Health & Welfare Plans Newsletter

March 11, 2020

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[Official Guidance]

Editor's Pick Text of DOL Q&As on COVID-19 or Other Public Health Emergencies and the Family and Medical Leave Act

11 Q&As, including: 

  • Can an employee stay home under FMLA leave to avoid getting pandemic influenza?
  • What legal responsibility do employers have to allow parents or care givers time off from work to care for the sick or children who have been dismissed from school? 
  • May employers send employees home if they show symptoms of pandemic influenza? Can the employees be required to take sick leave? Do they have to be paid? May employers prevent employees from coming to work?
  • May employers change their paid sick leave policy if a number of employees are out and they cannot afford to pay them all? 
  • If an employer temporarily closes his or her place of business because of an influenza pandemic and chooses to lay off some but not all employees, are there any federal laws that would govern this decision?
  • What types of policy options do employers have for preventing abuse of leave?

Employee Benefits Security Administration [EBSA], U.S. Department of Labor [DOL]

[Official Guidance]

Editor's Pick Text of IRS Notice 2020-15: High Deductible Health Plans and Expenses Related to COVID-19 (PDF)

"[T]his notice provides that, until further guidance is issued, a health plan that otherwise satisfies the requirements to be a high deductible health plan (HDHP) under section 223(c)(2)(A) of the Internal Revenue Code (Code) will not fail to be an HDHP under section 223(c)(2)(A) merely because the health plan provides health benefits associated with testing for and treatment of COVID-19 without a deductible, or with a deductible below the minimum deductible (self only or family) for an HDHP. Therefore, an individual covered by the HDHP will not be disqualified from being an eligible individual under section 223(c)(1) who may make tax-favored contributions to a health savings account (HSA)."

Internal Revenue Service [IRS]

[Guidance Overview]

CMS Issues COVID-19 Guidance: Medicare Coverage and Payment

"In its [March 5 guidance], CMS details coverage (as well as payment) information for Original Medicare and Medicare Part D and Medicare Advantage plans. The guidance reinforces current Medicare coverage policies, which continue to apply for COVID-19 patients, and highlights areas of coverage that necessitate flexibility within the program from providers, Medicare contractors and Medicare plan sponsors."

Dentons

[Guidance Overview]

CMS Issues Additional COVID-19 Guidance: Medicare Reimbursement for Diagnosis and Treatment

"[On March 6, CMS] issued frequently asked questions related to Medicare reimbursement for items and services provided in connection with the diagnosis and treatment of the coronavirus (COVID-19). While much of the guidance reiterates rules that have long been in place for Medicare billing and payment, it may be worth reviewing ... within the context of the nationwide -- and global -- response to the current outbreak."

Holland & Knight

Cigna Extends Free Coronavirus Tests to Self-Funded Employer Plans

"Cigna Corp. said it has signed up all of its self-insured employer clients to eliminate cost-sharing for coronavirus tests. Cigna sent letters to these 'administrative services only' clients ... giving them 10 business days to opt out of the program ... Two Democratic members of Congress introduced legislation [HR 6173]... that aims to fill gaps left by ERISA by requiring self-insured employers -- along with private health insurers -- to cover the full cost of the coronavirus diagnostic test and prevent them from passing those costs on to beneficiaries in the form of higher premiums."

Modern Healthcare Online; free registration required

Five Ways Plan Sponsors Can Manage Their Health Benefit Spend

"[1] Evaluate and optimize the value of health benefit plans ... [2] Review provider and vendor contracts ... [3] Respond to varied participant needs ... [4] Embrace technology ... [5] Communicate with participants about benefits."

Milliman

District Court Rules Colorado Law Turns Group Life Insurance Policy's Two-Year Suicide Exclusion into a One-Year Exclusion

"Colorado Revised Statute Section 10-7-109 nullifies suicide exclusions longer than one year in life insurance policies. MetLife argued the statute applied to individual policies, but not group policies. The court rejected this argument because the Supreme Court of Colorado had recognized the longstanding public policy in Colorado that disfavored suicide exclusions and had applied the statute to group credit life insurance -- a different, but similar type of group insurance." [Auwae v. Metropolitan Life Ins. Co., No. 19-2504 (D. Colo. Mar. 2, 2020)]

Kantor & Kantor

Benefits in General

Editor's Pick Society of Actuaries Research Brief: Impact of Coronavirus COVID-19 (PDF)

16 pages. "The result in February and March 2020 ha s been one where a confluence of risks has come together. Morbidity, mortality, asset/liability management and operational risks are all a part of the initial and evolving story. This Society of Actuaries Research Brief has been constructed to highlight some of the key features of the epidemic and contemplate the risks for the actuarial profession to consider in their work."

Society of Actuaries

Upcoming Events About Health & Welfare Plans

Mar. 12
Webcast
Free
It's Not You, It's Healthcare: What's Next for Access & Employee Education
Employee Benefit Adviser
Mar. 12
Webcast
Free
Getting It Right - Know Your Fiduciary Responsibilities: Retirement and Health Plan Sponsors - Day 2
Employee Benefits Security Administration [EBSA], U.S. Department of Labor
Mar. 12
Ohio
Annual Legal & Regulatory Update
Worldwide Employee Benefits Network [WEB] - Northeast Ohio Chapter
Mar. 16
Webcast
Free
Use of Individual Medicare Marketplaces for Public Sector Retiree Health Care: A Guide For Elected Officials
Center for State and Local Government Excellence
Mar. 17
Webcast
Free
Getting It Right - Know Your Fiduciary Responsibilities: Retirement and Health Plan Sponsors - Day 3
Employee Benefits Security Administration [EBSA], U.S. Department of Labor
Mar. 18
Texas
IRA and HSA Seminar
Ascensus
Mar. 18
District of Columbia
39th ECFC Annual Conference
ECFC [Employers Council on Flexible Compensation]

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