combsandco

We understand there have been numerous emails out there each day on Covid-19, believe us, we get about 50 a day as of late.  Below you’ll find helpful information broken into section topics for what your needs may be during this time.  We know we will all get through this, we are New Yorkers and we have seen far worse in our day.  Stay safe.

The Combs Crew

Business Interruption:

One thing to understand is that your broker serves in the role as an insurance intermediaries we are not the decision maker, but instead report claims and administer the communication between the carrier and the customer.  As brokers, we represent you as the client, not the insurers.  We are your advocates and will fight for you, but ultimately the decision rests on the carrier.

We all know this is a very stressful time all Small Businesses across the country and are getting multiple requests a day about coverage of a potential claim for Business Interruption.  Unfortunately, the carriers are being very tight lipped on if the Covid-19 would result in a Business Interruption claim being paid until they are able to review all aspects of the policy and claim.  We have been suggesting to all of our clients, to go ahead and move forward with a claim if they are able to prove a loss for their business during this time as there is zero chance of recovery if you never put in a claim.

Facts about Business Interruption:

1. If you have Business Interruption coverage, your policy should list or describe the type of events it covers.  Events that are not listed on, or not described in the policy, are typically not covered.
2. Business Interruption coverage typically can ONLY be triggered if you have a property loss that leads to the business interruption.
3. Often times there are exclusions for epidemics and pandemics in Business Interruption policies.

Example:  You have a fire in your office which has caused you to suspend your business activities, for more information CLICK HERE

Many state and city municipalities are working on Disaster Loan Assistance programs at this time, below you will find that information.

Disaster Loan Assistance:

For Disaster Loan assistance information by state, please CLICK HERE for more information from the SBA.  If you are local to NYC, CLICK HERE for local disaster loan assistance.

Please let us know if we can assist in any way during this time and if you are looking for overall general information on potential business impacts and resources, please CLICK HERE for Risk Advisory bulletins from EPIC.

Health Insurance:

For Individuals – NY State of Health and New York State Department of Financial Services Announce Special Enrollment Period for Uninsured New Yorkers, as Novel Coronavirus Cases Climb.

*Remind New Yorkers That There is No Cost Sharing for COVID-19 Testing Across Medicaid, Child Health Plus, Essential Plan, and Qualified Health Plans*

ALBANY, N.Y. (March 16, 2020) – NY State of Health, together with the New York State Department of Financial Services (DFS), today announced that New York will make a Special Enrollment Period available to New Yorkers during which eligible individuals will be able to enroll in insurance coverage through NY State of Health, New York’s official health plan Marketplace, and directly through insurers. This step is being taken in light of the COVID-19 public health emergency to further protect the public health of New Yorkers.  NY State of Health, DFS, and New York State health insurers are taking this action due to the exceptional nature of the public health emergency posed by the COVID-19 so that individuals do not avoid seeking testing or medical care for fear of cost. The open enrollment period for coverage in 2020 had previously ended on February 7, 2020.

Individuals who enroll in Qualified Health Plans through NY State of Health or directly through insurers between March 16 and April 15, 2020 will have coverage effective starting April 1, 2020.  Individuals who are eligible for other NY State of Health programs – Medicaid, Essential Plan and Child Health Plus – can enroll year-round.  As always, consumers can apply for coverage through NY State of Health on-line at www.nystateofhealth.ny.gov , by phone at 855-355-5777, and working with enrollment assistors.

If you have any questions or would like more personalized assistance, please reach out to Colleen Blum via email at:  cblum@combsandco.com

Workers Compensation:

Workers’ compensation insurance helps employees recover from work-related injuries or illnesses. Every state has its own workers’ compensation insurance laws and regulations that govern the coverage available. To file a workers’ compensation claim, the employee will need to demonstrate that the injury or illness arose both out of and in the course of their employment.

Mental Health Assistance: 

Many health insurance carriers are providing Mental Health Assistance at this time.  Below is some information on what United / Oxford is doing for their members and in some instances all citizens regardless if they are a member.  Please reach out to your health insurance provider to see what services they are providing specifically for you.

Free Emotional Support Help Line

Optum is offering a free emotional support help line for all individuals impacted.  Our toll-free emotional support help line at (866) 342-6892 is free of charge and available to anyone, so you can share it with family and friends. Caring professionals will connect people to resources. It will be open 24 hours a day, seven days a week.  Additionally, there are several coping and disaster tools and resources available to you on liveandworkwell.com. Log on to liveandworkwell.com with your HealthSafeID. Type the keywords “coping” or “disaster” into the search bar to get support.

Behavioral Health Virtual Visits

Also, as UnitedHealthcare members, you have access to Behavioral Health Virtual Visits where you can access a behavioral health professional through your mobile device, tablet, or computer.  Behavioral Health Virtual Visits are a separate benefit from the Virtual Visits with Teledoc, Amwell, and Doc on Demand.  For behavioral health, virtual visits are subject to the same out of pocket as an in-office visit (behavioral health outpatient office visit). Services are delivered by a network provider licensed within your state and may include psychiatrists, psychologists, and other practitioners licensed in behavioral health such as nurse practitioners and master level clinicians. Providers are able to prescribe medications in compliance with federal and other regulatory limitations.

Coronavirus Response Bill, with Required Paid Sick Leave, Enacted into Law:

Action Taken:  On March 18, 2020 President Trump signed into law H.R.6201, a $104 billion bill that, among other things, requires small employers (those with fewer than 500 employees) to provide paid sick leave to employees dealing with COVID-19 or with exposure to the coronavirus.  Family and medical leave both go into effect April 2 and expire December 31, 2020.  

Expanded FMLA.

1. 1. Who? The new law applies to all employers with fewer than 500 employees and to employees who have worked for at least 30 days.
   2. Reasons for Leave? An employee may take up to 12 weeks of leave to allow an employee who is unable to work or telework to care for the employee’s child (under 18 years of age) if the child’s school or place of care is closed or the childcare provider is unavailable due to a public health emergency. A public health emergency means an emergency with respect to COVID-19 declared by a federal, state, or local authority.
   3. Pay? Unpaid for the first 10-days after which the employer must pay full-time employees at two-thirds the employee’s regular rate for the number of hours the employee would otherwise be normally scheduled. The pay is limited to $200 per day and $10,000 in the aggregate. Part-time employees pay should be based on the average number of hours the employee worked for prior six months; or, if less than six months, based on the employee’s reasonable expectation at hiring of the average number of hours the employee would be scheduled to work.
   4. Job protection? Employers with 25 + employees have to return the employee to the same or equivalent position upon their return to work. Employers with fewer than 25 employees are excluded from this requirement if the employee’s position is eliminated due to economic conditions or other changes resulting from the public health emergency. Keep in mind, employers must still reasonably attempt to return the employee to an equivalent position and make efforts for the next year to return the employee to work.
   5. Exempt? The law allows small businesses with fewer than 50 employees to seek an exemption from the expanded leave entirely if the required leave would jeopardize the viability of their business.

Paid Sick Leave.

1. Who? Employers with fewer than 500 employees; all employees regardless of their tenure
2. Reasons for Leave?  An employee may take paid sick leave if he/she is unable to work or telework because:

• • the employee is subject to a federal, state, or local quarantine or isolation due to COVID-19;
  • a health care provider advised the employee to self-quarantine due to concerns related to COVID-19 (self-imposed quarantine does not qualify);

• • the employee is experiencing symptoms of COVID-19 and seeking a medical diagnosis;

• • the employee is caring for an individual who is either subject to a federal, state, or local quarantine or isolation due to COVID-19 or has been advised to self-quarantine due to concerns related to COVID-19;
  • the employee is caring for the employee’s child whose school has been closed or place of care is unavailable due to COVID-19 precautions; or
  • the employee is experiencing any other substantially similar condition as specified by the government (and to be clarified later).

1. Pay? Full-time employees receive 80 hours of paid sick leave; part-time employees receive the equivalent of the number of hours they would work, on average, during a two-week period.  Paid sick leave is paid at the employee’s regular rate if for a reason in paragraph (i), (ii), or (iii) above and caped at $511 per day and $5,110 in the aggregate; and two-thirds of an employee’s regular rate if based on reason (iv), (v), or (vi) and capped at $200 per day and $2,000 in the aggregate.
2. Misc. The leave does not carry over. Employers may not require employees to first use other paid leave before using paid sick leave. Employers can require reasonable notice procedures after the first workday that an employee receives paid sick leave. Employers must post a notice that advises employees of their rights which should be available by March 25.
3. Exempt? Like the FMLA above, the Act does contain language allowing small business with less than 50 employees to seek an exemption from the requirement.

New York Emergency Paid Sick Leave.

1. When? Only in the event of a “mandatory or precautionary order of quarantine or isolation issued by the State of New York, the NY Department of Health, a local board of health, or any government entity duly authorized to issue such order due to COVID-19”.
2. Who?

• • Employers with 10 or fewer employees and a net income less than $1 million must provide unpaid leave (and job protection) for the duration of the quarantine order and guarantee their workers access to Paid Family Leave and disability benefits (short-term disability) for the period of quarantine including wage replacement for their salaries up to $150,000.
  • Employers with 11-99 employees and employers with 10 or fewer employees and a net income greater than $1 million will provide at least 5 days of paid sick leave, job protection for the duration of the quarantine order, and guarantee their workers access to Paid Family Leave and disability benefits (short-term disability) for the period of quarantine including wage replacement for their salaries up to $150,000.
  • Employers with 100 or more employees, as well as all public employers (regardless of number of employees), will provide at least 14 days of paid sick leave and guarantee job protection for the duration of the quarantine order.

1. Has to be serious? These additional benefits are only available to employees who have been officially and formally quarantined or isolated by a local or state government agency; not those who are in voluntary quarantine or isolation, those who merely fear they have been infected, those who object to reporting to work, and those who are placed on leave, layoff, or furlough by an employer. It also does not apply to employees who are asymptomatic but have been quarantined or isolated, those who have not yet been diagnosed with any medical condition, and those who are physically able to work remotely.
2. Other Changes.

• • With regards to NY Paid Family Leave, the definition of “disability” was expanded to include “the inability to do work because of a mandatory or precautionary order of quarantine,”; and the definition of “family leave” was expanded to include a) leave taken to comply with a mandatory or precautionary order of quarantine; or b) to provide care for the employee’s minor, dependent child who is subject to a mandatory or precautionary order of quarantine.

Don’t forget, these are in addition to any current paid leave/medical leave programs applicable to your workforce.

Resources for Families:

We know that many families are struggling to figure out homeschooling at this time while balancing working from home in most cases.  We wanted to share this excellent post from the Today Show that provides a wealth of information for your little ones during this time, CLICK HERE for the article “How to homeschool during the coronavirus crisis with free resources”.

Job Resources:

Chameleon Resume is offering free tools to help with job searches.  CLICK HERE to access them.

New York & New Jersey has developed a state portals to access jobs that are looking for candidates now during the Covid-19 pandemic.

CLICK HERE to access the New York portal

CLICK HERE to access the New Jersey portal

To Apply for NY State Unemployment, CLICK HERE

To Apply for NJ State Unemployment, CLICK HERE