Health & Welfare Plans Newsletter

March 19, 2020

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[Official Guidance]

Text of CMS FAQs on Catastrophic Plan Coverage and the Coronavirus Disease 2019 (COVID-19) (PDF)

"Q1. Do catastrophic plans currently include coverage for the diagnosis and treatment of COVID-19? ... Yes. Catastrophic plans must cover the essential health benefits (EHB) ... Q2. In light of the public health emergency posted by COVID-19, will HHS allow issuers of catastrophic plans to provide coverage for the diagnosis and treatment of COVID-19 even before enrollees meet plan deductibles? A2. Yes.... [U]ntil further notice, HHS will not take enforcement action against any health insurance issuer that amends its catastrophic plans to provide pre-deductible coverage for services associated with the diagnosis and /or treatment of COVID-19."

Centers for Medicare & Medicaid Services [CMS], U.S. Department of Health and Human Services [HHS]

[Sponsored]

Comprehensive Directory of COVID-19 (Coronavirus) News for Employee Benefit Plans

Sponsored by BenefitsLink

Cumulative directory of: Official guidance issued by IRS, DOL, HHS and other federal agencies; Federal, state and local legislation;Analysis and explanations by law firms, consulting firms and others;Benefits-related items from popular news media and trade publications. Learn more


[Guidance Overview]

Families First Coronavirus Response Act: Issues for Employers

"This bipartisan legislation expands employee sick leave benefits, expands access to medical services, and provides monetary assistance to impacted Americans.... [1] Expansion of coverage required under group health plans ... [2] Impact on high deductible health plans ... [3] Expansion of telehealth coverage ... [4] Benefit continuation during expanded leave ... [5] Tax credits for smaller employers."

Thompson Hine

[Guidance Overview]

President Trump Signs Emergency FMLA Leave and Paid Sick Leave in Wake of Coronavirus Pandemic: Here Are the Details

"Eligible employees are entitled to take up to 12 weeks of FMLA leave for 'a qualifying need related to a public health emergency.' This 'qualifying need' is limited to circumstances where an employee is unable to work (or telework) to care for a minor child if the child's school or place of child care has been closed or is unavailable due to a public health emergency.... The first 10 days (two weeks) are unpaid, but an employee can substitute accrued paid leave, including emergency paid sick leave [provided by the Act].... The new law provides for a series of refundable tax credits for employers providing paid emergency sick leave or paid FMLA, including tax relief for self-employed individuals."

FMLA Insights

[Guidance Overview]

What Employers Need to Know About the Families First Coronavirus Response Act (HR 6201)

"[1] Which employers are covered? ... [2] Which employees are eligible? ... [3] What events will trigger coverage? ... [4] How does paid leave apply? ... [5] How does the statute interact with state and local law? ... [6] Does this paid leave ever expire? ... [7] How is the tax credit determined?"

ReedSmith

[Guidance Overview]

CMS and States Revise Requirements Affecting Telehealth Due to COVID-19 Pandemic

"[T]he State Medical Board of Ohio [has suspended]  enforcement of any regulations requiring in-person visits between providers and patients, including regulations related to providers prescribing to patients not seen in-person by the physician.... [T]he Texas Medical Board [is suspending certain sections] of the Texas Administrative Code. Specifically: [1] physicians may use telemedicine, including the use of telephone only, to establish a physician-patient relationship and [2] the use of telemedicine may be used for diagnosis, treatment, ordering of tests, and prescribing for all conditions.... [T]he Pennsylvania Department of Human Services' Office of Mental Health and Substance Abuse Services announced the temporary suspension of certain requirements for providing behavioral health services via telehealth."

Vorys

[Guidance Overview]

Statewide Paid Sick Leave Law and Separate COVID-19-Related Leave and Employee Protections Coming to New York

"The bill provides for additional paid sick leave, unpaid leave, as well as an expansion of the state's paid family leave and disability benefits, to certain employees who are 'subject to mandatory or precautionary orders of quarantine or isolation' related to COVID-19."

Seyfarth Shaw LLP

[Guidance Overview]

California Department of Managed Health Care Issues 'All Plans' Letter on Social Distancing and COVID-19

"[T]he Department encourages plans to expand the use of telehealth by [1] expediting or relaxing any pre-authorization/pre-certification requirements for contracted providers, so that providers are able to more quickly offer services via telehealth; and [2] waiving any telehealth cost-sharing above that which would be applicable if the provider had delivered in-person care.... [T]he Department encourages plans to decrease the need for in-person pharmacy visits[.]"

Sheppard Mullin

[Guidance Overview]

San Francisco to Provide Expanded Paid Sick Leave for Workers Impacted by Coronavirus

"The plan includes $10 million in funding that will allow businesses to provide an additional five days of sick leave pay beyond their existing policies. All businesses will be eligible to receive the funds, with up to 20 percent of funds reserved for businesses with 50 or fewer workers. The City will contribute up to one workweek -- 40 hours -- at $15.59 per hour per employee, or $623 per employee, and the employer will pay the difference between the $15.59 minimum wage and the employee's normal hourly rate."

ReedSmith

[Guidance Overview]

Nevada Labor Commissioner Issues Paid Leave Guidance on COVID-19

"The Commissioner advises that employers must not deduct hours from an employee's paid leave balance if the employee misses work because of a 'mandatory government quarantine by a state, federal, or local agency' for potential exposure to COVID-19. The guidance explains that since 'employees may not be accruing any type of leave or pay while under a mandatory government quarantine situation, this type of separation and/or leave from employment should not be counted against them.' "

Littler

[Guidance Overview]

Effect of COVID-19-Related Reduction of Hours, Furloughs, Layoff Pay, and Premium Shortfalls on Health Benefits

"The default position is that a reduction in hours to part-time work will cause a loss of eligibility for active health plan coverage, but multiple potential exceptions may apply.... [1] Protected leave under FMLA (or similar state law) ... [2] ALE subject to ACA employer mandate utilizing look-back measurement method to determine full-time status ... [3] Non-protected leave policy ... [4] Layoff pay and LOA pay is hours of service for ALEs ... Premium shortfalls if active coverage continues: taking employee contributions where there is insufficient pay to cover the employee-share of the premium."

ABD Insurance & Financial Services

New York Government Reaches Agreement on Mandatory Sick Leave in Response to Coronavirus Outbreak

"The proposed law ... protects employees by requiring employers to provide additional 'coronavirus-specific' paid sick leave to employees, and expanding the state's disability and paid family leave benefits to cover certain coronavirus-related leave. The governor and legislature are also using this crisis as an opportunity to implement a new paid sick leave mandate upon employers beginning January 1, 2021, separate and apart from the leave relating to coronavirus."

Nixon Peabody LLP

New York Governor Announces Agreement on Coronavirus Job Protection and Paid Sick Leave

"The state legislature is expected to approve the bill, which will then have to be signed by Governor Cuomo to become law. The provisions of the bill will take effect immediately upon passage.... Employers with 10 or fewer employees and a net income of less than one million in the previous tax year must provide quarantined or isolated employees with unpaid sick leave until the termination of any mandatory or precautionary quarantine or isolation order due to COVID-19.... Employers with between 11 and 99 employees, or 10 or fewer employees and a net income of greater than one million dollars in the previous tax year, must provide quarantined or isolated employees at least five days of paid sick leave, followed by unpaid leave until the termination of any mandatory or precautionary quarantine or isolation order due to COVID-19."

FordHarrison

Fever Screens and Benefits Continuation: COVID-19 Questions

"Employers everywhere are acting fast to protect their employees, their products and their customers from the coronavirus and its fallout. Two common questions are, 'Can we screen our employees for a fever?' and 'If we want to continue benefits for employees who'd otherwise lose eligibility, can we?' The answers are, probably and probably."

Lockton

Massachusetts Health Insurance Carriers Respond to COVID-19

"Massachusetts has directed health insurance carriers to ... relax cost-sharing and enhance telemedicine services.... Massachusetts carriers have answered the call by enhancing benefits and services, in some cases beyond what the new directives require. Employers can play a key role by informing employees of these new benefits and encouraging employees to use the benefits."

Mintz

Puerto Rico Senate Approves Bill on Sick Leave, Pay During Cessation of Operations Because of COVID-19

"[T]he Puerto Rico Senate has approved a bill addressing sick leave for private sector employees and requiring employers to pay employees if the employer decides to cease its operations due to the pandemic. Senate Bill No. 1538 generally provides that the new law would be effective until the Governor repeals Executive Order 2020-023, which established a state of emergency aimed at detaining the spread of COVID-19 in Puerto Rico."

Jackson Lewis P.C.

Dependent Care FSAs and Day Care Closures Due to COVID-19

"A significant change in child care costs is one such 'change event' that would allow an employee to change his or her dependent care FSA contributions mid-year. For example, an employee whose child is now at home because the child's day care closed has experienced a significant change in costs and could decrease his or her dependent care FSA contributions, or revoke them all together."

Warner Norcross & Judd LLP

Benefits in General

An Employee Has COVID-19. Now What Do I Do?

"The rule of thumb is that you can (and likely must) disclose that an employee has tested positive ... but you need to ensure that the disclosure does not share too much information.... Be very careful about how many people know the name of the ill individual and that each of them understands their obligation to keep information confidential.... Communication with the infected employee is critically important for many reasons including to offer support, to fully understand the link to the workplace and to protect other employees and your business."

Bond, Schoeneck & King

Editor's Pick Comprehensive Directory of COVID-19 (Coronavirus) News for Employee Benefit Plans

BenefitsLink presents a cumulative directory of

  • Official guidance issued by IRS, DOL, HHS and other federal agencies
  • Laws and bills from federal, state and local governments.
  • Analysis and explanations published online by law firms, consulting firms and others.
  • Benefits-related items from popular news media and trade publications.

Use the checkboxes and buttons at the top of the directory to narrow the view to either Retirement or Health & Welfare Plans, or to to one or more of the listed types of items.

This directory is updated each day as new items are added.

BenefitsLink

Upcoming Events About Health & Welfare Plans

Mar. 20
Webcast
Free
Preparing Your Workplace to Address Coronavirus
Vedder Price
Mar. 23
Webcast
Free
COVID-19 Updates for Employers: Employee Benefits and Compensation Issues
Ogletree Deakins
Mar. 24
Webcast
Free
Are You Getting Good Data on What is Driving Your Healthcare Costs?
University Conference Services
Mar. 24
Webcast
Free
Merger, Divestiture and Acquisitions and Employee Benefits
Wagner Law Group P.C.
Mar. 25
Webcast
Free
Tools You Can Use: Prediabetes & Diabetes Management in the Workplace
Midwest Business Group on Health
Mar. 26
Webcast
Free
HIPAA Training for Employers: From Portability to Privacy
ABD Insurance & Financial Services
Mar. 26
Webcast
Free
Voluntary Fiduciary Correction Program
Employee Benefits Security Administration [EBSA], U.S. Department of Labor
Mar. 26
Webcast
Free
Understanding Health & Welfare Section 125 Nondiscrimination Testing
ISCEBS - Pacific NW Chapter

Most Popular Items in the Previous Issue

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BenefitsLink Health & Welfare Plans Newsletter, ISSN no. 1536-9595. Copyright 2020 BenefitsLink.com, Inc. All materials contained in this newsletter are protected by United States copyright law and may not be reproduced, distributed, transmitted, displayed, published or broadcast without the prior written permission of BenefitsLink.com, Inc., or in the case of third party materials, the owner of those materials. You may not alter or remove any trademark, copyright or other notices from copies of the content.

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