Carriers

Aetna

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MEDICAL SPECIAL ENROLLMENT AND COVERAGE EXPANSION

Aetna Offers a Special Enrollment Period opt-in for Aetna Commercial-Insured and Small Group Aetna Funding Advantage customers. This enrollment opportunity will be offered from Monday, April 6, through Friday, April 17, 2020.

April 6, 2020

Aetna announces updates to their eligibility rules in response to COVID19. Through July 31, 2020 employees can maintain their coverage on their AFA plans so long as (1) the reduction in hours/lay off is a temporary measure resulting from the COVID-19 pandemic; (2) you continue to pay your monthly bill and (3) you do not terminate the employee(s).

Aetna is also supporting changes to the employers waiting period rule for re-hires once those employees resume working 30+ hours a week. For a complete list of details see the attached FAQ Aetna has provided.

Aetna announces updates to their (AFA/ACA/51-100) Frequently Asked Questions (FAQs) to help answer many of the outstanding questions you and your clients may have.

Aetna will continue to publish additional questions and responses through aetna.com.  It’s recommend that you bookmark this site and refer to it to gain the most up-to-date Aetna COVID-19 information. Click here for more details.

To view the formal announcement, click here.

March 2020

Aetna Funding Advantage’s current policy allows rehires to return to coverage on their date of rehire as long as the member was terminated for less than one year.

BCBS of South Carolina and BlueChoice HealthPlan

BlueCross BlueShield of South Carolina’s COVID-19 website
BlueChoice HealthPlan’s COVID-19 website

MEDICAL SPECIAL ENROLLMENT AND COVERAGE EXPANSION

To better serve their members during the COVID-19 crisis, BlueCross BlueShield of South Carolina and BlueChoice HealthPlan will waive all out-of-pocket costs related to in-network COVID-19 medical treatment.

For more details and to view the formal announcement, click here.

Updates as of March 2020

As noted in the recent agent newsletter from President Scott Graves, BlueCross and BlueChoice are continuing to find unquie solutions  for advisors and their customers. To view that letter, click here. Decisions regarding eligibility and re-hire waiting periods are considered and as soon as updates are made available, The Cason Group will be sure to pass along.

Updates as of April 6, 2020

Effective through May 31, 2020, BlueCross and BlueChoice will deem an employee to be actively at work, for eligibility purposes, so long as the employer:

  • considers the employee to be “employed”,
  • is collecting contributions toward insurance, unless 100% company paid
  • is paying the insurance premiums for that employee in a timely manner.

Returning Employees, rehired or returning to full time status, on or before May 31, 2020 will not be subject to a waiting period.

Pertaining to group size, effective through May 31, 2020 the group will remain active with BlueCross or BlueChoice, as long as:

  • at least two full-time employees remain on the group policy,
  • the group is collecting contributions toward insurance, unless 100% company paid, and
  • is paying the insurance premiums to BlueCross for those employees in a timely manner

Click here for more details.

BlueChoice HealthPlan: For New Groups now through 7/1/2020 effective dates, BlueChoice HealthPlan will consider individual policies as a valid waiver. In addition, BlueChoice HealthPlan of South Carolina has compiled a Frequently Asked Questions (FAQs) document to help you navigate your small group customers during this time. Topics include:

  • Eligibility
  • Business Rules and Practices
  • Telehealth
  • Care Management

BlueCross BlueShield and BlueChoice HealthPlan: Effective March 31, 2020, BlueCross BlueShield of South Carolina and BlueChoice HealthPlan members have an additional telehealth option available to them.

Members can now have a live video visit at no cost to them with a Doctors Care provider using Doctors Care Anywhere, available via https://doctorscare.com/anywhere/  or by downloading the app from the App Store or Google Play.  Promotional materials can be found here for BlueCross members and here for BlueChoice® members.

BlueCross BlueShield and BlueChoice HealthPlan have created webpages where members can go to access telehealth.

For BlueCross members, this information can be found here.

For BlueChoice members, this information can be found here.

Updates as of May 19th, 2020

Group Eligibility Guidelines Extended Through July 31, 2020, Due to COVID-19 Pandemic
As a result of the impact the COVID-19 pandemic is having on the workplace, BlueCross BlueShield of South Carolina (BlueCross) and BlueChoice HealthPlan of South Carolina, Inc. (BlueChoice®) provided this update on Group Eligibility Rules and Guidelines for their Fully Insured Group Lines of Business.

BCBS and BCHP are extending their group eligibility guidelines due to the COVID-19 pandemic through July 31, 2020.

Actively At Work
BlueCross and BlueChoice understand that employers may need to displace workers and amend work schedules during this crisis. Effective through July 31, 2020, BlueCross and BlueChoice will deem an employee to be actively at work, for eligibility purposes, so long as the employer:

  • considers the employee to be “employed,”
  • is collecting contributions toward insurance, unless 100 percent company paid, and is paying the insurance premiums for that employee in a timely manner

Coverage must continue to be offered on a uniform, non-discriminatory basis to all employees and employee contributions must be no greater than those in effect immediately prior to March 1, 2020.

Group Size
BlueCross and BlueChoice understand that some groups may lay off workers or downsize. Effective through July 31, 2020, the group will remain active with BlueCross or BlueChoice at the group’s current premium structure and/or rating methodology unless and until the group’s renewal as long as:

  • at least two full-time employees remain on the group policy,
  • the group is collecting contributions toward insurance, unless 100 percent company paid, and
  • is paying the insurance premiums to BlueCross or BlueChoice for those employees in a timely manner.

Coverage must continue to be offered on a uniform, non-discriminatory basis to all employees and employee contributions must be no greater than those in effect immediately prior to March 1, 2020.

Renewals
BlueCross and BlueChoice will continue to meet market and regulatory provisions for offering timely renewals. Unless any temporary impacts to group size are sufficiently significant and anticipated to be permanent, or the group’s average number of employees on business days in 2019 changed by a sufficiently significant amount from 2018 to cause the group’s market segment to change (from large to small), the group will be renewed under the rating methodology in place at the time of the last renewal.

COBRA and Continuation
Generally, employers with greater than 20 lives will qualify to offer COBRA coverage to displaced employees while employers with fewer than 20 lives may qualify for state continuation coverage. Additionally, BlueCross and BlueChoice can offer individual coverage options to displaced workers. Please contact your marketing representative to review options.

Returning Employees
Employees rehired or returning to full time status on or before July 31, 2020, will not be subject to a waiting period.

Helping Employees Find Other Insurance Coverage
If individuals lose coverage due to a loss of eligibility, BlueCross and BlueChoice will work with agents and employers to assist with transitions to other types of coverage. BCBS and BCHP can help assess options and eligibility for Medicare, Medicaid, individual coverage or even short-term products.

 

Updates as of October 5, 2020

BlueCross BlueShield of South Carolina and BlueChoice HealthPlan of South Carolina COVID-19 Pandemic Group Eligibility Guidelines Extended Through Dec. 31

 

As the COVID-19 pandemic continues to impact the workplace, BlueCross BlueShield of South Carolina and BlueChoice HealthPlan of South Carolina have extended the end dates of the Group Eligibility Rules and Guidelines for our Fully Insured Group lines of business.

While many questions can be addressed by our respective standard Premium Billing & Payment guidelines, we understand the need to remain flexible during this extraordinary time. As we have demonstrated during this pandemic and previous natural disasters, we will continue to work alongside our customers to keep individuals insured. Should local or federal authorities provide new or “emergency” guidelines or provisions, we will amend our policies consistent with such guidance.

Most inquiries continue to be related to eligibility and the “actively at work” provisions of our contracts. To clarify how we are determining eligibility during this time, we offer this guidance:

 

ACTIVELY AT WORK

BlueCross and BlueChoice® understand that employers may need to displace workers and amend work schedules during this crisis. Effective through Dec. 31, 2020, BlueCross and BlueChoice will deem an employee to be actively at work, for eligibility purposes, so long as the employer:

  • Considers the employee to be “employed.”
  • Is collecting contributions toward insurance, unless 100 percent company paid.
  • Is paying the insurance premiums for that employee in a timely manner.

Coverage must continue to be offered on a uniform, non-discriminatory basis to all employees, and employee contributions must be no greater than those in effect immediately before March 1, 2020.

 

GROUP SIZE

BlueCross and BlueChoice understand that some groups may downsize or lay off workers. Effective thorough Dec. 31, 2020, the group will remain active with BlueCross or BlueChoice at the group’s current premium structure and/or rating methodology until the group’s renewal as long as:

  • At least two full-time employees remain on the group policy.
  • The group is collecting contributions toward insurance, unless 100 percent company paid.
  • The company is paying insurance premiums in a timely manner.

Coverage must continue to be offered on a uniform, non-discriminatory basis to all employees, and employee contributions must be no greater than those in effect immediately before March 1, 2020.

 

RENEWALS

BlueCross and BlueChoice will continue to meet market and regulatory provisions for offering timely renewals. Unless any temporary impacts to group size are sufficiently significant and anticipated to be permanent, or the group’s average number of employees on business days in 2020 changed by a sufficiently significant amount from 2019 to cause the group’s market segment to change (from large to small), the group will be renewed under the rating methodology in place at the time of the last renewal.

 

COBRA AND CONTINUATION

Generally, employers with greater than 20 lives will qualify to offer COBRA coverage to displaced employees, while employers with fewer than 20 lives may qualify for state continuation coverage. BlueCross and BlueChoice also can offer individual coverage options to displaced workers. Please contact your marketing representative to review options.

 

RETURNING EMPLOYEES

Employees rehired or returning to full-time status on or before Dec. 31, 2020, will not be subject to a waiting period.

 

HELPING EMPLOYEES FIND OTHER INSURANCE COVERAGE

If individuals lose coverage due to a loss of eligibility, BlueCross and BlueChoice will work with agents and employers to assist with transitions to other types of coverage. We can help assess options and eligibility for Medicare, Medicaid, individual coverage or even short-term products.

Please continue to remind your customers who are our members that updated information regarding COVID-19 and any related changes in their coverage can be found on our websites.

BlueCross members: www.bcbs.sc/covid-19

BlueChoice members: www.BlueChoiceSC.com/COVID-19

Allsavers

Click here to view this carrier’s COVID-19 website

March 2020

Allsavers is offering a special enrollment opportunity from 3/23/20 – 4/6/20 allowing dependents such as spouses and children to be added if they enroll in the same benefit as the employee. Standard waiting periods are waived, but wage and tax will be needed (for 2-50) to validate the employee’s eligibility. Click here for more information.

Allstate

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March 2020

Allstate has taken proactive steps to outline their Group products and how they may have related COVID19 benefits. Click here for more information.

Companion Life

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ANCILLARY RATE HOLDS GO INTO EFFECT

Companion Life Insurance Company remains committed to their customers’ continued success and stability. Now more than ever, Companion Life wants to assure you that they are delivering practical solutions to assist you during this time of crisis. So, they are announcing a zero renewal rate increase for all Companion Life dental insurance groups that have an anniversary date of May 2020 through August 2020.

Click here to view the formal announcement from Companion Life.

March 2020

Companion Life has extended the group premium grace period to 90 days.  Employers may choose to deem employees still “actively employed” and “benefits eligible” during a temporary business closure. Companion Life will recognize that status. In the event an employer institutes a temporary layoff, any members rehired within 12 months will be enrolled at the first of the following month with no evidence of insurability or waiting period requirements. Click here for more information.

Guardian

Click here to view this carrier’s COVID-19 website

ANCILLARY RATE HOLDS GO INTO EFFECT

At Guardian, their customers are their top priority. Guardian continues to monitor the coronavirus (COVID‐19) pandemic and are sharing information to help support your Guardian benefit programs. They have discussed rate renewals during the current business disruption period with many customers, and are pleased to announce our plan renewal approach in the immediate term.

Employer Groups with Less Than 500 Employees , Guardian will retain rates (no rate change) on all renewals for May 1, 2020 through August 31, 2020 plan anniversary dates.

Click here for more details.

April 6, 2020

Guardian will retain rates (no rate change) on all renewals for May 1, 2020 through August 31, 2020 plan anniversary dates for groups under 500 lives. Click here for more details.

March 2020

Guardian will extend an additional 30 days to the grace period of any group struggling to pay their premium based on Covid-19. Guardian has also launched a site referenced below pertaining to their Group and Voluntary products related to COVID19 benefits.

Kansas City Life

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ANCILLARY RATE HOLDS GO INTO EFFECT

KCL recognizes that many of their clients and brokers are facing hardships at this time and, to ease some of that burden, Kansas City Life Group Benefits is forgoing renewal rate increases for clients renewing coverage May 1, 2020, through Aug. 1, 2020. Policies renewing during this time frame will retain their plan anniversary month and will be reviewed in 2021.

Click here for more details.

March 2020

KCL dental policies have a 3 month layoff provision currently. Employers may retain employees on the dental plan and continue to pay premium, and benefits will not be disrupted. Should an employer terminate an employee from the plan and rehire the employee within 6 months, the employee will be reinstate and not subject to probationary or waiting periods.

For all other coverages, KCL is extending the layoff or leave of absence provision to 90 days following the end of the month an employee was terminated. Provided an employer continues to pay premium and keeps the employee on the plan, the coverage will remain uninterrupted. Click here for more information.

Principal

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ANCILLARY RATE HOLDS GO INTO EFFECT

Principal would like to announce that for employers with less than 500 employees and policy anniversary dates of May 1, 2020 through Aug. 15, 2020, there won’t be any rate increases. To view the official announcement from Principal, click here.

Updates as of March 2020

Principal’s standard practice for an employee with reduced hours is to continue coverage only until the end of the month. However, if the reduced schedule continues into the next month, the coverage will continue as long as premiums are paid. This same policy applies to layoffs and furloughs.

Updates as of April 6, 2020

Rate Stability announcement!
Principal would like to announce that for employers with less than 500 employees and policy anniversary dates of May 1, 2020 through Aug. 15, 2020, there won’t be any rate increases. To view the official announcement from Principal, click here

Updates as of May 19th, 2020

Giving Back to Employers
COVID-19 is impacting everyone’s lives – including trips to the dentist. Most dental offices have been temporarily closed for non-emergency services. And Principal® understands employers and their employees have had limited use of their dental benefits.

Help for employers: 10% dental premium credit
Principal is giving a premium credit of 10% for the months of June-October 2020 to employers, based on the prior month’s billed premium, who have a fully insured dental policy with them. These employers will be notified by email on May 7 and will see the credit on their group dental coverage bills.

To view the latest update from Principal, click here.

Updates as of June 8, 2020

Principal DI:

  • Updated simplified underwriting guidelines extended through 7/31/2020
  • Online Part B now available for disability
  • Extended grace periods – policies with bill dates through June will continue to receive the grace period extension – an additional 60 days beyond what is offered with the policy. The grace period extension will end after June and policies will revert back to the standard grace period guidelines.

Sun Life

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ANCILLARY RATE HOLDS GO INTO EFFECT

For employer-paid and employee-paid Group Benefits (Life, Long-Term Disability, Short-Term Disability, Dental, Vision, Cancer, Critical Illness and Accident), Sun Life will be continuing the inforce rate for 6/1, 7/1 and 8/1 renewals for twelve months. This will be applicable for all groups with fewer than 500 lives (as determined by the highest currently enrolled SLF coverage)

Click here to see the announcement from Sun Life.

March 2020

Providing that the premium is paid and the group policy stays in force, SunLife is administratively extending the period of continuation on all group coverages to the earlier of 90 days or the end of the period when a person is unable to work, is working reduced hours, or is not working from their usual work location. This administrative extension timeframe is available for the period of 3/13/2020 – 9/1/2020 and should be applied uniformly at the employer level.

SunLife is extending their standard grace period for group premium payment an additional 30 days, if needed, on all coverage. There is not need to contact them, it will automatically be provided. If you do need support, 800-247-6875.

UnitedHealthCare

Click here to view this carrier’s COVID-19 website

MEDICAL SPECIAL ENROLLMENT AND COVERAGE EXPANSION

Member cost-sharing waived for COVID-19 through May 31
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. This builds on the company’s previously announced efforts to waive cost-sharing for COVID-19 testing and testing-related visits. Read more here.

Cost-sharing waived for network, non-COVID-19 telehealth visits
Starting March 31 through June 18, UnitedHealthcare will waive cost-sharing for network, non-COVID-19 telehealth visits for fully insured individual and group market health plans, as well as its Medicare Advantage and Medicaid plans. UnitedHealthcare has previously waived cost-sharing for telehealth visits related to COVID-19 testing. Read more here.

COVID-19 special open enrollment extended to April 13
UnitedHealthcare has extended the COVID-19 Special Enrollment Period (SEP) to April 13, and employers with multiple plan options also can buy down to a leaner plan.

Click here to review the full update.

Updates as of March 2020

United Healthcare is offering a special enrollment opportunity from 3/23/20 – 4/6/20 allowing dependents such as spouses and children to be added if they enroll in the same benefit as the employee. Standard waiting periods are waived, but wage and tax will be needed (for 2-50) to validate the employee’s eligibility

In addition, fully-insured clients can continue to offer medical benefits to employees furloughed due to COVID-19 as long as the plan sponsor continues to pay its share of premiums an offer the option to all furloughed employees on an equal basis. Employees remain eligible for coverage if they remain an active employee during periods of temporary layoff or reduction in hours as a result.
For more information, please click here.

Updates as of April 6, 2020

Premium Payment Questions:
UnitedHealthCare has received a high number of inquiries for groups that are having trouble making their premium payments due to temporary business closures due to COVID-19.  The standard grace period for UHC fully insured business and for All Savers level-funded business is 30 days.  Example: The premium due date of April premium payments is 4/1.  However, UHC groups and All Savers groups have a 30 day grace period until the end of April.

If a group is having trouble paying their March premium by the end of the grace period, the group can call Customer Service to see if a premium extension is available.  These requests will be reviewed by UHC’s finance team on a case-by-case basis.  These requests need to come directly from the group.

The numbers that groups can utilize to request premium extension for their March premium are as follows:

  • UnitedHealthcare Employer Customer Service Team: (888) 842-4571
  • All Savers Employer Customer Service Team: (866) 405-7174

Special Enrollment: Multi-option employer rules
The position on multi-option employers adding an additional lean plan design has changed. Temporarily, UnitedHealthcare will not impose any fully insured policy limitations on employer/plan sponsors that want to allow:

  • New enrollees (i.e., eligible individuals who previously declined group coverage during Open Enrollment) the opportunity to enroll in any plan option available under the employer/plan sponsor’s benefit offerings and/or
  • Existing enrollees (i.e., those who are currently enrolled in a benefit offering) the opportunity to change their prior election and enroll in a newly added leaner plan design.

As always, plan sponsors are encouraged to review any changes to their plan with their employee benefit plan counsel and tax advisor.

General Updates on COVID-19:
In order to access the most up to date information, please access the following links:

For updated FAQ, click here.

Updates as of May 19th, 2020

At UnitedHealthcare, they’re ready to help with insights and more as your clients prepare to transition their employees back to the workplace.

As part of this support, you and your clients have access to their Return to Worksite Toolkit designed to help clients assess their readiness and develop a strategy that’s consistent with federal and state public health policies and guidelines. To access this toolkit, please log in to United-e-Services (UeS).  Click here to view the one-page overview of UnitedHealthcare’s Return To Work initiative and toolkit.
If you or your clients have any questions regarding this information, please contact UnitedHealthCare’s customer service team:

  • Broker / Employer Helpline for UHC Fully Insured Groups: 1-888-842-4571
  • Broker Hotline for All Savers Groups: 866-405-7174

Special COVID-19 Dental and Vision Enrollment Opportunity
UnitedHealthcare is providing its fully-insured employer customers with a Special COVID-19 Dental and Vision Enrollment Opportunity (“Special Enrollment Opportunity”) to enroll employees who previously did not enroll in Dental and/or Vision coverage. The one-time opportunity will be limited to those employees who previously waived coverage or did not elect coverage for themselves or their dependents (e.g., spouses or children).

Click here for more information and the full announcement.

Unum

Click here to view this carrier’s COVID-19 website

March 2020

Employees who are required to work reduced hours, temporarily laid off, or furloughed will still have coverage. However, some employee certificates may not include furloughs as an approved leave of absence. As an accommodation, and provided premiums continue to be remitted to Unum:
For group-based products:

  • if the policy does not include furloughs as an approved leave of absence, then furloughed employees will be treated as if they are on an approved leave of absence; and
  • furloughed employees will remain eligible for coverage up to the leave of absence term that is in the policy, or 60 days – whichever is greater.

For Accident and Health:

  • As long as the enrollment file indicates coverage and the employee continues to pay premiums, their coverage remains in force.
  • If the employee doesn’t request direct bill within 30 days as directed in Unum’s conservation letter then a policy would be terminated.

For Dental:

  • Furlough or leave of absence is covered up until one year as long as premium is paid