Please see deadline extensions to June 30, 2020 and information regarding recent DOL/IRS rules in bold below.
During the COVID-19 crisis, Spectrum is committed to keeping policyholders and plan participants secure with flexible coverage and service options. Please note the following for all policyholders insured through Spectrum with Companion Life Insurance Company, Companion Life Insurance Company of California, Niagara Life & Health Insurance Company, and Ironshore Indemnity:
Effective retroactively to March 1st, 2020 and through at least June 30th, 2020, we will accept the following plan benefit changes, without requiring plan amendment and without prior notification:
- COVID-19 testing at 100% coverage with no deductible, coinsurance or co-payment.
- Telehealth services for COVID-19 testing at 100% coverage with no deductible, coinsurance or co-payment.
- No pre-authorization of COVID-19 testing is required.
- Waiver of prescription refill limitations for maintenance medications.
Also, through at least June 30th, 2020, we will make the following administrative accommodations for policyholders in the event COVID-19 causes alteration of normal business operations, including but not limited to quarantine and temporary business closure:
- We will
follow the policyholder’s determination to keep otherwise actively-at-work plan
participants on active status.
- Plan participants actively-at-work on the day prior to alteration of normal business operations will be considered actively-at-work provided premium continues to be paid for those participants.
- We will
allow hardship requests for premium due-date extensions on a case-by-case basis
and will also follow all federal and state mandates regarding premium payment
- Please note that no claims will be reimbursed for eligible claims paid by the plan after the last date for which premium was paid. All eligible claim payments will be released as soon as reasonably possible upon receipt of any overdue premium.
- Please direct hardship requests to Daniel Richards, Controller, at email@example.com.
Further, pursuant to Department of Labor (DOL) and Internal Revenue Service (IRS) rules regarding the extension of timeframes for ERISA plans, we will disregard the ‘Outbreak Period’ (per the DOL definition) when determining appropriate timeframes relating to HIPAA special enrollments, COBRA, claims procedures, and external reviews. No plan amendments are required; however, appropriate timeline documentation is required when filing stop loss claims impacted by these extensions.
Treatment for COVID-19 is typically covered under most plans the same as any other illness. If a policyholder wishes to increase benefits or waive plan participant cost-sharing for COVID-19 treatment, a plan document amendment is required, and we reserve the right to revise policy terms, including rates and factors.
We can both receive premium payments and pay eligible excess claims via ACH transaction. If interested in either option, please contact Daniel Richards, Controller, at firstname.lastname@example.org.
We will keep you updated as laws, regulations and circumstances change and will continue to work hard for you. Contact us with questions, comments, or concerns. Be diligent, thoughtful, healthy and safe – and wash your hands!