fully insured policyholders and for self-funded plan policyholders where the group has instructed us to provide this coverage. This coverage applies for both in-network and out-of-network providers. Back to top X. N/A Back to top Y. N/A Back to top Z. N/A Back to top   A | B | C | D | E | F | G | H | I | J | K | L | M | N | O | P | Q | R | S | T | U | V | W | X | Y | Z. America’s Health Insurance Plans (AHIP) will continue to monitor the spread of COVID-19 closely. We are working with our members to continue delivering affordable access to high-quality health care that Americans deserve. For more information, please visit our Fact Sheet. share facebookf twitterl linkedini pinterest& related content Get The Facts Health Insurance Provider Actions Concerning the COVID-19 Vaccines by AHIP. Blog How We Encourage and Enable Americans to Get Vaccinated by AHIP. AHIP Immunizing Americans to Protect Their Health by AHIP.
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Result 7
TitleFAQs About Insurance Claims Amid Coronavirus Pandemic
Urlhttps://www.aarp.org/money/budgeting-saving/info-2020/insurance-policies-during-coronavirus-faq.html
DescriptionHere are some answers to your questions about health, auto and other insurance policies and claims during the pandemic
DateNov 9, 2021
Organic Position3
H1AARP Answers: Your Insurance Coverage and the Coronavirus
H2The latest on auto, home, life and health policies during the outbreak
H3
H2WithAnchorsThe latest on auto, home, life and health policies during the outbreak
BodyAARP Answers: Your Insurance Coverage and the Coronavirus The latest on auto, home, life and health policies during the outbreak. by Andy Markowitz, AARP, Updated November 9, 2021 eternalcreative/Getty Images En español . Will my life insurance policy cover COVID-19? Yes. As long you have an active life insurance policy in good standing, your beneficiary or beneficiaries will get a death benefit should you die of coronavirus-related complications. In addition, your insurer cannot change your premiums or your health classification because you have or had COVID-19 or are at higher risk of exposure due to your job or recent travel to a virus hot spot. Claims on social media that life insurance companies will not pay off on a policy if the customer received a COVID-19 vaccine are "entirely false," according to the American Council of Life Insurers. "Life insurers do not consider whether or not a policyholder has received a COVID vaccine when deciding whether to pay a claim," the trade group said in a statement on its website. "Nothing has changed in the claims-paying process as a result of COVID-19 vaccinations."  What if I don't have life insurance? Can I get it during the pandemic? Yes. Insurers continue to offer new whole life and term life policies. “We have seen an increase in life insurance applications, perhaps as a result of the pandemic,” says Gina Morss-Fischer, a public affairs specialist at State Farm. However, getting covered could take longer, particularly if you are in a high-risk group, have recently traveled to a hot zone or had COVID-19 yourself. “It has become relatively common for survivors of COVID-19 to have their life insurance application be postponed for 30 days and provide medical records or other valid evidence that they are fully recovered,” says Eloise Spinello, a life insurance expert with online insurance marketplace Policygenius. Nationwide, for example, will consider a policy for someone who tested positive for COVID-19, but did not need hospitalization, once they’ve been symptom-free for 30 days. If the applicant was hospitalized, the waiting period is six months, a company spokesperson says. Age is a risk factor for COVID-19 — are life insurers taking that into account? Some are. Several large insurers restricted sales of new life policies for older adults. For example, Prudential, Lincoln National, Protective Life and Securian have suspended or postponed policy applications for people age 80 and over. Spinello says some companies have loosened age restrictions put in place early in the pandemic “as they’ve gained more information and data about what constitutes a higher COVID-19 risk.” Mutual of Omaha, for example, initially suspended sales of fully underwritten life policies (which require a medical exam) for those age 70 and over but has since raised the cut-off age to 80. “Insurers will continue to evaluate the situation as more data becomes available, and they are watching the vaccine rollout closely,” Spinello says. Could the outbreak affect my long-term care (LTC) insurance? According to Genworth, which issues LTC policies, premiums for existing policies can’t be raised for specific customers due to individual circumstances. However, rates can be subject to periodic group increases based on an insurer’s claims history, or actuarial projections for future claims. For example, using claims or actuarial data, insurers can ask state regulators to let them increase LTC premiums for groups of similar policyholders in that state. Any changes arising from the outbreak “wouldn’t happen immediately, as the insurers need time to do the proper research and analysis to verify necessary rate changes,” Policygenius CEO Jennifer Fitzgerald says. “As of now, we have not seen any impact on [existing] long-term care policies because of coronavirus.” The outbreak could have an effect if you are looking to purchase a new LTC policy. As with life insurance, age and health status can affect whether you qualify for long-term care insurance and what you pay. LTC insurers may take into account whether you are at elevated risk or have tested positive for COVID-19 in assessing a policy application. Are auto and home insurers offering policyholders any financial relief? Many did in the earlier stages of the pandemic. With most Americans sheltering in place and staying off the roads, major auto insurers provided partial refunds on premiums to customers in the spring and summer of 2020. While those companies have resumed normal billing, many offer help on a case-by-case basis to auto and home policyholders facing coronavirus-related financial hardship — for example, you may be able to request a flexible payment plan or other relief. In addition, some states have issued guidelines on billing leniency for insurance customers during the pandemic. Check your insurance company’s coronavirus web page or contact your state’s insurance department to learn about your options, and talk to your insurer before skipping any payments. Will it take longer for auto and home claims to get processed? Possibly. Many insurance claims involve person-to-person contacts that may be restricted or affected during the pandemic. For example, insurers may not be able to send an adjuster to investigate a home or auto claim. Wait times to get an agent on the phone may be longer. Third parties that play a role in damage claims, such as contractors and car repair shops, may be closed or keeping limited hours. “Because of this, one of the big things we’re seeing changing is how consumers file claims, both for home and auto insurance,” Fitzgerald says. “Some insurers are transitioning to allowing their policyholders to file virtual claims.” My small business was shut down by the pandemic. Will insurance cover my losses? It depends on the terms of your policy. Talk to your insurance company or broker, but be prepared for bad news: Even if your insurance includes “business interruption” coverage, it might not cover losses from the outbreak. Business interruption coverage is typically tied to physical damage from a cause you are insured for, such as a fire or hurricane. Absent such damage, it can be difficult to press a claim, says Shannon O’Malley, a partner in the Dallas office of the national law firm Zelle LLP, who wrote in-depth analysis of the issue early in the pandemic. In addition, many business policies explicitly exclude claims arising from a virus or communicable disease, or don’t address those causes, which can effectively mean the same thing. A flurry of lawsuits filed by businesses ranging from restaurants and hair salons to Major League Baseball teams have challenged insurance companies’ denial of COVID-related claims, but state and federal courts are largely finding for the insurers, according to tracking by the University of Pennsylvania’s Carey Law School. Even if a policy includes “civil authority” provisions related to a government order to close, these typically require that the order arise from physical damage caused by a covered event, O’Malley says. Claims on this basis are complex and contingent on individual circumstances; consider consulting an attorney well versed in insurance law to discuss your situation. Will my health insurer make me pay anything if I need coronavirus treatment? It depends on your health plan. Most large insurers waived cost-sharing for COVID-19 testing and treatment for most of 2020 and into 2021, but more than 4 in 5 were applying copays, coinsurance and deductibles for some of these services by the end of October, according to a Kaiser Family Foundation analysis. Regardless of your insurer, you should not have to pay anything out of pocket for federally approved COVID-19 vaccines.  More information is available from insurers’ websites. If your provider is not listed, call your health plan’s customer service number to find out about its coronavirus response. Aetna: No cost-sharing for diagnostic testing to determine whether treatment is needed, or for antibody tests ordered by a physician or medical professional. The waiver does not apply to tests for the purpose of returning to work or school, except as required by law. Cost-sharing is in effect for treatment for COVID-19. Anthem: No out-of-pocket costs for doctor-ordered COVID-19 testing and test-related visits. Copays, coinsurance and deductibles apply for COVID-19 medical care, according to the terms of your health plan. Blue Cross/Blue Shield: Blue Cross/Blue Shield is an association of member companies that operate independently, and COVID-19 cost-sharing policies may differ from state to state. Use the map at the Blue Cross/Blue Shield coronavirus web page to check on procedures in your state. Cigna: No out-of-pocket costs for COVID-19 diagnostic tests, or for diagnostic office visits with an in-network provider, through the end of the federally declared public health emergency, which currently runs until Jan. 16, 2022. There is cost-sharing for COVID-19 treatment. Health Care Services Corporation (HCSC): No cost-sharing for FDA-approved COVID-19 diagnostic tests or for testing-related visits with in-network providers until the end of the public health emergency. Out-of-pockets costs apply for COVID-19 treatment. Humana: COVID-19 diagnostic tests are 100 percent covered for Medicare Advantage plan holders in all circumstances and for members insured through employer plans if the test is ordered by a health care professional. Out-of-pockets costs for COVID-19 treatment are waived for the 2021 plan year for Medicare Advantage members, but standard copays, coinsurance and deductibles apply for people with employer plans. Kaiser Permanente: No-cost testing is available to members. COVID-19 treatment is subject to your policy's cost-sharing provisions. United Healthcare: No out-of-pocket costs for FDA-approved diagnostic tests ordered by a health care professional, or for testing-related visits, during the federal public health emergency. Standard cost-sharing applies for COVID-19 treatment with one exception: Medicare Advantage clients with a positive diagnosis can receive monoclonal antibody treatment at no cost through 2021. Is Medicare covering COVID-19 vaccines, testing and treatment? Medicare will pay all costs for any federally authorized COVID-19 vaccine and for testing ordered by a doctor or other health care provider. There will be no out-of-pocket costs, whether you have Original Medicare or a Medicare Advantage plan. People with original Medicare who are hospitalized for COVID-19 treatment will still have deductibles and copays. If you have a supplemental Medigap plan, it may cover these costs. If you have Medicare Advantage, out-of-pocket costs for hospital and outpatient treatment vary by plan. Contact your Advantage plan provider. You'll find more information in our AARP Answers on Medicare and the coronavirus. What about Affordable Care Act (ACA) health plans? Plans purchased through the ACA marketplace are required to cover emergency services and hospitalization, and that would apply to such treatment for COVID-19. You may incur out-of-pocket costs, depending on your plan. Some major providers of ACA plans, such as Centene and Molina Healthcare, have waived cost-sharing on coronavirus treatment for marketplace customers. Ask your plan provider about its coverage. For more information, see the AARP Answers on ACA insurance and the coronavirus. I don't have health insurance. Can I get covered? You may be able to get Medicaid, the federal-state health care program for low-income people, or an ACA plan. Medicaid enrollment is open all year. More than 4 million people have signed up since the start of the pandemic, according to data from the U.S. Centers for Medicare & Medicaid Services (CMS). Eligibility is based primarily on income and differs by state — contact your state's Medicaid program for information. ACA plans in most states are sold through the federal marketplace, which operates this year from Nov. 1 to Dec. 15. Several states also plan to maintain open enrollment beyond the federal period, in some cases into late January. Check with your state's exchange for information.   Outside of your state's open enrollment window, you can sign up for an ACA plan if you qualify for a special enrollment period due to a life-changing event, such as a loss of previous health coverage. Some health insurers sell short-term policies with low premiums, but these offer limited benefits and, unlike with Medicaid and ACA plans, you can be turned down for a preexisting condition. Closely read and carefully consider a short-term plan's provisions before signing up. Editor’s note: This story has been updated to reflect new COVID-19 information. Also of Interest. 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Come back again to check out all of the AARP Member Benefits and unlock the full power of membership.","ty_ctaText":"Continue","ty_socialMissionFlag":"","hideRestrictionsTab":"","hideLeavingAARP":"","hide_lto":"","lto_model_heading":"Limited Time Member Offers","lto_model_heading_spanish":"Ofertas para socios por tiempo limitado","lto_advertisement":"Member Exclusive Advertisement","lto_advertisement_spanish":"Anuncios publicitarios exclusivos para socios","lto_daysleft":"Days Left","lto_daysleft_spanish":"Días restantes","geoloc_experience_type":"full_location","geoloc_tab_label":"Locations","geoloc_tab_label_spanish":"Ubicaciones","geoloc_hide_tab":"true","geoloc_find_location_label":"Find a Location","geoloc_find_location_label_spanish":"Encuentre una ubicación","geoloc_tab_hint_text":"Enter an address, city, or ZIP","geoloc_tab_hint_text_spanish":"Ingresa tu dirección, ciudad o código postal","geoloc_search_icon":"","geoloc_total_results_label":"Result(s)","geoloc_total_results_label_spanish":"Resultado(s)","geoloc_see_more_button_text":"See More","geoloc_see_more_button_text_spanish":"Ver más","geoloc_see_more_label_text":"See More","geoloc_see_more_label_text_spanish":"Ver más","geoloc_see_more_limit_option":"","geoloc_provider_link_cta":"Learn more about this benefit by visiting the provider website","geoloc_provider_link_cta_spanish":"Obtenga más información sobre este beneficio visitando el sitio web del proveedor","geoloc_provider_link_cta_url":"","geoloc_provider_legal_info":"You will leave AARP.org and go to the website of a trusted provider. The provider’s terms, conditions, and policies apply.","geoloc_provider_legal_info_spanish":"Dejarás el sitio de AARP y accederás al de un proveedor confiable. Aplican los términos, las condiciones y políticas del proveedor. Este sitio web podría no estar disponible en español.","geoloc_no_results_view_message":"There are no locations within a 100 mile radius. Please try another location","geoloc_no_results_view_message_spanish":"No hay ubicaciones dentro de un radio de 100 millas. 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A different privacy policy and terms of service will apply.\u0027);return false;\" title\u003d\"Join AARP Today\" rel\u003d\"noreferrer\" href\u003d\"https://appsec.aarp.org/mem/join?campaignid\u003dUMBC144\" target\u003d\"_blank\"\u003eJoin today\u003c/a\u003e to get instant access to hundreds of benefits.\u0026nbsp;\u003c/p\u003e","redemption_type":"yes","starts_on":1538366400,"created_by":"asi_admin1","country_code":"US","tab_label_offer_details":"Details","tab_label_restrictions":"Disclosures","restrictions_label":"Disclosures","restrictions":"\u003cp\u003e\u003cb\u003eAT\u0026amp;T Signature Program Disclaimers\u003c/b\u003e\u003c/p\u003e\u003cp\u003e\u003cb\u003eAT\u0026amp;T SIGNATURE PROGRAM DISCOUNTS: \u003c/b\u003eAvailable to qualified employees, students \u0026amp; other authorized individuals associated with eligible companies, universities \u0026amp; other sponsoring organizations with a qualifying service agreement (Business Agreement). Must validate eligible online or provide valid employee badge/paystub, student ID, or other approved proof of eligibility in authorized retail store \u0026amp; subscribe to service under an individual responsibility account for which the qualifying individual is personally liable. Discount subject to Business Agreement \u0026amp; may be interrupted, changed, or discontinued without notice. Additional restrictions apply. \u003cb\u003e\u003cu\u003eCredits/Discounts\u003c/u\u003e\u003c/b\u003e: Start w/in 2 bill cycles after service activation \u0026amp; eligibility confirmed.  Applied after application of any available credit. \u003cb\u003e\u003cu\u003eService discount\u003c/u\u003e\u003c/b\u003e:  Req’s AT\u0026amp;T Unlimited Elite plan. $10 discount applied after the application of any available Autopay, paperless bill, only on phone lines 1 – 5. Any additional phone lines added over 5 and up to max of 10 reduces all phone line (including lines 1-5) discounts to $5/mo. per phone line. May not be stackable w/other offers, credits or discounts. \u003cb\u003e\u003cu\u003eExclusions\u003c/u\u003e\u003c/b\u003e: Military, Veterans, First Responders, Massachusetts Public Sector Employees, AT\u0026amp;T employees, EMO, IMO and FirstNet customers. May not be combinable with other select offers or promotions.  \u003c/p\u003e\u003cp\u003e\u003cb\u003e \u003c/b\u003e\u003c/p\u003e\u003cp\u003e\u003cb\u003eAT\u0026amp;T UNLIMITED ELITE® PLAN:\u003c/b\u003e All AT\u0026amp;T wireless services subject to terms and conditions in the Consumer Service Agreement (\u003ca data-overlay-msg\u003d\"AARP.Everywhere.LeavingModal.drawOverlay(this,\u0027\u0027,/mnt/overlay/wcm/core/content/sites/properties.html,\u0027\u0027,\u0027You are now leaving AARP.org and going to a website that is not operated by AARP. A different privacy policy and terms of service will apply.\u0027);return false;\" data-default-element-msg\u003d\"AARP.Everywhere.LeavingModal.drawOverlay(this,\u0027\u0027,/mnt/overlay/wcm/core/content/sites/properties.html,\u0027\u0027,\u0027You are now leaving AARP.org and going to a website that is not operated by AARP. A different privacy policy and terms of service will apply.\u0027);return false;\" data-displayoverlay\u003d\"displayOverlay\" title\u003d\"AT\u0026amp;T Website\" href\u003d\"https://www.att.com/legal/terms.consumerServiceAgreementInformation.html\" target\u003d\"_blank\" rel\u003d\"noreferrer\"\u003eatt.com/csa\u003c/a\u003e). Phones only. Advertised monthly price includes monthly plan charge for talk, text and data \u0026amp; monthly per-line phone access charge for access to such services.  \u003cb\u003eOTHER RESTRICTIONS \u0026amp; FEES:\u003c/b\u003e Activation/upgrade fee per line (up to $45) \u0026amp; deposit may apply.  \u003cb\u003eAutoPay \u0026amp; Paperless Bill Discount:\u003c/b\u003e Monthly discount $10 per phone line when active \u0026amp; enrolled in both. AT\u0026amp;T employees, retirees \u0026amp; IMO consumers are not eligible for the AutoPay and Paperless bill discount. Discount starts w/in 2 bill cycles. Credit card may be required (except for MA, PA and ND). Pay full plan cost until discount starts. \u003cb\u003eUNLIMITED DATA:\u003c/b\u003e For use in the United States (the “Domestic Coverage Area” or “DCA”), Mexico and Canada. \u003cb\u003eDATA RESTRICTIONS\u003c/b\u003e: 2G off-net data speeds may apply. All AT\u0026amp;T service is subject to AT\u0026amp;T network management policies. See \u003ca data-overlay-msg\u003d\"AARP.Everywhere.LeavingModal.drawOverlay(this,\u0027\u0027,/mnt/overlay/wcm/core/content/sites/properties.html,\u0027\u0027,\u0027You are now leaving AARP.org and going to a website that is not operated by AARP. A different privacy policy and terms of service will apply.\u0027);return false;\" data-default-element-msg\u003d\"AARP.Everywhere.LeavingModal.drawOverlay(this,\u0027\u0027,/mnt/overlay/wcm/core/content/sites/properties.html,\u0027\u0027,\u0027You are now leaving AARP.org and going to a website that is not operated by AARP. A different privacy policy and terms of service will apply.\u0027);return false;\" data-displayoverlay\u003d\"displayOverlay\" title\u003d\"AT\u0026amp;T Website\" href\u003d\"https://about.att.com/sites/broadband\" target\u003d\"_blank\"\u003eatt.com/broadbandinfo\u003c/a\u003e for details. \u003cb\u003e5G SERVICE\u003c/b\u003e: Requires a compatible 5G device. 5G service is not available everywhere. See \u003ca data-overlay-msg\u003d\"AARP.Everywhere.LeavingModal.drawOverlay(this,\u0027\u0027,/mnt/overlay/wcm/core/content/sites/properties.html,\u0027\u0027,\u0027You are now leaving AARP.org and going to a website that is not operated by AARP. A different privacy policy and terms of service will apply.\u0027);return false;\" data-default-element-msg\u003d\"AARP.Everywhere.LeavingModal.drawOverlay(this,\u0027\u0027,/mnt/overlay/wcm/core/content/sites/properties.html,\u0027\u0027,\u0027You are now leaving AARP.org and going to a website that is not operated by AARP. A different privacy policy and terms of service will apply.\u0027);return false;\" data-displayoverlay\u003d\"displayOverlay\" title\u003d\"AT\u0026amp;T Website\" href\u003d\"https://www.att.com/5g/consumer/\" target\u003d\"_blank\"\u003eatt.com/5Gforyou\u003c/a\u003e for details.  \u003cb\u003eVIDEO STREAMING:\u003c/b\u003e Includes Stream Saver feature which allows you to stream higher definition video (up to 4K UHD) in Standard Definition on compatible devices (unless video provider has opted out). Stream Saver will not recognize all video content. Ability to stream and video resolution may vary and be affected by other factors. To enjoy access to higher definition video on compatible devices and when available, you can turn it off or back on at any time at \u003ca data-overlay-msg\u003d\"AARP.Everywhere.LeavingModal.drawOverlay(this,\u0027\u0027,/mnt/overlay/wcm/core/content/sites/properties.html,\u0027\u0027,\u0027You are now leaving AARP.org and going to a website that is not operated by AARP. A different privacy policy and terms of service will apply.\u0027);return false;\" data-default-element-msg\u003d\"AARP.Everywhere.LeavingModal.drawOverlay(this,\u0027\u0027,/mnt/overlay/wcm/core/content/sites/properties.html,\u0027\u0027,\u0027You are now leaving AARP.org and going to a website that is not operated by AARP. A different privacy policy and terms of service will apply.\u0027);return false;\" data-displayoverlay\u003d\"displayOverlay\" title\u003d\"AT\u0026amp;T Website\" href\u003d\"https://att.com/myatt\" target\u003d\"_blank\"\u003eatt.com/myatt\u003c/a\u003e or call 611.  Restrictions apply. Details at \u003ca data-overlay-msg\u003d\"AARP.Everywhere.LeavingModal.drawOverlay(this,\u0027\u0027,/mnt/overlay/wcm/core/content/sites/properties.html,\u0027\u0027,\u0027You are now leaving AARP.org and going to a website that is not operated by AARP. A different privacy policy and terms of service will apply.\u0027);return false;\" data-default-element-msg\u003d\"AARP.Everywhere.LeavingModal.drawOverlay(this,\u0027\u0027,/mnt/overlay/wcm/core/content/sites/properties.html,\u0027\u0027,\u0027You are now leaving AARP.org and going to a website that is not operated by AARP. A different privacy policy and terms of service will apply.\u0027);return false;\" data-displayoverlay\u003d\"displayOverlay\" title\u003d\"AT\u0026amp;T Website\" href\u003d\"https://www.att.com/offers/streamsaver/\" target\u003d\"_blank\"\u003eatt.com/streamsaver\u003c/a\u003e. \u003cb\u003eActiveArmor\u003csup\u003eSM\u003c/sup\u003e Advanced Security: \u003c/b\u003eCompatible device required. You must download the AT\u0026amp;T Mobile Security app and AT\u0026amp;T Call Protect app and accept their terms and conditions for full App functionality. May not detect all threats. May inadvertently block wanted calls; settings can be adjusted in the App. \u003cb\u003ePersonal ID:\u003c/b\u003e May not detect all compromises or leaks of your personal data. \u003cb\u003eSafe Browsing:\u003c/b\u003e May not detect all suspicious websites. Details at \u003ca data-overlay-msg\u003d\"AARP.Everywhere.LeavingModal.drawOverlay(this,\u0027\u0027,/mnt/overlay/wcm/core/content/sites/properties.html,\u0027\u0027,\u0027You are now leaving AARP.org and going to a website that is not operated by AARP. A different privacy policy and terms of service will apply.\u0027);return false;\" data-default-element-msg\u003d\"AARP.Everywhere.LeavingModal.drawOverlay(this,\u0027\u0027,/mnt/overlay/wcm/core/content/sites/properties.html,\u0027\u0027,\u0027You are now leaving AARP.org and going to a website that is not operated by AARP. A different privacy policy and terms of service will apply.\u0027);return false;\" data-displayoverlay\u003d\"displayOverlay\" title\u003d\"AT\u0026amp;T Website\" href\u003d\"https://www.att.com/security/\" target\u003d\"_blank\"\u003eatt.com/activearmor\u003c/a\u003e. \u003cb\u003eMOBILE HOTSPOT:\u003c/b\u003e Requires compatible device. Includes up to 40GB per line per month. After 40GB, mobile hotspot speed slowed to max of 128Kbps for the rest of bill cycle.  After this, mobile hotspot data usage, will be impacted and not fully functional. \u003cb\u003eUNLIMITED TALK:\u003c/b\u003e Phones only. Includes calls w/in and between DCA, Mexico \u0026amp; Canada. You may be charged for calls to special or premium service numbers and calls to other countries. For rates, see \u003ca data-overlay-msg\u003d\"AARP.Everywhere.LeavingModal.drawOverlay(this,\u0027\u0027,/mnt/overlay/wcm/core/content/sites/properties.html,\u0027\u0027,\u0027You are now leaving AARP.org and going to a website that is not operated by AARP. A different privacy policy and terms of service will apply.\u0027);return false;\" data-default-element-msg\u003d\"AARP.Everywhere.LeavingModal.drawOverlay(this,\u0027\u0027,/mnt/overlay/wcm/core/content/sites/properties.html,\u0027\u0027,\u0027You are now leaving AARP.org and going to a website that is not operated by AARP. A different privacy policy and terms of service will apply.\u0027);return false;\" data-displayoverlay\u003d\"displayOverlay\" title\u003d\"AT\u0026amp;T Website\" href\u003d\"https://www.att.com/international/long-distance/?tab\u003d1\" target\u003d\"_blank\"\u003eatt.com/worldconnect\u003c/a\u003e. \u003cb\u003eUNLIMITED TEXT:\u003c/b\u003e Compatible phone and rate plan required. Includes unlimited messages up to 1MB in size within and from DCA, Mexico and Canada.  For texting to other countries, see \u003ca data-overlay-msg\u003d\"AARP.Everywhere.LeavingModal.drawOverlay(this,\u0027\u0027,/mnt/overlay/wcm/core/content/sites/properties.html,\u0027\u0027,\u0027You are now leaving AARP.org and going to a website that is not operated by AARP. A different privacy policy and terms of service will apply.\u0027);return false;\" data-default-element-msg\u003d\"AARP.Everywhere.LeavingModal.drawOverlay(this,\u0027\u0027,/mnt/overlay/wcm/core/content/sites/properties.html,\u0027\u0027,\u0027You are now leaving AARP.org and going to a website that is not operated by AARP. A different privacy policy and terms of service will apply.\u0027);return false;\" data-displayoverlay\u003d\"displayOverlay\" title\u003d\"AT\u0026amp;T Website\" href\u003d\"https://www.att.com/support/article/wireless/KM1231660\" target\u003d\"_blank\"\u003eatt.com/text2world\u003c/a\u003e. Messages sent through applications may incur data or other charges. \u003cb\u003eAdvanced Messaging:\u003c/b\u003e Not available for use in Mexico and Canada. Other restrictions apply \u0026amp; can be found at \u003ca data-overlay-msg\u003d\"AARP.Everywhere.LeavingModal.drawOverlay(this,\u0027\u0027,/mnt/overlay/wcm/core/content/sites/properties.html,\u0027\u0027,\u0027You are now leaving AARP.org and going to a website that is not operated by AARP. A different privacy policy and terms of service will apply.\u0027);return false;\" data-default-element-msg\u003d\"AARP.Everywhere.LeavingModal.drawOverlay(this,\u0027\u0027,/mnt/overlay/wcm/core/content/sites/properties.html,\u0027\u0027,\u0027You are now leaving AARP.org and going to a website that is not operated by AARP. A different privacy policy and terms of service will apply.\u0027);return false;\" data-displayoverlay\u003d\"displayOverlay\" title\u003d\"AT\u0026amp;T Website\" href\u003d\"https://www.att.com/features/advanced-messaging/\" target\u003d\"_blank\"\u003eatt.com/advancedmessaging\u003c/a\u003e. \u003cb\u003eLIMITS:\u003c/b\u003e Max 10 devices on Unlimited Your Way plan group.  These plans may not be eligible for additional discounts, including but not limited to Signature discounts. AT\u0026amp;T employees \u0026amp; retirees may not be eligible for certain benefits, offers, and discounts associated with these plans. \u003cb\u003eADDITIONAL MONTHLY FEES \u0026amp; TAXES:\u003c/b\u003e Apply per line \u0026amp; include Regulatory Cost Recovery Fee (up to $1.50), Administrative Fee ($1.99) \u0026amp; other fees which are not government-required surcharges as well as taxes. Additional one-time Fees may apply. See \u003ca href\u003d\"https://www.att.com/legal/terms.otherWirelessFeeSchedule.html?url\u003dhttps%3A%2F%2Fwww.att.com%2Fmobilityfees\u0026amp;data\u003d04%7C01%7CDCromer%40aarp.org%7C467c55d7776f4155322508d94615b04a%7Ca395e38b4b754e4493499a37de460a33%7C0%7C0%7C637617881238409823%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C1000\u0026amp;sdata\u003dlUnYovABIOkW%2FQsi1DGnNPi87wHsbhmVR6gOT%2FKnCd4%3D\u0026amp;reserved\u003d0\" target\u003d\"_blank\" data-overlay-msg\u003d\"AARP.Everywhere.LeavingModal.drawOverlay(this,\u0027\u0027,/mnt/overlay/wcm/core/content/sites/properties.html,\u0027\u0027,\u0027You are now leaving AARP.org and going to a website that is not operated by AARP. A different privacy policy and terms of service will apply.\u0027);return false;\" data-default-element-msg\u003d\"AARP.Everywhere.LeavingModal.drawOverlay(this,\u0027\u0027,/mnt/overlay/wcm/core/content/sites/properties.html,\u0027\u0027,\u0027You are now leaving AARP.org and going to a website that is not operated by AARP. A different privacy policy and terms of service will apply.\u0027);return false;\" data-displayoverlay\u003d\"displayOverlay\" title\u003d\"AT\u0026amp;T Website\" rel\u003d\"noreferrer\"\u003eatt.com/mobilityfees\u003c/a\u003e for more details.\u003c/p\u003e\u003cp\u003e\u003cb\u003e \u003c/b\u003e\u003c/p\u003e\u003cp\u003e\u003cb\u003eHBO MAX: \u003c/b\u003eAccess HBO Max through HBO Max app on compatible device (sold separately) or on hbomax.com using compatible browser with your AT\u0026amp;T log-in credentials. New AT\u0026amp;T customers: visit \u003ca data-overlay-msg\u003d\"AARP.Everywhere.LeavingModal.drawOverlay(this,\u0027\u0027,/mnt/overlay/wcm/core/content/sites/properties.html,\u0027\u0027,\u0027You are now leaving AARP.org and going to a website that is not operated by AARP. A different privacy policy and terms of service will apply.\u0027);return false;\" data-default-element-msg\u003d\"AARP.Everywhere.LeavingModal.drawOverlay(this,\u0027\u0027,/mnt/overlay/wcm/core/content/sites/properties.html,\u0027\u0027,\u0027You are now leaving AARP.org and going to a website that is not operated by AARP. A different privacy policy and terms of service will apply.\u0027);return false;\" data-displayoverlay\u003d\"displayOverlay\" title\u003d\"AT\u0026amp;T Website\" href\u003d\"https://att.com/myatt\" target\u003d\"_blank\"\u003eatt.com/myatt\u003c/a\u003e to create your account and obtain log-in credentials. \u003cb\u003eUse of HBO Max is subject to its own terms and conditions, see \u003ca data-overlay-msg\u003d\"AARP.Everywhere.LeavingModal.drawOverlay(this,\u0027\u0027,/mnt/overlay/wcm/core/content/sites/properties.html,\u0027\u0027,\u0027You are now leaving AARP.org and going to a website that is not operated by AARP. A different privacy policy and terms of service will apply.\u0027);return false;\" data-default-element-msg\u003d\"AARP.Everywhere.LeavingModal.drawOverlay(this,\u0027\u0027,/mnt/overlay/wcm/core/content/sites/properties.html,\u0027\u0027,\u0027You are now leaving AARP.org and going to a website that is not operated by AARP. A different privacy policy and terms of service will apply.\u0027);return false;\" data-displayoverlay\u003d\"displayOverlay\" title\u003d\"HBO MAX website terms of use\" href\u003d\"https://www.hbomax.com/terms-of-use\" target\u003d\"_blank\"\u003ehbomax.com/terms-of-use\u003c/a\u003e for details. \u003c/b\u003eIf you have residential DIRECTV (excluding Puerto Rico), AT\u0026amp;T TV, U-Verse TV or AT\u0026amp;T TV NOW, HBO channels and On Demand will also be added on that TV platform. May be billed and then credited (excluding PREMIER package on AT\u0026amp;T TV and AT\u0026amp;T TV NOW) on that TV platform within 2 bills.  \u003cb\u003eProgramming and content subj. to change and benefit may be modified, discontinued or terminated at any time without notice. \u003cu\u003eLOST ELIGIBILITY\u003c/u\u003e: \u003c/b\u003eUpon cancellation of eligible wireless plan you may lose access to HBO Max. \u003cb\u003e\u003cu\u003eLIMITS\u003c/u\u003e\u003c/b\u003e: Access to one HBO Max account per AT\u0026amp;T account holder. May not be stackable w/other offers, credits or discounts. \u003cb\u003eAT\u0026amp;T employees and retirees are not eligible for the HBO Max Add-on offer.\u003c/b\u003e To learn more, visit \u003ca data-overlay-msg\u003d\"AARP.Everywhere.LeavingModal.drawOverlay(this,\u0027\u0027,/mnt/overlay/wcm/core/content/sites/properties.html,\u0027\u0027,\u0027You are now leaving AARP.org and going to a website that is not operated by AARP. A different privacy policy and terms of service will apply.\u0027);return false;\" data-default-element-msg\u003d\"AARP.Everywhere.LeavingModal.drawOverlay(this,\u0027\u0027,/mnt/overlay/wcm/core/content/sites/properties.html,\u0027\u0027,\u0027You are now leaving AARP.org and going to a website that is not operated by AARP. A different privacy policy and terms of service will apply.\u0027);return false;\" data-displayoverlay\u003d\"displayOverlay\" title\u003d\"HBO Max website for AT\u0026amp;T \" href\u003d\"https://www.att.com/hbo-max/\" target\u003d\"_blank\"\u003eatt.com/hbomax\u003c/a\u003e. HBO Max is only accessible in the U.S. and certain U.S. territories where a high-speed broadband connection is available.  HBO MAX is used under license.\u003c/p\u003e\u003cp\u003e\u003cb\u003e \u003c/b\u003e\u003c/p\u003e\u003cp\u003e\u003cb\u003eAll offers, programming, promotions, pricing, terms, restrictions \u0026amp; conditions subject to change \u0026amp; may be modified, discontinued, or terminated at any time without notice\u003c/b\u003e.\u003c/p\u003e\u003cp\u003e©2021 AT\u0026amp;T Intellectual Property. All rights reserved. AT\u0026amp;T, the AT\u0026amp;T logo, all other AT\u0026amp;T marks contained herein are trademarks of AT\u0026amp;T Intellectual Property and/or AT\u0026amp;T affiliated companies.\u003c/p\u003e","offer_status":"Active","national_offer_flag":"yes","language_code":"EN","offer_type":"EverGreen","asi_category":"ASI Shopping","line_of_business":"ASI discounts","merchant_name":"","marketing_details":"","member_exclusive_flag":"no","parent_brand":"","source_name":"AT\u0026T","alternate_source_name":"","business_id":"30003","offer_video_thumbnail":"","image_url":"/content/dam/aarp/benefits_discounts/providers/att/1140x641-att-man-phone-scarf-blazer-balcony-mar-2020.jpg","vertical_image_url":"/content/dam/aarp/benefits_discounts/providers/att/258x334-att-man-phone-scarf-blazer-balcony-mar-2020.jpg","provider_image":"/content/dam/aarp/benefits_discounts/asi/offers/ATT/ATTAARPBrandingPage755x192.jpg","provider_logo":"/content/dam/aarp/benefits_discounts/providers/a-t-and-t/ATTGlobeATT.png","offer_video_path":"","offer_copy_video_path":"","interstitial_title":"","interstitial_desc":"You\u0027ll leave AARP.org and go to the website of a trusted provider. The provider\u0027s terms, conditions, and policies apply.","created_user_role":"","is_no_end_date":"","advertisement_flag":"","disclaimer_label":"","disclaimer":"","merchant_logo":"","show_phone_number_above_cta":false,"merchant_phone_label":"","merchant_phone":"","howto_redeem_label":"How to Access","howto_redeem_expired":"Renew to Learn More","howto_redeem_expired_2":"Renew to Learn More","howto_redeem_expired_link":"https://appsec.aarp.org/mem/renew?campaignid\u003dUMBC117AT\u0026hbm\u003dt\u0026intcmp\u003dMBCHAE-AUTH-RENEW\u0026offer\u003datt\u0026referrer\u003dhttps%3A%2F%2Fwww.att.com%2Fshopservlets%2Firulanding%3FiruToken%3DRIoTrGvHZHu2ly3uHnpnHb1iiuc8LpvuYIjOjJOJDyUO8KOJAEpv1PgPOG1pJlVzoDYAF8YNT7osObZiZdf7Pg%253D%253D%26src%3DMyAttSales","howto_redeem_expired_link_2":"https://appsec.aarp.org/mem/renew","howto_redeem_non_member":"Join to Learn More","howto_redeem_non_member_2":"Join to Learn More","howto_redeem_non_member_link":"https://appsec.aarp.org/mem/join?campaignid\u003dUMBC117AT\u0026hbm\u003dt\u0026intcmp\u003dMBCHAE-AUTH-JOIN\u0026offer\u003datt\u0026referrer\u003dhttps%3A%2F%2Fwww.att.com%2Fshopservlets%2Firulanding%3FiruToken%3DRIoTrGvHZHu2ly3uHnpnHb1iiuc8LpvuYIjOjJOJDyUO8KOJAEpv1PgPOG1pJlVzoDYAF8YNT7osObZiZdf7Pg%253D%253D%26src%3DMyAttSales","howto_redeem_non_member_link_2":"https://secure.aarp.org/applications/membershipChallenge/showChallengeForm.action?appName\u003daccount","howto_redeem_anonymous":"Join to Learn More","howto_redeem_anonymous_2":"Join to Learn More","howto_redeem_anonymous_link":"https://appsec.aarp.org/mem/join?campaignid\u003dUMBC117AT\u0026hbm\u003dt\u0026intcmp\u003dMBCHAE-AUTH-JOIN\u0026offer\u003datt\u0026referrer\u003dhttps%3A%2F%2Fwww.att.com%2Fshopservlets%2Firulanding%3FiruToken%3DRIoTrGvHZHu2ly3uHnpnHb1iiuc8LpvuYIjOjJOJDyUO8KOJAEpv1PgPOG1pJlVzoDYAF8YNT7osObZiZdf7Pg%253D%253D%26src%3DMyAttSales","howto_redeem_anonymous_link_2":"https://appsec.aarp.org/mem/join?campaignid\u003dUASMBP1\u0026intcmp\u003dEWHERE-MBCHAE-LP-MMA-JOIN","howto_redeem_already_registered_anon_label":"Already a member?","howto_redeem_already_registered_anon":"Login to your account. ","howto_redeem_already_registered_nonmember_label":"Already a member?","howto_redeem_already_registered_nonmember":"Link your membership","howto_redeem_already_registered_nonmember_link":"https://secure.aarp.org/applications/membershipChallenge/showChallengeForm.action?appName\u003daccount","howto_redeem_already_registered_anon_link":"https://login.aarp.org/online-community/loginform.action?custom\u003dMBC\u0026offer\u003datt\u0026referrer\u003dhttps%3A%2F%2Fwww.att.com%2Fshopservlets%2Firulanding%3FiruToken%3DRIoTrGvHZHu2ly3uHnpnHb1iiuc8LpvuYIjOjJOJDyUO8KOJAEpv1PgPOG1pJlVzoDYAF8YNT7osObZiZdf7Pg%253D%253D%26src%3DMyAttSales","howto_redeem":"Learn More","howto_redeem_2":"Learn More","howto_redeem_url":"https://www.att.com/offers/discount-program/aarp/","howto_redeem_url_2":"","show_redeem_cta_2":false,"howto_redeem_desc":"Present your AARP membership card in-store or use your AARP login to shop on the AT\u0026T website.","is_redeemable_in_person":"true","howto_redeem_in_person":"","howto_redeem_cta_phone":"","howto_redeem_phone_instructions":"","howto_redeem_online_instructions":"","show_state_availability":"","state_availability_text":"SEE AVAILABILITY IN YOUR STATE","cardlinked_flag":"","ty_interstitialText":"Thanks for visiting aarp.org! Come back again to check out all of the AARP Member Benefits and unlock the full power of membership.","ty_ctaText":"Continue","ty_socialMissionFlag":"","hideRestrictionsTab":"","hideLeavingAARP":"","hide_lto":"","lto_model_heading":"Limited Time Member Offers","lto_model_heading_spanish":"Ofertas para socios por tiempo limitado","lto_advertisement":"Member Exclusive Advertisement","lto_advertisement_spanish":"Anuncios publicitarios exclusivos para socios","lto_daysleft":"Days Left","lto_daysleft_spanish":"Días restantes","geoloc_experience_type":"full_location","geoloc_tab_label":"Locations","geoloc_tab_label_spanish":"Ubicaciones","geoloc_hide_tab":"","geoloc_find_location_label":"Find a Location","geoloc_find_location_label_spanish":"Encuentre una ubicación","geoloc_tab_hint_text":"Enter an address, city, or ZIP","geoloc_tab_hint_text_spanish":"Ingresa tu dirección, ciudad o código postal","geoloc_search_icon":"","geoloc_total_results_label":"Result(s)","geoloc_total_results_label_spanish":"Resultado(s)","geoloc_see_more_button_text":"See More","geoloc_see_more_button_text_spanish":"Ver más","geoloc_see_more_label_text":"See More","geoloc_see_more_label_text_spanish":"Ver más","geoloc_see_more_limit_option":"","geoloc_provider_link_cta":"Learn more about this benefit by visiting the provider website","geoloc_provider_link_cta_spanish":"Obtenga más información sobre este beneficio visitando el sitio web del proveedor","geoloc_provider_link_cta_url":"","geoloc_provider_legal_info":"You will leave AARP.org and go to the website of a trusted provider. The provider’s terms, conditions, and policies apply.","geoloc_provider_legal_info_spanish":"Dejarás el sitio de AARP y accederás al de un proveedor confiable. Aplican los términos, las condiciones y políticas del proveedor. Este sitio web podría no estar disponible en español.","geoloc_no_results_view_message":"There are no locations within a 100 mile radius. Please try another location","geoloc_no_results_view_message_spanish":"No hay ubicaciones dentro de un radio de 100 millas. 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Result 8
TitleCoronavirus 2019 (COVID-19) | California EDD
Urlhttps://edd.ca.gov/about_edd/coronavirus-2019.htm
DescriptionFor the latest Unemployment Insurance (UI) claim data, visit our Data Dashboard. ... including those who lost their job because of the pandemic.
Date
Organic Position4
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Result 9
Title2021 Special Enrollment Period in response to the COVID-19 ...
Urlhttps://www.cms.gov/newsroom/fact-sheets/2021-special-enrollment-period-response-covid-19-emergency
DescriptionMillions of Americans are facing uncertainty and millions of Americans are experiencing new health problems during the pandemic. Due to the ...
DateJan 28, 2021
Organic Position5
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Result 10
TitleHow Has the Pandemic Affected Health Coverage in the U.S.? | KFF
Urlhttps://www.kff.org/policy-watch/how-has-the-pandemic-affected-health-coverage-in-the-u-s/
DescriptionFindings from administrative data suggest that the decline in enrollment among employer-sponsored insurance was far less than overall declines in employment as of September, and that many who did lose their job-based coverage likely found a safety net in coverage through Medicaid or the ACA marketplaces
DateDec 9, 2020
Organic Position6
H1
H2How Has the Pandemic Affected Health Coverage in the U.S.?
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H2WithAnchorsHow Has the Pandemic Affected Health Coverage in the U.S.?
Bodyrc="//www.googletagmanager.com/ns.html?id=GTM-PPSVK8" height="0" width="0" style="display:none;visibility:hidden"> Filling the need for trusted information on national health issues menu Filling the need for trusted information on national health issues Donate Share on Facebook. Opens in a new window. Share on Twitter. Opens in a new window. Email. Opens in a new window. Twitter Facebook Instagram LinkedIn Email How Has the Pandemic Affected Health Coverage in the U.S.? . Daniel McDermott , Cynthia Cox Follow @cynthiaccox on Twitter , Robin Rudowitz Follow @RRudowitz on Twitter , and Rachel Garfield Follow @RachelLGarfield on Twitter Dec 09, 2020 Facebook Twitter LinkedIn Email Print Job losses caused by the coronavirus pandemic have threatened to disrupt health coverage for millions of people as most working-age adults get coverage for themselves and their families through their work. Tracking real-time changes in coverage and the uninsured rate is difficult to do with much precision because the large national surveys that produce these estimates lag by months or years, and private surveys generally lack sufficient sample to measure coverage changes precisely. Many real-time surveys have faced challenges of high rates of survey nonresponse (not responding to the survey or particular questions) particularly among populations most likely affected by the economic downturn, including the Census Bureau’s Household Pulse Survey. However, various sources of administrative data allow us to piece together what might be happening to health coverage rates amid the pandemic. Declines in employer sponsored insurance are far less than overall declines in employment.  First, using administrative data insurers file with state regulators (compiled by Mark Farrah Associates TM), we can see how enrollment in employer plans has changed through the end of September. Although employment rates fell by 6.2% from March to September, enrollment in the fully-insured group market decreased by just 1.5% over the same period. If we extrapolate this finding to the entire group market, including self-insured employer plans, this would suggest that a total of roughly 2 to 3 million people may have lost employer-based coverage between March and September. To be very clear, this is only a rough estimate. We do not have reliable data for self-insured employers (which insure about 6 in 10 people with employer coverage and tend to be larger), and those employers may have made different decisions than fully-insured employers did about layoffs and whether and how to maintain coverage for employees. Loss of employer-based coverage may have been offset by strong enrollment in Medicaid and Marketplaces. Many of those who lost job-based health coverage would have qualified for Medicaid or for a special enrollment opportunity to purchase individual market health coverage (either on- or off- exchange). Preliminary administrative data for the Medicaid program shows enrollment increased by 4.3 million people (6.1%) from February through July 2020. More recent data for 30 states show that enrollment in managed care plans increased by about 5 million, or 11.3%, from March to September 2020. Nationally, MCOs cover over two-thirds of Medicaid beneficiaries. States attribute these increases to rising unemployment (and loss of employer sponsored insurance) as well as the “maintenance of eligibility” (MOE) requirements tied to a 6.2 percentage point increase in the federal match rate (FMAP) authorized by the Families First Coronavirus Response Act (FFCRA) – which prevents states from disenrolling Medicaid beneficiaries if they accept the additional federal funding. Using the same administrative data above (from Mark Farah Associates TM), we find that enrollment in the individual market was fairly steady from March to September 2020. In normal years, there is typically more attrition during these months as more people leave the market than come in during special enrollment periods (SEP). However, SEP enrollment was higher this year in healthcare.gov and state based exchanges. While much is unknown, a review of administrative data suggest that the uninsured rate may not have changed much during the pandemic to date. There is still much we do not know, and these administrative data do not account for other changes like people aging on to Medicare and population growth. Nonetheless, it appears that the decline in employer-based health insurance coverage may have been offset by gains in Medicaid and largely steady enrollment in the individual market. There are several possible explanations for the relatively modest decrease in employer-based coverage despite massive job losses. First, many of the people who have lost employment likely were never enrolled in coverage through their job in the first place; lower wage workers are less likely to be covered by their employer’s plan and, similarly, job losses have been highest and most sustained among industries that tend to have lower coverage offer rates (e.g., retail, service, hospitality). Second, many people who lost their jobs may have been able to retain their health coverage temporarily. A number of employers elected to keep furloughed or laid off workers enrolled in their firm’s plan at least in the short term. In addition, an unknown number of permanently laid off employees may have elected COBRA (which would be classified as group coverage) at their own expense, although this number is likely small due to the high costs of such coverage. Employment rates are starting to recover but a larger share of people filing unemployment claims say their job loss is permanent compared to earlier in the pandemic, suggesting there may be more coverage loss to come. That the uninsured rate may not have substantially changed this year could be taken as both good news and bad news. A largely flat uninsured rate would be good news because health insurance coverage rates tend to fall whenever there is an economic downturn in the United States. Between many employers maintaining coverage and the Affordable Care Act along with Medicaid serving as a safety net for those who did lose coverage, the uninsured rate in the U.S. does not appear to have risen nearly as much as it could have, given the scale of employment losses. The bad news is that, if the uninsured rate has indeed held steady, there are still tens of millions of people without health coverage during the worst pandemic to hit the country in one hundred years. Despite some recent legislation and administrative action aimed at protecting the uninsured from some of the costs associated with COVID-19 testing and treatment, those without coverage still face tremendous financial and health risks. Four out of ten people who were uninsured before the pandemic could be getting health insurance coverage for free, either through Medicaid or a zero-premium bronze plan on the exchange. Open Enrollment for 2021 coverage on the ACA exchange markets is now in its fifth week and early figures show that, while overall enrollment is strong, new enrollment is about the same as past years. The Trump Administration has drastically reduced funds for ACA outreach and marketing activities, as well as for navigators who help people enroll in Marketplace coverage. President-elect Biden has vowed to reinstitute funding for ACA marketing, outreach, and navigator programs. The federal Open Enrollment period will have ended by the time Biden takes office, but he could open a new SEP without limitations on who qualifies to enroll. Topics. Uninsured Private Insurance Medicaid Tags. Coronavirus Employment Affordable Care Act Medicaid's Future Coverage
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Result 11
TitleCalifornia Joins President Biden In Responding To Covid 19 Pandemic By Announcing Special Enrollment To Help People Get Insurance
Urlhttps://www.coveredca.com/newsroom/news-releases/2021/01/28/california-joins-president-biden-in-responding-to-covid-19-pandemic-by-announcing-special-enrollment-to-help-people-get-insurance/
DescriptionOn the heels of an announcement by President Biden, Covered California said on Thursday that it would establish a special-enrollment period to give people more opportunities to sign up for health care coverage as the country continues to grapple with the COVID-19 pandemic and economic recession. The move comes after the president established a national special-enrollment period for the 36 states served by the federally facilitated marketplace and after announcing his commitment to launching a marketing campaign to promote enrollment
DateJan 28, 2021
Organic Position7
H1California Joins President Biden in Responding to COVID-19 Pandemic by Announcing Special Enrollment to Help People Get Insurance
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BodyCalifornia Joins President Biden in Responding to COVID-19 Pandemic by Announcing Special Enrollment to Help People Get Insurance Tweet This. “The pandemic and recession continue to be a painful reality, and Covered California is doing whatever it can to make sure people have every opportunity to sign up for health care coverage.” “With this Executive Order the Biden-Harris Administration have demonstrated their commitment to getting as many Americans needed health care.” “This marks a sea-change after four years of inaction and Americans across the country will benefit from this leadership.” Covered California announced today that effective Feb. 1, anyone uninsured and eligible to enroll in health care coverage through Covered California can sign up through May 15. The move follows President Biden’s executive order to declare a special enrollment period from Feb. 15 through May 15 for the 36 states served by the federally facilitated marketplace, reopening the doors to coverage for millions of Americans. An estimated 2.7 million Californians are uninsured, including 1.2 million who are eligible for financial help from Covered California or through Medi-Cal. Covered California’s current open-enrollment period runs through Jan. 31, and consumers must sign up by that deadline to have coverage that starts on Feb. 1. La versión en español de este Comunicado puede ser descargada en este enlace SACRAMENTO, Calif. — On the heels of an announcement by President Biden, Covered California said on Thursday that it would establish a special-enrollment period to give people more opportunities to sign up for health care coverage as the country continues to grapple with the COVID-19 pandemic and economic recession. The move comes after the president established a national special-enrollment period for the 36 states served by the federally facilitated marketplace and after announcing his commitment to launching a marketing campaign to promote enrollment. “The pandemic and recession continue to be a painful reality, and Covered California is doing whatever it can to make sure people have every opportunity to sign up for health care coverage,” said Peter V. Lee, executive director of Covered California. “There are millions of Californians out there without the peace of mind and protection of health care coverage, and now is not the time to be uninsured.” Similar to the steps Covered California took last year, the new special-enrollment period will allow uninsured individuals to sign up for coverage without needing to meet the normal qualifying life events, such as recent loss of coverage or moving. Anyone who meets Covered California’s eligibility requirements, which are similar to those in place during the annual open-enrollment period, can sign up for coverage through May 15 and have their coverage begin on the first of the following month. “With this Executive Order the Biden-Harris Administration have demonstrated their commitment to getting as many Americans needed health care,” said Lee.  “This marks a sea-change after four years of inaction and Americans across the country will benefit from this leadership.” The executive order issued by President Biden will strengthen the Affordable Care Act and Medicaid so they can continue to provide access to live-saving care. The order directs federal agencies to reconsider policies that limit access, undermine protections for people with pre-existing conditions – including complications related to COVID-19 – make it more difficult to enroll or reduce affordability. You can view the administration’s fact sheet here. “Keeping the doors open at Covered California — and reopening them for millions of Americans across the country — is the right thing to do,” said Dr. Mark Ghaly, the California Health and Human Services secretary and chair of the Covered California Board of Directors. “California applauds the Biden-Harris administration and looks forward to working with the federal government to not only respond to the COVID-19 pandemic, but to also get as many Californians covered as possible.” An estimated 2.7 million Californians are uninsured, including a projected 1.2 million who are eligible for financial help through Covered California, or for low-cost or no-cost coverage through Medi-Cal. The largest portion of these uninsured who are eligible for help are in Southern California, with an estimated 718,000 people living in the Los Angeles, Inland Empire, Orange and San Diego metro areas (see Figure 1: Where California’s Uninsured Who Are Eligible for Financial Help Live). Last year, Covered California established a COVID-19 special-enrollment period from March 20 to Aug. 31, which allowed any eligible uninsured individual to enroll. In addition, the exchange spent $9 million on an ad campaign to spread the word to those who needed coverage during the crisis. More than 289,000 people signed up for health care coverage during that time, which is more than twice the number who signed up during the same period in 2019. “While vaccines are being distributed to Californians across the state, it will still be several months before enough people are inoculated to provide the kind of protection we need,” Lee said. “We are still in the grips of this pandemic, and now is the time to make sure you and your family have health care coverage in case you get sick or injured.” Figure 1:  Where California’s Uninsured Who Are Eligible for Financial Help Live Financial Help Lowers the Cost of Coverage The most recent data shows that 1.4 million people, or nearly 90 percent of Covered California’s enrollees, are receiving some level of financial help that lowers the cost of their monthly premium by an average of nearly 80 percent. Of those receiving financial help, almost half — over 640,000 — are benefiting from the state subsidy program launched in 2020 to make coverage more affordable, including 44,500 middle-income consumers who were previously ineligible for assistance because they exceeded the federal income requirements. Under the landmark state program, Californians earning up to $76,560 — or a family of four with a household income of up to $157,200 — may be eligible for financial help to lower the cost of their coverage. “Most of the people who are uninsured who can get help do not know they are eligible for financial assistance, or they have not checked recently to see how affordable quality coverage can be,” Lee said. “No one should wait to sign up. Enroll now and tell your family and friends so we can make sure everyone possible has health insurance during this pandemic.”                                                                        Medi-Cal and Off-Exchange Coverage In addition, consumers who sign up through CoveredCA.com may find out that they are eligible for no-cost or low-cost coverage through Medi-Cal, which they can enroll in online. It is important to note that those who are eligible for Medi-Cal can enroll year-round and have coverage that is effective immediately. The California Department of Managed Health Care (DMHC) and the California Department of Insurance have also extended the special-enrollment period through May 15, which applies to all health plans in the individual market, including off-exchange health plans. “The impact of this pandemic continues to be felt throughout California, and the DMHC is committed to helping those affected by the COVID-19 emergency,” said DMHC Director Mary Watanabe. “Once again we will be providing continued access to comprehensive and affordable health care coverage options for those who need it through the creation of this special-enrollment period.” New Ad Campaigns: Nationally and in California The executive order also announced that the federal government will resume investing in marketing and outreach which will help inform and enroll Americans across the nation. In addition, Covered California will be investing at least $6 million over the next few months to raise public awareness about the new special-enrollment period. Digital ads will begin appearing on Monday, Feb. 1, and new television ads will start airing statewide on Monday, Feb. 15. “Today marks a new day for health care in America,” Lee said. “We are seeing an administration that is aggressively investing in marketing and outreach, and one that is committed to getting more Americans covered.” Watch the new television ads focusing on the special-enrollment period, in both English and Spanish, at this link. Deadline of Jan. 31 Still in Place to Get Covered by Feb. 1 While the new special-enrollment period will help millions of Americans across the country, open enrollment is still underway in California, and consumers have a few days left to sign up for coverage that starts Feb. 1. The annual open-enrollment period runs through Jan. 31, and consumers who sign up this month will need to pay their first bill in order to have their coverage take effect on Monday. “You can still get coverage that takes effect in February, but time is running out,” Lee said. “Sign up by Jan. 31, pay your bill and you will have health care coverage that is effective for the whole month of February — now is not the time to go without insurance.”               **Staying Safe While Getting Help Enrolling ** Covered California also continues to support COVID-19 safety precautions — including wearing a mask, washing your hands and watching your distance — as well as contact-free enrollment over the phone or online. Consumers can safely find out if they are eligible for financial help through Covered California, or low-cost or no-cost Medi-Cal, and see which plans are available in their area by using the CoveredCA.Com Shop and Compare Tool. All they need to do is enter their ZIP code, household income and the ages of those who need coverage and they will see the options available in their area. Covered California is also working with more than 10,000 Licensed Insurance Agents who help Californians sign up and understand their coverage options through phone-based service models.   Those interested in learning more about their coverage options can also: Visit www.CoveredCA.com. Get free and confidential assistance over the phone, in a variety of languages, from a certified enroller. Have a certified enroller call them and help them for free. Call Covered California at (800) 300-1506. Another important reason to sign up is that California’s individual mandate penalty remains in place for 2021. Consumers who can afford health care coverage, but choose to go without, could pay a penalty when filing their state income taxes in 2022. The penalty is administered by California’s Franchise Tax Board, and could be as much as $2,250 for a family of four. About Covered California Covered California is the state’s health insurance marketplace, where Californians can find affordable, high-quality insurance from top insurance companies. Covered California is the only place where individuals who qualify can get financial assistance on a sliding scale to reduce premium costs. Consumers can then compare health insurance plans and choose the plan that works best for their health needs and budget. Depending on their income, some consumers may qualify for the low-cost or no-cost Medi-Cal program. Covered California is an independent part of the state government whose job is to make the health insurance marketplace work for California’s consumers. It is overseen by a five-member board appointed by the governor and the Legislature. For more information about Covered California, please visit www.CoveredCA.com. News Releases Home SHARE THIS STORY. × Learn more about health insurance plans for individuals and families. Obtenga más información sobre los planes de seguro de salud para individuos y familias. Accessibility and Nondiscrimination | Terms of Use | Privacy Policy | Protecting Our Consumers CoveredCA.com is sponsored by Covered California and the Department of Health Care Services, which work together to support health insurance shoppers to get the coverage and care that's right for them. Copyright © 2020 Covered California
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Result 12
TitleCoronavirus (COVID-19) information - Health Consumer ...
Urlhttps://healthconsumer.org/covid19/
Description... or My Health LA? How can I access medical care during the pandemic? ... The three vaccines that are currently available in California are safe.
Date
Organic Position8
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TitlePolicies To Improve Health Insurance Coverage as America
Urlhttps://www.americanprogress.org/article/policies-improve-health-insurance-coverage-america-recovers-covid-19/
DescriptionPrior to the pandemic, nearly 1 in 10 (8.3 percent) of adults reported not getting care due to cost during the past year. Throughout the ...
DateMar 11, 2021
Organic Position9
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TitleCovid rescue package offers help for health insurance. Here's how to get the most benefit
Urlhttps://www.nbcnews.com/health/health-care/covid-rescue-package-offers-help-health-insurance-here-s-how-n1261776
DescriptionAmerican Rescue Plan Act: The relief package will offer some of the most significant help for Americans to pay for health insurance in a decade
DateMar 23, 2021
Organic Position10
H1Covid rescue package offers help for health insurance. Here's how to get the most benefit
H2Enhanced premium subsidies for marketplace plans
What's in it for you?: Stephanie Ruhle breaks down how much you could be getting in covid relief
Free marketplace health insurance for people on unemployment
No Payback of Excess Marketplace Subsidies
Subsidies to Cover 100 percent of COBRA Premiums
H3
H2WithAnchorsEnhanced premium subsidies for marketplace plans
What's in it for you?: Stephanie Ruhle breaks down how much you could be getting in covid relief
Free marketplace health insurance for people on unemployment
No Payback of Excess Marketplace Subsidies
Subsidies to Cover 100 percent of COBRA Premiums
BodyCovid rescue package offers help for health insurance. Here's how to get the most benefitThe $1.9 trillion Covid-19 relief package will offer some of the most significant help for Americans to pay for health insurance in a decade.Speaker of the House Nancy Pelosi and Senate Majority Leader Chuck Schumer hold the signed American Rescue Plan Act at the US Capitol on March 10, 2021.Olivier Douliery / AFP - Getty ImagesMarch 23, 2021, 4:03 PM UTC / Source: Kaiser Health NewsBy Michelle Andrews, Kaiser Health NewsThere’s something for everyone with private health insurance in the American Rescue Plan Act, but determining the best way to benefit may be confusing.The $1.9 trillion Covid-19 relief law that President Joe Biden signed this month will make coverage significantly more affordable for millions of people who either who have marketplace coverage, are uninsured or have lost their employer coverage. In addition, it will eliminate repayment requirements for premium tax credits. Consumers can begin to see those improvements next month, but they may need to go to healthcare.gov and update their application for the changes to take effect then.The new provisions are temporary; none will extend past 2022 unless Congress acts to make them permanent. Many health care advocates hope that will happen.“If Congress can circle back and make these improvements permanent, it will go a long way toward making insurance affordable in this country,” said Stan Dorn, director of the National Center for Coverage Innovation at Families USA, a nonpartisan consumer health care advocacy organization.In the meantime, these provisions will help Americans get or keep their health insurance and provide economic stability as the country emerges from the Covid-19 pandemic.What’s new:Enhanced premium subsidies for marketplace plans. When: 2021 and 2022Who benefits: Just about everyone who has coverage through the Affordable Care Act’s marketplaces. Premium costs for people eligible for subsidies will shrink by $50 per month on average, according to the federal government, but some people will see much larger savings.Under the ACA, people with incomes between 100 percent and 400 percent of the federal poverty level (from $12,760 to $51,040 for one person or $26,200 to $104,800 for a family of four) were eligible for premium tax credits to reduce their premiums for marketplace coverage.But under the changes passed in the new law, how much people owe is reduced at every income level and capped at 8.5 percent overall.What's in it for you?: Stephanie Ruhle breaks down how much you could be getting in covid relief. March 15, 202107:50For example, a single person who makes $30,000 annually will pay $85 per month in premiums on average under the new law for a silver-level plan instead of $195, according to an analysis by the Center on Budget and Policy Priorities. A family of four making $75,000 will pay $340 rather than $588 per month for similar coverage, the analysis found.Everyone benefits from the changes, said Tara Straw, a senior policy analyst at the center, including people with incomes above 400 percent of the poverty level ($51,040 for one person) who were previously not eligible for premium tax credits.An older customer not yet in Medicare “with an income just over 400 percent of the federal poverty level in some states would be paying 20 percent to 30 percent of their income toward their health care premium,” she said. “Now that will be capped at 8.5 percent.”At the other end of the income spectrum, people with incomes up to 150 percent of the poverty level ($19,140) will owe nothing in premiums. Under the ACA, they had been required to pay up to 4.14 percent of their income as their share of the premium cost.Steps to take now:People who have marketplace coverage in one of the 36 states that use the federal healthcare.gov platform should go back in and update their applications and reselect their current plan to get new details about their subsidies starting April 1.People with marketplace coverage in states that run their own marketplaces should check the procedures there. States including California and Rhode Island, as well as the District of Columbia, have announced they will automatically adjust enrollees’ premiums.The enhanced tax credit is in effect for all of 2021 and 2022. Look for guidance from the federal government on how the additional subsidies will be applied to premiums already paid in January through March.People who don’t update their applications now will still be able to claim the additional tax credit amount when their file their taxes in 2022.The more generous premium tax credits may mean people can switch to better coverage with lower cost sharing for the same contribution. A potential snag: Switching plans may mean that amounts already paid toward a deductible under the current plan are lost. Check with the insurer.People who bought a 2021 plan off the marketplace , perhaps because their income is too high to qualify for premium tax credits, will have to enroll in coverage on the marketplace now in order to get the new premium tax credits, said Straw.People who are uninsured can sign up now during the covid special enrollment period that runs through May 15 on the federal exchange. (Individual states have similar special enrollment periods.) People who sign up before April 1 should go back in after April 1 to update their applications.Free marketplace health insurance for people on unemployment . When: 2021Who benefits: Anyone who has received or has been approved to receive unemployment insurance benefits in 2021.Under the American Rescue Plan, anyone who has received unemployment benefits this year will be considered to have income at 133 percent of the federal poverty level (about $17,000) for the purposes of calculating how much they owe in premium contributions for a marketplace plan. Since people with incomes up to 150% of the poverty level don’t owe anything in premiums under the new law, these unemployed workers can get a zero-premium plan. If they buy a silver-level plan, they can also be eligible for cost-sharing reductions that shrink their deductible and other out-of-pocket costs.Officials are urging people receiving unemployment insurance to enroll in a marketplace plan now to take advantage of the law’s enhanced premium tax credits. The federal government said it will provide more information this summer about how to receive the additional premium tax credits for people who collect unemployment insurance.Step to take now:People who are uninsured or have marketplace coverage can still receive the enhanced premium subsidies described above in the meantime. And because the new law excludes the first $10,200 in unemployment insurance from income for the 2020 tax year, people may be able to qualify for higher premium tax credits based on lower income, Straw said.No Payback of Excess Marketplace Subsidies. When: 2020Who benefits: People who earned more money last year than they estimated when they signed up for marketplace coverage.Under the ACA, people estimate their income for the upcoming year, and the marketplace estimates how much in premium tax credits can be advanced to them every month. At tax time, people reconcile their actual income with their projected income, and if they received too much in tax credits, they generally must pay it back to the government.The new Covid-19 relief bill eliminates that requirement for 2020. The provision could help people who received unforeseen income last year such as hazard pay or perhaps were laid off and hired back as a contractor at higher pay but without benefits, experts said.Unfortunately, because of the timing of the new law, income tax forms and tax filing software don’t reflect these changes, said Sabrina Corlette, a research professor at Georgetown University’s Center on Health Insurance Reforms.“A lot of people are going to think they owe money but they’re not going to,” she said.Steps to take now:If you’ve already filed your income taxes for 2020, sit tight. The IRS is reviewing the law and will provide details soon. People should not file an amended tax return at this time.If you haven’t yet filed, “some people may want to wait and see if tax software is updated to allow them to file with this adjustment on their tax return,” said Straw. Last week, the IRS announced that the deadline for filing individual federal tax returns for 2020 has been extended this year from April 15 to May 17.Subsidies to Cover 100 percent of COBRA Premiums. When: April through September 2021Who benefits: People who lost their employer-sponsored coverage and want to stay on that plan.Generally, when people get laid off and lose their employer coverage they can opt to keep it for 18 months, but they have to pay the entire premium plus a 2 percent administrative fee. This is done under provisions of a law known as COBRA. Under the new law, the federal government will pay the entire COBRA premium through September of this year.For people undergoing treatment for a medical condition, it can be important to keep their coverage and existing providers. And switching plans midyear can leave people on the hook for a brand-new deductible.But the newly enacted enhanced premium tax credits and free marketplace coverage for people who collect unemployment insurance make marketplace coverage much more affordable than in the past, experts note.That could be important because, after September, the new COBRA subsidies will end and people will be responsible for the entire premium, unless the government puts in place a special enrollment period for that circumstance. Without another special enrollment period, they might not be able to get into a marketplace plan until January.Steps to take now:People who missed the original 60-day enrollment window for keeping their job-based coverage can go back and enroll in COBRA now. They have 60 days to enroll after they’re notified of the new provisions under the covid relief plan. They will not owe premiums back to their original eligibility date, but any medical claims they incurred before their enrollment won’t be covered.Review coverage to determine whether COBRA or marketplace coverage is the best, most affordable option.Follow NBC HEALTH on Twitter & FacebookMichelle Andrews, Kaiser Health News
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Result 15
TitleResponding to the COVID-19 and pandemic protection gap in insurance
Urlhttps://www.oecd.org/coronavirus/policy-responses/responding-to-the-covid-19-and-pandemic-protection-gap-in-insurance-35e74736/
DescriptionThe COVID-19 pandemic and the measures taken to limit the spread of the disease have significantly disrupted economic activity in countries around the world, resulting in significant business interruption losses. The vast majority of these losses are likely to be absorbed by policyholders as, unless governments (or courts) intervene, few companies have business interruption coverage that is likely to respond to these types of losses – exposing the existence of an important protection gap for some pandemic-related business interruption losses. This note provides an overview of how business interruption insurance against pandemic risk could be provided with support from governments, and some of the challenges and considerations necessary for establishing such a programme
DateMar 16, 2021
Organic Position11
H1Responding to the COVID-19 and pandemic protection gap in insurance
H2Abstract
COVID-19 business interruption protection gap
Responses to the COVID-19 business interruption protection gap
Longer-term policy responses to the pandemic business interruption protection gap
Broad coverage, potentially through automatic coverage extensions
Limit public exposure by leveraging available private sector capacity
Provide incentives (or requirements) for risk reduction
Consider whether insurance is the most efficient mechanism
Pandemic risk insurance programme proposals
Annex A. Catastrophe risk insurance programmes
References
Contact
Notes
H3Characteristics of pandemic risk
Key uninsured (or underinsured) exposure is business interruption5
The cost of coverage may be substantial
Challenges in ensuring broad coverage
Correlated exposures across countries and markets
There may be limited private sector appetite for pandemic risk
Few risk reduction options for policyholders
Europe
France
Germany
Italy
United Kingdom
United States
Overview of catastrophe risk insurance programmes
Achieving broad coverage for targeted peril(s)
Improving the affordability of coverage
Limiting public sector exposure
Providing incentives for risk reduction (directly or indirectly)
H2WithAnchorsAbstract
COVID-19 business interruption protection gap
Responses to the COVID-19 business interruption protection gap
Longer-term policy responses to the pandemic business interruption protection gap
Broad coverage, potentially through automatic coverage extensions
Limit public exposure by leveraging available private sector capacity
Provide incentives (or requirements) for risk reduction
Consider whether insurance is the most efficient mechanism
Pandemic risk insurance programme proposals
Annex A. Catastrophe risk insurance programmes
References
Contact
Notes
BodyResponding to the COVID-19 and pandemic protection gap in insuranceUpdated 16 March 2021Open PDF  ╳DisclaimerResponding to the COVID-19 and pandemic protection gap in insuranceCOVID-19 business interruption protection gapBox 1. Estimates of business revenue lossesFigure 1. Estimates of monthly impact of confinement measures on business revenues (USD billion)Box 2. Insurance coverage developed for pandemic (and non-damage) business interruptionResponses to the COVID-19 business interruption protection gapBox 3. Voluntary payments and coverage extensions for business interruption lossesBox 4. Test cases and legal interpretations on coverage applicabilityLonger-term policy responses to the pandemic business interruption protection gapCharacteristics of pandemic riskKey uninsured (or underinsured) exposure is business interruptionThe cost of coverage may be substantialFigure 2. Pandemic-related business interruption: potential annual premium requirementChallenges in ensuring broad coverageCorrelated exposures across countries and marketsThere may be limited private sector appetite for pandemic riskFew risk reduction options for policyholdersBox 5. Potential design features of a pandemic risk insurance programme Pandemic risk insurance programme proposalsEurope FranceGermanyItalyUnited KingdomUnited StatesBox.6. The scope for international cooperationTable 1. Overview of selected pandemic risk insurance programme proposalsAnnex A. Catastrophe risk insurance programmesOverview of catastrophe risk insurance programmesPerils coveredType of coverage providedTableA.1. Catastrophe risk insurance programmes Achieving broad coverage for targeted peril(s)Figure A A.1. Insured share of losses for perils covered by catastrophe risk insurance programmesImproving the affordability of coverageRisk diversificationReduced cost of reinsurance Lower capital required Limiting public sector exposureCoverage limitsRisk selectionFlexibility to leverage market capacityReturning risk to the marketBox A A.1. Increasing the sharing of terrorism risk with private markets: Australia, United Kingdom and United StatesFigure A A.2. Estimated impact of terrorism (re)insurance programme changes on loss distributionCeiling on government exposureProviding incentives for risk reduction (directly or indirectly)Use of modelling for risk management Pricing that reflects risk reductionRisk reduction pre-requisitesReferencesContactNotesShareAbstract. The COVID-19 pandemic and the measures taken to limit the spread of the disease have significantly disrupted economic activity in countries around the world, resulting in significant business interruption losses. The vast majority of these losses are likely to be absorbed by policyholders as, unless governments (or courts) intervene, few companies have business interruption coverage that is likely to respond to these types of losses – exposing the existence of an important protection gap for some pandemic-related business interruption losses. This note provides an overview of how business interruption insurance against pandemic risk could be provided with support from governments, and some of the challenges and considerations necessary for establishing such a programme. The closure of manufacturing plants, restaurants, retail establishments and other places of business to limit the spread of COVID-19 has resulted in significant business interruption losses. The vast majority of these losses are likely to be absorbed by the affected businesses as: (i) many businesses have not acquired coverage for business interruption losses; and (ii) unless governments (or courts) intervene, few of the companies that have acquired business interruption coverage have coverage that is likely to respond to these types of losses (see the OECD’s Initial assessment of insurance coverage and gaps for tackling COVID-19 impacts for a more detailed assessment of the insurance coverage available for COVID-19 related losses). In response to the current crisis, policymakers in a number of jurisdictions are examining various ways to support commercial policyholders (particularly small and medium-sized enterprises (SMEs)) in the context of the uninsured business interruption losses that they have faced as a result of the current COVID-19 pandemic. Policymakers are also beginning to examine longer-term solutions to address the gap in financial protection for pandemic-related business interruption that has come to light as a result of the current crisis. This note provides an overview of the initial responses to the likely business interruption protection gap for COVID-19 and a discussion of how business interruption insurance against pandemic risk could be provided with support from governments based on the experience of other catastrophe risk insurance programmes.COVID-19 business interruption protection gap. Businesses across many sectors of the economy have faced a significant decline in revenue as a result of government directives to close their businesses or curtail their activities in order to slow the spread of the virus among employees and customers. The OECD estimates that one-month of strict confinement measures leads to approximately USD 1.7 trillion in revenue losses (see Box 1). Most governments have implemented programmes to support businesses that have faced significant disruption as a result of COVID-19, focused on ensuring the availability of financing for businesses or income for their employees. Some commercial property insurance policies also include coverage for business interruption losses which provides policyholders with protection against some of the losses that they incur when their business is forced to close, subject to the terms and conditions of the individual policy. Box 1. Estimates of business revenue lossesThe initial set of confinement measures that occurred in March-June 2020 across most OECD countries had different impacts on different businesses sectors. Some types of business activities were able to be maintained at (or near) normal levels, while others had to shut down.1 In Canada, the national statistics office (Statistics Canada) undertook a survey of businesses to determine the change in businesses revenues in April 2020 (during the period of confinement) relative to April 2019 (Statistics Canada, 2020[1]). While the survey only provided ranges for revenue changes, there was sufficient granularity to allow for a rough calculation of the average decline in revenues across sectors (ranging from an 11.7% decline in the agriculture, forestry, fishing and hunting sector to a 41.0% decline in the accommodation and food services sector). Figure 1 applies these sector-level average declines in revenue across other OECD countries to provide estimates of the losses that would be incurred in different countries, adjusting for the different composition of business activities in different countries (and assuming that the different confinement measures resulted in similar impacts on revenues).2 For the 27 OECD countries for which the necessary data was available (in addition to Canada, calculated based on (Statistics Canada, 2020[2])), a month of confinement measures could result in total business revenue losses of USD 1.7 trillion. The 28 countries included account for approximately 93% of OECD country GDP. Additional periods of confinement and business closures (as are occurring already in many countries) would of course increase the overall level of losses. Figure 1. Estimates of monthly impact of confinement measures on business revenues (USD billion)Source: Data on output by business sector is taken from (OECD, 2020[3]). The latest available data for many countries was 2017 and so the figures were adjusted upwards to account for GDP growth in 2018 (from (OECD, 2020[4]) and inflated to 2019 USD.1. For example, one survey of US small businesses found that those businesses involved in service-type industries (such as retail or food services) and physical-type industries (such as construction or manufacturing) were much more likely to face severe decreases or even total losses of revenue than businesses operating in knowledge-type industries (SHRM, 2020[5]).2. Confinement measures were of course different across countries and also had different impacts on business revenues. In the United States, one estimate suggests that the overall decline in business revenues among small businesses reached 38.2% as of 30 April 2020 (relative to January 2020) (Chetty et al., 2020[6]) which is higher than the overall estimate for Canadian businesses (25.5%). In Australia, data on the share of businesses that faced decreases in revenue have been published (although not estimates of the amount of decline). In May 2020, it was estimated that 72% of businesses faced a reduction in revenues (Australian Bureau of Statistics, n.d.[7]) which is comparable to the figure for the Canadian sample for April (70.2%).Insurers and their associations around the world have indicated that most policyholders have not acquired insurance coverage that will respond to the business interruption losses that result from COVID-19 business closures. In most countries, business interruption coverage is provided as an optional coverage attached to commercial property insurance that is often (but not always)1 triggered only as a result of damage to physical property. In addition, in a few countries and policies (notably, in the United States), an exclusion was developed (more than 15 years ago) and has been applied with the aim of specifically excluding coverage for losses due to virus (or bacteria) (or specifically losses in the context of a pandemic).2 Some explicit coverage for business interruption losses resulting from a pandemic has been made available as endorsements or specialty coverage although take-up of this explicit coverage has been limited (see Box 2). Box 2. Insurance coverage developed for pandemic (and non-damage) business interruptionSome insurance products have been developed to offer explicit coverage for business interruption losses suffered as a result of an infectious disease outbreak, either as a specialty stand-alone policy or as an endorsement to a policyholder’s existing business interruption coverage. In 2018, for example, a specific coverage for financial losses due to outbreaks, epidemics or pandemics was made available (Marsh, 2020[8]) although there has reportedly been almost no take-up (Collins, 2020[9]). The Insurance Services Office in the United States developed two optional endorsements for commercial property policies applicable to business interruption losses as a result of business closures related to COVID-19 in February 2020 although it is too early to determine whether insurers will seek to offer that coverage (Barlow, 2020[10]). There are also a few commercial insurance policies that specifically include pandemics as a covered peril in some markets (such as a property and liability policy tailored to dentist practices in Canada) (O’Hara, 2020[11]). In addition, some coverage has been developed for non-damage business interruption which is meant to respond to any interruption to business that does not involve physical damage to the insured premises or a building in proximity to the insured premises (which would include pandemics unless specifically excluded under the terms of the coverage). However, non-damage business interruption remains a specialty coverage with limited penetration.Responses to the COVID-19 business interruption protection gap. A number of insurance supervisors have assessed the potential for business interruption coverage to respond to losses incurred as a result of COVID-19 related business closures. In the US state of Washington, for example, the Office of the Insurance Commissioner undertook a review of policy wordings offered by 84 insurance companies and found that only two insurance companies offered coverage for a pandemic in their base policies while 15 others offered limited coverage through endorsements to other policies (Washington state Office of the Insurance Commissioner, 2020[12]). In France, the Autorité de contrôle prudentiel et de résolution (ACPR) requested information from approximately 20 insurers (accounting for a significant portion of business interruption coverage in the French market) and found that only 2.6% of these companies’ policyholders had explicit business interruption for a COVID-19-type event while a further 4.1% had coverage that could potentially respond (i.e. their policy wordings did not provide certainty on coverage) (ACPR, 2020[13]).3 It appears that many policyholder claims for COVID-19-related business interruption losses are being rejected by insurance companies. For example, in the United Kingdom, a survey of hospitality-related businesses found that less than 1% of hospitality businesses, 3% of innkeepers and 4% of beer and pub businesses had received a positive response from their insurer regarding business interruption coverage for COVID-19 related closures (Gould, 2020[14]). In the United States (as of November 2020), less than 2% of closed claims for business interruption losses submitted to insurers were paid4 (NAIC, 2020[15]). Some insurance companies have responded by offering additional coverage or making voluntary payments to support businesses affected by disruptions as a result of COVID-19 (see Box 3).Box 3. Voluntary payments and coverage extensions for business interruption lossesIn a few jurisdictions, insurance companies are offering additional coverage or making voluntary payments to support businesses affected by disruptions as a result of COVID-19. In Switzerland, a number of companies have agreed to voluntarily compensate their policyholders in the restaurant sector for some business interruption losses. In the German state of Bavaria, insurance companies have agreed to provide voluntary compensation for 10%-15% of the normal daily cost of business interruption to policyholders in the hospitality sector (Bayerisches Staatsministerium für Wirtschaft, 2020[16]). At least one German insurer will reportedly provide similar compensation to all of its German policyholders (Huebner, 2020[17]). In France, insurance companies announced that they will collectively contribute EUR 400 million to a solidarity fund for affected businesses (FFA, 2020[18]) and some insurers are reportedly providing small firms with ex-gratia payments (Huebner, 2020[17]). In the United States, a legislative proposal has been introduced that would allow insurers to voluntarily make payments (reimbursed by government) for business interruption losses under policies that provide coverage for losses related to civil authority closures and apply a virus exclusion (Office of Congressman Mike Thompson, 2020[19]).According to the Italian insurance association (Associazione Nazionale fra le Imprese Assicuratrici (ANIA)), insurance coverage for business interruption is not common on the Italian market, particularly among SMEs – and where acquired, it may only be triggered as a result of physical damage to the insured premises. As a result, Italian SMEs subjected to closure orders (e.g. retail shops, bars and restaurants and various types of service providers) were unlikely to receive any insurance payments for the losses incurred as a result of the closures. A group of insurance companies responded by designing a coverage extension to provide affected SMEs with a daily allowance valid for up to 15 days of ordered business closure. In addition, insurance companies in many jurisdictions are providing various forms of support to policyholders, including businesses, such as premium grace periods and refunds and flexibility in terms of coverage interpretation (see the OECD report on Insurance Sector Responses to COVID-19 for an overview of these initiatives).Legislators in some jurisdictions have raised concerns about the lack of coverage for COVID-19-related business interruption losses. For example, the Chair of the UK House of Commons Treasury Select Committee wrote to the Association of British Insurers requesting information on the approach that insurers will take to business interruption claims and the amount of losses that insurers expect to pay (Stride, 2020[20]). In France, a senator representing the district of Ille-et-Vilaine submitted a written question to the Minister of Economy and Finance on 9 April regarding the need to extend retroactive coverage for business interruption losses through the French natural catastrophe insurance programme (Robert, 2020[21]). In a few jurisdictions, governments are also considering ways to ensure that insurance coverage responds to the business interruption losses that have been (and are being incurred) by businesses. In the United States, for example, legislation has been proposed in a number of jurisdictions (including District of Columbia, Louisiana, Massachusetts, New Jersey, New York, Pennsylvania, Ohio, Rhode Island and South Carolina (Turner, 2020[22])) that, if adopted, might require insurers to pay certain business interruption claims submitted by businesses that had business interruption insurance at the time COVID-19 measures were implemented – even where insurance policies have exclusions or other policy terms and conditions that ordinarily would preclude coverage for such losses. In the US state of California, a recent legislative proposal reportedly includes a rebuttable presumption that would, for the purposes of claims interpretation, require an assumption that during the state of emergency, COVID-19 was present, caused physical damage and was the direct cause of business interruption to businesses in the state (Insurance Journal, 2020[23]). At the time of writing, many of the state legislative proposals were at an early stage of development and some of the early proposals (including legislative proposals in the District of Columbia and Louisiana) have reportedly been abandoned (Foggan, Sabino and Sutta, 2020[24])). Insurance regulators and supervisors (along with insurance companies) have raised concerns over the implications of retroactively expanding coverage obligations. The International Association of Insurance Supervisors issued a statement in May 2020 that cautioned against “initiatives seeking to require insurers to retroactively cover Covid-19 related losses, such as business interruption, that are specifically excluded in existing insurance contracts”. The IAIS also noted that these “initiatives could ultimately threaten policyholder protection and financial stability, further aggravating the financial and economic impacts of Covid-19” (IAIS, 2020[25]). In the United States, the NAIC issued a statement raising concerns with proposals to require retroactive coverage of business interruption claims and highlighted the significant solvency risks to the sector as well as the macroprudential risks associated with such proposals (NAIC, 2020[26]). The US Department of the Treasury has also noted concerns about potential interference with the contractual arrangements made between insurers and their policyholders and the possibility that such proposals could introduce stability risks (Vaughan, 2020[27]). In France, the ACPR has reminded insurers that they should not make payments for losses that are not included within the scope of coverage that they provided (ACPR, 2020[28]). Proposals which may require insurers to pay claims for losses that they did not intend to cover and for which they have not collected premiums or set aside provisions/reserves could have serious implications. The scale of losses that policyholders are incurring as a result of business disruption are multiples of the amount that insurers will normally payout for business interruption claims and may far exceed the amount of surplus capital (see below). If surplus capital were exhausted as a result of mandated payouts for COVID-19 business interruption, the ability of insurers to respond to losses from future events would be uncertain. The certainty of contractually-agreed insurance coverage would also likely come into question if legislators could intervene to alter outcomes – and there could be cross-border implications if some of the losses covered retroactively in one jurisdiction are reinsured in another.The absence of (or uncertainty regarding) coverage has led (and will continue to lead) to a large number of disputes between insurers and their policyholders which is likely to take months (if not years) to resolve. For example, in the United States, over 1 500 COVID-19-related insurance coverage lawsuits have reportedly been filed (as of February 2020) (Baker, 2021[29]) with early outcomes suggesting different judicial interpretations of key issues and limited potential for any consolidation of proceedings (Covington, 2020[30]) (although with a large number of those cases subjected to a motion to dismiss by the insurer dismissed, particularly in Federal courts (Baker, 2021[29])). Some legislators, insurance regulators (particularly market conduct and consumer protection authorities) and insurance associations are taking steps to support a more efficient resolution of these disputes, including through the submission of test cases meant to provide clarity on the interpretation of commonly-used policy wordings (see Box 4). Box 4. Test cases and legal interpretations on coverage applicabilityInsurance regulators and supervisors, and insurance associations in a number of jurisdictions are submitting or sponsoring cases for legal interpretation to address some of the uncertainties related to business interruption coverage that have arisen based on the policy wordings commonly used by insurance companies in their jurisdictions: In the United Kingdom, the Financial Conduct Authority (FCA) took the unprecedented step of seeking clarity from the courts on some specific areas of potential coverage disputes related to non-damage business interruption coverage1 with the aim of expediting a resolution and reducing the need for lengthy litigation between insurers and their policyholders (FCA, 2020[31]). A High Court judgement was made in September 2020 with certain elements of that judgement appealed to the Supreme Court which rendered judgement in January 2021. The courts found that many of 21 policy wordings examined included coverage applicable to business interruption losses through the interpretation of disease clauses (which provide coverage in the event that an outbreak of notifiable disease occurs in proximity to the insured) and coverage for prevention of access and that trends clauses2 cannot (generally) be applied to reduce the amount of claims paid to policyholders (Lewis et al., 2021[33]). The FCA issued a Dear CEO letter after the Supreme Court judgement outlining its expectation that insurers make payment on claims as quickly as possible under impacted policies (FCA, 2021[34]). In Switzerland, the Ombudsman of Private Insurance commissioned a third party legal opinion seeking clarity on the applicability of various pandemic exclusions that are applied as part of the general conditions of some Swiss property and business property insurance policies (Dörig and Bösch, 2020[35]). In South Africa, the Financial Sector Conduct Authority (FSCA) identified the types of business interruption policies that could potentially include coverage and the evidence required to demonstrate coverage which is meant to reduce variation in interpretation by insurance companies using similar wordings (FSCA, 2020[36]). A number of non-life insurers agreed (as part of a discussion with prudential and market conduct regulators) to provide interim payments to some or all policyholders with a potentially relevant coverage for infectious diseases while legal certainty was sought on the applicability of coverage (FSCA, 2020[37]). According to the Financial Sector Conduct Authority (based on discussions with non-life insurers), recent judicial rulings have provided legal certainty on the applicability of contingent business interruption coverage to losses resulting from closure orders related to COVID-19 (FSCA, 2021[38]) and South African insurers have begun making payments to eligible policyholders (Rumney, 2020[39]), (Mukherjee, 2021[40]). The FSCA has responded to the decision on the applicability of contingent business interruption by providing further guidance on the payment of claims under applicable policies (FSCA, 2021[38]). In Ireland, the Central Bank of Ireland has established a COVID-19 and Business Interruption Insurance Supervisory Framework that outlines its expectations of insurers in terms of responding to business interruptions claims, including guidance on the interpretation of some issues, the allocation of litigation costs, particularly for cases deemed to be possible “test cases” and a requirement for insurers to extend the benefits of dispute resolutions to other relevant policyholders (Carrigy and Grogan, 2020[42]), (Moore, 2020[43]). This expectation was recently reiterated by the Central Bank of Ireland Governor following a High Court (“test case”) decision that found that business interruption coverage applied to losses faced by four pub owners as a result of business closure orders (Makhlouf, 2021[44]). In Australia, the Insurance Council of Australia (non-life insurance industry association) has launched two test case to seek clarity on the applicability of business interruption coverage. The first test case was launched in the state of New South Wales based on two small business claims made to the Australian Financial Complaints Authority (AFCA). The policies in question reportedly use exclusionary language for listed human diseases that is common to many insurance policies in Australia (Williams and Cabban, 2020[46]). In November 2020, the New South Wales Court of Appeal ruled that policies that applied exclusions that referenced the repealed Quarantine Act of 19083 were not enforceable and that coverage was therefore applicable (Collins, 2020[47]). Some insurance companies have increased their claims provisions and are considering raising additional capital as a result of the decision (Dowding, 2020[48]) although the Insurance Council of Australia has made an application to appeal the decision (ICA, 2021[49]). The second test case is meant to seek clarity on various policy wording issues included in nine separate small business claims disputes lodged with the AFCA, including the definition of a disease, proximity of an outbreak to a business, and prevention of access to premises due to a government mandate (ICA, 2021[49]), (ICA, 2021[50]).← 1. The FCA sought an urgent declaratory judgement from the courts on the applicability of non-damage business interruption coverage (including coverage for pandemics, denial of access and civil authority closures that do not require physical damage to be triggered) provided in a set of 17 commercial property policies to COVID-19-related losses. The test case did not address the uncertainty related to whether virus contamination could be considered physical damage, which is another significant area of potential disputes (FCA, 2020[51]) (Jones and Cohn, 2020[52]), (Le Marquer, 2020[53]).← 2. In some business interruption coverage, a trends clause may be applied to adjust the calculation of lost revenues to account for factors unrelated to the triggering peril that would have had an impact on the amount of revenues earned had the covered event not occurred. ← 3. A policy exclusion that referenced the Biosecurity Act of 2015, which replaced the Quarantine Act of 1908 and included COVID-19 as a listed disease, was found to be applicable in a separate decision by the Full Federal Court that denied coverage for business interruption losses resulting from lockdown measures (Saville and Burgess, 2020[54]).Longer-term policy responses to the pandemic business interruption protection gap. Policymakers and other stakeholders are beginning to examine longer-term solutions to the business interruption protection gap as many private insurance market participants have expressed concerns about offering comprehensive coverage without some form of loss-sharing programme. A number of insurance and risk management associations have publicly indicated their support for developing a programme to cover pandemic-related business interruption losses, including risk management, broker and insurance associations from across Europe and the United States (Ladbury, 2020[55]), (Collins and Norris, 2020[56]), (Ladbury, 2020[57]). In the United States, a legislative proposal to establish a federal pandemic risk reinsurance programme (“Pandemic Risk Insurance Act of 2020”) has been introduced to Congress. Working groups, in some cases involving both the public and private sectors, have been established in France, Germany, Switzerland, the United Kingdom (amongst other jurisdictions), as well as by the European Insurance and Occupational Pensions Authority (EIOPA) to examine possible solutions for providing insurance for future pandemics (Direction générale du Trésor, 2020[58]), (Insurance Journal, 2020[59]), (EIOPA, 2020[60]). There is significant international experience in establishing catastrophe risk insurance programmes to respond to other catastrophe perils which may provide some lessons for responding to future pandemics (although pandemics may present different risks and challenges, as outlined in the section below). Annex A provides an overview of catastrophe risk programmes and good practices for supporting broad coverage, lowering the aggregate cost of coverage, minimising public financial exposure and encouraging risk reduction through programme design.Characteristics of pandemic risk. A pandemic presents different risks and challenges from many of the other types of perils that have been targeted by catastrophe risk insurance programmes.Key uninsured (or underinsured) exposure is business interruption5. Catastrophe risk insurance programmes are often targeted at property damage, whether to residential or commercial buildings. In mature insurance markets, coverage for property damage is acquired by almost all commercial entities. As a result, coverage for property damage of the peril targeted by the catastrophe risk insurance programme can be attached to the coverage that already exists in the market and achieve broad penetration (although some programmes have established their own coverage terms and conditions). However, the share of businesses that have acquired business interruption coverage is much lower. In the United States, for example, approximately 30% of businesses have acquired coverage for business interruption. In France, the Fédération française de l’assurance estimates that approximately 50% of SMEs have business interruption coverage (relative to 100% that have coverage for property damage) (FFA, 2020[61]). As a result, it would likely be more difficult to achieve broad penetration by attaching pandemic coverage to business interruption policies. In addition, one of the main (disputed) limitations to coverage of business interruption losses resulting from COVID-19 (or other infectious diseases) in many jurisdictions is that coverage may only be triggered as a result of physical damage and contamination may not be considered property damage.6 The challenge will be to add coverage through a pandemic risk insurance programme without altering existing commercial practices related to the coverage of non-damage business interruption. The cost of coverage may be substantial. While it is difficult to assess the frequency of pandemics, the potential severity of losses is immense. The magnitude of business interruption losses that are likely to be incurred as a result of COVID-19 (whether by policyholders or their insurers) is much higher than the losses incurred as a result of any recent single catastrophe event. As noted in Box 1, businesses across OECD countries faced an estimated USD 1.7 trillion in revenue losses for one-month of strict confinement measures. By comparison, the Great East Japan Earthquake in 2011 (the largest economic loss from a single event since at least 1970) resulted in USD 234 billion in losses (in 2018 USD). Potential losses of this magnitude would far exceed the amount of premiums collected for business interruption coverage. For example, the approximately 20 French insurers surveyed by ACPR reportedly collected a total of EUR 354 million in premiums for business interruption coverage in 2019 (ACPR, 2020[13]). Figure 2 provides broad estimates of the potential amount of premiums that would need to be collected (as a share of gross direct property insurance premium) in order to provide some coverage7 for one month of business interruption losses (for a return period of 100 years and 35 years8). Figure 2. Pandemic-related business interruption: potential annual premium requirementNote: Revenue decline estimates were derived as outlined in Figure 1 above. The premium requirements were calculated for a coverage of 50% of one-month of revenue losses and incorporate a loss ratio of approximately 65%.Source: OECD calculations as outlined in Figure 1. Property premium data is from (OECD, 2020[63]).The cost of capital requirements – which are usually higher for low frequency events, would not benefit from any significant deductions as a result of diversification9 and would need to account for the high-level of uncertainty regarding frequency and severity – would add a substantial amount to the premium requirement. These estimates suggest that providing comprehensive coverage for all business interruption losses for a pandemic of similar magnitude as COVID-19 would entail absorbing losses at much greater levels than any catastrophe event in the past and would require a significant increase in the amount of premiums collected to fund those losses in most countries (although in some countries, the increase in required premiums could be less than 10% of current premium levels).Challenges in ensuring broad coverage. The design of a catastrophe risk insurance programme would need to consider the best way to achieve broad coverage. Where optional coverage for pandemic risk has been available, it has not been frequently acquired.The experience of COVID-19 will certainly lead to an increase in interest for such coverage although it’s not assured that this will lead to a long-term change in voluntary take-up particularly if the cost of coverage is substantial. Experience from other catastrophe risk insurance programmes suggests that merely making coverage available may not be sufficient for achieving broad coverage. Correlated exposures across countries and markets. Given the potential for a pandemic to affect all parts of the world (near) simultaneously, the financial benefits of diversifying exposure geographically will be limited (at least in the context of a global pandemic).10 The ability of reinsurance markets (including alternative risk transfer through capital markets) to provide coverage for risks at a lower cost than primary insurers operating in a single market depends on their ability to pool uncorrelated risks from around the world. The nature of pandemic risk challenges the ability of the private market to diversify the risk and would likely lead to a higher cost for reinsurance or retrocession (including through alternative risk transfer markets) than in the case of other perils whose occurrence would not be correlated across countries or with financial markets. In the case of alternative risk transfer markets, one of the attractive features for investors has been a lack of correlation between the performance of these instruments and financial market performance.11 However, the current crisis has demonstrated that a large-scale pandemic is also likely to have a negative impact on financial markets.There may be limited private sector appetite for pandemic risk. Given the recent experience with COVID-19, it is likely that insurers will be reluctant to provide broad coverage for business interruption in the near future (or at least not at a cost broadly accessible to commercial policyholders). Some reports suggest that insurers are reducing or eliminating any potential coverage for pandemic risk in property damage and business interruption policies (Marsh, 2020[8]) and are considering applying various exclusions in other lines of business where some exposure is likely (e.g. directors and officers liability insurance (Collins, 2020[68])). The potential that confinement measures would be imposed broadly as part of any effective response to an infectious disease outbreak is likely to limit the appetite of private insurance markets to offer significant capacity even in terms of first-loss coverage as such measures would lead to many policyholders being affected simultaneously. In the United States, for example, the insurance associations that have put forward the Business Continuity Protection Program proposal (see below) do not include a risk-taking role for insurers (although (re)insurers in France have indicated that they would be willing to provide EUR 2 billion in (first-loss) coverage capacity with access to reinsurance through CCR (public reinsurer) (FFA, 2020[61])). There is also a high-level of uncertainty related to the frequency and severity of infectious disease outbreaks. While catastrophe models for pandemic risk have existed for a number years, these models are focused on morbidity and mortality, not the business interruption losses that would be addressed by a pandemic risk business interruption insurance programme.Few risk reduction options for policyholders. There would be challenges in terms of designing a programme that encourages risk reduction by policyholders. There may be more limited actions that policyholders can take to reduce their risk than in the case of other types of perils. Box 5. Potential design features of a pandemic risk insurance programme Given the nature of pandemic risk, governments wishing to establish a pandemic risk insurance programme should consider how the following practices could support the design of a programme that achieves broad coverage, limits public sector exposure and encourages risk reduction.Broad coverage, potentially through automatic coverage extensions . Governments may wish to consider approaches that involve an automatic extension of coverage for pandemic risk business interruption in order to ensure broad coverage. An automatic extension to include coverage for pandemic risk business interruption as part of commercial property insurance policies or an approach that involves the voiding of relevant exclusions (on an ex ante, not ex post or retroactive basis) under specific circumstances (e.g. a pandemic that has been formally declared as such by a government authority) would likely be more effective in ensuring broad coverage than simply making coverage available. As outlined in Annex A, programmes that make coverage available on an optional basis have generally had more limited success in reducing the protection gap for targeted perils. Voiding applicable exclusions might help address the challenges of integrating coverage for pandemic-related business interruption into the existing scope of commercial property policies. Limit public exposure by leveraging available private sector capacity . The design of a pandemic risk business interruption insurance programme should involve a careful assessment of the appetite of private (re)insurance markets to provide coverage for different infectious disease outbreak scenarios as well as the cost effectiveness of different approaches to publicly-provided coverage. The limited ability to diversify risk in reinsurance and retrocession markets would likely lead to higher costs for reinsurance coverage which may suggest that government-backing should target higher layers of losses, allowing private insurance (and reinsurance) markets to develop for losses below a threshold for government involvement (as outlined below, many of the proposals put forward to provide coverage for pandemic-related business interruption losses in the longer-term recommend a role for government as reinsurer). Catastrophe risk insurance programmes that provide coverage as direct insurance or for lower loss layers (usually) depend on private reinsurance, retrocession and capital markets for leveraging private market capacity although these markets may not have significant capacity for a peril that is difficult to diversify geographically, may be highly correlated with financial markets and could result in very large losses. However, as it may take some time before private (re)insurance markets will be willing to make available significant capacity, thresholds for government involvement may need to be set at fairly low levels initially. It is unlikely that private (re)insurance markets would ever have the capacity to manage the losses resulting from a pandemic on the scale of COVID-19. However, any risk-absorption by private markets would nonetheless reduce public sector exposure.Some have suggested that any programme established to address pandemic-related business interruption should also provide a solution to other uninsured (or underinsured) non-damage business interruption perils (such as cyber perils or major power disruption) (recommended by the Federation of European Risk Management Associations (FERMA) (FERMA, 2020[69]). Offering coverage for a broader set of perils could offer benefits in terms of the diversification of programme exposure. Provide incentives (or requirements) for risk reduction. One of the challenges that has exacerbated business interruption losses (in some sectors) has been difficulties in transitioning to a work from home approach. Insurers could be required to ensure that policyholders have business continuity plans or other risk mitigation measures in place (or could offer premium discounts) that support the continuity of operations (where possible) and reduce the amount of business interruption losses incurred in the event of widespread business closures. A pandemic risk insurance programme could also integrate requirements for covered businesses to implement measures to limit the spread of the virus (such as a strengthened capacity for remote working) and protect the health and safety of employees and customers. The Business Continuity Protection Program proposal put forward by US insurance association, for example, includes a recommendation that adherence to federal health guidance be a condition for access to compensation (NAMIC, APCIA and Big I, 2020[70]). The insurance sector could also become an advocate for strengthening government preparedness through a pandemic risk insurance programme.1 Consider whether insurance is the most efficient mechanism. Governments are providing various types of financial support to address the financial implications of COVID-19 on individuals and businesses, including a number of programmes that compensate for costs that would normally be covered under business interruption insurance. Ultimately, governments will need to consider whether it is more cost-effective to provide financial support for a catastrophe risk insurance programme for these losses or simply provide this support directly to businesses from the general government budget. Governments could also consider whether it would be more cost-effective to access private insurance markets as a means to protect public finances rather than through a cost-share catastrophe risk insurance programme. An insurance programme would be most beneficial if it increases private market appetite for assuming pandemic-related risks, supports risk understanding and risk reduction and provides certainty to business regarding their coverage for future pandemic-related business interruption losses. ← 1. In the United Kingdom, for example, insurance companies have historically agreed to provide broad coverage for flood damage based on a commitment by government to make sufficient investment in flood risk mitigation.Pandemic risk insurance programme proposals. In many jurisdictions, policymakers, legislators and insurance organisations have established working groups, developed legislation and made various proposals on the establishment of pandemic risk insurance programmes. In some cases, these proposals have been published or reported in the media.Europe . EIOPA has developed an issues paper setting out some of the issues and options for establishing an insurance solution for addressing pandemic-related business interruption losses (“shared resilience solution”), based on discussions with representatives from the insurance industry and commercial insurance buyers. The issues paper outlines potential options for addressing risk assessment challenges (such as the modelling of non-damage business interruption (NDBI) risk) and incentivising risk prevention measures (through pricing and contractual terms) as well as some potential product design features to provide NDBI cover in the short or medium term (such as the choice of payment trigger, the scope or mandatory nature of the cover). The paper also sets out risk transfer approaches based on different mechanisms for risk sharing between insurers, reinsurers and governments at national or European level (EIOPA, 2020[71]). In February 2021, EIOPA issued a staff paper examining possible approaches to improving the insurability of pandemic business interruption risks, including through prevention measures, risk transfer to capital markets and by establishing a multi-peril solution for systemic risks (EIOPA, 2021[72]).The European Parliament, in its Report on a New Industrial Strategy for Europe, has called on the European Commission to “work towards the creation of a framework involving institutional investors, Member States and the EU, to cover the losses due to business interruption in case of a future pandemic” (European Parliament: Committee on Industry, 2020[73]). France. As noted above, the French Minister of Economy and Finances established a working group in April comprised of representatives from business and insurance associations, CCR and members of Parliament mandated to develop a framework for providing insurance for exceptional events, such as a global pandemic. The Fédération française de l’assurance, a member of the working group, has published its proposal for a CATEX (catastrophes exceptionnelles) programme to provide coverage for business interruption losses that result from a reduction in economic activity following an extraordinary event (pandemics, terrorist attack, natural catastrophe, etc.). Under the proposal, the coverage could be triggered by a state administrative action that resulted in the closure of businesses in a given geographic region for a specified amount of time and would apply to businesses directly affected by the administrative order as well as those indirectly affected as a result of reduced economic activity outside the specified region. The coverage would be attached to either commercial property or business interruption coverage and would be available to SMEs (TPE and PME in French). The coverage would provide lump-sum payments (i.e. without loss adjustment) and would be calibrated to replace gross business disruption costs net of salaries and profits. The coverage would be funded by a premium paid by SMEs and backed by the government based on the existing regimes for natural catastrophes and terrorism risk. As noted above, French insurers and reinsurers have indicated that they would provide EUR 2 billion in capacity based on an expectation that CCR would provide reinsurance for additional amounts (FFA, 2020[61]). It should be noted that, at the time of writing, the formal proposal of the working group has not been published and that other members of the group are reportedly developing alternative proposals (Ladbury, 2020[74]).Germany. The German Insurance Association (GDV) established an expert group from the insurance industry to develop potential models to address the economic impacts of pandemics. The GDV published a Green Paper in June 2020 proposing the establishment of a legal entity that would collect funds from policyholders (either directly as risk-based premiums or through a compulsory flat-rate levy attached to certain policies) and would make payments to policyholders in the event of a WHO-declared pandemic and/or the declaration of regional epidemic by the relevant German public authorities. Payments would be made to all businesses (flat-rate levy model) or those that paid premiums for coverage based on the amount of capital accumulated by the legal entity (including as a result of any reinsurance coverage acquired by the entity) – with the government providing a backstop for losses above the capacity of the legal entity (GDV, 2020[75]). According to the GDV, representatives of the business community have initially indicated that they would prefer a voluntary solution. Italy. Generali Group published a perspective on pandemic risk pooling in September 2020 that recommends the establishment of a public-private partnership to provide insurance protection against pandemic-related business interruption losses for SMEs, harmonised at the European-level. The mechanism would include an initial coverage that would potentially be funded by the insurance sector and could potentially be based on a mix of parametric triggers (Generali Group, 2020[76]). United Kingdom. In the United Kingdom, industry representatives have formed working groups to develop solutions to the business interruption protection gap for pandemic risk. A set of working groups have been established to develop a proposal to establish Pandemic Re which would create a government-backed reinsurance pool. The initiative includes broad participation from across the UK insurance sector and intended to submit a proposal to the UK government in late 2020. In addition, the Lloyd’s market has developed and published details on three proposed solutions to address various elements of the pandemic-related business interruption protection gap (Lloyd’s, 2020[77]). The proposals have been published as open-source frameworks for the design of programmes to deal with non-damage business interruption (including pandemics) in the short and longer-term:For the short-term, Lloyd’s has proposed the establishment of a ReStart programme that would pool capacity within the Lloyd’s market to provide business interruption coverage for small companies for future potential waves of COVID-19 (with the possibility to extend the scope of the programme to include SMEs more generally). For the medium and longer-term, Lloyd’s has proposed the establishment of Recover Re which would collect premiums (under a policy that lasts multiple years) to be used to make payments to policyholders for non-damage business interruption after an event, including the current COVID-19 pandemic as well future pandemics or other perils that lead to business interruption (without the physical damage that triggers such coverage in many commercial property policies). Policyholders would make continuous premium payments over many years to fund a pool that would provide this coverage. The role of government would be to provide a guarantee against policyholder premium payment defaults and, potentially, to fund payouts in the initial years before Recover Re accumulates sufficient capital.For the longer-term, Lloyd’s has proposed the establishment of Black Swan Re, a reinsurance pool backstopped by a government guarantee that would provide coverage for systemic non-damage business interruption losses. Under this proposal, the insurance industry layer would be relatively small at first but would increase over time (subject to loss experience). United States. In the United States, a legislative proposal to establish a federal pandemic risk reinsurance programme – the “Pandemic Risk Insurance Act of 2020” (PRIA) – has been introduced in Congress. The programme would operate in a similar way as the Terrorism Risk Insurance Program by providing a federal backstop for business interruption and event cancellation losses incurred by participating insurers as a result of a “covered public health emergency” (i.e. an event certified as such by the Secretary of Health and Human Services, such as a pandemic or infectious disease outbreak). Under the draft PRIA legislation, the private sector would take on some portion of the future pandemic risk. The federal reinsurance would cover 95% of losses above an individual participating insurers’ deductible once an industry loss threshold of USD 250 million was achieved – with an overall annual limit of USD 750 billion in annual payouts. The purchase and offering of the federally-reinsured coverage would be voluntary (Dawson and McCarty, 2020[78]), (Sclafane, 2020[79]). The legislation has been endorsed by a number of business and insurance associations, including Non-profit New York, the U.S. Travel Association, The National Retail Federation, the American Society of Association Executives, and the Council of Insurance Agents and Brokers (amongst others) (Office of Congresswoman Carolyn Maloney, 2020[80]). A group of US insurance associations (American Property Casualty Insurance Association (APCIA), the National Association of Mutual Insurance Companies (NAMIC) and the Independent Insurance Agents and Brokers of America (Big I)) have proposed the establishment of a Business Continuity Protection Program that would provide federal compensation for up to 80% of specific types of operating expenses (including payroll, employee benefits and other operating expenses) for up to three months following the declaration of an emergency. Businesses would need to purchase this protection in advance and would need to certify that: (a) the proceeds of the compensation will be used to retain employees and pay necessary operating expenses; and (b) that the business will implement all applicable federal guidance on health and safety measures during the health emergency. The protection could be acquired by any business incorporated in the United States on a voluntary basis. The private sector would not take on any of the future pandemic risk, and it would be completely backstopped by the U.S. federal government (NAMIC, APCIA and Big I, 2020[70]), (Hatler, Mihocik and Roman, 2020[81]). A “Pandemic Reinsurance Corporation” proposal has also been reported in the media although it does not appear to have been formally proposed as legislation. Under this proposal, reinsurance coverage would be made available for both small and large businesses although with small businesses receiving payouts based on a standard formula and large businesses receiving payouts calculated on an indemnity basis. The coverage would automatically be included in small business insurance policies (business owner policies or workers compensation policies) although large businesses would need to specifically acquire the coverage. The insurance industry would be responsible for approximately USD 15 billion of losses faced by small businesses and a similar amount for large businesses after a few years (Sclafane, 2020[82]).In early July, a large US property and casualty insurer (Chubb) released a proposal for establishing a Pandemic Business Interruption Program involving facilities for small companies and for medium and large companies. For small businesses, the programme would provide a fixed payment based on a multiple of payroll costs in the event of a government-declared pandemic and lockdown with a first layer of losses (beyond a deductible and up to USD 250 billion) co-insured by insurance companies and government (with the industry share increasing over time) and an excess layer of USD 500 billion funded by government. Policyholders would only be required to pay premium to cover the industry share of losses which would reduce the cost of this insurance. Companies would be required to opt-out of purchasing this coverage and, in doing so, would confirm that they will not have access to business interruption coverage or federal assistance programmes in the event of a pandemic. For medium and large companies, business interruption coverage could be acquired on a voluntary basis from private insurers who would cede a proportion of the risk (and premium) to a government reinsurer (Pandemic Re). Coverage would be limited to USD 50 million per policy and the industry retention would be limited to USD 15 billion initially and increasing over time (Chubb, 2020[83]). In December 2020, Zurich North America released a draft concept for providing financial protection against future pandemics. The proposed approach would provide business interruption coverage to businesses for essential expenses (up to 80% of expenses for three months, capped at USD 20 million per month) with a deductible (waiting period) chosen by the policyholder and reduced premium rates for smaller businesses. Insurers would be required to offer this coverage but can choose to cede 90%, 95% or 100% of the risk to government-backed reinsurance pools. The coverage would be triggered in the event of federal emergency disaster declaration, federal disaster declaration for the relevant state and a business shut down declaration made at the state level (Zurich (North America), 2020[84]). A coalition of US businesses (Business Continuity Coalition (BCC)) has also been established to advocate for an insurance coverage for future pandemic-related losses. The BCC is recommending the establishment of a pandemic risk insurance programme that would support the availability of affordable non-damage business interruption coverage as well as respond to emerging insurance coverage gaps in other lines of business such as event cancellation, workers compensation and general and employment practices liability. The coverage would be distributed by the insurance sector and available to businesses of all sizes with subsidised premium rates. Payments would be made on a parametric basis triggered by national health declaration and business closure orders made at the state-level. The programme would encourage insurers to assume some portion of the risk and make use of international reinsurance and capital markets to assume some of the risk taken by government (Business Continuity Coalition, 2020[85]). Table 1 provides a comparison of some of the common design features across the various proposals.Box.6. The scope for international cooperationCOVID-19 has become a truly global event that has created similar challenges for the insurance and reinsurance sector (and for policyholders) in almost every country around the world. Responding to these challenges will require a global response. There is a significant opportunity for countries to share lessons and experience from both existing catastrophe risk insurance programmes as well as from the analyses and examinations that are being invested in developing a response to COVID-19. There may also be opportunities to examine the potential benefits of risk-sharing arrangements across countries for the extreme events. For example, in the case of nuclear insurance, a number of national nuclear insurance pools have entered into reinsurance arrangements with other national nuclear insurance pools with the aim of ensuring sufficient overall capacity to address the losses from a major event (Nuclear Pools, n.d.[86]). Ultimately, international cooperation can support a response that meets the policy objectives of governments and the financial needs of businesses and their insurers.Table 1. Overview of selected pandemic risk insurance programme proposalsProposalDistributionType of coveragePerilsEligible policyholdersCoverage triggerGovernment involvementEIOPA (Europe)Insurance sector (bundled with other coverage)Non-damage business interruption (potentially parametric)PandemicSMEs (potentially)Not specifiedNational government (third risk layer)Europe (fourth risk layer)CATEX (Federation française des assureurs)Insurance sector (attached to commercial property or business interruption policies) Business interruption (resilience capital)Extraordinary events (cyber, terrorism, pandemic, etc.)No restrictionHealth emergency declaration and closure orderReinsurance provided by public reinsurer (CCR)GDV (Germany)Insurance sector (levy or policy extension) Business interruptionPandemic (or epidemic)No restrictionWHO/German authority declaration Government retrocession/guarantee (highest layer)ReStart (Lloyd’s)Insurance sectorBusiness interruptionCOVID-19Small companies (potentially all SMEs)Evidence of health emergency and revenue declineNo requirement for government backstopRecover Re (Lloyd’s)Insurance sector (stand-alone, multi-year policy)Non-damage business interruptionPandemic and other perilsNo restrictionEvidence of health emergency and revenue declineGovernment guarantee against default on future premium paymentsBlack Swan Re (Lloyd’s)Insurance sectorNon-damage business interruption (systemic event)Systemic risk perilsNo restrictionNot specifiedGovernment backstop for reinsurance poolPandemic Risk Insurance Act (United States)Insurance sector Business interruption and event cancellationPandemic and infectious disease outbreaksNo restrictionCertification by Secretary of Health and Human Services5% industry retention and 5% industry co-insurance above retentionBusiness Continuity Protection Program (APCIA, NAMIC, Big I – United States))Insurance sector (stand-alone policy)Business interruption PandemicNo restriction (although coverage amounts are smaller for larger companies)Health emergency declaration and closure orderGovernment would pay all claimsPandemic Business Interruption Program (Chubb – United States)Insurance sectorBusiness interruption PandemicSME programme and larger company programmePandemic declaration and closure order6% retention up to USD 15 billion (SME programme)5% retention up to USD 15 billion (larger companies)Industry share to increase over timeDraft concept for facilitating pandemic protection (Zurich North America – United States)Insurance sectorBusiness interruptionPandemicNo restrictionHealth emergency declaration and closure orderGovernment reinsurance pools that would assume 90%, 95% or 100% of risk (cedant chooses cession level)Business Continuity Coalition (United States)Insurance sectorBusiness interruption and event cancellationPandemicNo restrictionHealth emergency declaration and closure orderGovernment reinsurance for 95% of losses (first event) and 90% of losses (second event)Annex A. Catastrophe risk insurance programmes. In a number of countries, insurance programmes or pools have been established, usually with the support of the public sector, to provide insurance coverage for certain risks and/or for certain segments of the population.12 In many cases, these programmes have been established to provide affordable insurance coverage for risks that have been deemed uninsurable through private insurance markets – although in others, the programmes have been established in order to promote solidarity in terms of loss-sharing across regions. Since 2000, approximately 40% of all economic losses due to flood, storms and earthquakes in OECD countries have been incurred in countries (or regions) covered by catastrophe risk insurance programmes.13 Overview of catastrophe risk insurance programmes. Perils covered. Some of these programmes have a broad scope, covering multiple perils and lines of insurance. For example, the Consorcio de Compensación de Seguros (CCS) in Spain provides insurance coverage for residential and commercial property, motor vehicles as well accident and sickness against a broad range of both natural and man-made perils. Others are focused on specific (high-risk) perils (e.g. earthquake in Japan or wind in the US state of Florida), specific lines of business (e.g. residential property for natural hazards or commercial property in the case of terrorism) or even a particular exposed segment (e.g. residential property at high-risk of flooding in the United Kingdom). Type of coverage provided. There is a broad range of approaches to providing programme coverage. Some programmes offer direct (primary) insurance while others provide a reinsurance coverage. Many of the terrorism insurance programmes (and some natural catastrophe insurance programmes) are organised as co-insurance pools that collectively access reinsurance and (in some cases) a government backstop. The US Terrorism Risk Insurance Program is a federal backstop administered as a co-insurance arrangement that shares losses between the government and insurance companies at a defined ratio once losses exceed a specific threshold. Table A.1 provides an overview of the types of insurance programmes for catastrophe risk that have been established in OECD and a few non-OECD countries and territories. TableA.1. Catastrophe risk insurance programmes ProgrammeRisks coveredType of insurance Public sector involvementAustraliaAustralian Reinsurance Pool Corporation (ARPC)TerrorismReinsuranceARPC is a government enterpriseBackstop for losses above ARPC capacity and up to AUD 10 billionAustriaÖsterreichischer Versicherungspool zur Deckung von Terrorrisiken (OVDT)TerrorismCo-insurance/ ReinsuranceNoneBelgiumTerrorism Reinsurance and Insurance PoolTerrorismCo-insurance/ ReinsuranceBackstop for losses above TRIP capacity and up to EUR 300 millionDenmarkDanish Storm CouncilStorm surge and inland floodDirect insurance The Storm Council is a public entity that provides compensation for damages funded by a tax on fire insurance policies.Danish Terrorism Insurance Pool for Non-Life Insurance (TIPNLI)Terrorism (NBCR)Direct insuranceCoverage provided for up to DKK 15 billion FranceCaisse centrale de réassurance (CCR)Flood, earthquake, tsunami, landslide, mudslide, avalanche, subsidence and cyclonic winds; terrorism ReinsuranceCCR is a government entity backed by an unlimited government guaranteeGestion de l'Assurance et de la Réassurance des risques Attentats et actes de Terrorisme (GAREAT)TerrorismCo-insurance/ ReinsuranceGAREAT’s reinsurance coverage is provided by private reinsurers and CCR (government entity)GermanyExtremusTerrorismDirect insuranceBackstop for losses above Extremus capacity and up to EUR 6.48 billionIcelandNatural Catastrophe Insurance of Iceland (NTI)Volcanic eruptions, earthquakes, landslides, avalanches, floodDirect insuranceNTI is a government entity backed by an unlimited government guaranteeJapanJapan Earthquake Reinsurance (JER)Earthquake, volcanic eruptions, tsunamiReinsuranceLosses above a certain threshold are shared by the government and industryNetherlands Nederlandse Herverzekeringsmaatschappij voor Terrorismeschaden (NHT)TerrorismReinsuranceBackstop for losses above NHT capacity and up to EUR 50 millionNew ZealandEarthquake Commission (EQC)Earthquake, volcanic eruptions, tsunami, landslides, storm/flood (for land only)Direct insuranceEQC is a government entity backed by an unlimited government guaranteeNorwayNorsk NaturskadepoolFlood, storm, landslide, avalanche, volcanic eruption, earthquakeCo-insuranceEstablished by legislationSpainConsorcio de Compensación de SegurosFlood, earthquake, tsunami, volcanic eruption, windstorm, terrorism Direct insuranceCCS is a government entity backed by an unlimited government guarantee (although self-financed with its own capital and reserves)SwitzerlandKantonalen Gebäudeversicherungen (19 cantons) (e.g. Neuchâtel)1Flood, cyclone, hail, avalanche, landslide (as well as fire)Direct insuranceEstablished by legislationInterkantonale Rückversicherungsverband (IRV)Flood, cyclone, hail, avalanche, landslide (as well as fire)Reinsurance for cantonal insurersEstablished by legislationSchweizerische Pool für ErdbebendeckungEarthquakeDirect insurance (compensation)NoneSchweizerischer Elementarschadenpool of the private insurance sectorFlood, cyclone, hail, avalanche, landslideCo-insuranceNoneTurkeyTurkish Catastrophe Insurance Pool (TCIP)Earthquake, tsunami, landslide (and other perils triggered by earthquake)Direct insuranceTCIP has access to EUR 250 million in reinsurance provided by the government.United KingdomFlood ReFloodReinsuranceEstablished by legislationPool ReTerrorismReinsuranceBackstop for losses above Pool Re capacity (not sure if maximum)United StatesNational Flood Insurance Program (NFIP)FloodDirect insurance and risk management programNFIP is administered by the Federal Emergency Management Agency (a government agency)The NFIP collects premiums and has the authority to borrow from the US Treasury. NFIP has transferred part of its risk to private reinsurance companies and capital market investors Terrorism Risk Insurance ProgramTerrorismCo-insuranceFederal government backstop through co-insurance for losses above industry loss of USD 200 million with cap on overall losses of USD 100 billion annuallyCalifornia Earthquake AuthorityEarthquakeDirect insuranceEstablished by legislationCitizens Property Insurance Corporation (Florida)2Storm (wind)Direct insuranceCitizens is a state government entityFlorida Hurricane Catastrophe Fund (FHCF)Storm (wind)Reinsurance (reimbursement)Established by legislation and administered by a government agencyChinaChina Residential Earthquake Insurance Pool (CREIP)EarthquakeDirect insurance (co-insurance pool)The co-insurance pool is reinsured by a state-owned reinsurerIndiaIndian Market Terrorism Risk Insurance PoolTerrorismCo-insurance/ ReinsuranceThe co-insurance pool is reinsured by a state-owned reinsurerRomaniaPool-ul de Asigurare împotriva Dezastrelor Naturale (PAID)Earthquake, flood, landslide Direct insuranceGovernment is lender of last resort for losses beyond PAID’s financial capacityRussian FederationRussian Anti-Terrorism Insurance PoolTerrorism (and SRCC)Co-insurance/ ReinsuranceNoneAssistance for damaged and lost dwellings with priority of insurance indemnityFire, flood and other natural disastersCo-insurance/ReinsuranceLosses are shared by the government and industrySouth AfricaSasriaTerrorism (and SRCC) Direct insuranceSASRIA is a government entity although is not backstopped by an explicit guaranteeChinese TaipeiTaiwan Residential Earthquake Insurance Fund (TREIF)Earthquake, tsunami, landslide (and other perils triggered by earthquake)ReinsuranceTREIF may seek access to government collateral to support funding for losses beyond TREIF’s financial capacity Note: 1 As noted, there are public cantonal insurers in 19 Swiss cantons. The information provided in the table is for the Établissement cantonal d'assurance et de prevention in the canton of Neuchâtel (as an illustrative example). 2There are a number of other pooled and/or residual insurance arrangements for wind risk in other states, including Alabama, Georgia, Louisiana, Mississippi, North Carolina (the North Carolina Coastal Property Insurance Pool, formerly known as the Beach Plan), South Carolina and Texas (the Texas Windstorm Insurance Association).. Similar to Citizens in Florida, these programmes are aimed at making insurance coverage available to households that are unable to secure coverage in the private market.Source: (OECD, 2020[87]), (OECD, 2018[88]), (OECD, 2016[89]), (IFTRIP, 2017[90]), (World Forum of Catastrophe Programmes, n.d.[91])The different approaches lead to different outcomes in terms of: (i) achieving a broad level of coverage for catastrophe perils (or the specific peril targeted); (ii) improving the affordability of coverage for targeted perils; (iii) maximising the role of private markets; and (iv) providing incentives for risk reduction. The following section provides a brief discussion of good practices for achieving these outcomes.Achieving broad coverage for targeted peril(s). An obvious indicator of a catastrophe risk insurance programme’s success is the extent to which the intervention achieves broad coverage for the targeted peril(s), whether through the programme directly or in combination with coverage provided by the private insurance market. To achieve this, a number of countries impose requirements such as:Policyholders are required to purchase coverage for the targeted perils (e.g. Iceland, some Swiss cantons, Belgium for terrorism in some lines of business); Insurance companies are required to include coverage automatically (e.g. France, Spain, Australia for terrorism14) or make coverage available (e.g. Japan and California for earthquake, United States for terrorism); or Lenders are required to ensure that their borrowers are properly insured (e.g. United States for flood in designated high-risk flood zones). In general, the share of losses insured tends to be higher where the purchase of insurance is mandatory or where standard property policies are automatically extended to include coverage for the targeted peril(s) (New Zealand and Chinese Taipei in the case of earthquakes, France, Norway, Spain and Switzerland for the broader set of perils)15 (see Figure A A.1).Figure A A.1. Insured share of losses for perils covered by catastrophe risk insurance programmesNote: For the purposes of this calculation, catastrophe risk insurance programmes include Denmark (storm), France (storm, flood, earthquake), Iceland (storm, flood, earthquake), Japan (earthquake), New Zealand (earthquake), Norway (storm, flood, earthquake), Romania (storm, flood, earthquake), Spain (storm, flood, earthquake), Chinese Taipei (earthquake) and Turkey (earthquake) as well as Switzerland (flood and storm, depending on the canton that was mainly impacted) and the United States (flood, earthquake (California), and storm (if the main impacts occurred in Alabama, Florida, Georgia, Mississippi, North Carolina, South Carolina or Texas)). It should be noted that in France and Spain, only some storm events are covered by the catastrophe risk insurance programme as these programmes include a wind speed threshold.Source: OECD calculations based on (Swiss Re sigma, 2019[92]).Improving the affordability of coverage. By pooling a large share of a country’s exposure to a given peril (or set of perils), a catastrophe risk insurance programme might be able to achieve a lower aggregate cost of coverage than individual insurers could achieve on their own. Risk diversification. A single pool providing coverage for all of a country’s building stock, for example, would create a more diversified portfolio of risks than any insurance company could achieve on its own (without a 100% market share).16 An insurance company (or pool) with a higher level of risk diversification will have lower economic and (often regulatory) capital needs (other things equal) and can therefore offer lower pricing. Reduced cost of reinsurance . Also, the cost of reinsurance tends to decline as the level of diversification increases so the cost to reinsure a single (diversified) pool of risks should be lower than the aggregate cost of reinsuring multiple (less diversified) pools of risks – which also should contribute to lower pricing for the policyholder. Lower capital required . An assessment of the amount of capital required to protect against a 1-in-100 hurricane affecting eight US states was found to be 45% less (USD 71 billion instead of USD 130 billion) if the states pooled their risks rather than covering the risk independently (Dumm, Johnson and Watson, 2015[93]). The impact of a catastrophe risk insurance programme on improving affordability will be greatest where the programme is able to establish a highly diversified pool of risks. Limiting public sector exposure. An important objective of catastrophe risk insurance programmes should be to limit the exposure of the public sector to losses from the targeted peril – potentially by maximising the contribution of private markets to providing coverage. The catastrophe risk insurance programmes that have been established for various perils aim to achieve this objective through a variety of approaches.Coverage limits. Some programmes that provide government-backed direct insurance limit public sector exposure by placing ceilings on the amount of coverage available (New Zealand, Romania, Chinese Taipei, Turkey, United States (flood) – Japan’s Basic Earthquake Insurance policy is also limited although the government-backed coverage is provided through reinsurance). In some of these cases, coverage is limited to an amount that is significantly below the sum insured under the standard property insurance policy which limits the government’s potential exposure. In a few countries (e.g. New Zealand), the private market has developed coverage for amounts above the limits imposed by the catastrophe risk insurance programme although in most countries, losses above the basic coverage are often uninsured (see Figure A A.1). Risk selection. Programmes can also be made available only to policyholders who are not adequately served by the private market. The insurance coverage for terrorism provided by Extremus in Germany (which benefits from a government backstop) is only available as an endorsement for policies with sums insured above EUR 25 million as the market is able to provide coverage against terrorism for smaller coverage levels. Some US states have residual market mechanisms that act as insurers of last resort and will only accept policyholders that can demonstrate that they could not access coverage at a reasonable cost in the private market. Flexibility to leverage market capacity. Many programmes provide government-backed coverage as reinsurance (or as a backstop through co-insurance in the United States for terrorism) which usually means that, through the use of retention requirements, direct insurers will absorb most or all losses for smaller-scale events and only high loss events above the threshold would be covered by the programme. Some countries adjust the level of direct insurer retention over time, either based on specific measures of the capacity of the private market (e.g. Japan for earthquake) or with the aim of increasing the private market’s share of risk over time (Australia, United Kingdom, United States for terrorism, see Box A A.1). In the United States, the trigger for Terrorism Risk Insurance Act backstop is set at a level where direct insurers will often seek private reinsurance to cover losses below the programme trigger. Many of the catastrophe risk reinsurance programmes make reinsurance available but do not require direct insurers to make use of that reinsurance capacity (Australia, United States for terrorism, United Kingdom for terrorism and flood, France for natural catastrophe risk and for terrorism risk coverage for smaller companies) which allows direct insurers to retain the risk if they have sufficient capacity or transfer the risk to private market reinsurers. Returning risk to the market. Most catastrophe risk insurance programmes make use of private market reinsurance (for programmes that provide direct insurance coverage) or retrocession (for programmes that provide reinsurance coverage). Many of the terrorism (re)insurance programmes operate as co-insurance pools that jointly access reinsurance coverage from private reinsurance markets (Austria, Belgium, France, India, Russian Federation) while programmes providing reinsurance tend to access private retrocession markets to increase their claims-paying capacity for large (infrequent) events (Australia and United Kingdom for terrorism, Turkey for earthquake). Japan Earthquake Reinsurance retrocedes a part of its exposure back to direct insurers. As noted above, the pooling of risk prior to transferring that risk to the market can have cost-saving benefits.Box A A.1. Increasing the sharing of terrorism risk with private markets: Australia, United Kingdom and United StatesIn Australia, the United Kingdom and the United States, a number of changes have been made to terrorism (re)insurance programmes in order to increase the share of risk retained by (or transferred to) private (re)insurance markets:In Australia, deductibles (retentions) are established (per event) as a share of fire insurance premiums and subject to both a company minimum and maximum deductible and an industry-wide maximum deductible. Since 2007, the company-specific deductible has been increased to 5% of the company’s fire insurance premium (from 4%) and a minimum deductible of AUD 100 000 has been implemented. Maximum company and industry-wide deductibles have been increased from AUD 10 million to AUD 12.5 million and from AUD 100 million to AUD 200 million, respectively. ARPC has also developed a retrocession programme to increase its capacity to absorb losses before calling on the government guarantee. In the United Kingdom, a per event industry deductible is applied and has been increased from GBP 100 million to GBP 150 million. Pool Re has also transferred a significant amount of risk to retrocession markets in recent years.In the United States, the co-insurance provided under the Terrorism Risk Insurance Act is only available for events that lead to industry losses above USD 200 million (an increase from USD 100 million in 2015). Individual company deductibles have increased from 15% of TRIA-eligible premiums to 20% (i.e. premiums written in lines of business that are eligible for coverage under the Act) while the industry share of losses once the programme is triggered has increased from 15% to 20%.These changes have led to a significant increase in the share of losses that would be covered by private insurance companies and a corresponding reduction in government exposure. For example, based on an estimate of the losses incurred after the September 11th terrorist attacks and a simplified application of the programme triggers and thresholds in place in 2017, the amount of losses that would not be covered by the programmes (and left to be absorbed by policyholders or the state) would decline by approximately USD 4 billion in Australia, USD 2.7 billion in the United Kingdom and USD 800 million in the United States (see Figure A A.2).Figure A A.2. Estimated impact of terrorism (re)insurance programme changes on loss distributionNote: The distribution of losses was estimated based on insured loss estimates provided in (Swiss Re sigma, 2019[92]) and the terms of coverage of each terrorism insurance programme in 2017 and 2007 (or 2014 in the case of the United Kingdom). A number of simplifying assumptions were made, including: (i) that all reported losses fell within the scope of coverage of the programmes; and (ii) related to the market share of different primary insurers (required for the calculation of applicable deductibles in Australia, United Kingdom and United States – simplified with the assumption that only the 6 largest providers of commercial insurance faced losses). Source: OECD calculationsCeiling on government exposure. Another way to limit government exposure to losses for perils targeted by catastrophe risk insurance programmes is to establish a ceiling on the amount of losses that the government will absorb. Most programmes that apply a ceiling will force losses above the ceiling to be absorbed by policyholders on a pro rata basis (Australia, Netherlands and United States for terrorism). Some programmes also reduce the ultimate public exposure by allowing or requiring insurance companies to repay the government for any amounts paid.Providing incentives for risk reduction (directly or indirectly). Insurance will make a greater contribution to managing catastrophe risks if the process of transferring these risks supports risk management. Insurance can play an important role in improving risk management by supporting risk assessment/understanding and encouraging risk reduction.Use of modelling for risk management . The (re)insurance sector has developed a strong capacity for modelling the financial consequences of catastrophe risks, whether natural or man-made. This modelling capacity has broader (if underutilised) applications to other aspects of risk management, including for informing land-use planning and building code development as well as in decisions on investing in structural mitigation infrastructure. The need for private sector (re)insurers to accurately price and provision for the occurrence of catastrophe events has driven the development of the modelling industry which means that model availability and sophistication is generally highest where private (re)insurers play a large role in providing coverage for catastrophe perils. Programmes that maximise the role of private insurance markets are therefore more likely to support the development of a modelling industry and its derivative benefits.17 Pricing that reflects risk reduction. Pricing for insurance (or reinsurance) coverage that varies by level of risk should provide an incentive for policyholders (or insurers) to invest in risk reduction (or ensure underwriting discipline) in order to lower the cost of that coverage. While a number of catastrophe risk insurance programmes have implemented pricing that varies by risk zone or building type – none have implemented an approach to pricing their insurance, reinsurance or co-insurance coverage that provide significant incentives for reducing risk. Implementing variable pricing (and particularly, premium reductions for risk mitigation measures) is a challenge for many types of perils (and potentially impossible for some) although advances in modelling will continue to support the ability of these programmes to price their coverage based on more granular assessments of risk. Risk reduction pre-requisites. Some programmes include specific risk reduction requirements as part of programme design – which is particularly relevant in countries where important risk management decisions are made at different levels of government. For example, the US National Flood Insurance Programme is only made available in communities that have agreed to implement certain floodplain management techniques. In France, deductibles are increased for properties that face repetitive losses if the municipality has not implemented a risk reduction plan. In the United Kingdom, the reinsurance coverage made available through Flood Re is only available for properties constructed after 2009 which is meant to ensure that new developments only occur in areas where insurers are willing to provide coverage without Flood Re backing.References. 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Mamiko YOKOI-ARAI (✉ [email protected])Leigh WOLFROM (✉ [email protected])Notes. ← 1. In some countries (e.g. Germany), business interruption coverage may not require physical damage although pandemic-related exclusions may apply. ← 2. In Switzerland, for example, some policies were found to provide coverage for business interruption resulting from the presence of a virus or infectious disease but not in the context of a pandemic.← 3. The ACPR found that, in the case of the 93% of policyholders whose coverage would not respond to COVID-19-related business interruption losses, the vast majority had business interruption coverage that would only be triggered by physical damage to the insured’s property while only a few had policy wordings that excluded pandemic as a peril for the purposes of administrative business closures (ACPR, 2020[13]).← 4. Just under 13% of the 210 454 claims submitted remained open as of November 2020 (NAIC, 2020[15]).← 5. Gaps in coverage may exist (or may emerge as a result of COVID-19) across other lines of business (e.g. event cancellation, health or various liability coverages) which may also need to be addressed through through some form of catastrophe risk insurance programme. ← 6. Although, as noted above, insurers in a number of jurisdictions offer business interruption coverage that can be triggered without property damage and therefore any disputes are focused on other elements of the terms and conditions. For example, in Switzerland, many of the disputes are centred around whether a pandemic (rather than an epidemic or other infectious disease outbreak) precludes coverage in some policies.← 7. For the purposes of this assessment, it is assumed that insurance would cover 50% of estimated business revenue losses insured for one month and that insurers would achieve a 65% loss ratio (based on the average non-life loss ratio achieved by insurers in OECD countries). ← 8. The estimates are provided for a 1-in-100 year return period (as the last global respiratory disease pandemic occurred approximately 100 years ago) and a 1-in-35 year return period based on the potential for increased frequency (and consistent with estimates published by The Geneva Association of a 1-in-30 to 1-in-40 year return period (Schanz, 2020[104])).← 9. In many solvency requirement frameworks, insurers can reduce the amount of capital that they hold for a given level of liabilities to account for the level of diversification in their portfolio (as, for most perils, not all policyholders will be affected simultaneously). It would be difficult to demonstrate that liabilities for business interruption losses from an infectious disease outbreak with potentially global implications are diversified and should benefit from a capital requirement deduction. This lack of diversification applies especially for monoline insurers. For insurers with multiple lines of business, there is risk diversification between pandemic losses and losses from other lines such as earthquake, fire or motor.← 10. Not all infectious disease outbreaks will necessarily result in a global pandemic and therefore some diversification benefits may be possible to achieve.← 11. There has been very limited use of alternative risk transfer markets for the coverage of pandemic risks (and no experience focused on business interruption) which would likely lead to a higher cost for such coverage in the short-term. That said, Lloyd’s has recently indicated an interest in examining the potential for capital markets to provide capacity for pandemic-related business interruption coverage (Lloyd’s, 2020[77]).← 12. There are also a number of catastrophe risk insurance programmes that provide governments with a source of funding for emergency response and recovery, usually established on a regional basis in order to benefit from geographic diversification (e.g. CCRIF in the Caribbean and Central America, PCRIC in the Pacific Islands and SEADRIF in South East Asia). ← 13. OECD calculations based on (Swiss Re sigma, 2019[92]). For the purposes of this calculation, catastrophe risk insurance programmes include Denmark (storm), France (storm, flood, earthquake), Iceland (storm, flood, earthquake), Japan (earthquake), New Zealand (earthquake), Norway ((storm, flood, earthquake), Spain (storm, flood, earthquake) and Turkey (earthquake) as well as Switzerland (flood and storm, depending on the canton that was mainly impacted) and the United States (flood, earthquake (California), and storm (if the main impacts occurred in Alabama, Florida, Georgia, Mississippi, North Carolina, South Carolina or Texas)). It should be noted that in France and Spain, only some storm events are covered by the catastrophe risk insurance programme as these programmes include a wind speed threshold.← 14. In Australia, this is achieved by the voiding of terrorism exclusions in the event that a terrorist incident is declared.← 15. In Romania and Turkey, there are requirements to purchase insurance coverage for earthquakes (as well as floods and landslides in Romania) although there are challenges in both countries in enforcing these requirements. ← 16. However, it should be noted that the establishment of a single pool for all risk also creates an accumulated exposure which would likely increase the need for public-sector backing.← 17. Catastrophe risk insurance programmes in some countries have also played a large role in supporting the development of catastrophe models for the perils that they cover, particularly where the peril is not widely covered by private insurance markets (e.g. terrorism). 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(2020), Report on a New Industrial Strategy for Europe (A9-0197/2020), European Parliament. References[61] FFA (2020), La Fédération Française de l’Assurance présente sa contribution au débat sur la création d’un régime de catastrophes exceptionnelles : le dispositif CATEX, Fédération Française de l’Assurance, https://www.ffa-assurance.fr/actualites/la-federation-francaise-de-assurance-presente-sa-contribution-au-debat-sur-la-creation-un (accessed on 8 July 2020).  Open URLReferences[74] Ladbury, A. (2020), “French pandemic insurance scheme plans near completion: AMRAE”, Commercial Risk, https://www.commercialriskonline.com/french-state-and-insurers-moving-close-to-creation-of-pandemic-scheme/ (accessed on 3 July 2020).  Open URLReferences[75] GDV (2020), Green paper: Supporting the economy to better cope with the consequences of future pandemic events, Gesamtverband der Deutschen Versicherungswirtschaf, https://www.en.gdv.de/resource/blob/59854/079826b589006ed3bd4fc7a09e64cf1a/pandemiefonds-vorschlag-download-green-paper-data.pdf.  Open URLReferences[76] Generali Group (2020), Pandemic Risk Pooling: Generali’s perspective. References[77] Lloyd’s (2020), Supporting global recovery and resilience for customers and economies: the insurance response to COVID-19, Lloyd’s, https://www.lloyds.com/news-and-risk-insight/media-centre/coronavirus-updates-hub/supporting-global-recovery-and-resilience-for-customers-and-economies (accessed on 8 July 2020).  Open URLReferences[78] Dawson, T. and D. McCarty (2020), Federal Pandemic Risk Reinsurance Program: Updated Discussion Draft of Proposed Legislation, McDermott Will & Emery, https://www.mwe.com/insights/federal-pandemic-risk-reinsurance-program-updated-discussion-draft-proposed-legislation-covid/ (accessed on 7 June 2020).  Open URLReferences[79] Sclafane, S. (2020), “Federal PRIA Bill Officially Introduced for Biz Interruption, Event Cancellation”, Carrier Management, https://www.carriermanagement.com/news/2020/05/27/207112.htm (accessed on 7 June 2020).  Open URLReferences[80] Office of Congresswoman Carolyn Maloney (2020), Rep. Maloney Joins with Industry and Trade Association Leaders to Introduce the Pandemic Risk Insurance Act, Congresswoman Carolyn Maloney, https://maloney.house.gov/media-center/press-releases/rep-maloney-joins-with-industry-and-trade-association-leaders-to (accessed on 3 July 2020).  Open URLReferences[70] NAMIC, APCIA and Big I (2020), Insurance Trades Unveil Federal Pandemic Solution, American Property Casualty Insurance Association, http://www.pciaa.net/pciwebsite/Cms/Content/ViewPage?sitepageid=60933 (accessed on 7 June 2020).  Open URLReferences[81] Hatler, P., K. Mihocik and B. Roman (2020), US Federal Business Interruption Legislation Update: Federally Funded or Private/Public Partnership?, Squire Patton Briggs, https://www.lexology.com/library/document.ashx?g=b6769e1c-7b59-4c3e-a4af-9274294ff797.  Open URLReferences[82] Sclafane, S. (2020), “Proposed Pandemic Re Corp. Would Treat Small, Large Biz Interruptions Differently”, Carrier Management, https://www.carriermanagement.com/news/2020/06/04/207430.htm (accessed on 7 June 2020).  Open URLReferences[83] Chubb (2020), Business Interruption Program for Pandemic-related Losses, Chubb, https://www.chubb.com/us-en/about-chubb/pandemic-business-interruption-program.aspx (accessed on 10 July 2020).  Open URLReferences[84] Zurich (North America) (2020), Zurich’s draft concept for facilitating pandemic protection, https://www.zurichna.com/-/media/project/zwp/zna/docs/kh/pandemic/zurich-pandemic-risk-concept-powerpoint-final.pdf?la=en&rev=474a56fd3a6140cab37083773d2bfa83&hash=EBACB3CFE7D8D7ACB63CBBAA357AAC7B (accessed on 11 March 2021).  Open URLReferences[85] Business Continuity Coalition (2020), Statement of the Business Continuity Coalition to United States Senate Committee on Commerce, Science, & Transportation Subcommittee on Manufacturing, Trade, and Consumer Protection (Hearing on “Examining the Impact of COVID-19 on the Live Event Entertainment Industry”), https://download-files.wixmp.com/ugd/d2e71d_1434ddcabf6b4f459786ca68844237b1.pdf?token=eyJhbGciOiJIUzI1NiIsInR5cCI6IkpXVCJ9.eyJpc3MiOiJ1cm46YXBwOmU2NjYzMGU3MTRmMDQ5MGFhZWExZjE0OWIzYjY5ZTMyIiwic3ViIjoidXJuOmFwcDplNjY2MzBlNzE0ZjA0OTBhYWVhMWYxNDliM2I2OWUzMiIsImF1ZCI6WyJ1cm46c2VydmljZTpmaWxlLmRvd25sb2FkIl0sImlhdCI6MTYxNTQ4MTg3MSwiZXhwIjoxNjE1NTE3ODgxLCJqdGkiOiIzOWJmZmQzNWMxNGEiLCJvYmoiOltbeyJwYXRoIjoiL3VnZC9kMmU3MWRfMTQzNGRkY2FiZjZiNGY0NTk3ODZjYTY4ODQ0MjM3YjEucGRmIn1dXX0.7nGSzBi9DjzYeOxLD_gER1UZIxmu (accessed on 11 March 2021).  Open URLReferences[86] Nuclear Pools (n.d.), Nuclear Pools: About Us, Nuclear Pools, https://www.nuclearpools.com/about-us (accessed on 8 July 2020).  Open URLReferences[87] OECD (2020), Insurance coverage for cyber-terrorism in Australia, Organisation for Economic Cooperation and Development and Australian Reinsurance Pool Corporation. References[88] OECD (2018), Financial Management of Earthquake Risk, OECD, http://www.oecd.org/finance/insurance/Financial-management-of-earthquake-risk.pdf (accessed on 24 January 2019).  Open URLReferences[89] OECD (2016), Financial Management of Flood Risk, OECD Publishing, Paris, https://dx.doi.org/10.1787/9789264257689-en.  Open DOIReferences[90] IFTRIP (2017), World Terrorism Insurance Pools and Schemes, International Forum for Terrorism Risk (Re)Insurance Pools, http://iftrip.org/wp-content/uploads/2017/02/IFTRIP-brochure-final.pdf (accessed on 26 October 2018).  Open URLReferences[91] World Forum of Catastrophe Programmes (n.d.), Comparative Table, World Forum of Catastrophe Programmes, https://www.wfcatprogrammes.com/documents/20142/34113/Comparative_table.xlsx/267f5cb3-d7d7-60c2-df10-a5d460d8473a (accessed on 6 April 2020).  Open URLReferences[92] Swiss Re sigma (2019), Natural catastrophes and man-made disasters: 1990-2018 (dataset), Swiss Re. References[93] Dumm, R., M. Johnson and C. Watson (2015), “An examination of the geographic aggregation of catastrophic risk”, Geneva Papers on Risk and Insurance: Issues and Practice, Vol. 40/1, pp. 159-177, http://dx.doi.org/10.1057/gpp.2014.20.  Open DOIReferences[92] Swiss Re sigma (2019), Natural catastrophes and man-made disasters: 1990-2018 (dataset), Swiss Re. References[13] ACPR (2020), Garantie « pertes d’exploitation » : l’état des lieux de l’ACPR, Autorité de contrôle prudentiel et de résolution, https://acpr.banque-france.fr/communications-de-lacpr-dans-le-contexte-de-la-pandemie-covid-19 (accessed on 3 July 2020).  Open URLReferences[15] NAIC (2020), COVID-19 Property & Casualty Insurance Business Interruption Data Call: Part 2 - Claim and Loss Information (November 2020), National Association of Insurance Commissioners. References[104] Schanz, K. (2020), An Investigation into the Insurability of Pandemic Risk, The Geneva Association, https://www.genevaassociation.org/research-topics/socio-economic-resilience/investigation-insurability-pandemic-risk-research-report (accessed on 14 November 2020).  Open URLReferences[77] Lloyd’s (2020), Supporting global recovery and resilience for customers and economies: the insurance response to COVID-19, Lloyd’s, https://www.lloyds.com/news-and-risk-insight/media-centre/coronavirus-updates-hub/supporting-global-recovery-and-resilience-for-customers-and-economies (accessed on 8 July 2020).  Open URLReferences[92] Swiss Re sigma (2019), Natural catastrophes and man-made disasters: 1990-2018 (dataset), Swiss Re. ╳DisclaimerThis paper is published under the responsibility of the Secretary-General of the OECD. The opinions expressed and the arguments employed herein do not necessarily reflect the official views of OECD member countries.This document, as well as any data and map included herein, are without prejudice to the status of or sovereignty over any territory, to the delimitation of international frontiers and boundaries and to the name of any territory, city or area.© OECD 2021The use of this work, whether digital or print, is governed by the Terms and Conditions to be found at http://www.oecd.org/termsandconditions.Tackling coronavirus (COVID-19) - Browse OECD contributions
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Result 16
TitleMost private insurers are no longer waiving cost-sharing for COVID-19 treatment - Peterson-KFF Health System Tracker
Urlhttps://www.healthsystemtracker.org/brief/most-private-insurers-are-no-longer-waiving-cost-sharing-for-covid-19-treatment/
Description
DateAug 19, 2021
Organic Position12
H1Most private insurers are no longer waiving cost-sharing for COVID-19 treatment
H2Nearly three-quarters of the largest health plans are no longer waiving cost-sharing for COVID-19 treatment
In early 2021, about one-third of employers said their largest plan waived COVID-19 treatment costs
H3Health Spending
Looking for more data?
H2WithAnchorsNearly three-quarters of the largest health plans are no longer waiving cost-sharing for COVID-19 treatment
In early 2021, about one-third of employers said their largest plan waived COVID-19 treatment costs
BodyMost private insurers are no longer waiving cost-sharing for COVID-19 treatment By Jared Ortaliza, Matthew Rae Twitter, Krutika Amin Twitter, Matthew McGough, and Cynthia Cox Twitter   KFF August 19, 2021 Stay Connected Get the best of the Health System Tracker delivered to your inbox. Get the best of the Health System Tracker delivered to your inbox. Federal law requires all private insurance plans to cover the entire cost associated with approved COVID-19 testing so long as the test is deemed medically appropriate. Additionally, the U.S. government pre-paid for COVID-19 vaccines and required COVID-19 vaccines be made available at no out-of-pocket costs regardless of whether the vaccine recipient is insured. However, while a handful of states required or created agreements with insurers to waive COVID-19 out-of-pocket treatment costs for their fully-insured plan enrollees, there is no federal mandate requiring insurers to do so. Earlier in the pandemic, we found that the vast majority (88%) of people enrolled in fully-insured private health plans nonetheless would have had their out-of-pocket costs waived if they were hospitalized with COVID-19. At the time, health insurers were highly profitable due to lower-than-expected health care use, while hospitals and health care workers were overwhelmed with COVID-19 patients. Insurers may have also wanted to be sympathetic toward COVID-19 patients, and some may have also feared the possibility of a federal mandate to provide care free-of-charge to COVID-19 patients, so they voluntarily waived these costs for at least some period of time during the pandemic. Our subsequent analysis found that several of these insurers were starting to phase out COVID-19 cost-sharing waivers by November 2020. In the last few months, the environment has shifted with safe and highly effective vaccines now widely available. In this brief, we once again review how many private insurers are continuing to waive patient cost sharing for COVID-19 treatment. We find that 72% of the two largest insurers in each state and DC (102 health plans) are no longer waiving these costs, and another 10% of plans are phasing out waivers by the end of October. Nearly three-quarters of the largest health plans are no longer waiving cost-sharing for COVID-19 treatment. Across the two largest health plans in each state and D.C. (102 plans), 73 plans (72% of 102 plans) are no longer waiving out-of-pocket costs for COVID-19 treatment. Almost half these plans (50 plans) ended cost-sharing waivers by April 2021, which is around the time most states were opening vaccinations to all adults. Of the 29 plans still waiving cost-sharing for COVID-19 treatment, 10 waivers are set to expire by the end of October. This includes waivers that tie to the end of the federal Public Health Emergency, which is currently set to expire on October 17, 2021, though may be extended. Another 12 plans state that their cost-sharing waivers will expire by the end of 2021. Two plans specified end dates for COVID-19 treatment waivers in 2022 and 5 plans did not specify an expiration date. All of the 102 plans we reviewed (two largest plans in each state) had waived cost-sharing for COVID-19 treatment at some point since 2020. (These health plans represent 62% of enrollment across the fully insured individual and group markets).Related Content:Health & WellbeingCOVID-19 preventable mortality and leading cause of death ranking. Health & WellbeingHow does U.S. life expectancy compare to other countries? In early 2021, about one-third of employers said their largest plan waived COVID-19 treatment costs. Many employers offering self-funded and fully insured health plans to their employees also reported waiving COVID-19 treatment cost sharing based on preliminary results from the 2021 KFF Employer Health Benefits Survey (EHBS), which was fielded between January and July 2021 with over 70% of the interviews completed before April 19th when vaccines became available for most adults. Since this survey was conducted earlier in the year, many of the waivers may have already expired by the time of this report. Based on preliminary results from the 2021 EHBS, 36% of firms (with 50 or more employees) reported that their largest plan waived cost sharing for COVID-19 treatment at the time of the survey. Larger firms with 1,000 or more workers were more likely to waive COVID-19 treatment cost-sharing for enrollees than smaller employers. This survey includes both self-funded employers and those buying fully insured coverage. Before this survey, there was no way to know whether self-funded employers were also waiving these costs as the decision was not up to the insurer administering the plan. In the survey, we see that self-funded employers were similarly likely as employers purchasing fully-insured plans to offer waivers for COVID-19 cost sharing. Discussion Motivated by high profits, ACA medical loss ratio rebate requirements, public health concerns about managing the pandemic, and concern over a federal mandate to cover COVID-19 treatment costs, many insurers offered financial relief to their enrollees amid the coronavirus pandemic, primarily through waived COVID-19 treatment costs and less commonly through premium credits or reductions.   Earlier in the pandemic, relatively few COVID-19 patients would have been billed for their hospitalization because of the voluntary waivers extended by private insurers and employers. But as vaccines have become widely available to adults in the U.S. and health care utilization has rebounded more generally, health insurers may no longer face political or public relations pressure to continue waiving costs for COVID-19 treatment. As more waivers expire, more people hospitalized for COVID-19 – the vast majority of whom are unvaccinated – will likely receive significant medical bills for their treatment. The typical deductible in employer health plans is $1,644, and our earlier analysis found that large group enrollees hospitalized with pneumonia (requiring similar treatment to those hospitalized with COVID-19) paid an average of over $1,300 out-of-pocket. Although this is a large amount to most patients, and could be an incentive to get vaccinated, it still only represents a fraction of the cost born to society for these largely preventable hospitalizations. Unvaccinated COVID-19 hospitalizations cost the U.S. health system $2.3 billion in June and July 2021. Methods We used the 2019 Mark Farrah HHS MLR Reporting data to identify the top two plans with the largest combined individual and fully-insured plan enrollment in each state and D.C. We systematically reviewed whether each of the 102 plan provided cost-sharing waivers for COVID-19 treatment and when the waivers expired using each insurer’s COVID-19 resources webpage and relevant press releases. Many insurers referenced “treatment” broadly in context of cost-sharing waivers. However, there were instances when the form of treatment was specified. We used the cost-sharing waiver expiration date for hospitalizations and emergency room visits when the insurer reported different cost-sharing waiver expiration dates for antibody treatment and for hospitalizations and emergency room visits. If the information could not be located on the plan’s website, we pulled information from the insurer’s parent company’s website and made phone calls to insurers when necessary. In instances where we could not locate information from insurer or parent company websites, we deferred to the America’s Health Insurance Plans (AHIP), the trade association representing private insurers, summary that was last updated as of April 8, 2021. If a date of expiration was unavailable for insurers that said they were waiving treatment costs, we categorized the plans as “not specified.” The annual KFF Employer Health Benefits Survey (EHBS) for 2021 was conducted between January and July of 2021 and included almost 1,700 randomly selected, non-federal public and private firms with three or more employees. The methods for the 2021 EHBS are similar to those used in 2020. In 2021, we asked firms if they currently waived cost-sharing for treating enrollees who become infected with COVID-19. A full description of the 2021 methods, finalized data, and findings on other topics such as health insurance premiums and firm offer rates will be released in the fall of 2021. The results described above are preliminary.   About this site . The Peterson Center on Healthcare and KFF are partnering to monitor how well the U.S. healthcare system is performing in terms of quality and cost. More from Health System Tracker Health Spending Potential costs of COVID-19 treatment for people with employer coverage. Health Spending The Real Cost of Health Care: Interactive Calculator Estimates Both Direct and Hidden Household Spending. Dashboard Looking for more data? Find out more details about U.S. healthcare from our updated dashboard. Visit the Dashboard Stay Connected Get the best of the Health System Tracker delivered to your inbox. Get the best of the Health System Tracker delivered to your inbox. A Partnership Of Share Health System Tracker
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TitleAs Pandemic Eases What’s State of Coverage Affordability in U.S.? | Commonwealth Fund
Urlhttps://www.commonwealthfund.org/publications/issue-briefs/2021/jul/as-pandemic-eases-what-is-state-coverage-affordability-survey
DescriptionAfter severe job market disruption and massive federal pandemic relief effort, what is the state of health care coverage and affordability in the United States?
DateJul 16, 2021
Organic Position13
H1As the Pandemic Eases, What Is the State of Health Care Coverage and Affordability in the U.S.?
H2Survey Findings
Policy Implications
H3Findings from the Commonwealth Fund Health Care Coverage and COVID-19 Survey, March–June 2021
Highlights
Quick Facts About the Survey
Is the Percentage of Uninsured Americans Falling?
How We Conducted This Survey
Acknowledgments
Related Content
Unpacking Colorado’s New Guidance on Transgender Health
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What Is Your State Doing to Affect Access to Adequate Health Insurance?
H2WithAnchorsSurvey Findings
Policy Implications
BodyAs the Pandemic Eases, What Is the State of Health Care Coverage and Affordability in the U.S.? Findings from the Commonwealth Fund Health Care Coverage and COVID-19 Survey, March–June 2021 . A “We Are Open” sign is seen on the side of a restaurant as indoor dining partially reopens in Los Angeles on March 15, 2021. The COVID-19 pandemic raised concerns that millions of people would lose their job-based health coverage, but surveys and estimates based on federal data and unemployment claims suggest that coverage losses were relatively small. Photo by Frederic J. Brown/AFP via Getty Images A “We Are Open” sign is seen on the side of a restaurant as indoor dining partially reopens in Los Angeles on March 15, 2021. The COVID-19 pandemic raised concerns that millions of people would lose their job-based health coverage, but surveys and estimates based on federal data and unemployment claims suggest that coverage losses were relatively small. Photo by Frederic J. Brown/AFP via Getty Images To shore up an economy and health system battered during the COVID-19-induced recession, the U.S. Congress passed four major relief bills in 2020 and 2021. The Biden administration also made a number of administrative changes, including some aimed at helping people enroll in health insurance coverage. After a year of severe job market disruption combined with a massive federal pandemic relief effort, what is the state of health care coverage and affordability in the United States? To answer these and related questions, the survey research firm SSRS interviewed a random, nationally representative sample of 5,450 adults ages 19 to 64 from March 9 through June 8, 2021. This brief reports on the survey’s findings about current uninsured rates, pandemic-related coverage loss, and Americans’ ongoing struggles to pay their medical bills. Highlights. About 10 percent of adults ages 19 to 64 were uninsured during the first half of 2021. Rates were higher among Latinx/Hispanic and Black adults compared to white adults. Six percent of working-age adults reported they lost their employer health coverage because of job loss related to the pandemic; of those, 67 percent gained other coverage. Just under half of respondents reported they had been directly affected by the pandemic in at least one of three ways: getting COVID-19, losing income, or losing employer coverage. One-third reported lost income. More than one-third of insured adults and half of uninsured adults reported they had problems paying medical bills or were paying off medical debt during the prior year. These rates were similar to those found in Commonwealth Fund surveys fielded prior to the pandemic. People directly affected by the pandemic reported having medical bill and debt problems at higher rates than those not directly affected. Among respondents with medical bill and debt problems, 35 percent used up all or most of their savings, 35 percent took on credit card debt, 27 percent had been unable to pay for basic necessities like food or rent, and 23 percent delayed education or career plans. Quick Facts About the Survey. Included 5,450 adults ages 19 to 64. Interviews were obtained through two sources: 1) a stratified address-based sample (ABS) of the population that oversampled harder-to-reach populations (i.e., low-income, Black, and Latinx/Hispanic adults), and 2) the SSRS probability-based Opinion Panel, which targeted groups with disproportionate nonresponse from the ABS sample and harder-to-reach populations. Most interviews were completed online. The survey has an overall margin of error of +/– 1.8 percentage points. Results were weighted to be representative of the U.S. adult (19–64) population. Survey Findings. The survey indicates that the uninsured rate among people ages 19–64 in the first half of 2021 was 9.9 percent, a rate below those recorded in 2020 and 2019 in both federal and private surveys. Because the estimate has a margin of error of +/– 1.15 percent, the true estimate is likely between 8.9 percent and 11.1 percent.1 Uninsured rates were highest among people with low income, adults under age 50, and Latinx/Hispanic adults. Latinx/Hispanic and Black adults had higher uninsured rates than white adults. See the box below for insights on why the U.S. adult uninsured rate may be falling. Is the Percentage of Uninsured Americans Falling? This survey revealed an uninsured rate among people ages 19–64 below the most recent estimates found in surveys fielded annually by the U.S. Centers for Disease Control and Prevention and the U.S. Census Bureau, as well as by private surveys conducted in 2020, including the Commonwealth Fund’s Biennial Health Insurance Survey (see How We Conducted This Survey for survey comparisons). Well-designed smaller surveys can achieve similar accuracy of large benchmark surveys, but confidence in point estimates like the uninsured rate is lower. Given the lag in federal surveys, these smaller surveys contribute to our understanding of current phenomena. The directional change in the uninsured rate revealed by this survey is also evident in the weekly Household Pulse Survey, an experimental online survey of about 60,000 people that the Census Bureau launched in April 2020 to provide rapid data on the pandemic.2 In the most recent Household Pulse Survey, the estimated uninsured rate was 11.4 percent for adults ages 18 to 64, with a range of 10.7 percent to 12.2 percent. While that survey’s findings vary from week to week and must be viewed in the context of the survey's limitations, the overall trend in the percentage of uninsured for 2021 is below that for 2020. There are at least four reasons why the uninsured rate may be falling: Limited pandemic-related coverage losses. The pandemic-related coverage losses were relatively small, as this survey confirms, and the majority of people who lost coverage ultimately gained other coverage. Federal restrictions on Medicaid disenrollment during the pandemic. The Families First Coronavirus Response Act, passed by Congress in March 2020, prevented states that accepted the law's temporary increase in federal Medicaid funding from disenrolling people from the program through the end of the public health emergency.3 This requirement reduced the usual number of people who leave Medicaid either because they have lost eligibility or failed to reenroll.4 Marketplace special enrollment periods. Most states that run their own Affordable Care Act marketplaces opened a special enrollment period last year for any eligible person needing coverage.5 The Biden administration did the same for HealthCare.gov, the federal exchange, in January 2021, extending the period through August; all state marketplaces followed with variable time periods. The administration also reinstated deep Trump administration cuts in marketplace advertising and enrollment assistance, and it has mounted a nationwide effort to get people enrolled. Increased marketplace subsidies and COBRA premium support. The American Rescue Plan, signed into law in March 2021, included a temporary but substantial increase in marketplace premium subsidies. Zero-premium plans are available for people with the lowest incomes, and, for the first time, people with incomes above 400 percent of the federal poverty level can get subsidized coverage. Beginning in April 2021, people who experienced pandemic-related coverage loss were eligible for 100 percent premium subsidies for COBRA coverage. The consequences of these changes are apparent in recent marketplace and Medicaid enrollment data. Combined, marketplace enrollment by people who paid their premiums in 2021 together with sign-ups during the special enrollment period are estimated at 12.4 million as of June, nearly 2 million more than a year earlier.6 Adult Medicaid enrollment climbed by 6.3 million people between February 2020 and January 2021.7 The COVID-19 pandemic triggered a deep economic recession that left millions of people unemployed and raised concerns that millions would also lose their job-based health coverage. But early Commonwealth Fund survey research and estimates based on federal data and unemployment claims suggested that coverage losses were relatively small.8 In this survey, we checked in with respondents again, finding that about 6 percent of working-age adults lost job-based coverage — whether through their own or that of a spouse, partner, or parent — since the pandemic began. Of these individuals, 67 percent gained coverage elsewhere. One of five who lost coverage got insured through another employer plan and the same percentage elected COBRA. The Affordable Care Act’s coverage expansions also acted as an insurance safety net: 16 percent of people who lost coverage enrolled in Medicaid and 9 percent purchased a plan through the marketplaces. Gaps in health insurance can leave people exposed to high medical bills and prevent them from getting health care when needed. That’s why people need an easy way to transition to a new source of coverage during a major life event or an economic shock. Last year we saw just how important it is to have this flexibility. The survey asked respondents who had lost job-based coverage and did not get COBRA how long they were without insurance. More than half (54%) experienced a brief coverage gap of three or fewer months. But about 30 percent didn’t gain insurance until after four to 11 months, and 16 percent were uninsured for longer than a year. Even short gaps in coverage can leave people exposed to catastrophic health care costs, whether from COVID-19 or some other serious medical event. The economic shutdown had a more devastating impact on certain sectors of the economy compared to others. The service industry, including restaurants and travel-related businesses, was particularly hard hit.9 Black, Latinx/Hispanic, and lower-income adults disproportionately work in such jobs. These groups were more likely to report having lost income than white or higher-income adults. Given the economic and health crises of the past year, the survey asked Americans a series of questions about their medical bills during that time — a key measure of health care affordability the Commonwealth Fund has tracked in previous surveys.10 We find that the share of Americans who had difficulties with medical bills in 2021 is similar to the rates reported in Commonwealth Fund surveys conducted in 2018 and the first half of 2020.11 More than a third (38%) of adults reported that over the prior 12 months they or a family member had problems paying medical bills, had been contacted by a collection agency about unpaid bills, had to change their way of life to pay their bills, or were paying off medical bills and debt over time. Although uninsured people reported medical bill problems at the highest rates, 64 percent of respondents with a medical bill or debt problem said they or the family member who incurred the bill had been insured at the time (data not shown). A third of those with debt said they were paying off $4,000 or more (data not shown). In asking people about their experiences during the pandemic, just under half reported they had been directly affected in at least one of three ways: testing positive or getting sick from COVID-19 losing income losing employer coverage. The most frequently cited problem was lost income. Some people experienced more than one problem: for example, 23 percent reported only losing income, 5 percent reported losing income and getting COVID-19, 4 percent lost income and their employer coverage, and 1 percent had all three problems (data not shown). Black and Latinx/Hispanic adults and those with lower incomes reported at least one of these effects at higher rates than white adults and those with higher incomes (data not shown). We did not specifically ask people who reported any one of these pandemic effects whether they had medical bill or debt problems as a result. But the survey indicates that this group of people also reported higher rates of problems with medical bills and debt than people not affected by the pandemic in these ways. Stratification by income and race/ethnicity suggests medical bill problems were more common among those affected (data not shown). People who lost income reported medical bill problems at the highest rates, especially those who also tested positive or became sick with COVID-19 or lost coverage. People covered by either public or private insurance at the time of the survey reported problems with medical bills or debt (some may not have had coverage for the full year). For people with low income who are enrolled in Medicare or Medicaid, even small bills related to premiums, deductibles, coinsurance and copayments, or uncovered health services can place a strain on limited budgets. Especially at risk are nonelderly adults who are enrolled in Medicare because of a disability or severe illness — a group that includes some of the sickest and poorest people under age 65. And while federal Medicaid rules cap the amount of money that enrollees can spend on premiums and out-of-pocket costs, there is much variability by state.12 Private insurance, both individual-market and employer group plans, often feature significant cost-sharing. Plans requiring deductibles have become more common, and the size of deductibles has grown as well, leaving increasing numbers of privately insured people exposed to potentially high costs.13 In addition, consumers frequently face coverage denials, out-of-network surprise bills, billing mistakes, and confusing contract language regarding which services are covered or excluded. The ACA’s minimum benefit requirements and preexisting condition protections, along with cost-sharing subsidies and limits on out-of-pocket costs, have significantly improved the coverage offered by plans sold in the individual market. But the greatest protections are aimed at people with the lowest incomes and are far less extensive for people farther up the income scale. Even when stratifying by income level, medical bill problems were more common among Black adults compared to white adults (data not shown). For many Americans, medical bill problems and debt are undermining economic, food, and housing security and hindering educations and careers. Policy Implications. The survey findings provide a glimpse of insurance coverage in the United States during one of the most challenging economic periods in recent history. Its findings suggest that federal relief efforts to help people maintain their Medicaid coverage, combined with state and federal efforts to encourage people to enroll in the ACA marketplaces and in Medicaid, may have offset pandemic-related, job-based coverage losses. These public policies also may have helped lower the uninsured rate below prepandemic levels. But the findings also show that large shares of adults continue to suffer financially when they get health care, even if they are covered by Medicare, Medicaid, or private insurance. The people most affected are those with low income and those who are Black or Latinx/Hispanic. The findings on medical bill problems and their consequences — from ruined credit ratings to the inability to afford basic life necessities — are in line with past Commonwealth Fund surveys. People who suffered the most during the pandemic also suffered the most from medical bill problems. But the overall rates of problems reported in the survey for the past 12 months are similar to those reported by adults prior to the pandemic. This consistency suggests that cost burdens are a chronic aspect of U.S. health care that that may be exacerbated by economic and health crises, and ultimately undermine America’s overall economic well-being. The historic No Surprises Act, which is set to go into effect in January 2022, will protect most consumers from surprise medical bills from out-of-network providers and some emergency transportation providers.14 What additional policies are needed to protect consumers? Insure more people: Make the temporary American Rescue Plan marketplace subsidies permanent to potentially reduce the number of uninsured by 4.2 million in 2022.15 Provide Medicaid-eligible adults in the 13 states that have not yet expanded their program a federal insurance option to cover an estimated 2.3 million uninsured people.16 Ensure that the millions of people who maintained their Medicaid coverage under the Families First Coronavirus Response Act don’t lose it at the end of the COVID-19 emergency. Federal and state policymakers also could consider adjustments to stabilize Medicaid coverage.17 Develop an autoenrollment mechanism to help people enroll and stay enrolled in comprehensive coverage. Creating a public plan as a default option would be essential to a national autoenrollment program.18 Make health insurance more comprehensive: Rein in deductibles and out-of-pocket costs in marketplace plans. A bill introduced by Senator Jeanne Shaheen (D–N.H.) could eliminate deductibles for some people and reduce it for others by as much as $1,650.19 Combined with the reduction in deductibles and out-of-pocket costs, fix the “family coverage glitch” and lower the “employer firewall” threshold to make this better coverage available to more people currently in employer plans. Under current law, people in single-coverage employer plans with premiums that exceed 9.8 percent of income are eligible for subsidies through the marketplaces. Lowering this “firewall” affordability threshold for employer plans to 8.5 percent (the American Rescue Plan’s out-of-pocket premium cap) and fixing the coverage glitch to make this threshold apply to premiums in both single and family policies would mean that no one would have to spend more than that for their health insurance.20 Standardize and simplify health plans sold in the marketplaces to make it easier for consumers to understand which health services are covered. Investigate the increasing reports of coverage denials in the individual market and improve the ability of consumers with public or private insurance to contest these denials.21 Lower the often-high prices that private insurers pay to hospitals to help reduce premiums and deductibles. This could be pursued by adding a public plan option to the marketplaces, among other approaches.22 The U.S. Supreme Court’s recent decision reaffirming the constitutionality of the Affordable Care Act paves the way for Congress to use the tools provided by the health law to not only cover the remaining uninsured but to finally make health care in the U.S. affordable to all. Doing so will be essential to the country’s postpandemic recovery and its future prosperity. How We Conducted This Survey. The Commonwealth Fund Health Care Coverage and COVID-19 Survey was conducted by SSRS from March 9 through June 8, 2021. The survey was conducted primarily via web with telephone offered as a call-in option among a nationally representative sample of 5,450 adults ages 19 to 64. Nearly all the interviews were completed via an online survey (n=5,384), with a small percentage conducted via phone call-ins (n=66). Interviews were obtained through two sources: 1) a stratified address-based sample (ABS) of the population, and 2) the SSRS Opinion Panel. More than half (n=3,464) of the completed interviews were obtained through ABS; 1,986 were obtained through the SSRS Opinion Panel. The ABS sample was generated from the United States Postal Service (USPS) Computerized Delivery Sequence File (CDSF). The CDSF is a computerized file that contains information on all delivery addresses serviced by the USPS. The frame was divided into 32 strata defined by Census region, incidence of low-income households, incidence of Black residents, and incidence of Latinx/Hispanic residents. Independent random samples were drawn from each stratum. By oversampling strata that have higher incidences of the target groups relative to other strata, their representation was increased in the sample while maintaining a probability sample design. Invitation letters were mailed in three releases to a total of 74,400 households, inviting a member of the household to participate in the survey, followed shortly by a reminder postcard. This letter provided potential respondents with a link (URL), an individual passcode to log on to the study, a QR code for easy scannable entry into the survey, and a toll-free number for respondents to call in to complete the survey with a trained interviewer. Panelists in the SSRS Opinion Panel are recruited randomly based on nationally representative ABS design. The SSRS Opinion Panel recruits hard-to-reach demographic groups via the SSRS Omnibus survey platform. The SSRS Omnibus is a nationally representative bilingual telephone survey. For the Commonwealth Fund Health Care Coverage and COVID-19 Survey, the SSRS Opinion Panel was used to target groups with disproportionate nonresponse from the ABS completes and harder-to-reach populations. It also was used to obtain gender balance in the final sample of completed interviews. Both samples were weighted to compensate for sample designs and patterns of nonresponse that might bias results. The weighting ensures that the demographic profile of the sample matches the profile of the target population. The margin of error for the entire sample is +/ – 1.8 percentage points. The response rate for the ABS portion of the survey was 6.1 percent. The completion rate for the SSRS Opinion Panel was 46.8 percent and the composite response rate, which includes the response rate for the Opinion panel recruitment, was 1 percent. Estimates of U.S. Uninsured Rates. Current uninsured rate Population Time frame Sample design Commonwealth Fund Health Care Coverage and COVID-19 Survey23 9.9%[8.9%, 11.1%] U.S. adults ages 19–64 March–June 2021 Address-based sample and SSRS multimode panel24 Household Pulse Survey (June 2021)25 11.4%[10.7%, 12.2%] U.S. adults ages 18–64 June 9–June 21, 2021 U.S. Census Bureau Master Address File (MAF) sample26 National Health Interview Survey (NHIS) (Jan.–June 2020)27 13.4%[12.3%, 14.6%] U.S. adults ages 18–64 January–June 2020 Crosssectional household interview survey28 Commonwealth Fund Biennial Health Insurance Survey (Jan.–June 2020)29 12.5%[11.2%, 13.9%] U.S. adults ages 19–64 January–June 2020 Dual-frame, RDD telephone survey Urban Institute Coronavirus Tracking Survey (May 2020)30 11.3% U.S. adults ages 18–64 May 2020 Ipsos probability-based panel31 Current Population Survey (CPS) (2019)32 11.1%[10.8%, 11.4%] U.S. adults ages 19–64 January–December 2019 Probability-selected sample; personal and telephone interviews33 Acknowledgments. The authors thank Robyn Rapoport, Erin Czyzewicz, Rob Manley, and Kiersten Millward of SSRS; and David Blumenthal, Eric Schneider, Melinda Abrams, Chris Hollander, Jen Wilson, Paul Frame, Jesse Baumgartner, and Arnav Shah, all of the Commonwealth Fund. NOTES. 1. The Commonwealth Fund Health Care Coverage and COVID-19 Survey has a maximum margin of sampling error of +/– 1.8 percentage points at the 95 percent confidence interval. As estimates get further from 50 percent in either direction, the margin of sampling error decreases. This is why the estimated uninsured rate has a smaller margin of sampling error. 2. National Center for Health Statistics and U.S. Census Bureau, “Health Insurance Coverage: Household Pulse Survey,” last reviewed June 30, 2021. 3. Sarah Sugar et al., Medicaid Churning and Continuity of Care: Evidence and Policy Considerations Before and After the COVID-19 Pandemic (Assistant Secretary for Planning and Evaluation, Office of Health Policy, Apr. 2021); and Sara Rosenbaum, Morgan Handley, and Rebecca Morris, Winding Down Continuous Enrollment for Medicaid Beneficiaries When the Public Health Emergency Ends (Commonwealth Fund, Jan. 2021). 4. Sugar et al., Medicaid Churning, 2021. 5. Madeline O’Brien and Sabrina Corlette, “State Action Related to COVID-19 Relief: Expanding Access to Affordable Coverage Options,” Commonwealth Fund, last updated June 28, 2021. 6. Centers for Medicare and Medicaid Services, “2021 Marketplace Special Enrollment Period Report,” fact sheet, July 14, 2021; Centers for Medicare and Medicaid Services, “Effectuated Enrollment: Early 2021 Snapshot and Full Year 2020 Average,” June 5, 2021; Andrew Sprung, “Obamacare Mid-Year Enrollment Is Likely Up 19% over Past Peak,” XPOSTFACTOID (blog), June 10, 2021; and Charles Gaba, “Breaking: CMS Announces Over 1.24 Million Have Enrolled Via HC.Gov SEP So Far; #GetCovered Thru 8/15,” ACASignups.net (blog), June 14, 2021. 7. Centers for Medicare and Medicaid Services, December 2020 and January 2021 Medicaid and CHIP Enrollment Trends Snapshot (CMS, June 2021). 8. Sara R. Collins et al., An Early Look at the Potential Implications of the COVID-19 Pandemic for Health Insurance Coverage — Commonwealth Fund Health Care Poll: COVID-19, May–June 2020 (Commonwealth Fund, June 2020); Paul Fronstin and Stephen A. Woodbury, How Many Americans Have Lost Jobs with Employer Health Coverage During the Pandemic? (Commonwealth Fund, Oct. 2020); Paul Fronstin and Stephen A. Woodbury, “Update: How Many Americans Have Lost Jobs with Employer Health Coverage During the Pandemic?,” To the Point (blog), Commonwealth Fund, Jan. 11, 2021; and Jessica Banthin et al., Changes in Health Insurance Coverage Due to the COVID-19 Recession: Preliminary Estimates Using Microsimulation (Urban Institute, July 2020). 9. Fronstin and Woodbury, How Many Americans?, 2020. 10. Sara R. Collins, Munira Z. Gunja, and Gabriella N. Aboulafia, U.S. Health Insurance Coverage in 2020: A Looming Crisis in Affordability — Findings from the Commonwealth Fund Biennial Health Insurance Survey, 2020 (Commonwealth Fund, Aug. 2020). 11. Collins et al., U.S. Health Insurance Coverage, 2020; and Sara R. Collins, Herman K. Bhupal, and Michelle M. Doty, Health Insurance Coverage Eight Years After the ACA: Fewer Uninsured Americans and Shorter Coverage Gaps, But More Underinsured (Commonwealth Fund, Feb. 2019). 12. Sophie Beutel, Munira Z. Gunja, and Sara R. Collins, How Much Financial Protection Do Marketplace Plans Provide in States Not Expanding Medicaid? (Commonwealth Fund, June 2016). 13. Collins et al., U.S. Health Insurance Coverage, 2020; Sara R. Collins, David C. Radley, and Jesse C. Baumgartner, State Trends in Employer Premiums and Deductibles, 2010–2019 (Commonwealth Fund, Nov. 2020); and Sherry A. Glied and Benjamin Zhu, Catastrophic Out-of-Pocket Health Care Costs: A Problem Mainly for Middle-Income Americans with Employer Coverage (Commonwealth Fund, Apr. 2020). 14. Jack Hoadley and Kevin Lucia, “Putting Surprise Billing Protections into Practice: Biden Administration Releases First Set of Regulations,” To the Point (blog), Commonwealth Fund, July 14, 2021. 15. The White House, “Fact Sheet: The American Families Plan,” Apr. 28, 2021; and Jessica Banthin et al., What if the American Rescue Plan’s Enhanced Marketplace Subsidies Were Made Permanent? Estimates for 2022 (Urban Institute, Apr. 2021). 16. D. Keith Branham, Christie Peters, and Benjamin D. Sommers, Estimates of Uninsured Adults Newly Eligible for Medicaid If Remaining Non-Expansion States Expand (Assistant Secretary for Planning and Evaluation, Office of Health Policy, May 2021); Sherry A. Glied and Richard G. Frank, “Extend Marketplace Coverage to Insure More People in States That Have Not Expanded Medicaid,” To the Point (blog), Commonwealth Fund, June 10, 2021; John Holahan et al., Filling the Gap in States That Have Not Expanded Medicaid Eligibility (Commonwealth Fund, June 2021); Sara Rosenbaum, Morgan Handley, and Rebecca Morris, “How the Experience of Insuring Legal Immigrants Can Offer Insights into Insuring Eligible Residents in Medicaid Nonexpansion States,” To the Point (blog), Commonwealth Fund, June 3, 2021; and Sara Rosenbaum, “Confronting the Consequences of National Federation of Independent Business v Sebelius to Insure the Poor,” Milbank Quarterly Opinion, Apr. 13, 2021. 17. Sugar et al., Medicaid Churning, 2021. 18. Linda J. Blumberg, John Holahan, and Jason Levitis, How Auto-Enrollment Can Achieve Near-Universal Coverage: Policy and Implementation Issues (Commonwealth Fund, June 2021). 19. Improving Health Insurance Affordability Act of 2021, S. 499, 117th Cong. (2021); and Linda J. Blumberg et al., From Incremental to Comprehensive Health Insurance Reform: How Various Reform Options Compare on Coverage and Costs (Urban Institute, Oct. 2019). 20. Timothy S. Jost, “Eliminating the Family Glitch,” To the Point (blog), Commonwealth Fund, May 18, 2021; and Matthew Buettgens and Jessica Banthin, Changing the “Family Glitch” Would Make Health Coverage More Affordable for Many Families (Urban Institute, May 2021). 21. Karen Pollitz and Daniel McDermott, Claims Denials and Appeals in ACA Marketplace Plans (Henry J. Kaiser Family Foundation, Jan. 2021). 22. Linda J. Blumberg et al., Comparing Health Insurance Reform Options: From “Building on the ACA” to Single Payer (Commonwealth Fund, Oct. 2019); John Holahan, Michael Simpson, and Linda J. Blumberg, What Are the Effects of Alternative Public Option Proposals (Urban Institute, Mar. 2021); and Sherry A. Glied and Jeanne M. Lambrew, “How Democratic Candidates for the Presidency in 2020 Could Choose Among Public Health Insurance Plans,” Health Affairs 37, no. 12 (Dec. 2018): 2084–91. 23. Commonwealth Fund Health Care Coverage and COVID-19 Survey, March–June 2021. 24. SSRS, “SSRS Opinion Panel,” n.d. 25. NCHS and Census, “Household Pulse Survey,” 2021. 26. U.S. Census Bureau, “Source of the Data and Accuracy of the Estimates for the Household Pulse Survey – Phase 3.1,” n.d. 27. Robin A. Cohen et al., Health Insurance Coverage: Early Release of Estimates from the National Health Interview Survey, Jan-June 2020 (National Center for Health Statistics, Feb. 2021). 28. National Center for Health Statistics, “About the National Health Interview Survey,” last reviewed Sept. 16, 2020. 29. Collins et al., U.S. Health Insurance Coverage, 2020. 30. Michael Karpman, Stephen Zuckerman, and Graeme Peterson, Adults in Families Losing Jobs During the Pandemic Also Lost Employer-Sponsored Health Insurance (Urban Institute, July 2020). 31. Urban Institute, “Health Reform Monitoring Survey: HRMS Frequently Asked Questions,” n.d. 32. Katherine Keisler-Starkey and Lisa N. Bunch, Health Insurance Coverage in the United States: 2019 (U.S. Census Bureau, Sept. 2020). 33. U.S. Census Bureau, “CPS Methodology,” n.d. Publication Details Date July 16, 2021 Contact Sara R. Collins, Vice President, Health Care Coverage and Access, The Commonwealth Fund [email protected] Citation Sara R. Collins, Gabriella N. Aboulafia, and Munira Z. Gunja, As the Pandemic Eases, What Is the State of Health Care Coverage and Affordability in the U.S.? Findings from the Commonwealth Fund Health Care Coverage and COVID-19 Survey, March–June 2021 (Commonwealth Fund, July 2021). https://doi.org/10.26099/6w2d-7161 Area of Focus Achieving Universal Coverage Topics COVID-19, Access to Care, Medical Bills and Debt, Health Disparities Related Content. Achieving Universal Coverage Unpacking Colorado’s New Guidance on Transgender Health . blog / Nov 10, 2021 Achieving Universal Coverage During the ACA’s Open Enrollment Period, Consumers Will Get Lower Premiums, More Time, and More Help . blog / Nov 01, 2021 Achieving Universal Coverage What Is Your State Doing to Affect Access to Adequate Health Insurance? . Maps and Interactives / Oct 25, 2021
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TitleHere are ways to get health insurance if lost your job during pandemic
Urlhttps://www.cnbc.com/2020/10/16/here-are-ways-to-get-health-insurance-if-lost-your-job-during-pandemic.html
DescriptionUp to 15 million people lost employer-sponsored health insurance due to unemployment in recent months. But there are options available to keep from being uninsured during the health crisis
DateOct 16, 2020
Organic Position14
H1Here’s what you need to know about getting health insurance if you lost a job during the pandemic
H2Size of the problem
Medicaid
Insurance via spouse or parent
ACA marketplaces
ACA subsidies
COBRA
Short-term plans
CHIP
H3
H2WithAnchorsSize of the problem
Medicaid
Insurance via spouse or parent
ACA marketplaces
ACA subsidies
COBRA
Short-term plans
CHIP
BodyHere’s what you need to know about getting health insurance if you lost a job during the pandemicPublished Fri, Oct 16 20208:30 AM EDTGreg [email protected] LIVEKey PointsEmployer-sponsored health insurance is the most common form of health coverage for Americans.Up to roughly 15 million people lost coverage via employer-sponsored insurance during the Covid-19 pandemic.Such workers can consider Medicaid, an Affordable Care Act plan, coverage via a spouse or parent, COBRA, short-term health plans and CHIP to get insurance.People wait in their cars as they line up to collect unemployment forms in Hialeah, Florida.CHANDAN KHANNA/AFP via Getty ImagesMillions of workers have lost their jobs — and their employer-sponsored health insurance — due to the coronavirus pandemic.But other options are available to those who lose health coverage. These include Medicaid, an Affordable Care Act marketplace plan, job-based coverage from a spouse or parent, short-term health plans and coverage under the Consolidated Omnibus Budget Reconciliation Act, known as COBRA. Uninsured kids may also get coverage through the Children's Health Insurance Program, or CHIP.Below, is an outline of each option and costs in more detail.Size of the problem. But first, how big is the problem?Employer-sponsored coverage is the most common form of health insurance for Americans.Around 175 million workers and their dependents had coverage last year, according to a recent study published by researchers at the Employee Benefit Research Institute and W.E. Upjohn Institute for Employment Research.In the spring, unemployment ballooned to levels unseen since the Great Depression.More from Personal Finance:Mortgage refinancing options, even for those with bad creditHouse proposes emergency 3% Social Security COLASupreme Court may gut the Affordable Care Act. What's next?That caused up to about 15 million people (nearly 8 million workers and 7 million dependents) to lose coverage through employer-sponsored health insurance as of June 2020, according to the joint EBRI-Upjohn report.Many of these workers may have kept their insurance in the event of a temporary layoff, or furlough, researchers said. And others were likely able to find insurance elsewhere.Roughly a third of those who lose employer coverage due to the pandemic this year will become uninsured, the Urban Institute estimated.Medicaid. A rally against Medicaid cuts in front of the U.S. Capitol on June 6, 2017.Bill Clark | CQ-Roll Call, Inc. | Getty ImagesWorkers should first consider Medicaid in the event of job loss, according to Karen Pollitz, a senior fellow at the Henry J. Kaiser Family Foundation.Medicaid — public health insurance — will likely be the most comprehensive and affordable insurance option, generally with low (or no) premiums and deductibles for care, Pollitz said.Workers can also enroll year-round and don't have to wait for an open-enrollment period."Medicaid is a safety net for people when they have low income," Pollitz said. "You just have to be having a hard couple of months [to qualify for coverage]."The Affordable Care Act, or ACA, made it easier to qualify for Medicaid in many states.Medicaid is a safety net for people when they have low income.Karen Pollitzsenior fellow at the Henry J. Kaiser Family FoundationMore than 60% of people who lose job-based coverage during the pandemic may be eligible, the Kaiser Family Foundation estimates.In states that expanded Medicaid under the ACA, individuals with income below 138% of the federal poverty level can generally qualify. (That equates to roughly $1,500 a month for single people.)It's more difficult to qualify in the dozen or so states that didn't expand Medicaid, Pollitz said.Medicaid only considers current income, rather than income earned earlier in the year. That makes it more likely that newly unemployed workers can qualify based on their current financial situation.There also isn't an asset test that disqualifies those with retirement savings, for example.Insurance via spouse or parent. Around a third of workers who lose a job during the pandemic will get insured through a family member, according to an estimate from the Urban Institute.Children can remain on a parent's health plan up to age 26 per the ACA. More than 2 million have coverage through this provision.ACA marketplaces. Workers who lose employer-sponsored coverage can also buy private insurance via marketplaces offering plans through the ACA — also known as Obamacare — at Healthcare.gov.These are comprehensive health plans that cover doctor and hospital visits, prescriptions and maternity care, for example.Nearly 11 million Americans had coverage through these exchanges as of March, according to the Department of Health and Human Services.KAREN BLEIER | AFP | Getty ImagesThere are four tiers of health plans (bronze, silver, gold and platinum) available through these exchanges. Tiers offer different levels of premium and out-of-pocket costs.For example, a bronze-level plan carries a $6,500 annual deductible before an insurer starts paying for care, according to Kaiser. Those deductibles are around $4,500 for a silver plan, $1,500 (gold) and $28 (platinum).(This analysis is for the average person in 2020 who has a health plan with combined medical and prescription drug deductibles.)As a trade-off, plans with higher out-of-pocket costs for care generally carry lower monthly premiums.ACA subsidies. The ACA extends cost-sharing subsidies and premium tax credits to help make insurance and care more affordable for consumers.Tax credits to help lower monthly premiums are available to consumers with annual income between 100% and 400% of the federal poverty level, which is $12,760 for singles and $26,200 for a family of four this year.Marketplace plans had a $576 monthly premium, on average, in February, according to the Department of Health and Human Services.However, the average person got a $492 tax credit — resulting in a net premium of $84 a month.VIDEO3:3003:30Suze Orman shares how ignoring little things cost her bigInvest in You: Ready. Set. Grow.More than 9 million people, or 86% of people who bought a marketplace health plan, got a premium tax credit, according to HHS.Consumers can also reduce out-of-pocket costs for care via subsidies, available to those with annual income between 100% and 250% of the federal poverty level. These subsidies are only available for silver-tier plans.A single person at the poverty line would see their annual deductible fall to about $210, on average, from $4,500, courtesy of those subsidies, according to Kaiser.Unlike with Medicaid, eligibility for premium tax credits and cost-reduction subsidies is based on the entire year's income.The ACA open enrollment period for next year starts Nov. 1 and ends Dec. 15.COBRA. COBRA allows workers to continue with the same insurance plan they had through their employer, generally for up to 18 months.  "It's expensive, and particularly expensive for someone losing a job," said John Graves, an associate professor of health policy at Vanderbilt University.That's because employers would no longer subsidize the cost.Single workers paid $1,243 a year for employer-sponsored health insurance in 2020, according to Kaiser. Employers paid the rest of the $7,470 total premium. (For family coverage, workers paid $5,588 of a $21,342 annual premium.)Unemployed workers would be on the hook for 102% of the entire annual premium through COBRA.It may make sense to continue the coverage if workers can afford to, Graves said.Any out-of-pocket expenses applied toward an annual deductible would remain, and in-network providers would be the same, for example.Short-term plans. Short-term limited-duration plans pre-date the ACA and are generally only meant to cover catastrophic coverage (hospitalization, for example) for a few months at a time, Graves said.They generally come with skimpier benefits than ACA plans, and those with pre-existing conditions may not qualify, he said. Insurers might not cover costs associated with Covid-19, depending on the policy, he said.But the monthly premiums are generally low."If you're healthy and need coverage for a month, couldn't afford it if you got in a huge car accident, but you could put off primary-care visits for month or two, it is an option, and a cheap option for people," Graves said.CHIP. Most children who lose insurance due to a parent's unemployment will be eligible for CHIP, according to Kaiser.The program offers health coverage to uninsured children (under 19 years old) in families with incomes too high to qualify for Medicaid.Income eligibility varies by state, but can range up to around 400% of the federal poverty level.TVWATCH LIVEWATCH IN THE APPUP NEXT | ETListenTVWATCH LIVEWATCH IN THE APPUP NEXT | ETListen
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TitleMillions Have Lost Health Insurance in Pandemic-Driven Recession - The New York Times
Urlhttps://www.nytimes.com/2020/07/13/us/politics/coronavirus-health-insurance-trump.html
DescriptionA new study estimates that more than five million American workers lost their insurance this spring, a number higher than those in any full year of insurance losses
DateJul 14, 2020
Organic Position15
H1Millions Have Lost Health Insurance in Pandemic-Driven Recession
H2
H3
H2WithAnchors
BodyMillions Have Lost Health Insurance in Pandemic-Driven RecessionA new study estimates that more than five million American workers lost their insurance this spring, a number higher than those in any full year of insurance losses.Read in appSend any friend a storyAs a subscriber, you have 10 gift articles to give each month. Anyone can read what you share.Give this articleShareRead in appMedics bringing a patient to Houston Methodist Hospital last month.Credit...Erin Schaff/The New York TimesBy Sheryl Gay StolbergPublished July 13, 2020Updated Nov. 1, 2021WASHINGTON — The coronavirus pandemic stripped an estimated 5.4 million American workers of their health insurance between February and May, a stretch in which more adults became uninsured because of job losses than have ever lost coverage in a single year, according to a new analysis.The study, to be announced Tuesday by the nonpartisan consumer advocacy group Families USA, found that the estimated increase in uninsured workers from February to May was nearly 40 percent higher than the highest previous increase, which occurred during the recession of 2008 and 2009, when 3.9 million adults lost insurance.“We knew these numbers would be big,” said Stan Dorn, who directs the group’s National Center for Coverage Innovation and wrote the study. “This is the worst economic downturn since World War II. It dwarfs the Great Recession. So it’s not surprising that we would also see the worst increase in the uninsured.”Families USA is one of a number of groups trying to estimate the number of people who have lost insurance during the pandemic; definitive data will not become available until mid- to late 2021, when the federal government publishes health insurance estimates for 2020. The analyses vary, but all reach the same grim conclusion: More people lack insurance than ever before.The nonpartisan Kaiser Family Foundation has estimated that 27 million Americans have lost coverage in the pandemic; that study took into account family members of the insured. Another analysis, published Monday by the Urban Institute and the Robert Wood Johnson Foundation, projected that by the end of 2020, 10.1 million people will no longer have employer-sponsored health insurance or coverage that was tied to a job they lost because of the pandemic.And those losing coverage could face staggering costs if they are struck by Covid-19, which has sent the seriously ill to hospital intensive care units for weeks, sometimes months.The studies come in the thick of the campaign season, when health care — and in particular the future of the Affordable Care Act, popularly known as Obamacare — will be a major issue. Democrats and their presumptive presidential nominee, Joseph R. Biden Jr., want to expand the law. President Trump has asked the Supreme Court to overturn it.Four of every five people who have lost employer-provided health insurance during the coronavirus pandemic are eligible for free coverage through expanded Medicaid programs or government-subsidized private insurance through the Obama-era health law, according to the Kaiser Family Foundation.But experts say that insuring the recently unemployed is a difficult challenge. Many people cannot afford premiums for coverage through either the health care law or the program known as COBRA, for the Consolidated Omnibus Budget Reconciliation Act. Others might not know they are eligible for Medicaid.The White House and Congress have done little to help. The Trump administration has imposed sharp cuts on the funding for outreach programs that assist people in signing up for coverage under the health law. And while House Democrats have passed legislation intended to help people to keep their health insurance, the bill is stuck in the Republican-controlled Senate.Rather than expand access to subsidized insurance under the Affordable Care Act, Mr. Trump has promised to directly reimburse hospitals for the care of coronavirus patients who have lost their insurance. But there is little evidence that has begun.“Helping people keep their insurance through a public health crisis surprisingly has not gotten much attention,” said Larry Levitt, executive vice president for health policy at the Kaiser Family Foundation. “This is the first recession in which the A.C.A. is there as a safety net, but it’s an imperfect safety net.”The Families USA study is a state-by-state examination of the effects of the pandemic on laid-off adults younger than 65, the age at which Americans become eligible for Medicare. It found that nearly half — 46 percent — of the coverage losses from the pandemic came in five states: California, Texas, Florida, New York and North Carolina.In Texas alone, the number of uninsured jumped from about 4.3 million to nearly 4.9 million; three out of every 10 Texans are uninsured, the research found. In the 37 states that expanded Medicaid under the Affordable Care Act, 23 percent of laid-off workers became uninsured; the percentage was nearly double that — 43 percent — in the 13 states that did not expand Medicaid, which include Texas, Florida and North Carolina.Five states have experienced increases in the number of uninsured adults that exceed 40 percent, the analysis found. In Massachusetts, the number nearly doubled, rising by 93 percent — a figure Mr. Dorn attributed to a large number of people losing employer-based coverage there. Across the country as a whole, more than one in seven adults — 16 percent — is now uninsured, the analysis found.To generate the estimates, Mr. Dorn examined the number of laid-off workers in each state and calculated how many had become uninsured based on coverage patterns since 2014, when the central provisions of the Affordable Care Act went into effect. The underlying data for those patterns comes from work published by the Urban Institute in April.Although analysts will have a clearer picture of the actual figures next year, Mr. Dorn said, “policymakers need to know now what the approximate magnitude is of insurance losses to decide what they need to do. So this is our best estimate for what the actual coverage losses have been.”Democrats and health care advocacy groups argue that the importance of insurance coverage extends beyond personal well-being because the uninsured tend to avoid going to the doctor, and that exposes others to an infectious disease outbreak like Covid-19.On Capitol Hill, Senator Patty Murray of Washington, the top Democrat on the Senate health committee, has been pressing the Trump administration to do a better job of promoting a provision in the Affordable Care Act that creates a special enrollment period for people who lose their jobs.Ms. Murray and other Democrats have also called for the federal government to provide financial assistance to help workers who are laid off maintain their coverage through COBRA, and to give states that have refused to expand Medicaid an incentive to do so, by increasing the federal share of the cost“Taking steps like these to help people get access to health care during a pandemic shouldn’t be controversial, it should be common sense,” Ms. Murray said in an email, “and we should be doing it right now instead of waiting for things to get even worse.”AdvertisementContinue reading the main story
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TitleState, Federal Actions Protected Health Coverage for Millions During Pandemic - California Health Care Foundation
Urlhttps://www.chcf.org/blog/state-federal-actions-protected-coverage-millions-pandemic/
DescriptionStories That Caught Our Attention: The percentage of Americans with health insurance remained stable during 2020 despite a hobbled economy
DateSep 27, 2021
Organic Position16
H1California Health Care Foundation
H2Stories that caught our attention
Different from Other Recessions
Record Number of Californians with Coverage
Temporary Changes Mean Challenges Remain
Recent Articles
H3Whole Person Care Pilots Set the Stage for CalAIM
CalAIM: Why It’s So Much More Than Another New Health Program
The Work of Family Caregiving: Invisible, Costly, and Taxing
Delivering Whole-Person Care, One Meal at a Time
Digital Startup Is Transforming Mental Health Care in Schools
H2WithAnchorsStories that caught our attention
Different from Other Recessions
Record Number of Californians with Coverage
Temporary Changes Mean Challenges Remain
Recent Articles
BodyCalifornia Health Care Foundation CHCF Blog State, Federal Actions Protected Health Coverage for Millions During Pandemic Stories that caught our attention. September 27, 2021 By Heather Tirado Gilligan In California, rising enrollment in plans offered through Covered California, the state health insurance marketplace, was an important factor in keeping the uninsured population from surging amid significant job losses. Photo: Covered California Deborah Kagan, a New Yorker with type 1 diabetes, lost her job during the pandemic. When a move took her to Florida, she wasn’t eligible to maintain her Medicaid coverage there. “Without my medication, I’m dead,” she told NPR reporter Selena Simmons-Duffin. A pandemic policy change — one of many made by federal and state governments — averted disaster for Kagan. Because she was on unemployment benefits, she found a lifeline thanks to the expansion of the Affordable Care Act (ACA) that was part of this year’s COVID relief legislation. She enrolled in an ACA silver plan that will cover most of her health costs for the rest of 2021. That scenario was repeated often last year, as jobs lost to COVID-19-related shutdowns might have had disastrous consequences for Americans’ health insurance. Nearly half of the US is insured through employer-sponsored health plans, and the unemployment rate in April 2020 ballooned to an unprecedented high of nearly 15%. In past economic downturns, large-scale job loss meant insurance loss for many. But in this recession, that didn’t happen. Instead, the percentage of Americans with health insurance remained stable during 2020. “It’s remarkable that, during a pandemic with massive job losses, the share of Americans uninsured did not go up. This is likely a testament to what is now a much more protective health insurance safety net,” Larry Levitt, executive vice president for health policy at KFF, told Kaiser Health News reporters Victoria Knight and Julie Appleby. This time, the enhanced ACA, heavy investment by the federal government, and an array of COVID-related federal and state policies helped Americans hold on to their coverage. Different from Other Recessions. During two recessions in the early 2000s, the number of Americans with insurance fell. But both of those downturns predated the ACA’s health insurance coverage expansions, which took effect in 2014. The ACA made coverage more available and affordable through insurance marketplaces and subsidies to help pay for their policies. The law also allowed states to substantially expand Medicaid, the government health insurance program for Americans with low incomes. All but about a dozen states have opted to use the ACA to expand eligibility for their Medicaid programs. A recent report from the Commonwealth Fund found that an important factor in keeping people insured was new federal restrictions, tied to additional temporary Medicaid funding, that kept states from disenrolling people from the program during the federal public health emergency of the pandemic. Usually, people leave the program either because they lost eligibility or failed to reenroll. Most states also held special enrollment periods for their ACA health insurance marketplaces to sign up any eligible person needing coverage. “The COVID-19 relief measures from early 2020 almost certainly played a huge role as well,” Jonathan Cohn wrote in HuffPost, “both by subsidizing businesses so they could keep workers on the payroll and by giving the unemployed extra money so that they could keep their old employer health policies [through COBRA].” In 2021, the Biden administration took additional steps to increase access to health insurance. Nearly three million Americans signed up for insurance during a special open enrollment period for Healthcare.gov, the federal ACA marketplace. Enrollments in the ACA marketplaces were likely bolstered by the substantial, but temporary, increase in ACA marketplace premium subsidies included in the American Rescue Plan passed in March. Also part of the American Rescue Plan, beginning in April 2021, people who experienced pandemic-related coverage loss because they lost their job or had hours reduced were also eligible for 100% premium subsidies for COBRA coverage. Record Number of Californians with Coverage. In 2020, more Californians had health insurance than ever before, according to recent data from the California Department of Managed Health Care and the California Department of Insurance. In an analysis of the data, commissioned by CHCF, Katherine Wilson noted that total health insurance enrollment in the pandemic year 2020 increased by more than one million despite significant job losses. The California Health Interview Survey (CHIS) found that 94% of Californians were insured in 2020, a record high for the state since CHIS researchers began asking state residents about health care coverage in 2001. While the gain of more than one million insured Californians in 2020 was driven mostly by growth in Medi-Cal enrollment, it also included increases in individual coverage and Medicare, Wilson found. Medi-Cal enrollment was higher because California paused disenrollments for the duration of the public health emergency, consistent with federal requirements. The number of insured people also remained high because, despite the economic upheaval of the pandemic, “enrollment declines among employer-sponsored insurance were smaller than job losses might have predicted,” Wilson reported. Many losing their job-based coverage turned to the state’s ACA marketplace, Covered California, which, through special enrollment periods linked to the pandemic, recession, and wildfires, kept sign-ups open throughout much of the year. In addition to these factors, in 2020 the state funded premium assistance that subsidized insurance policies for 45,000 middle-income enrollees and added to existing federal assistance for another 500,000 people, driving participation in Covered California. People who had lost job-based insurance also turned to Covered California. Overall, enrollment in Covered California increased by 19% in 2020, Wilson found. Temporary Changes Mean Challenges Remain. The  boost in federal subsidies available through the ACA marketplaces is temporary. California passed its own subsidies in last year’s budget, which the federal subsidies replaced only temporarily. A permanent increase in ACA subsidies is one of many health care components in the federal human infrastructure bill that Democrats want to pass, Cohn reported. Wilson notes that once the federal public health emergency officially ends, so will the federal prohibition on Medicaid disenrollments. California will then have to start reverifying Medi-Cal enrollees’ eligibility, which could result in many leaving the program. A large decline in Medicaid coverage at that point is a looming national problem that could disproportionately affect people of color. Manatt Health recently urged state and federal Medicaid leaders to start work now to streamline and improve their redetermination processes. Otherwise, there is considerable risk of many losing coverage — even those still eligible for the program after the emergency. (Recent qualitative research published by CHCF offers insights into how to improve enrollment and retention in Medi-Cal.) Other challenges remain, in California and nationwide. The Commonwealth Fund notes that insurance has not eliminated medical debt, for instance, including debt related to COVID. The same report highlighted continued national racial disparities in coverage. CHIS researchers noted that while California coverage rates were at an all-time high in 2020, too many Californians continue to have difficulty accessing care. While great progress has been made to expand coverage to undocumented Californians, many California adults between the ages of 26 and 50, including numerous frontline and essential workers, remain excluded from Medi-Cal and Covered California due to immigration status. Despite the work that remains, the state and federal policies enacted to help people get and keep coverage during the pandemic have made a huge difference for millions of Americans. To send questions or comments, tweet at me with #EssentialCoverage or email me. Related Tags: ACA, Affordability, CHCF Goal: Laying the Foundation, Coverage Trends, Covered California, COVID-19, Essential Coverage, Expanding Health Coverage, Health Care Journalism, Medi-Cal, State Health Policy, Uninsured Heather Tirado Gilligan Heather Tirado Gilligan is a journalist who has written for publications including Slate, The Nation, CNN, and the Washington Post. Previously, she was executive editor of the California Health Report, a news nonprofit covering disparities in health and access to health care. Heather received a master’s degree in journalism from UC Berkeley and a PhD in English from Rutgers University, where she studied race in American culture. More by this Author: Through the Looking Glass: What’s Behind Hospital Prices for Care, The Work of Family Caregiving: Invisible, Costly, and Taxing, Health Affairs Explores Mental Health Link to Birth Outcomes Recent Articles . Whole Person Care Pilots Set the Stage for CalAIM. Melora Simon - Senior Strategist December 9, 2021 CalAIM: Why It’s So Much More Than Another New Health Program. Kara Carter - Senior Vice President, Strategy and Programs December 7, 2021 The Work of Family Caregiving: Invisible, Costly, and Taxing. Heather Tirado Gilligan - Journalist December 6, 2021 Delivering Whole-Person Care, One Meal at a Time. Hilda Martinez - Senior Communications Officer, Innovation Fund November 5, 2021 Digital Startup Is Transforming Mental Health Care in Schools. Brian Rinker - Freelance writer September 28, 2021 Close *** We use cookies on our website to give you the most relevant experience by remembering your preferences and repeat visits. 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TitleJAMA Health Forum – Health Policy, Health Care Reform, Health Affairs | JAMA Health Forum | JAMA Network
Urlhttps://jamanetwork.com/journals/jama-health-forum/fullarticle/2783874
DescriptionExplore the latest in national and global health policy, including health care pricing, delivery, access, quality, safety, equity, and reform
Dateby MK Bundorf · 2021 · Cited by 5
Organic Position17
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BodyJAMA Health Forum – Health Policy, Health Care Reform, Health Affairs | JAMA Health Forum | JAMA Network Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue [Skip to Navigation]
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TitleCOVID-19 and the Family and Medical Leave Act Questions and Answers | U.S. Department of Labor
Urlhttps://www.dol.gov/agencies/whd/fmla/pandemic
Description
Date
Organic Position18
H1COVID-19 and the Family and Medical Leave Act Questions and Answers
H2submenu
1. Who can take FMLA leave?
2. What benefits are available under the FMLA?
3. Can an employee who is sick with COVID-19, or who is caring for a family member who is sick with COVID-19, take FMLA leave?
4. Can an employee stay home under FMLA leave to avoid getting COVID-19?
5. I was not paid for COVID-19 related leave in 2020. Do I still have rights under the Families First Coronavirus Response Act (FFCRA)?
6. Can parents or other care givers take time off from work to care for a child whose school is closed or whose care provider is no longer available due to COVID-19 reasons?
7. Is an employer required by law to provide paid sick leave to employees who are unable to work because they have COVID-19, have been exposed to a family member with COVID-19, or are caring for a family member with COVID-19?
8. May an employer require an employee who is out sick with COVID-19 to provide a doctor’s note, submit to a medical exam, or remain symptom-free for a specified amount of time before returning to work?
9. May my employer require me to submit a doctor’s note to use FMLA leave if I am sick and unable to work because of COVID-19?
10. Are there protections that apply if an employer temporarily closes his or her place of business because of a pandemic and chooses to lay off some but not all employees?
11. I am unable to work because I need to take care of sick family members. Can my employer terminate or lay me off for this reason?
12. I am unable to work because I have COVID-19. Can my employer terminate or lay me off for this reason?
13. Due to safety and health concerns related to COVID-19, many health care providers are treating patients for a variety of conditions, including those unrelated to COVID-19, via telemedicine. Telemedicine involves face-to-face examinations or treatment of patients by remote video conference via computers or mobile devices. Under these circumstances, will a telemedicine visit count as an in-person visit to establish a serious health condition under the FMLA?
14. I was out on FMLA leave unrelated to COVID-19. While I was out, my company implemented a new policy requiring everyone to take a COVID-19 test before they come to the office. Under the FMLA, can my employer require me to get a COVID-19 test under this policy?
Contact Us
H3
H2WithAnchorssubmenu
1. Who can take FMLA leave?
2. What benefits are available under the FMLA?
3. Can an employee who is sick with COVID-19, or who is caring for a family member who is sick with COVID-19, take FMLA leave?
4. Can an employee stay home under FMLA leave to avoid getting COVID-19?
5. I was not paid for COVID-19 related leave in 2020. Do I still have rights under the Families First Coronavirus Response Act (FFCRA)?
6. Can parents or other care givers take time off from work to care for a child whose school is closed or whose care provider is no longer available due to COVID-19 reasons?
7. Is an employer required by law to provide paid sick leave to employees who are unable to work because they have COVID-19, have been exposed to a family member with COVID-19, or are caring for a family member with COVID-19?
8. May an employer require an employee who is out sick with COVID-19 to provide a doctor’s note, submit to a medical exam, or remain symptom-free for a specified amount of time before returning to work?
9. May my employer require me to submit a doctor’s note to use FMLA leave if I am sick and unable to work because of COVID-19?
10. Are there protections that apply if an employer temporarily closes his or her place of business because of a pandemic and chooses to lay off some but not all employees?
11. I am unable to work because I need to take care of sick family members. Can my employer terminate or lay me off for this reason?
12. I am unable to work because I have COVID-19. Can my employer terminate or lay me off for this reason?
13. Due to safety and health concerns related to COVID-19, many health care providers are treating patients for a variety of conditions, including those unrelated to COVID-19, via telemedicine. Telemedicine involves face-to-face examinations or treatment of patients by remote video conference via computers or mobile devices. Under these circumstances, will a telemedicine visit count as an in-person visit to establish a serious health condition under the FMLA?
14. I was out on FMLA leave unrelated to COVID-19. While I was out, my company implemented a new policy requiring everyone to take a COVID-19 test before they come to the office. Under the FMLA, can my employer require me to get a COVID-19 test under this policy?
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BodyCOVID-19 and the Family and Medical Leave Act Questions and Answers If you are out with COVID-19 or are caring for ill family members, check with the Department of  Labor (DOL) for information on whether such leave is covered under the Family and Medical Leave Act (FMLA). Under the FMLA, covered employers must provide employees job-protected, unpaid leave for specified family and medical reasons. Employees on FMLA leave are entitled to the  continuation of group health insurance coverage under the same terms as existed before they took FMLA leave. (See the U.S. Department of Labor Wage and Hour Division or call 1-866-487-9243 for additional information on the FMLA.) The Families First Coronavirus Response Act (FFCRA) required covered employers to provide eligible employees  with paid sick and expanded family and medical leave for certain COVID-19 related reasons. The requirement that employers provide paid sick or expanded family and medical leave under the FFCRA employer mandate provisions applies to leave taken or requested during the effective period of April 1, 2020 through December 31, 2020.  Please see Families First Coronavirus Response Act: Questions and Answers for questions specific to the application  of the FFCRA mandate.  Employers who choose to provide such leave between January 1, 2021 and September 30, 2021 may be eligible for employer tax credits.  Information about claiming the tax credits for paid sick leave or paid family leave wages can be found on the IRS website at: (https://www.irs.gov/newsroom/covid-19-related-tax-credits-for-paid-leave-provided-by-small-and-midsize-businesses-faqs). Additionally, certain state or local laws may have different requirements, which    employers must also consider when determining their obligation to provide paid sick leave. See the State Labor Offices for information about leave laws in your state.   Who can take FMLA leave? What benefits are available under the FMLA? Can an employee who is sick with COVID-19, or who is caring for a family member who is sick with COVID-19, take FMLA leave? Can an employee stay home under FMLA leave to avoid getting COVID-19? I was not paid for COVID-19 related leave in 2020. Do I still have rights under the Families First Coronavirus Response Act (FFCRA)? Can parents or other care givers take time off from work to care for a child whose school is closed or whose care provider is no longer available due to COVID-19 reasons? Is an employer required by law to provide paid sick leave to employees who are unable to work because they have COVID-19, have been exposed to a family member with COVID-19, or are caring for a family member with COVID-19? May an employer require an employee who is out sick with COVID-19 to provide a doctor’s note, submit to a medical exam, or remain symptom-free for a specified amount of time before returning to work? May my employer require me to submit a doctor’s note to use FMLA leave if I am sick and unable to work because of COVID-19? Are there protections that apply if an employer temporarily closes his or her place of business because of a pandemic and chooses to lay off some but not all employees? I am unable to work because I need to take care of sick family members. Can my employer terminate or lay me off for this reason? I am unable to work because I have COVID-19. Can my employer terminate or lay me off for this reason? Due to safety and health concerns related to COVID-19, many health care providers are treating patients for a variety of conditions, including those unrelated to COVID-19, via telemedicine. Telemedicine involves face-to-face examinations or treatment of patients by remote video conference via computers or mobile devices. Under these circumstances, will a telemedicine visit count as an in-person visit to establish a serious health condition under the FMLA? I was out on FMLA leave unrelated to COVID-19. While I was out, my company implemented a new policy requiring everyone to take a COVID-19 test before they come to the office. Under the FMLA, can my employer require me to get a COVID-19 test under this policy?     1. Who can take FMLA leave? Employees are eligible to take FMLA leave if they work for a covered employer and: have worked for their employer for at least 12 months; have at least 1,250 hours of service over the 12 month period before their leave begins; and work at a location where at least 50 employees are employed by the employer within 75 miles. Private employers are covered employers under the FMLA if they have 50 or more employees in any 20 workweeks in the current or preceding calendar year. Public agencies (including federal, state, and local government agencies) and public and private elementary and secondary schools are covered FMLA employers regardless of the number of employees they have.  Special hours of service requirements apply to airline flight crew employees and to breaks in service to fulfill National Guard or Reserve military service obligations pursuant to the Uniformed Services Employment and Reemployment Rights Act (USERRA). Back to Top   2. What benefits are available under the FMLA? The FMLA provides eligible employees of covered employers with unpaid, job-protected leave for specified family and medical reasons. Among other benefits, an eligible employee may take up to 12 workweeks of leave in a 12-month period for a serious health condition that makes the employee unable to perform the functions of the employee’s job, and to care for the employee’s spouse, child, or parent who has a serious health condition. In addition to providing eligible employees an entitlement to leave, the FMLA requires that employers maintain employees’ health benefits during leave and restore employees to their same or an equivalent job after leave. The law also protects employees from interference and retaliation for exercising or attempting to exercise their FMLA rights. Back to Top   3. Can an employee who is sick with COVID-19, or who is caring for a family member who is sick with COVID-19, take FMLA leave? An employee who works for a covered employer, is eligible for FMLA, and is sick, or is caring for a family member who is sick, with COVID-19 may be entitled to leave under the FMLA under certain circumstances. An FMLA-eligible employee can take up to 12 weeks of unpaid, job-protected leave in a designated 12-month leave year for specified family and medical reasons, including a serious health condition as defined by the FMLA. The most common serious health conditions that qualify for FMLA leave include: conditions requiring an overnight stay in a hospital or other medical care facility; conditions that incapacitate the employee or the employee’s family member (for example, unable to work or attend school) for more than three consecutive days and that include ongoing medical treatment (either multiple appointments with a health care provider, or a single appointment and follow-up care, such as prescription medication); and, chronic conditions that cause occasional periods when the employee or the employee’s family member is incapacitated, and which require treatment by a health care provider at least twice a year. Workers who are ill with COVID-19 or have a family member with COVID-19 are urged to stay home to minimize the spread of the pandemic. Employers are encouraged to support these and other community mitigation strategies and should consider flexible leave policies for their employees.  While the requirement that employers provide paid sick leave and expanded family and medical leave under the Families First Coronavirus Response Act (FFCRA) expired on December 31, 2020, tax credits may be available to employers who voluntarily continue to provide paid sick leave or paid family leave for COVID-19 related reasons.  Employers who choose to provide such leave between January 1, 2021 and September 30, 2021 may be eligible for employer tax credits.  Information about claiming the tax credits for paid sick leave or paid family leave wages can be found on the IRS website at: (https://www.irs.gov/newsroom/covid-19-related-tax-credits-for-paid-leave-provided-by-small-and-midsize-businesses-faqs). Due to safety and health concerns related to COVID-19, many health care providers are treating patients for a variety of conditions, including those unrelated to COVID-19, via telemedicine. The Wage and Hour Division will consider telemedicine visits to be in-person visits for purposes of establishing a serious health condition under the FMLA where certain conditions exist.  Please see Question 11 and Field Assistance Bulletin 2020-8: Telemedicine and Serious Health Conditions under the Family and Medical Leave Act (FMLA) for more information. Back to Top   4. Can an employee stay home under FMLA leave to avoid getting COVID-19? No. The FMLA protects eligible employees who are incapacitated by a serious health condition, as may be the case with COVID-19 in some instances, or who are needed to care for covered family members who are incapacitated by a serious health condition. Leave taken by an employee solely for the purpose of avoiding exposure to COVID-19 is not protected under the FMLA. Certain state or local laws may have different requirements, which    employers must also consider when determining their obligation to provide leave. See the State Labor Offices for information about leave laws in your state.  Additionally, there may be other protections or guidance available under federal or state health and safety laws that are not enforced by the Wage and Hour Division if you are concerned that your employer is not following federal or state guidelines. Back to Top   5. I was not paid for COVID-19 related leave in 2020. Do I still have rights under the Families First Coronavirus Response Act (FFCRA)? Yes. The Wage and Hour Division (WHD) will enforce the FFCRA for leave taken or requested during the effective period of April 1, 2020, through December 31, 2020, for complaints made within the statute of limitations. The statute of limitations for both the paid sick leave and expanded family and medical leave provisions of the FFCRA is two years from the date of the alleged violation (or three years in cases involving alleged willful violations). Therefore, if your employer failed to pay you as required by the FFCRA for your leave that occurred before December 31, 2020, you may contact the WHD about filing a complaint as long as you do so within two years of the last action you believe to be in violation of the FFCRA. You may also have a private right of action for alleged violations. Please see visit WHD’s FFCRA Questions and Answers page for more information. Back to Top   6. Can parents or other care givers take time off from work to care for a child whose school is closed or whose care provider is no longer available due to COVID-19 reasons? There is currently no federal law covering non-government employees who take off from work to care for healthy children, and employers are not required by federal law to provide leave to employees caring for a child whose school is closed or whose care provider is unavailable due to COVID-19 reasons. However, given the potential for significant illness under pandemic scenarios, employers should review their leave policies to consider providing increased flexibility   to their employees and their families. Federal law requires that these leave policies be administered in a manner that does not discriminate against employees because of race, color, sex, national origin, religion, age (40 and over), disability, or veteran status. Covered employers must abide by the FMLA as well as any applicable state family and medical leave laws. An employee who is sick, or whose family members are sick, may be entitled to leave under the FMLA.    Additionally, the Families First Coronavirus Response Act (FFCRA), which applies to leave taken or requested during the effective period of April 1, 2020 through December 31, 2020, required covered employers to provide eligible employees with up to two weeks of paid sick leave and up to an additional 10 weeks of expanded family and medical leave if the employee was  unable to work or telework due to a need for leave to care for a child whose school, place of care, or child care provider was closed or unavailable for reasons related to COVID-19. Please see Families First Coronavirus Response Act: Questions and Answers for questions specific to the application of the FFCRA. Employers are not required to provide employees with FFCRA leave after December 31, 2020, but employers who choose to provide such leave between April 1, 2021 and September 30, 2021 may be eligible for employer tax credits.  Information about claiming the tax credits for paid sick leave or paid family leave wages can be found on the IRS website at: (https://www.irs.gov/newsroom/covid-19-related-tax-credits-for-paid-leave-provided-by-small-and-midsize-businesses-faqs). Back to Top   7. Is an employer required by law to provide paid sick leave to employees who are unable to work because they have COVID-19, have been exposed to a family member with COVID-19, or are caring for a family member with COVID-19? Currently, federal law generally does not require employers to provide paid leave to employees who are absent from work because they are sick with COVID-19, have been exposed to someone with COVID-19, or are caring for someone with COVID-19.  Under Executive Order 13706, some federal contractors may be required to provide such leave to employees under certain circumstances, such as if the employee or a family member is sick with COVID-19 or seeking care related to COVID-19. Certain state or local laws may have different requirements, which    employers must also consider when determining their obligation to provide paid sick leave. If the leave qualifies as FMLA-protected leave, the employee may elect, or the employer may require the employee, to substitute accrued paid sick and paid vacation/personal leave for unpaid FMLA leave in some circumstances. Substitute in this case means the accrued paid leave runs concurrently with unpaid FMLA leave. Employers should encourage employees who are ill with COVID-19 to stay home and should consider flexible leave policies for their employees. Additionally, under the Families First Coronavirus Response Act (FFCRA), covered employers were required to provide eligible employees up to two weeks of paid sick leave for specified reasons related to COVID-19 for leave taken or requested from April 1, 2020 through December 31, 2020, including where the employee is unable to work because he or she is quarantined (pursuant to Federal, State, or local government order or advice of a health care provider), experiencing COVID-19 symptoms and seeking a medical diagnosis, or has a need to care for an individual  subject to quarantine (pursuant to Federal, State, or local government order or advice of a health care provider). Please see Families First Coronavirus Response Act: Questions and Answers for questions specific to the application of the FFCRA. Employers are not required to provide employees with FFCRA leave after December 31, 2020, but employers who choose to provide such leave between January 1, 2021 and September 30, 2021 may be eligible for employer tax credits. Information about claiming the tax credits for paid sick leave or paid family leave wages can be found on the IRS website at: (https://www.irs.gov/newsroom/covid-19-related-tax-credits-for-paid-leave-provided-by-small-and-midsize-businesses-faqs). Back to Top   8. May an employer require an employee who is out sick with COVID-19 to provide a doctor’s note, submit to a medical exam, or remain symptom-free for a specified amount of time before returning to work? Yes, a doctor’s note may be required. However, DOL encourages employers to consider that during a pandemic, healthcare resources may be overwhelmed and it  may be difficult for employees to get appointments with doctors or other health care providers to verify they are well or no longer contagious.  Not requiring employees to secure a note from a doctor can help reduce strain on the medical system during this critical time.   Under the Americans with Disabilities Act (ADA), an employer would be allowed to require a doctor’s note, a medical examination, or a time period during which the employee has been symptom free, before it allows the employee to return to work, where the employer has a reasonable belief – based on objective evidence – that the employee’s present medical condition would: impair his ability to perform essential job functions (i.e., fundamental job duties) with or without reasonable accommodation, or, pose a direct threat (i.e., significant risk of substantial harm that cannot be reduced or eliminated by reasonable accommodation) to safety in the workplace. In situations in which an employee’s leave is covered by the FMLA, the employer may have a uniformly-applied policy or practice that requires all similarly-situated employees to obtain and present a fitness-for-duty certification from the employee’s health care provider that confirms the employee is able to resume work. Employers are required to notify employees in advance if the employer will require a fitness-for-duty certification to return to work. If state or local law or the terms of a collective bargaining agreement govern an employee’s return to work, those provisions apply. Employers should be aware that fitness-for-duty certifications may be difficult to obtain during a pandemic. Due to safety and health concerns related to COVID-19, many health care providers are treating patients for a variety of conditions, including those unrelated to COVID-19, via telemedicine.  The Wage and Hour Division considers telemedicine visits to be in-person visits for purposes of establishing a serious health condition under the FMLA where certain conditions exist.  Please see Question 11 and Field Assistance Bulletin 2020-8: Telemedicine and Serious Health Conditions under the Family and Medical Leave Act (FMLA) for more information. Back to Top   9. May my employer require me to submit a doctor’s note to use FMLA leave if I am sick and unable to work because of COVID-19? Yes, a doctor’s note may be required in order to take FMLA leave. Under the FMLA, an employer may require a certification by a health care provider when an employee requests leave because of a serious health condition. The certification allows the employer to obtain information related to the FMLA leave request, and verify that an employee has a serious health condition. Leave when you are sick with COVID-19 may be an FMLA serious health condition under certain circumstances.  Please see Question 2 for more information. DOL encourages employers to consider that during a pandemic, healthcare resources may be overwhelmed and it may be difficult for employees to get appointments with doctors or other health care providers to verify they are well or no longer contagious.  Not requiring employees to secure a note from a doctor can help reduce strain on the medical system during this critical time.   An employee can provide the required information in any format, for example on the letterhead of the healthcare provider. Employers must accept a complete and sufficient certification, regardless of the format. A certification is considered “incomplete” if one or more of the applicable entries on the form have not been completed.  A certification is considered “insufficient” if the information provided is vague, unclear, or nonresponsive. After acquiring a complete and sufficient certification, an employer is not permitted to ask for more information, such as requiring a doctor’s note for each FMLA-related absence.         Please see Fact Sheet 28G for more information.  Back to Top   10. Are there protections that apply if an employer temporarily closes his or her place of business because of a pandemic and chooses to lay off some but not all employees? The federal laws prohibiting discrimination in the workplace on the basis of race, sex (including pregnancy, gender identity, and sexual orientation), age (40 and over), color, religion, national origin, disability, genetic information, and retaliation may apply. (See the U.S. Equal Employment Opportunity Commission (EEOC) or call 1-800-669-4000 if you have questions.) Other specific Federal laws that prohibit discrimination on these or additional bases may also govern if an employer is a Federal contractor or a recipient of Federal financial assistance. Additionally, the Worker Adjustment and Retraining Notification (WARN) Act helps ensure advance notice in cases of    qualified plant closings and mass layoffs. For more information about the WARN Act, see https://www.dol.gov/agencies/eta/layoffs/warn. Employers are also prohibited from discriminating against an employee because the employee has requested or used qualifying FMLA leave or leave under the Families First Coronavirus Response Act (FFCRA). In addition, employers are prohibited from discriminating against an employee because he or she is a past or present member of the United States uniformed service. (See the U.S. Department of Labor, Veterans’ Employment and Training Service for additional information or call 1-866-889-5627 if you have questions.) Finally, in some circumstances, employers are prohibited from discriminating against an employee because of his or her citizenship or immigration status. (See the U.S. Department of Justice, Immigrant and Employee Rights Section for additional information or call 1-800-255-8155) Back to Top   11. I am unable to work because I need to take care of sick family members. Can my employer terminate or lay me off for this reason? If an employee is covered and eligible under the FMLA and is needed to care for a spouse, daughter, son, or parent who has a serious health condition, then the employee is entitled to up to 12 weeks of job-protected, unpaid leave during any 12-month period. An employer is prohibited from interfering with, restraining, or denying the exercise of an employee’s rights under the FMLA. Employers are also prohibited from discriminating or retaliating against an employee for having exercised or attempted to exercise any FMLA right. Examples of prohibited conduct include using an employee’s request for or use of FMLA leave as a negative factor in employment actions such as hiring, promotions, or disciplinary actions, or failing to provide benefits to an employee on unpaid FMLA leave if the employer provides those benefits to employees who use other types of unpaid leave. Please see Question 1 and Fact Sheet 77-B for more information.   Some states may have similar family leave laws. In those situations, covered employers must comply with the federal or state provision that provides the greater benefit to their employees. Additionally, under the Families First Coronavirus Response Act (FFCRA), covered employers were required to provide eligible employees up to two weeks of paid sick leave for specified reasons related to COVID-19 for leave taken or requested from April 1, 2020 through December 31, 2020, including where the employee is unable to work because he or she is quarantined (pursuant to Federal, State, or local government order or advice of a health care provider). The FFCRA prohibits discrimination on the basis of FFCRA leave used. Employers’ requirement to provide FFCRA leave expired December 31, 2020. However, WHD will enforce the FFCRA for leave taken or requested during the effective period of April 1, 2020 through December 31, 2020, for complaints made within the statute of limitations, which permits complaints to be filed for up to two years from the date of the alleged violation. A three-year statute of limitations applies in cases involving willful violations. Please see Families First Coronavirus Response Act: Questions and Answers for questions specific to the application of the FFCRA. Employers are not required to provide employees with FFCRA leave after December 31, 2020, although employers who choose to provide paid sick and family leave for COVID-19 related reasons between January 1, 2021 and September 30, 2021 may be eligible for employer tax credits. Information about claiming the tax credits for paid sick leave or paid family l