The COVID-19 situation is constantly changing and our carriers are adapting to help members stay protected and access care. Below are summaries for how each of our carriers are handling the situation along with any available resources.
We know that this is a difficult time and that groups have questions about premium leniency and employee eligibility. We've reached out to our carriers and will provide information below as we hear back. Additionally, we've consolidated the information into a carrier comparison PDF for your reference.
General updates:
Contact your B&P Sales Rep if you have questions regarding the information below.
We hope you and your family stay safe and healthy through this trying time.
Will Aetna cover the cost of COVID-19 testing and treatment for members?
Yes, Aetna is waiving copays for all diagnostic testing related to COVID-19.
On March 25th, Aetna announced they will also be waiving cost-sharing and copays for treatment of COVID-19. Please see our news post and CVS Health's press release for complete details.
Does Aetna offer telemedicine options?
Yes, Aetna offers telemedicine through Teladoc. Aetna is offering $0 Teladoc visits until June 4, 2020 for any reason.
What other steps is Aetna taking?
Aetna is providing EAP to all members and employers:
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Is Aetna extending new business deadlines?
Yes, for April 1, 2020 and beyond, Aetna will extend their new business case submission deadline as follows:
Please submit Aetna groups to B&P at least a day before the due date so we can ensure a clean and complete submission. Incomplete cases will be moved to the next effective date.
Is Aetna offering a COVID-19 Special Enrollment Period?
Yes, Aetna is allowing previously waived employees to enroll between April 6th and April 17th. They can choose between an April 1st or May 1st effective date. See our news post for complete details.
What's Aetna's policy on rehires?
Yes, through July 31, 2020, Aetna will alow groups to waive the waiting period for rehires that resume working 30+ hours a week. Any change in the waiting period rules that extends into the next plan year will be considered in the renewal.
Is Aetna adjusting their employee eligibility rules?
Yes, employees can maintain their coverage on Aetna plans so long as:
This option is available to customers until July 31, 2020. Please note the guidelines must be applied uniformly without regard to health status-related factors.
Is Aetna allowing downgrades off anniversary?
Aetna will consider downgrades on a case-by-case basis through July 31, 2020. See our news post for additional details.
Will Aetna be lenient on premium payments?
Aetna will be following the recommendation from the Insurance Commissioner and will be allowing the 60 day grace period for payment.
Will Anthem cover the cost of COVID-19 testing for members?
Yes, Anthem will continue to waive copays, coinsurance and deductibles for diagnostic tests related to COVID-19. This includes visits associated with in-network COVID-19 testing whether the care is received in a physician’s office, an urgent care center or an emergency department.
Will Anthem cover the cost of COVID-19 treatment?
Yes, Anthem announced it will expand coverage, effective April 1, for members in its affiliated health plans undergoing treatment related to a COVID-19 diagnosis. Read their press release for complete details.
Does Anthem offer telemedicine options?
Yes, Anthem offers telemedicine through LiveHealth Online. On March 17, 2020, Anthem announced they are waiving the cost of LiveHealth Online visits for members through June 14, 2020.
What other steps is Anthem taking?
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What's Anthem's policy on rehires?
Anthem's COVID-19 External FAQs released on 3/20/20 addressed this question in section 6.9:
Is Anthem extending new business deadlines?
Yes, Anthem is extending their March and April deadlines:
Read our news post for complete details.
Will Anthem be offering a special COVID-19 enrollment period?
Yes, Anthem will provide fully insured groups a special enrollment period to enroll employees who previously did not elect to enroll in coverage at the time of open enrollment. This group special enrollment period will last from March 23rd through April 15th and applies to small and large groups, coverage will be effective April 1, 2020.
Read our news post for complete details.
Is Anthem allowing downgrades off anniversary?
No, they are not allowing downgrades. Anthem is only allowing employees to come onto the plan if they meet the special COVID-19 enrollment requirements as mentioned above.
Will Anthem be offering any leniency on premium payments?
Anthem will work with groups to see if there are any options. Groups should reach out to their account manager if they are having trouble making payments.
Is Anthem adjusting employee eligibility rules?
Yes. Anthem’s requirement for employees to be actively working in order to be eligible for coverage will be relaxed through May 31, 2020 as long as the monthly premium payment is received.
Coverage must be offered on a uniform, non- discriminatory basis to all employees and employee premium contributions must be the same or less prior to the layoffs.
Please see the specific carrier sections for how CalChoice carriers are handling COVID-19 member benefits like testing, treatment, telehealth, etc.
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What's CalChoice's policy on rehires?
CalChoice will allow the group to define the waiting period when the employee returns to work.
Is CalChoice extending new business deadlines?
Yes, CalChoice is extending new business deadlines to the 15th of the month.
Will CalChoice be offering a special COVID-19 enrollment period?
Yes, CalChoice will allow a group special open enrollment for a 4/1/2020 effective date for employees that previously waived coverage. Enrollment applications must be received by 4/10/2020.
Is CalChoice allowing downgrades off anniversary?
Employers may make a one-time, “mid-plan year” change to their contribution or plan to reduce their premiums and maintain coverage for the balance of the contract year. Employees may make a one-time “mid-plan year” change to downgrade from the current plan they are on to a lower cost plan as long as they remain with the same Health Plan.
Will CalChoice be offering any leniency on premium payments?
If customers are having trouble making payments they should reach out to their account manager or customer service. CalChoice will evaluate payment extensions on a case-by case basis.
Is CalChoice adjusting employee eligibility rules?
As long as the group and employees are current on their monthly payments, CalChoice will allow employees that would otherwise have lost eligibility to remain on the plan.
Is CCSB offering a special enrollment period?
Yes, CCSB will be offering a COVID-19 Special Enrollment Period for qualified employees through the end of June. Qualified employees and enrollment in CCSB employer plans that are permitted during a COVID-19 Special Enrollment Period through the end of June are as follows:
A qualified employee and/or dependents (i.e., spouse, child(ren)) declined coverage during renewal or original enrollment, but now wants to sign up for CCSB plans offered by the employer.
Is CCSB allowing employees to change plans, including to downgrade off anniversary?
No.
What's CCSB's policy of rehires?
CCSB will waive the waiting period for rehires as long as there is no discrimination.
Will Health Net cover the cost of COVID-19 testing for members?
Health Net is waiving cost-sharing for medically-necessary COVID-19 screenings, tests and doctor office, urgent care and outpatient hospital (including emergency departments) visits.
Will Health Net cover the cost of COVID-19 treatment for members?
Yes, Health Net will waive member cost sharing for COVID-19 related treatments for all Medicare, Medi-Cal and commercial fully insured members.
Does Health Net offer telemedicine options?
Yes, Health Net offers telemedicine through Teladoc.
What other steps is Health Net taking?
Members that are quarantined and need an emergency supply of their medications should call Health Net at 1-800-400-8987 for assistance.
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What's Health Net's policy on rehires?
Employees rehired by May 31, 2020 will not be subject to a waiting period.
Will Health Net be flexible on new business submission requirements (proof of business, payroll, etc.)?
Yes, Health Net will provide an extension for new group business through June 30, 2020.
Will Health Net allow downgrades off anniversary?
Yes, Health Net will allow a one-time Exception Request for an insured employer that has only a single benefit plan, to change to a leaner plan within the next 90 days.
Is Health Net offering any leniency on premium payments?
No.
Is Health Net adjusting employee eligiblity?
Through May 31, 2020, Health Net is temporarily relaxing its requirement that employees be actively working to be eligible for coverage and will allow employers to cover their reduced-hour employees, as long as employers pay the monthly premium. Employers must offer this coverage on a uniform, non-discriminatory basis.
Is Health Net offering a COVID-19 Special Enrollment Period?
Yes, Health Net is offering a special enrollment period that will last until April 20, 2020 for employees, spouses and children who have previously waived coverage at an employer. Provided the employer remits the full premium for the month of April, coverage will be effective April 1, 2020. Customers are not required to adopt the special enrollment period. No opt out action is required from the group.
Will Kaiser Permanente cover the cost of COVID-19 testing for members?
Yes, Kaiser Permanente members will not have to pay for costs related to COVID-19 screening or testing if referred by a Kaiser Permanente doctor.
Will Kaiser Permanente cover the cost of COVID-19 treatment for members?
Kaiser Permanente has announced that it will waive all member out-of-pocket costs for inpatient and outpatient services related to the treatment of COVID-19, as of April 1, 2020. 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.
See their announcement for more information.
Does Kaiser Permanente offer telemedicine?
Yes, Kaiser Permanente members can access phone, video, and email telehealth options.
What other steps is Kaiser Permanente taking?
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What's Kaiser's policy on rehires?
From Kaiser's FAQs, they will allow the group to define the waiting period when the employee returns to work, with no minimum, but no greater than 90 days.
Will Kaiser be lenient on premium payments?
Yes, Kaiser Permanente is following the California Insurance Commissioner’s recommendation of allowing a 60-day grace period before suspending coverage. This applies to all of Kaiser's business regulated by the California Insurance Commissioner, including Large Group and Small Group. While the guidance does not apply to the majority of Kaiser Permanente's business because they are regulated by the Department of Managed Health Care, they are still complying with the grace period for all groups.
Will Kaiser be offering a special COVID-19 open enrollment?
Yes, Kaiser Permanente will allow a special open enrollment for a 4/1/2020 effective date for employees/dependents that previously waived coverage as long as the enrollment application is received by 4/3/2020. Applications that are received between 4/4/2020 and 4/15/2020 may be applied for a 5/1/2020 effective date if the employer agrees. The following conditions must be met:
Is Kaiser allowing downgrades off anniversary?
Yes, must be made by a 5/1/2020 effective date.
Will UnitedHealthcare cover the cost of COVID-19 testing for members?
Yes, UnitedHealthcare is waiving costs for COVID-19 testing provided at approved locations. This coverage applies to Medicare and Medicaid members as well as their commercial insured members.
Will UnitedHealthcare cover the cost of COVID-19 treatment for members?
UnitedHealthcare is waiving member cost-sharing for the treatment of COVID-19 through May 31, 2020 for its fully-insured Commercial, Medicare Advantage and Medicaid plans. See their news post for more information.
Does UnitedHealthcare offer telemedicine?
Yes, UHC offers virtual visits and cost sharing for members with a telehealth benefit through their employer-sponsored plan will be waived through June 18, 2020. This includes telehealth visits that are not related to COVID-19, see their news post for more information.
What other steps is UnitedHealthcare taking?
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What's UHC's policy on rehires?
UHC will waive any rehire waiting period for rehired employees who were terminated due to COVID-19.
Is UHC offering a special enrollment period?
Yes, UHC is offering a special enrollment opportunity for fully insured Small Business and Key Accounts clients. The opportunity will be limited to employees who previously did not elect coverage for themselves (spouses, children) or waived coverage. The enrollment opportunity will extend from March 23 to April 13, 2020 and be for an April 1st effective date.
UHC will provide a "Notice of Special COVID-19 Enrollment Opportunity" to inform employees of this opportunity to enroll in their group health plan.
Please note that UHC will require payroll to prove that the employee works for the employer.
Is UHC allowing downgrades off anniversary?
Yes, UHC is allowing downgrades off anniversary. See bullets 2 and 3 in our news post for more information.
Will Blue Shield of California cover the cost of COVID-19 testing for members?
Yes, starting immediately Blue Shield is waiving all cost-sharing and any prior approval for Covid-19 testing prescribed by a physician for all members enrolled in Blue Shield’s 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.
Will Blue Shield of California cover the cost of COVID-19 treatment for members?
Yes, Blue Shield announced it will cover members’ coinsurance, copayments and deductibles for COVID-19 medical treatments through May 31, 2020. Read their press release for more information.
Does Blue Shield of California offer telemedicine options?
Yes, Blue Shield offers telemedicine through Teladoc. On March 16, 2020, Blue Shield announced it will waive out-of-pocket costs for most of its members to use Teladoc Health’s virtual care service until May 31, 2020.
What other steps is Blue Shield of California taking?
Blue Shield is offering members early prescription refills if they cannot access their current supply of medication or require an additional supply.
Blue Shield's philanthropy supports some of their most underserved communities most impacted by COVID-19:
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Please visit the following CCHP pages for more information on COVID-19 and how CCHP is handling the situation:
Will Oscar Health cover the cost of COVID-19 testing for members?
Yes, Oscar is waiving cost-sharing for diagnostic testing for COVID-19 for all members, when the test is recommended by a doctor. This includes in-network and out-of-network testing facilities.
Does Oscar Health offer telemedicine options?
Yes, Oscar Health offers telemedicine through Doctor on Call, offered at $0 copay for members regarding COVID-19 treatment.
What other steps is Oscar Health taking?
Oscar Health launched the first testing center locator for COVID-19 in the U.S., featuring more than 100 centers today. It is accessible to the general public and more testing centers are being added every day.
Oscar posted a COVID-19 Risk Assessment page on their website that's available to members and non-members.
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Will Sharp Health Plan cover the cost of COVID-19 testing for members?
Yes, Sharp Health Plan has reduced the cost-share to $0 for all medically necessary screening and testing for coronavirus. This includes hospital (including emergency department), urgent care, provider office visits, and telehealth appointments for the purpose of screening and/or testing for coronavirus.
Does Sharp Health Plan offer telemedicine options?
Yes, Video and phone appointments are convenient and safe, and are being provided free of charge to Sharp Rees-Stealy Medical Group patients, regardless of insurance type.
What other steps is Sharp Health Plan taking?
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Will Sutter Health cover the cost of COVID-19 testing for members?
Sutter will not collect patient cost shares in advance of providing services for medically necessary COVID-19 screening and testing administered at Sutter hospitals, emergency departments, Walk-in Care clinics and other medical provider locations. This means Sutter Health will not collect a copay, deductible or co-insurance in advance.
Does Sutter Health offer telemedicine options?
Yes, Sutter Health offers telemedicine through My Health Online.
What other steps is Sutter Health taking?
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Will Western Health Advantage cover the cost of COVID-19 testing for members?
WHA is waiving all cost-sharing for medically necessary screening and testing for COVID-1919, 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.
Does Western Health Advantage offer telemedicine options?
Yes, WHA offers telemedicine through provider partners at the same cost-sharing as an in-person office visit.
What other steps is Western Health Advantage taking?
WHA is encouraging members to fill their maintenance prescriptions through OptumRx’s mail order program. This not only avoids members having to wait in line at the pharmacy during the COVID-19 outbreak, but it can give them up to a 90-day supply of medication.
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Will ChoiceBuilder be extending new business deadlines?
Yes, ChoiceBuilder is extending new business deadlines to the 15th of the month.
Will ChoiceBuilder adjust employee eligibility?
As long as the group and employees are current on their monthly payments, ChoiceBuilder will allow employees that would otherwise have lost eligibility to remain on the plan.
Will ChoiceBuilder allow downgrades off anniversary?
Employers may make a one-time, “mid-plan year” change to their contribution or plan to reduce their premiums and maintain coverage for the balance of the contract year. Employees may also make a one-time “mid-plan year” change to downgrade from the current plan they are on to a lower cost plan as long as they remain with the same Ancillary Carrier.
What is ChoiceBuilder's policy on rehires?
ChoiceBuilder will allow the group to define the waiting period when the employee returns to work.
Will ChoiceBuilder offer any leniency on premiums?
If customers are having trouble making payments they should reach out to their ChoiceBuilder account manager or customer service. ChoiceBuilder will evaluate payment extensions on a case-by case basis.
Will ChoiceBuilder be offering a COVID-19 Special Enrollment Period?
Yes, ChoiceBuilder will allow a group special open enrollment for a 4/1/20 effective date for employees that previously waived coverage. Enrollment applications must be received by 4/10/20.
Will Delta Dental be offering any leniency on premium payments?
Yes, Delta Dental will delay the period in which payment is required from 30 to 60 days for all clients without impact to member coverage. This applies to fully insured business and self-funded administrative service fees.
Will Delta Dental be adjusting employee eligibility?
Yes, members furloughed or temporarily laid off by their employers as a result of the impacts of COVID-19 will continue coverage through the employer dental plan, contingent upon:
What is Delta Dental's policy on rehires?
Delta Dental will waive waiting periods for members laid-off and rehired within 6 months by the same employer.
Please visit Guardian's COVID-19 page:
Will Guardian be lenient on premium payments?
Guardian is issuing a 60-day grace period for their planholders regardless of state rules. Claims will be paid once premium is paid.
Will Guardian be extending new business deadlines?
Guardian can accept paperwork for a 4/1 effective date up to 4/15. They will need a planholder letter stating there are no pending claims for Life and STD/LTD policies. Rates are good through 6/1 if a group wants to push the effective date.
Is Guardian adjusting employee eligibility?
Yes, effective 3/1/2020, Guardian will continue to consider an employee who was enrolled as of that date to be eligible for benefits until 6/30/2020 if premium continues to be paid when:
Guardian will communicate any changes regarding this temporary accommodation prior to 6/30/2020, including whether they will be extending the accommodation timeframe, or if they will return to the original contract provisions in the group's policy regarding eligibility requirements.
This temporary accommodation applies to Dental, Vision, Accident and Cancer, Critical Illness, Hospital Indemnity, Life, Short Term Disability, Accidental Death and Dismemberment, Optional Life, and Optional Accidental Death and Dismemberment products.
Is Guardian adjusting renewals?
Yes, for groups with fewer than 500 lives, Guardian will retain rates (no rate change) on all renewals for May 1, 2020 through August 31, 2020 plan anniversary dates. The next renewal rate review will be set to the plan anniversary month/day in 2021.
For example, if the original renewal anniversary date was August 1, 2020, the group would continue their current rates as of that date, and their next renewal anniversary will be August 1, 2021.
Is MetLife offering any leniency on premiums?
Yes, MetLife will make an exception to extend the Grace Period for premium payment to 60 days after the Premium Due Date, for customers with a policy Grace Period less favorable than 60 days. Customers with Grace Periods greater than 60 days will retain the Grace Period in their policy. This policy will be applied for all premiums due 3/1/2020 and forward, until this crisis is deemed over, as well as apply to any premium within the current 30-day grace period.
Is MetLife adjusting employee eligibility?
Yes, for group life, dental, AD&D, vision, accident & health and legal coverage, MetLife is willing to allow employees who are furloughed, temporarily laid-off or have reduced hours/salary to continue their coverage for 12 months from the date of the furlough, temporary lay-off or reduced hours/salary (collectively, “temporary salary reductions”). Premiums need to be remitted for coverage to remain active.
For purposes of group life, the coverage amounts will not be reduced as a result of temporary salary reductions and will remain in effect just as they were prior to the furlough, temporary lay-off or reduced hours/salary. Accordingly, premium needs to be remitted based on the volume for the regular (non-reduced) coverage amounts.
For group disability, MetLife is willing to allow employees who experience a furlough, temporary lay-off or have reduced hours/salary between March 1, 2020 and May 31, 2020, to continue their coverage for 60 days from the date of the furlough, temporary lay-off, or reduced hours/salary. Coverage amounts will not be reduced as a result of temporary salary reductions and will remain in effect just as they were prior to the furlough, temporary lay-off or reduced hours/salary. Accordingly, premium needs to be remitted based on the volume for the regular (non-reduced) coverage amounts.
In all instances, if a group policy allows for longer periods of continued coverage under any of the circumstances outlined above, MetLife will honor the longer period of time.
In addition, if a group's coverage is self-insured, and they are not comfortable with the timelines outlined above, please have them contact their MetLife Account Executive for alternatives.
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What's MetLife's policy on rehires?
MetLife will allow an employee that is rehired within 6 months of their termination to waive the waiting period.
Will MetLife be offering any renewal rate passes?
Yes, MetLife will be notifying their group customers with fewer than 500 lives that they will hold rates (no rate increase) for all renewals with June 1, 2020 through September 1, 2020 renewal dates. This excludes cases written through a Trust, Association or PEO.
Will MetLife allow downgrades off anniversary?
Yes, on a case-by-case basis.
Will MetLife be offering a COVID-19 Special Enrollment Period?
Not at this time.
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Can a group downgrade off anniversary?
Yes, the Account Executive assigned to the case can assist with this process.
Will Principal be lenient on premium payments?
Principal is implementing a 60-day grace period for all customers to help manage through this difficult time and will have an email address and an 800# to help customers and brokers with any questions relating to the billing.
Is Principal adjusting employee eligibility?
Principal recognizes businesses may struggle through this environment. For employees who experience a reduction in hours, furlough, layoff or are impacted by a temporary business closure between March 1, 2020 and April 30, 2020, the employer can continue their coverage through May 31, 2020 subject to premium payment.
Is Principal offering any renewal rate passes?
Yes, in order to make this time period easier on brokers and clients, Principal is going to institute rate passes for all groups under 500 lives for May 2020 – August 2020. In the event Principal and the group negotiated a decrease in rates previously that will be honored.
Will Principal be offering a COVID-19 Special Enrollment Period?
Not at this time.
Please visit VSP's COVID-19 web page:
Update on Visionworks locations:
All Visionworks locations will temporarily close, starting March 21st but VSP will preserve access to Visionworks for doctors for essential and emergency eye care needs.
How is EMPLOYERS handling late payments and cancellations for non-payment?
Given the extraordinary national circumstances, EMPLOYERS is offering immediate relief by placing a moratorium on all billing cancellations. Additionally, all pending cancellations that were effective as of 3/1/2020 have been rescinded.
The moratorium will be re-evaluated by 4/19/2020 for alteration or extension.
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Disclosure: We will do our best to update this page when new information is available but we encourage you to go to the carrier’s website for their most up to date information.
