COVID-19 Employer Questions
We recognize the unprecedented circumstances employers have been facing with the COVID-19 pandemic, and we want to work with our employer groups to provide as much flexibility as possible to support care and coverage for your employees.
We will continue to provide updates here; we encourage you to check regularly. As always, thank you for placing your trust in HealthPartners.
For information on prevention, symptoms and what to do if you’re feeling sick, visit our COVID-19 information page.
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Frequently Asked Questions
Below are answers to some of the most common questions we’ve received. Click on the topic or question to jump to the answer.
A: All policies have existing premium billing grace periods which continue to apply and provide some flexibility. The federal and state governments are providing financial support in the form of loans that can be forgiven (e.g., the Paycheck Protection Program.) These programs can be used for eligible business expenses like payroll and health insurance premiums. Employers should speak to their legal counsel or trade groups to learn more.
A: A group that does not contribute a minimum of 50 percent for its leanest plan would not be eligible for renewal.
A: Health plan contract termination would occur in the month following the end of the grace period.
A: Yes. We allow automatic bank drafts or electronic fund transfers as part of our e-billing options. There are no changes for groups using e-billing. Groups that would like to move to e-billing should alert their sales representatives.
A: A diagnostic test is used to determine if a person currently has COVID-19. It is done by testing a sample of the mucus from a person’s nose or throat or a sample of a person’s saliva to determine if that person has an active infection of the SARS-CoV-2 virus, which is the virus that causes COVID-19. There are several different types of diagnostic tests, including “PCR” and “antigen” tests.
A: An antibody or serology test is used to determine if a person has previously had and recovered from COVID-19. It is done by testing a sample of a person’s blood to determine if that person has antibodies to the SARS-CoV-2 virus, which is the virus that causes COVID-19. It is very important to note that a positive result on an antibody test does NOT necessarily mean you are immune to getting COVID-19.
A: Yes. Based on the Families First Coronavirus Response Act, we cover any type of provider visit associated with diagnostic testing for COVID-19 with no member cost sharing, regardless of plan design. This includes care at Virtuwell, Doctor on Demand, Teladoc and all e-care visits.
A: Based on the Families First Coronavirus Response Act, during the Public Health Emergency, HealthPartners plans will cover COVID-19 tests and any associated provider visit, including telehealth visits, with no member cost sharing. This is for all plan designs, including HSA-qualified plans.
The full cost of the testing and the associated diagnostic visit will be covered in instances where a test is administered and/or a primary diagnosis of COVID-19 has been made, HealthPartners will waive member cost sharing for COVID-19 tests and diagnosis-related provider visits. Additionally, the health plan covers medically necessary testing that is used to help determine care or treatment decisions or to inform medical advice specific to the patient. It is determined by the patient’s doctor or other appropriately licensed provider. If a member seeks care and is not tested for COVID-19, the health plan coverage applied for the visit will follow the member’s standard (i.e. non-COVID-19) health plan coverage and cost sharing benefits. The cost of testing for purposes of personal or business travel, employment reasons or public health programs are not covered by your health plan.
For fully insured plans, if a member has received a primary COVID-19 diagnosis AND is receiving care directly related to that COVID-19 diagnosis, HealthPartners is waiving member cost sharing for treatment through December 31, 2021. Self-insured plans have the option to waive member cost sharing for COVID-19 treatment, and each self-insured group will make its own decision. HealthPartners Member Services maintains current information regarding each employer’s decisions relating to coverage of COVID-19 related expenses, and will relay that information to covered members as it is requested.
In the majority of cases, most people are directed to self-care. These members will be told to self-quarantine and contact their provider as needed. Most people will recover without needing additional services.
HealthPartners Care Group provides COVID-19 testing at many locations. Patients must complete a screening and set-up an appointment prior to being tested. More information can be found here.
A: Virtual visits for services not related to COVID-19 testing and diagnosis, including physical therapy, speech therapy and occupational therapy, follow current plan coverage and cost sharing.
A: During the COVID-19 pandemic, HealthPartners covers antibody tests under appropriate circumstances. The test should be: ordered by a doctor or appropriately licensed provider; for medically necessary purposes; and must use a test that is on the Federal Drug Administration (FDA) Emergency Use Authorization (EUA) list or on a state-approved antibody test list.
A: No, the antibody test performed must be on the Federal Drug Administration (FDA) Emergency Use Authorization (EUA) list or on a state-approved antibody test list in order to be covered.
A: If a member has tested positive for COVID-19 AND is receiving medically necessary and appropriate care directly related to the COVID-19 diagnosis, all HealthPartners members on fully insured plans will have their member cost sharing waived for that treatment when a primary diagnosis code of COVID-19 is billed by the provider. This is in effect until December 31st, 2021.
For our self-insured customers, it is up to the employer to determine how they want to cover COVID-19 treatments.
In all cases, HealthPartners relies on providers to accurately submit claims for testing, diagnosis and treatment of COVID-19.
HealthPartners will work to process claims with information available and will re-process if necessary based on additional information provided. We will continue to monitor this and make necessary changes based on federal regulations.
A: Yes. In many cases, care providers are now providing telemedicine options to their patients. Especially during the crisis, and pursuant to state and federal guidelines and regulations, care that is delivered by telemedicine options will be covered the same as if the care were delivered in person. Also, depending on where they live, members have other coverage options under their plan that may include virtuwell and/or Doctor on Demand.
A: This varies by which service is used:
- CareLine – all calls to CareLine are free of charge to the member. Nurses will triage all calls based upon medically accepted protocols. If a CareLine nurse recommends the patient seek additional services from their provider, the actual claim for any COVID-19 testing would be handled as outlined above.
- Doctor on Demand – if a member uses Doctor on Demand, the visit will be covered at 100% (i.e., waive member cost sharing) if there is a COVID-19 test ordered and performed. eVisit with provider – many clinics have added eVisits for their patients. All eVisits are covered as per the plan’s schedule of benefits (varies by plan.) Again, the only time the member cost share is waived (i.e., the visit is covered at 100%) would be for those situations in which a test was subsequently ordered and performed.
A: No. The Families First Coronavirus Response Act, signed into law on March 18, included the provision that self-insured groups cannot opt out of this coverage. The same criteria outlined above apply.
A: No. Stop loss claims will continue to be processed as they are currently, per the stop loss contract. Claims for members allowed under the flexibility in eligibility definitions for furloughed employees will be considered eligible expenses for stop loss.
A: If a member remains eligible under the self-insured plan from the employer, then any claims for that member will be eligible under stop loss so long as premium payments continue uninterrupted.
A: All COVID-19 claims that are eligible under the underlying policy will be eligible expenses for stop loss.
A: Yes. Due to the lag between the date a medical service is incurred and the date that service is paid, the claims incurred by the covered population this month, for example, will not be the claims paid this month. As a result, the minimum attachment point will continue to be applied.
A: Mid-year changes in the specific stop-loss level would be considered on a case-by-case basis. Please work with your account manager if interested.
A: We will not change the expected claims rates if a self-insured group chooses to cover COVID-19 treatment with no cost sharing.
A: Furlough is a temporary leave of absence or reduction in hours imposed by the employer, typically for business or economic reasons, where employment has not been terminated.
Temporary layoff is a temporary termination of employment with the intent to rehire or recall at some point in the near future (e.g., within 6 months.)
Permanent layoff is a permanent termination of employment with no specific intent to rehire or recall the employee to work. Permanent layoff or termination results in a loss of coverage and a COBRA event or option for individual coverage.
At this time, HealthPartners is not differentiating between furlough and temporary layoff in terms of applying contract eligibility provisions. Employees and their dependents who are on furlough or temporarily laid off will remain eligible for coverage as long as the employer contribution and the premium payments continue on the same basis as they previously did (i.e., no change in the cost share and premiums remitted by employers via the normal billing process.)
A: Yes. We’re allowing flexibility in the plan eligibility definition as long as premium payments continue on the same basis as they currently do. That includes the contribution amounts from the employer and employee remaining the same. See question on premium amounts above.
A: If an employee is laid off with the intent to bring them back in the future, our expanded definitions of eligibility as outlined above would apply, assuming premium payments are made as before.
If your group is permanently terminating or laying off employees, they should go through your normal termination process and the employee should be offered COBRA.
Individuals who lose coverage and do not choose COBRA may obtain coverage on the Individual market, and may be subsidy-eligible based on income.
In Minnesota, MNSure HealthPartners individual plans are available to residents living in the Twin Cities, western MN and St. Cloud areas through MNSure or directly from HealthPartners by calling (enter individual sales number here) on healthpartners.com.
Wisconsin, Iowa, South Dakota and North Dakota utilize the federal exchange and further information is available at Heatlhcare.gov. Loss of job based coverage is considered an event that allows a person to seek new coverage under a Special Enrollment Period.
A: The presumption with a furloughed employee under our current, more flexible definition of an eligible employee during this COVID-19 pandemic is that the furloughed employee is still receiving coverage under the same premium payment arrangement with the employer as previously was occurring. If the employer subsequently determines that the employee will not be rehired, and ultimately stops paying premium, coverage is terminated at the end of the month in which premium was received, and the normal termination process would start, with all of the typical COBRA rights and obligations.
A: Yes. During this unprecedented time, we will count furloughed employees for group size determination so long as premium payments continue on the same basis as they currently do.
A: Not without an underwriting review. The percentages of premium paid by each should remain what they are today. For example, if the employer contributes 75% and the employee contributes 25%, those should remain the same. If a group wants to continue coverage but change the contribution percentages, we will review on a case by case basis to determine how the proposed change may impact the underlying risk of the group.
A: No. If there are no active employees, the group would need to terminate coverage. If your group is terminating coverage, standard contract termination provisions apply. In this case, COBRA does not apply. Individuals may obtain coverage on the Individual market, which may be subsidy-eligible based on income.
A: These situations would be unique to each employer. Employers should speak to their own legal counsel, trade groups or consult regulatory guidance on this topic.
A: We’re allowing flexibility in the plan eligibility definition as long as premium payments continue on the same basis as they currently do. That includes the contribution amounts from the employer and employee remaining the same. See question on premium amounts below.
A: Yes. We are allowing employers to continue making contract changes to shorten waiting periods. Making a change in eligibility to date of hire will have an effective date of the first of the month following receipt of the request. All other changes to waiting periods may be made effective the first of the month the request is received if they want to allow employees currently in their waiting period to be eligible for coverage within a shorter period of time. If a group changes its waiting period during this time, that change will remain in place for the rest of the policy year.
A: Yes. A rehire provision may have a different waiting period from that of new hires, as long as you treat all similarly situated employees equally.
A: Yes. In general, these changes should remain in place for the rest of the policy year. To avoid unnecessary administrative costs and adverse selection, only one request per contract year for a waiting period change off-cycle is allowed. We will review other requests on a case by case basis, and only in unusual circumstances would an additional change be considered.
A: No. Since we’re allowing flexibility in the plan’s eligibility definition, as long as premium payments continue on the same basis as they currently do, the rehire clause wouldn’t apply because those employees are still considered eligible and on the plan.
A: Those employees would fall under the rehire provision and would be subject to any waiting period under the rehire provision of the plan. Employers can shorten their waiting periods (see question above). Additionally, employers can change their rehire waiting period to “date of hire” or “no waiting period.”
A: Yes. For population changes above 10%, employers should expect to be reviewed via the normal underwriting process. We will be as flexible as we can assuming the underlying risk has not substantially changed. But if the risk has substantially changed, we reserve the right to adjust premiums accordingly.
A: All non-grandfathered private health plans (individual, small group, large group and group health plans) must cover certain preventive services without cost-sharing. The CARES Act required that COVID-19 vaccines (or other items or services to prevent or mitigate COVID-19) must be covered with no cost-sharing within 15 business days of their receiving appropriate recommendation by the United States Preventive Services Task Force (USPTSF) or Advisory Committee on Immunization Practices (ACIP).
A: For qualifying events, employees do have the option to make mid-year contribution changes to their Dependent Care Account. Contributions can be decreased or increased up to the allowable IRS maximum. Employees may also elect to completely discontinue contributions to their account. The following are examples of the most common Dependent Care Account qualifying events occurring due to COVID-19:
- Change in daycare provider
- Change in the employment status of employee or employee’s spouse(e.g. changing from full-time to part time, or job loss)
- Change in cost or coverage of dependent care (e.g. child-care center charges a different rate or temporary closes).
Please refer to your plan document for a complete list of qualifying events and effective date of mid-year contribution changes.
A: Yes. With the passage of the Coronavirus Aid, Relief and Economic Security (CARES) Act, the Federal government reinstated coverage of over-the-counter (OTC) products as eligible for reimbursement on CDHP accounts without the need for a prescription. This change is effective for expenses incurred on or after January 1, 2020. The law applies to the FSAs and HRAs administered by HealthPartners, and also to HSAs. The law also expanded the definition of qualified OTC items to include menstrual care products.
While merchants are working to update their systems to accommodate this change to recognize OTC products as qualified expenses, we anticipate members may experience inconsistences among retailers being able to automatically substantiate these purchases as eligible claims when using a debit card. If this occurs, members can submit their claims for the purchase using the myHP mobile app, online using their HealthPartners account, or manually.
A: HealthPartners presented a webinar on COVID-19 on Friday, March 20 for EAP customers. It was recorded and can be watched here. You can also go to hpeap.com and find it under Online Seminars. The session offered tips for reducing stress, working from home (especially if you have kids at home with you), and maintaining perspective during this unprecedented time.
A: These situations are unique to each employer. We cannot provide advice on this matter. Employers should speak to their own legal counsel, trade groups or consult regulatory guidance. We also encourage you to check the CDC’s Resources for Businesses and Employers for recommendations.
A: We have many resources available for HealthPartners members by logging into their web account.
A: While we are making as many accommodations as possible during this time, there has been no state or federal direction around this issue thus far, and therefore we need to maintain the appropriate level of documentation as required under current statutes.
A: No, there has been no state or federal guidance on this. We will continue to monitor this.
A: We will allow off-cycle plan changes for both medical and dental groups to a leaner plan. No retroactive plan changes will be allowed.
Criteria:
- We must receive the request in writing prior to the first of the month. The change will go into effect the first of the month following the request. No retro changes will be allowed.
- The group can change to a leaner plan only; they can’t move to a richer plan design.
- The group needs to keep the same benefit administration year: plan year to plan year, and calendar to calendar year.
- The group will keep the same renewal date.
- The group will pay as billed and would receive a credit for any plan changes on an upcoming bill. (It may be the next bill depending on the timing.)
- Claims: If the group is moving to a higher deductible, claims will not be reprocessed.
- Example: January group making a plan change on 5/1. From 1/1/2020 – 4/30/2020, they would be on Plan A and all the meters would be counting towards Plan A. On 5/1/2020, with the plan change, they would be put into Plan B. All the meters would transfer over but the claims from 1/1/2020 – 4/30/2020 are not reprocessed. If the member has additional claims after 5/1, they will be responsible for meeting the new deductible/OOP but their meters would carry over.
- Large groups: Same criteria applies as above. Sales should work with your underwriter on rates for alternate plan.