On March 18, 2020, President Trump signed the Families First Coronavirus Response Act (the Act) into law. Among other things, this Act requires health plans to cover COVID-19 testing without imposing any cost sharing and requires employers to provide paid leave for employees related to the COVID-19 pandemic.
This coverage mandate is effective immediately and applies to the following health plans and issuers, regardless of grandfathered status under the Affordable Care Act (ACA):
- All fully insured group health plans
- All self-insured group health plans
- Health insurance issuers offering group or individual coverage
During this public health emergency, health plans and issuers must cover FDA-approved diagnostic testing products for COVID-19, including any items or services provided during a visit to a provider (in-person or telehealth), urgent care center or emergency room that relate to COVID-19 testing. This coverage cannot be subject to any plan deductible, copayment or coinsurance and must be provided without prior authorization or other medical management requirements
It is important to note that this mandate does not require health plans and issuers to cover COVID-19 treatment at no charge. Exact coverage details for COVID-19 treatment, including any cost-sharing amounts, will vary by plan.
The IRS has advised that high-deductible health plans (HDHPs) can pay for COVID-19 testing and treatment before plan deductibles have been met without jeopardizing their status. According to the IRS, individuals who are participating in these plans may continue to contribute to their HSAs.
Emergency Leave Measures
The leave provisions of the Act take effect no later than April 2, 2020 (15 days after it was signed by the president). The emergency leave benefits are scheduled to expire on December 31, 2020.
Paid Sick Leave
The Act requires 80 hours of paid sick leave for government workers and employees of companies with fewer than 500 employees. Leave must be made available to workers who are symptomatic or are under an order or advice to quarantine or self-isolate, who have to care for a family member under such an order or advice, or who have a child whose school or child care provider or facility has closed or is unavailable due to the coronavirus.
Future regulations may exempt small businesses with fewer than 50 employees from the paid sick leave requirement. Healthcare providers and emergency responders may be excluded from both types of leave benefits.
Emergency Family and Medical Leave Act
The Act also provides FMLA rights for some employees of companies with fewer than 500 employees, requiring partially paid leave after 10 days when an employee is unable to work or telework due to school or child-care closures related to the coronavirus.
The Act provides funding for economic assistance. A refundable tax credit for employers that provide paid leave benefits as required by the Act is also included. The U.S. Treasury is expected to use its regulatory authority to advance funds to some small businesses to cover the cost of providing paid sick leave.
Webinar and More Information
Reach out to your Hylant representative for further information, or visit the Hylant Coronavirus Resource Center at www.hylantcoronavirusinfo.com to access a wide variety of materials designed to help you navigate these unprecedented times.
The above information does not constitute advice. Always contact your employee benefits broker or trusted adviser for insurance-related questions.