General News
Published May 26, 2020
Premera Blue Cross is here to help support you and your clients during the COVID-19 outbreak. This FCheck out our complete COVID-19 FAQ for the most current information.
Important updates from July 9, 2020
- Premera’s Benefit Coverage Guideline is effective for serology tests for dates of service July 1, 2020 and forward. Premera will reimburse for serology tests that are for the purpose of supporting a COVID-19 diagnosis as part of the treatment or management
of a patient’s medical condition.
- We won't include testing coverage (molecular/antigen or antibody tests) for return-to-work strategies for our insured book of business just as we don’t cover drug testing for employment purposes, as an example. The EEOC has clarified (see A.6) that any mandatory medical test is job related and consistent with business necessity.
Important updates from May 26, 2020
IRS
NOTICE 2020-29 includes the following changes:
- Ability to amend plan documents (if group currently offers a grace period) to allow an extended grace period for FSA and DCAP plans to December 31, 2020.
- Employers decide whether or not they want to extend the grace period. It does not allow for groups to amend their plan to opt into a grace period if they didn’t previously offer it.
- Change is only applicable to grace periods ending in 2020 and may only continue to December 31, 2020 regardless of when grace period was scheduled to end. Example: A grace period ending March 15, 2020 or December 29, 2020 may only be extended
to December 31, 2020.
The FSA grace period is defined as a two month and 15 day period following the end of the plan year that allows FSA/DCFSA owners who have remaining funds from prior plan years to use their funds for current plan year expenses. Note – not all employer
plan designs offer a grace period.
DOL guidance issued to extend health care benefit deadlines
The new Rule and guidance (EBSA Disaster Relief Notice 2020-01)
extend certain health care benefit deadlines under the Employee Retirement Income Security Act (ERISA) and may impact your ConnectYourCare (CYC) programs, including flexible spending accounts (FSAs), health reimbursement arrangements (HRAs), and COBRA.
CYC is currently working diligently to assess their systems and procedures to support these changes."
Important updates from May 14, 2020
- Premera will provide up to $65 million in premium relief funds across Washington state. All active insured small and large group employers including associations will receive a one-time credit of up to 15% on the group’s August 2020 premium bill.
- Every business has a different set of circumstances and requirements that should guide their return to work decisions. We’ve learned of several resources that other businesses are finding helpful in determining their return to work strategy. We’ll
continue to update this list as we come across additional resources.
- We’re continuing to monitor local, state, and federal guidance as well clinical expert organizations such as the CDC, as it pertains to return-to-work protocols and testing. We’ll keep you updated as more information is available.
- Premera is waiving cost shares for all COVID-19 related testing and treatment. Learn more about cost share waivers.
Important updates from May 11, 2020
- Premera has expanded the available invoices from the past 12 months to the past 24 months. This will allow your client to download the entire 2019 calendar year.
- The employer portal has previously limited availability of invoices to only 12 months.
- As part of an application for a Small Business Association (SBA) loan, employers must provide an accounting of all expenses for the 2019 calendar year.
To review available invoices, log into the secure employer portal.
For questions, please contact your Premera account team.
Important updates from April 16, 2020
- We've recently extended our 30-day premium grace period to 60 days for our fully insured groups.
- During this grace period, we’ll hold claims while continuing to show employees as eligible so they can get the care and prescriptions needed during this critical time.
- The Washington State Office of the Insurance Commissioner (OIC) is requiring that insurers notify employees that their group is delinquent. These letters will only go to employees of a fully insured delinquent group.
- If an employer can't pay their premiums for more than 60 days, employees may be required to pay for any unpaid medical bills.
Important updates from April 2, 2020
- We're waiving cost shares and deductibles for all COVID-19-related testing and treatment (both inpatient and outpatient).
- This cost share waiver will continue through October 1, 2020.
- This includes hospitalizations and medical transport when needed, and FDA-approved medications delivered as in-patient for in- or out-of-network providers.
- Premera Blue Cross will review claims received since January 1, 2020 and reprocess any with COVID-19 related diagnoses.
- For Medicare, we will review claims back to February 4, 2020 per Centers for Medicare and Medicaid Services (CMS) guidelines.
Important updates from April 1, 2020
- We’re expanding our telehealth network and waiving all cost shares for in-network telehealth providers.
- This now includes employees enrolled in qualified high-deductible health plans (QHDHP) plans.
- This expanded network and cost share waiving is available until June 30, 2020, with a potential extension based on businesses and epidemiological considerations.
- We established a grace period for OptiFlex monthly funding rates, and ASC administration fees only. This grace period extension is in effect until further notice.
- All Premera Medicare plan members can now use telehealth services if their provider offers it.
- Premera Medicare Advantage plans cover telehealth visits with in-network providers who offer the service. This remains unchanged.
- Premera Medicare Supplement plans now cover telehealth visits if their provider offers it.
- CMS temporarily expanded coverage of telehealth services for all Medicare recipients during the COVID-19 outbreak.
Important updates from March 23, 2020
- We’ve made changes and clarifications relating to group eligibility rules that are in effect during the COVID-19 nationwide public health crisis. These are temporary measures are meant to help your clients during this difficult time.
- Our updated FAQ has detailed information about group eligibility rules and requirements.
For more information, visit the FAQ.
If you have any questions, contact your Premera account manager.