Q:Can employers keep their policies active if there are no employees employed?
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..
Q: If employees are currently not working due to FMLA, disability or other unique circumstances, are they eligible to stay on the plan?
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.
Q: If employees are still employed but not working the same hours or not actively working at this time, are they eligible to stay on the plan?
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.
Q: Can employers waive their current new hire waiting period during this time?
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.
Q: Can an employer add a rehire waiting period that is different from the new hire waiting period provision?
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.
Q: If the waiting period changes now, does it remain that way for the rest of the plan year?
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.
Q: If employees are being furloughed or not actively working but remain on the plan, does the employee fall under the rehire clause?
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.
Q: How will waiting periods be treated for employees who were terminated and are coming back to work after the COVID-19 pandemic ends?
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.”
Q: Are you maintaining the practice of underwriting if there is more than a 10 percent enrollment change?
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.