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5 things employers need to know about the CARES Act

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.



Stay Safe – Understanding the Symptoms of Covid-19

Just some quick information on symptoms of Covid-19 and what to do if you think you may be infected.



How CARES Act Impacts Employer Health Plans

Curious how the CARES Act will impact Employer Health Plans? Check out this great video from colleague, Chelsea Whalley of J Donovan Financial.

On March 27, 2020, President Trump signed the Coronavirus Aid, Relief and Economic Security Act (CARES Act) into law to provide $2.2 trillion in federal funding to address the COVID-19 crisis. The CARES Act makes a variety of changes affecting health plans. These changes include:

1. Expanding the types of coronavirus testing that all health plans and health insurance issuers must cover without cost-sharing (such as deductibles, copayments or coinsurance) or prior authorization

2. Accelerating the process that will require health plans and issuers to cover preventive services and vaccines related to COVID-19

3. Allowing telehealth and other remote care services to be covered under a high deductible health plan (HDHP) before the deductible is met, without affecting the HDHP’s compatibility with health savings accounts (HSAs) (applicable for HDHP plan years beginning on or before Dec. 31, 2021)

4. Treating over-the-counter (OTC) medications, along with menstrual care products, as qualified medical expenses that may be paid for using HSAs or other tax-advantaged arrangements, such as health flexible spending accounts (FSAs) or health reimbursement arrangements (HRAs)



4 Ways to Keep Health Coverage

Here are 4 quick ways to keep your health insurance coverage by our Combs & Company friend, Chelsea Whalley of J Donovan Financial.

This is for employees who have lost coverage through an Employer Sponsored Plan.

1) COBRA- Contact your Benefits Administrator. Remember, there is no employer contribution so this is an expensive option.

2) Spouse Plan- This Qualifying Life Event (loss of coverage) creates a window of opportunity to join your spouse’s health plan. Contact your spouse’s Benefits Administrator for pricing.

3) Medicaid- A severe loss of income may qualify you for Medicaid at http://www.medicaid.gov

4) Healthcare.gov – The QLE allows you 60 days to enroll in an individual plan on the marketplace.



Paycheck Protection Program Forgivability Explained

Looking for an easy digestible explanation for how the Paycheck Protection Program (PPP) works? Check out this great video from colleague, Chelsea Whalley of J Donovan Financial.

PAYCHECK PROTECTION PROGRAM
  • Total Loan Value: Lesser of 10 million or 2.5x the average monthly total payroll incurred in the one year period prior to the loan start date.
  • Forgivable Portion: 8 weeks from the loan start date used for payroll, interest on mortgage, rent and utilities. At least 75% to payroll.
  • Main Point: The FORGIVABLE portion of the loan is tied DIRECTLY to Employees being paid- if you decrease wages or terminate, the forgivability is threatened.
  • *This loan is designed specifically to connect employees back to their employers.
  • * Loan Application: https://home.treasury.gov/system/file…
  • Find Approved Lenders: https://www.sba.gov/funding-programs/…

 

 



New York Tough
April 6, 2020, 8:21 am
Filed under: Combs & Company, Covid-19, Motivational | Tags: , , ,

Hey Guys—

Know it’s rough for us here in NY, but we got this.  It’s a new week and we got this.  Don’t forget that we are New York Tough!

– Combs Crew

Credit: 



Small Business Exemptions for Paid Sick Leave Explained
Looking for an easy digestible explanation of the exemptions for companies under Paid Sick Leave? Check out this great video from colleague, Chelsea Whalley of J Donovan Financial.
DOL Clarifies Exemptions to Coronavirus Paid Sick Leave Laws
– Less than 50 employees
– Leave is requested because the child’s school or place of care is closed due to COVID-19 related reasons
– An authorized officer of business has determined that at least one of the 3 conditions described below have been met:
1) The provision would result in small business’s expenses and financial obligations to exceed available business revenue and cause business to cease operating at minimal capacity
2) The employee requesting leave has a specific set of skills and knowledge that without it, the business’s financial and operational health is severely threatened
3) There are not sufficient workers who are able, willing and qualified to perform duties of person requesting leave and this would not allow business to operate at minimal capacity.
DOL is encouraging employers and employees to work together to find a solution during this time that allows the business to be maintained as well as the safety of employees.