You and/or your employees may be receiving information about a Blue Cross Blue Shield Class Action Settlement soon.
You may be eligible to submit a claim if you are an INDIVIDUAL, INSURED GROUP (and their employees) or a SELF-FUNDED ACCOUNT that purchased or was enrolled in a Blue Cross or Blue Shield from February 7, 2008 through October 16, 2020. This includes groups (and their employees) purchasing coverage through an Association Plan that utilizes one of these insurance companies.
The Net Settlement Fund is estimated to be approximately $1.9 billion after attorney fees, administration expenses and other costs are deducted from the total $2.67 billion Settlement Fund.
We can not estimate how much you might be eligible to receive as it will be based on the number of claimants and several other factors. If the total payment for any claimant is equal or less than $5.00, no payment will be made.
THE INSIDER LEGISLATIVE UPDATES BROADCAST Click the play button below for a broadcast where Colleen Patterson, Director, Employer Services and Compliance, and Christine Guzzardo, J.D., Senior Employer Services Specialist, ERISA, discuss the latest updates on the Blue Cross Blue Shield Settlement.
Below is also some additional contact information for your reference.
How often do you think about the information contained on a state-issued identification document (such as a driver’s license)? How about your passport, which is internationally recognized? The data on your credit card’s magnetic strip? Pretty sure most people would answer never or infrequently to any or all of these questions, which is why there are folks like James (Jim) Mottola.
Jim spent 26 years at the Secret Service, thinking a lot about identification documents and the information contained – and not contained – on them. To law enforcement, identification is a vital part of the job. But with COVID-19, questions about identification data have taken on new forms and urgencies, beyond law enforcement and the ability to get on an airplane or drive a car. A great many of those questions revolve around health ID’s; documents that could confirm a person has the COVID-19 antibodies, or never tested positive for the virus, or received the proper immunizations before traveling to other parts of the world.
Would a health ID work, especially here in the United States? If so, how would it work and most importantly, how would you protect the data? “Dynamic Identification” is a conversation I recorded with Jim to discuss these questions and others. It’s a topic that touches on every citizen and business. If interested, just click on the video below.
Each business or entity, including those that have been designated as essential under Empire State Development’s Essential Business Guidance, must develop a written Safety Plan outlining how its workplace will prevent the spread of COVID-19.
A business may fill out THIS TEMPLATE to fulfill the requirement, or may develop its own Safety Plan. This plan does not need to be submitted to a state agency for approval but must be retained on the premises of the business and must made available to the New York State Department of Health (DOH) or local health or safety authorities in the event of an inspection. Business owners should refer to the State’s industry-specific guidance for more information on how to safely operate. For a list of regions and sectors that are authorized to re-open, as well as detailed guidance for each sector, please visit: www.forward.ny.gov. If your industry is not included in the posted guidance but your businesses has been operating as essential, please refer to ESD’s Essential Business Guidance and adhere to the guidelines within this Safety Plan.
Please continue to regularly check the New York Forward site for guidance that is applicable to your business or certain parts of your business functions, and consult the state and federal resources listed below.
Here is a helpful list of things to keep in mind during this time:
New York businesses must create a COVID-19 health and safety plan for employees and the public. A template includes provisions for developing physical distancing protocols, providing personal protective equipment to employees, creating hygiene and cleaning protocols, implementing communication practices, creating a COVID-19 screening process, adopting contact tracing protocols, and developing a plan for cleaning and disinfection. It’s also a great resource for NJ businesses.
Make sure to implement mandatory health screening assessments including a questionnaire and temperature checks.
Limit the total number of employees in the office, enforce 6ft social distancing, and modify/reconfigure the office to allow for social distancing.
Provide workers with facemasks at no cost and have an adequate supply in case of need for replacement. Train workers on how to use PPE. Limit the sharing of objects (i.e. tools, machinery, etc.)
Adhere to hygiene, cleaning and disinfection requirements of the CDC and Department of Health. Provide and maintain hand hygiene stations in the office. Clean and disinfect the offices on a routine basis.
Communicate, post signage and train employees on COVID 19 issues.
Employees who are sick should stay home or return home if they become ill at work.
Don’t forget about your leave obligations under FFCRA, Emergency FMLA, New York State COVID-19 leave, New York Paid Family Leave, New York City or Westchester Earned Sick Time, New Jersey Earned sick Leave, or short-term disability leave
Consider a delayed reopening or a slow opening, allowing employees to continue to obtain increased unemployment benefits.
Don’t forget about your wage and hour obligations i.e. when you reduce salary/hours, pay wages, furlough employees, have employees work from home, impose temperature checks, pre-shift sanitizing, or daily check-in procedures.
*Attorney Advertising: The foregoing is a summary of the laws discussed above for the purpose of providing a general overview of these laws. These materials are not meant, nor should they be construed, to provide information that is specific to any law(s). The above is not legal advice and you should consult with counsel concerning the applicability of any law to your particular situation.
Did you get the PPP loan and now you are concerned about making sure the loan is fully forgiven? Check out this great video from colleague, Chelsea Whalley of J Donovan Financial.
U.S. small businesses that were able to secure financial relief through the SBA’s Payroll Protection Program should consider the following to help their cause for qualification of forgiveness of the full principal amount of the loan and any accrued interest:
• Use the loan funds only toward: payroll, including salary, wages, tips and covered benefits for employees; rent or mortgage interest; and utilities.
• Ensure at least 75% of loan funds are allocated for payroll costs.
• Maintain the level of full-time employee (FTE) headcount without reduction during the eight-week covered period.
• Maintain the salaries and wages of your workforce during the eight-week covered period. Any reduction of more than 25% for any employee who makes less than $100,000 will reduce the amount forgiven.
• Preserve proper documentation to support the amount of proceeds used for payroll costs, rent or mortgage, and utilities.
• Prior to June 30, 2020, restore all full-time employment and salary levels back from any reductions made between Feb. 15, 2020, and April 26, 2020. As mentioned above, preserving proper documentation is important, as this information will be used by your lender when evaluating whether an employer qualifies for PPP loan forgiveness.
Most people are working from home these days due to the Covid-19 Pandemic. In order to make work more efficient it’s important to follow these steps in order to be most productive.
1. Follow your standard routine.
2. Set up a special workspace.
3. Use video calls to keep in touch.
4. Use task management to keep track of progress.
5. Do not stay in the same position for too long.
6. Make sure to exercise everyday.
7. Find what helps you concentrate.
8. Look after your mental health.
Looking for an easy digestible explanation what considerations to make for Mid-Year Enrollments under a Section 125 plan? Check out this great video from colleague, Chelsea Whalley of J Donovan Financial.
Special Mid-Year Enrollment Window
1. Get Approval from Health Insurer in writing. If Self-funded, approval comes from stop-loss carrier.
2. Decide if these special deductions will be pre-tax or post-tax. As of right now, the IRS has issued no guidance for pre-tax elections due to COVID-19.
Section 125 Mid Year Election Change Events:
1. Change in employment status if the change impacts eligibility for health plan
2. A significant change in health plan coverage
3. HIPAA Special Enrollment (marriage, birth, etc)
To avoid any unintended liability, employers should check with your CPA and/or attorney to decide what is best for your business.
Click Here to see the original article in Employee Benefit Advisor
The Coronavirus Aid, Relief, and Economic Security (CARES) Act was signed by President Trump on March 27 after passing both the House and Senate earlier in the week. This $2.2 trillion stimulus package is wide-reaching and intended to provide economic relief for the individuals and businesses hit hardest by the coronavirus pandemic and the resulting financial downturn.
Within the 800-page bill, there are several important provisions affecting employers, including requirements for coverage of COVID-19 testing and treatments. There are also provisions that extend beyond the coronavirus into other areas of employer benefit designs with potential impact to group health plans beyond the current public health emergency.
1. Coverage of COVID-19 Testing and Treatment
Group health plans must cover COVID-19 screening and the related office visit without cost sharing, which includes COVID-19 tests that may not have been approved by the US Food and Drug Administration. Group health plans must cover, without cost-sharing, “qualifying coronavirus preventive services,” which are items, services and immunizations intended to prevent or mitigate COVID-19 that receive a rating of “A” or “B” from the US Preventive Services Task Force (USPSTF) or a recommendation from the CDC Advisory Committee on Immunization Practices (ACIP) with respect to the individual involved. This requirement will apply 15 business days after the recommendation is made by the USPSTF or ACIP.
2. Payment for COVID-19 Testing and Treatment
Group health plans providing COVID-19 testing must reimburse the provider in the amount of the negotiated rate, if in effect before the public health emergency began, or if not, an amount that equals the cash price as listed by the provider on a public internet website, or a negotiated rate with the provider for less than the cash price. This provision is effective upon enactment of the CARES Act (March 27, 2020) and is not retroactive.
3. Telehealth
The Act allows a high-deductible health plan with a health savings account (HSA) to cover telehealth services prior to a patient reaching the deductible, without regard to whether the services provided via telehealth relate to COVID-19. This provision is effective upon enactment and lasts through plan years beginning in 2021.
4. Over-the-counter Medical Products without a Prescription
The Act allows for account-based plans, including HSAs, flexible spending accounts and health reimbursement arrangements, to reimburse members for the purchase of over-the-counter medical products without a prescription from a physician, regardless whether the product is related to treatment of COVID-19. This reverses a restriction imposed by the Affordable Care Act. These changes are effective for amounts paid/expenses incurred after 2019 and seem to apply indefinitely.
5. Expansion of DOL Authority to Postpone Certain Deadlines
The Act amends ERISA to provide DOL the ability to postpone certain ERISA filing deadlines and provide other relief for a period of up to one year in the case of a public health emergency.
A few things were also noticeably left out of the CARES Act, including two issues many employer groups have been monitoring closely. First, besides the HSA over-the-counter provision described above, there is nothing in this legislation to address prescription drug pricing. No portions of HR 3 or any other existing drug pricing legislation were included in the CARES Act. Second, there is nothing in the package to address the larger issue of surprise billing. Like the drug pricing issue, no language from existing legislation addressing surprise billing was included in the CARES Act.
The good news is that the Act seems to have bought more time on these issues since the healthcare “extender” deadline set to expire May 22 has been changed to November via this bill. The bad news is that means drug pricing and/or surprise billing legislation will need to be addressed in a lame duck session of Congress where it’s difficult, though not impossible, to pass major bipartisan legislation.
Employer groups will continue monitoring these issues as we work through coronavirus-related legislation implementation, and seek opportunities to be included in discussions, on both COVID-19 and other health policy issues, to ensure employer perspectives continue to be heard.
Curious how the forgivable loans work under the CARES Act? Check out this great video from colleague, Chelsea Whalley of J Donovan Financial.
Coronavirus Aid and Relief Economic Security Act
Emergency grants: The bill provides $10 billion for grants of up to $10,000 to provide emergency funds for small businesses to cover immediate operating costs.
The application process ends on June 30th (“The Covered Period”)
Forgivable loans: There is $350 billion allocated for the Small Business Administration to provide loans of up to $10 million per business. Any portion of that loan used to maintain payroll, keep workers on the books or pay for rent, mortgage and existing debt could be forgiven, provided workers stay employed through the end of June.
Relief for existing loans: There is $17 billion to cover six months of payments for small businesses already using SBA loans.
On Monday, Inspector General Michael Horowitz took a strong first step toward implementing the oversight requirements included in the Coronavirus Aid, Relief, and Economic Security (CARES) Act by quickly appointing a Chair for the Pandemic Response Accountability Committee (PRAC). This committee was created by one of the provisions Carolyn B. Maloney offered to the CARES Act as Chairwoman of the Committee on Oversight and Reform.
Maloney’s office created this FAQ sheet for small businesses and nonprofits to help you navigate some of these new resources.
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