COVID-19 Frequently Asked Questions – For Employers


Last Updated 4/1/2020


Health New England continues to monitor the spread of coronavirus (COVID-19) on behalf of our members, employers, providers and brokers. As information is constantly changing, this page will be the best source for updated information—know that we are working through business decisions as quickly as possible to ensure we are meeting your needs.


What is Health New England’s business continuity plan?

We are prepared to operate effectively under conditions of increased absenteeism or quarantine by utilizing our technological capabilities for associates to work from home, if necessary.

Although the precautions to avoid the spread of COVID-19 may impact where staff works, we will still maintain full infrastructure capacity. This means we do not have to reduce critical functions because our day-to-day member and provider operations capabilities can be operated remotely minimizing impact to services and needed care.

What is Health New England’s coverage and cost sharing related to Teladoc and telehealth services for coronavirus (COVID-19)? 

Health New England is waiving and reimbursing copays for COVID-19 services for members* with access to Teladoc®, our telehealth platform, and telehealth services with local providers as they become available. Our 24/7 Nurse Advice Line at (866) 389-7613 remains available for free to all members.

Members should call their primary care provider (PCP) first. PCPs may have the ability to evaluate members over the phone (telehealth) in order to limit potential exposure in physician offices. If a PCP isn’t available, most Health New England members* have access to Teladoc® for non-emergency medical issues.

While there is no specific treatment for coronavirus at this time, most symptoms of the virus can be managed at home under the direction of your PCP or a Teladoc physician. Go to https://www.teladoc.com/coronavirus/ for more information about Teladoc and to schedule a virtual visit.
 
Please note: Cost sharing for telehealth services not related to COVD-19 will incur normal cost sharing responsibility.  

*Some self-funded employer groups do not participate in Health New England’s Teladoc benefit.


If employees lose their health coverage due to COVID-19, what are their options?

If you or your company is impacted by COVID-19, you may qualify for state or federal health insurance programs including Health New England plans through the Health Connector (the Massachusetts Exchange), an intermediary (HSA Insurance), or MassHealth (Massachusetts Medicaid).

Massachusetts Health Connector and MassHealth

https://mahealthconnector.optum.com/individual/

Call Center: 1-877-MA-ENROLL (1-877-623-6765)

TTY: (877) 623-7773 for people who are deaf, hard of hearing, or speech disabled

HSA Insurance (intermediary)

https://www.hsainsurance.com/Home.aspx

Customer Service: (781) 228-2222

Toll-Free: (877) 777-4414

Sales@hsainsurance.com

What if my company has to reduce hours and/or lay off employees due to COVID-19? Can I continue to cover these employees on my policy?

Health New England will reduce the minimum number of hours required to work from 30 to 0 in order for employees who are currently covered to stay eligible for coverage, assuming at least one employee of the company continues to actively work at least 30 hours per week.

Ultimately, the employer group can decide to absorb the full cost of premiums or full cost of COBRA, as long as (1) it’s done uniformly in a non-discriminatory fashion; (2) the reduction in hours/lay off is a temporary measure resulting from the COVID-19 pandemic; (3) you continue to pay your monthly bill; and (4) you do not terminate the employee(s). This temporary option is available through July 31, 2020.

COBRA coverage is determined by either a loss of coverage due to termination of employment or a reduction of hours. For employer groups that close permanently, their employees are not eligible for COBRA.

  • Small groups (fewer than 20 employees): Health New England will provide benefits to small employers in accordance with "mini COBRA" under state continuation.
  • Large groups (20 or more employees): Health New England will provide benefits to large employers in accordance with federal COBRA.

Please note: Employees who lose group health coverage may also obtain health coverage through the state Exchange program and may be eligible for premium assistance through the Exchanges (see previous question for more).

Will Health New England offer a special open enrollment period due to COVID-19?

At this time, Health New England will not be offering special open enrollment periods due to COVID-19 as the Division of Insurance (DOI) has not offered guidance around this topic.

However, the Massachusetts Health Connector and DOI are extending the newly created Special Enrollment Period (SEP) for currently uninsured Massachusetts residents from April 25 to May 25, 2020. This SEP applies to On Exchange through the Health Connector and Off Exchange through HSA for uninsured residents to enroll into Individual coverage (see above for contact information).

Will Health New England waive enrollment waiting periods?

We will support our employer groups in their decision. The law permits employers to select waivers between 0-90 days. We recommend employers consult with their broker, consultant and/or legal counsel on the risk of waiving waiting periods mid-year. Self-funded groups should also consult their stop-loss carriers to ensure that such waiver is permitted.

What are qualifying events for coverage?

Qualifying events are defined by the IRS. If an employee meets one of the qualifying categories, they are able to enroll off-cycle. Currently, COVID-19 is not considered a qualifying event defined by the IRS.

What is Health New England’s premium assistance and hardship process?

For April, 2020 Premiums due on April 1st, 2020 Health New England will extend the statutory grace period, one time, for an additional thirty (30) days. On a case-by-case basis, groups may request and complete the COVID-19 Hardship Request Form to enroll in a payment plan. Consideration will be given solely as a result of the COVID-19 pandemic and its impact on an employer group’s ability to pay premiums in a timely manner.

If you have premium payment related questions, concerns or need a Health New England COVID-19 Hardship Request Form, please contact Accounting or our Member Services team:

Please review the Employer Reference Guide for information about Health New England’s current billing methods. View additional FAQs about our Premiums/Hardship process.

What can you do if you are experiencing mental health challenges with the COVID-19 situation?

In just a few weeks, the world has changed dramatically due to coronavirus (COVID-19). It can be difficult to face both personal and professional changes. If you are experiencing mental health challenges due to this pandemic, you are not alone.

As your local health plan, we would like to remind you of some resources that may be able to provide assistance:

  • Ask your employer or human resources department if they offer an Employee Assistance Program (EAP), which can provide confidential assistance with a variety of challenges, including mental health.
  • Access behavioral health care services from one of our in-network providers. Search for behavioral health providers or call our Member Services team for assistance finding a provider at (800) 310-2835.
  • Call the Disaster Distress Helpline at (800) 985-5990, which is a 24/7, 365-day-a-year, national hotline dedicated to providing immediate crisis counseling for people who are experiencing emotional distress related to any natural or human-caused disaster, including disease outbreaks like COVID-19. This toll-free, multilingual, and confidential crisis support service is available to all residents in the United States and its territories.

As additional resources are made available, we will continue to do our best to provide updates. We are here with you…every step of the way as we continue our journey through these difficult times. 


For additional Coronavirus information, see our Coronavirus FAQ page and our Coronavirus Member Coverage and Cost Sharing page