Deadlines for Covid-19 Related Claims Approaching

A joint notice from the Department of Labor, the IRS, and the Department of the Treasury recently provided guidance to health plan administrators about upcoming deadlines and requirements under ERISA and the IRS.
According to the joint notice, deadlines are from March 1, 2020 until 60 days after the announcement of the COVID-19 National Emergency or another date announced by the participating agencies during the outbreak period.
For TPAs, the guidance includes:

  • Ensure that the plan’s third-party administrators understand and are abiding by the Joint Notice requirements.
  • Confirm that the plan’s third-party administrators are providing the correct language in their letters and in response to any phone or web-based inquiries.
  • Document all communications with third-party administrators regarding implementation of the Joint Notice. Read more about this.

Source: National Law Review

Self-Insured Employers May Not Be Exempt from Covid-19 Testing Coverage

Some self-insured employers are not waiving all of the Covid-19 testing costs for employees including co-pays and some bills such as doctor visits to rule out the flu. However, health policy experts warn that there are no loopholes for Covid-19 testing coverage. “It doesn't matter if it's a self-funded plan or a fully insured plan if you get it from a small employer or a large employer if you buy it on your own in the marketplace," said Karen Pollitz, a senior fellow with Kaiser Family Foundation. "All private insurance has to cover 100% of the cost of COVID-19 testing." Read more.
Source: Modern Healthcare

Self-Insurance Institute of America (SIIA) Statement on Covid

The Self-Insurance Institute of America (SIIA), issued a letter to Congress about the proactive work self-insured employer groups are doing to extend benefits for testing, treatment, and other medical needs during the Covid crisis.

SIIA also recommended that Congress be careful about issuing a mandate for experimental treatments as well as consider federal reinsurance mitigation and offer “federal assistance for COBRA coverage.” Read more.

Wording in HHS Covid Relief Info May Ban Surprise Billing for All Patients

Providers and hospitals who have received emergency funds related to Covid-19 are barred from sending bills to patients to cover the balance of treatment. These kinds of surprise medical bills are the topic of many debates surrounding health care today and the Department of Health and Human Services (HHS), just may have banned the practice altogether.
The language used in the Covid-19 relief funds is broad and includes every patient seen as a potential Covid-19 patient. Hospitals and providers who received these funds are banned from charging more to the patient for out of network billing. Read more.

Ruling on Banner Health ERISA Litigation

Banner Health was sued by former employees for how it handled its 401(k) plan. The plaintiffs alleged that the plan was mismanaged by failing to monitor certain plan offerings, retaining some investments too long, and for excessive record-keeping fees.

A judge issued a mixed ruling on the issue finding that there was no causation between Banner’s monitoring of the investments and economic losses to plan participants. However, the judge did rule that the record-keeping fees were excessive and financial compensation may be forthcoming. Read more in-depth here.

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