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. We've consolidated the information into a carrier comparison PDF for your reference, or create a custom comparison using our new COVID-19 generator.
California Resources:
With Q4 rates available, it's now more important than ever to leverage multiple technologies to help your agency provide the service your clients expect. Our Q4 Best Practices page covers some different things you can implement to help make life a little easier during this unprecedented time.
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.
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.
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.
Online payments can be made at http://www.aetna.com/pspregister.
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 December 31, 2020. Please note the guidelines must be applied uniformly without regard to health status-related factors.
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 September 30, 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 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 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.
Their FAQ update on 9/16/20 states that they will waive cost-sharing and copays for treatment of COVID-19 through December 31, 2020.
Resources
What other steps is Aetna taking?
Aetna is providing EAP to all members and employers:
Does Aetna offer telemedicine options?
Yes, Aetna extended all member cost-sharing waivers for covered in-network telemedicine visits for outpatient behavioral and mental health counseling services through December 31, 2020.
Is Anthem extending new business deadlines?
Yes, Anthem has extended the following deadlines:
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.
Online payments can be made at https://employer.anthem.com/eea/public/registration.
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 December 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.
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 20th and applies to small and large groups, coverage will be effective April 1, 2020.
Read our news post for complete details.
Anthem announced a second Special Enrollment Period. Fully Insured and self-funded Small and Large Groups can choose to offer a Special Enrollment Period for employees who did not select any benefits during Open Enrollment. This period will end on August 1, 2020, and does not include Anthem Life and Disability plans.
What's Anthem's policy on rehires?
Employees who are rehired by December 31, 2020 will not be subject to the waiting period.
Is Anthem allowing downgrades off anniversary?
Yes, Anthem will allow currently covered employees to switch to a lower priced option if one is offered. This is not considered to be an open enrollment. This option is available for through December 1, 2020. No retrospective plan changes will be allowed. The amount of the deductible and out-of-pocket max that has already been met will accumulate towards the deductible and out-of-pocket maximum in the less expensive plan design that the employees switch to. For groups undergoing a system migration it may take longer than 10 days to implement the accumulators. Note that the employer should review its cafeteria plan document for qualifying event options to ensure compliance.
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.
On May 28, 2020, Anthem announced they will extend this through December 31, 2020.
Resources
What other steps is Anthem taking?
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.
Anthem later extended this through September 30, 2020.
Please see the specific carrier sections for how CalChoice carriers are handling COVID-19 member benefits like testing, treatment, telehealth, etc.
Is CalChoice extending new business deadlines?
Yes, CalChoice has extended deadlines due to COVID-19. July submissions are due by July 13th.
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.
Payments can be made at https://www.calchoice.com/.
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.
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.
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 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.
Resources
Is CCSB offering any premium leniency?
Yes, on 4/30/20, CCSB announed they will allow groups another 30 days for April and May premium payments. They also announced a Premium Deferral Program for groups that hadn't paid their April and/or May premiums that allows them to defer up to 75% of their premiums. See their news release for complete details.
Payments can be made at https://myccsb.com/er/login.
Is CCSB adjusting employee eligibility rules?
CCSB states this decision is up to the Employer.
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.
What's CCSB's policy of rehires?
CCSB will waive the waiting period for rehires as long as there is no discrimination.
Is CCSB allowing employees to change plans, including to downgrade off anniversary?
No.
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 December 31, 2020.
Is Health Net offering any leniency on premium payments?
No.
Payments can be made at https://www.healthnet.com/.
Is Health Net adjusting employee eligibility?
Through December 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 Health Net allow downgrades off anniversary?
Groups have a one-time opportunity to downgrade their existing plans without penalty.
What's Health Net's policy on rehires?
Employees rehired by December 31, 2020 will not be subject to a waiting period.
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.
Resources
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.
Does Health Net offer telemedicine options?
Yes, to limit members' risk of COVID-19 infection, Health Net encourages use of telehealth to deliver care when medically appropriate and capable through telehealth modalities for all services. Member cost share is waived for telehealth services until further notice. (Updated 7/29/20)
Is Kaiser extending new business deadlines?
Yes, Kaiser is extending their new business deadlines to the 15th of the month for 2020 effective dates.
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.
Payments can be made at https://account.kp.org/.
Is Kaiser adjusting employee eligibility?
As long as the group and employee are current on their monthly payments, Kaiser Permanente will allow employees that would otherwise have lost eligibility to remain on the plan.
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:
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.
Is Kaiser allowing downgrades off anniversary?
Yes, Kaiser Permanente is making an exception to their current rules during the federally declared COVID-19 national emergency. Groups may choose to conduct a special enrollment period (SEP) for a limited time for all employees to enroll in a less expensive plan. This would include all employees actively enrolled in the plan, regardless of whether they have reduced hours or are furloughed.
Will Kaiser Permanente cover the cost of COVID-19 treatment for members?
Yes, Kaiser Permanente has been waiving all member out-of-pocket costs related to in-network COVID-19 treatment since April 1. They are now extending this policy through the end of the year for all fully insured customers and will continue to waive the member out-of-pocket costs for treatment delivered by Kaiser Permanente providers.
Resources
What other steps is Kaiser Permanente taking?
Does Kaiser Permanente offer telemedicine?
Yes, Kaiser Permanente members can access phone, video, and email telehealth options.
Is UHC extending new business deadlines?
No, but they are flexible. Please contact your B&P Sales Rep if you have any questions.
Will UHC be lenient on premium payments?
On a case-by-case basis.
Payments can be made at https://www.employereservices.com/.
Is UHC adjusting employee eligibility rules?
Yes, UnitedHealthcare is temporarily relaxing its requirement that employees be actively working to be eligible for coverage and will allow groups to cover their reduced hour employees, as long as they pay the monthly premium.
UHC's policies vary depending on the line of coverage.
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.
Additionally, UHC is offering a special enrollment period for fully insured employer customers for Dental and/or Vision coverage. The special enrollment opportunity is available from May 18 to May 29, 2020 for a June 1, 2020 effective date. See our news post for complete details.
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 allowing downgrades off anniversary?
Yes, UHC is allowing downgrades off anniversary. See bullets 2 and 3 in our news post for more information.
Will UnitedHealthcare cover the cost of COVID-19 treatment for members?
UnitedHealthcare is waiving member cost-sharing for the treatment of COVID-19 through October 22, 2020 for its fully-insured Commercial, Medicare Advantage and Medicaid plans.
Resources
Is UHC providing any premium credits?
Yes, UnitedHealth Group announced that groups will get a premium relief credit on their July statement.
Does UnitedHealthcare offer telemedicine?
Yes, they are covering telehealth as follows:
What other steps is UnitedHealthcare taking?
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:
Resources
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.
Resources
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?
Resources
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?
Resources
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.
Resources
Resources
Will ChoiceBuilder be extending new business deadlines?
Yes, ChoiceBuilder has extended deadlines due to COVID-19. July submissions are due by July 13th.
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.
Will Delta Dental be offering any renewal rate passes?
Yes, Delta Dental will have 2-year rate passes for all renewals from August 2020 through July 2021 effective dates.
Will Delta Dental be offering any premium assistance?
Yes, Delta Dental is giving plans a one-month premium holiday for September 2020.
Resources
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.
Resources
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.
MetLife also announced on July 22, 2020 that group customers with 99 or fewer employees would have rate passes on renewals through March 31, 2021. Read our news post for more information.
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.
Resources
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?
Yes, any employee no longer eligible due to reduced hours or furlough/layoff on or after March 1, 2020, through June 30, 2020, may continue coverage for 90 days, provided premiums continue to be paid.
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 – October 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:
Will VSP be lenient on premium payments?
Yes, VSP is extending the grace period and abiding by the state mandate per DOI.
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.
Resources
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.
