Coronavirus COVID-19 Update

 

Effective as of 6/1/2020

While there is no question about the disruption to the health care industry due to the Covid-19 pandemic, the team at McLaren Health Plan has worked tirelessly to maintain its commitment to provide timely access to health care services to our members and to keep our agents and employers informed of all decisions necessary to swiftly adapt to changing industry needs.

We have monitored and continue to follow all suggested and mandated guidelines necessary to ensure the health and safety of all our constituents – members, providers, agents, employers and our own employees.

In this Alert you’ll find revised dates on previously communicated information about layoffs, closings, eligibility changes, grace periods for premium payments and other information relevant to your business. We’ve also included information on auto reform, the Medicare Supplement household discount and changes to the MHP sales team; please see below.

Thank you for your continued partnership and support. If you have any questions, contact your McLaren Health Plan sales executive. 

TEMPORARY LAYOFFS/CLOSINGS/COBRA-click to expand  

How long can employees remain covered with McLaren Health Plan if an employer needs to close their business temporarily due to a virus outbreak or needs to temporarily layoff or furlough employees, but they want to keep their benefits?
McLaren Health Plan will temporarily continue to provide coverage if a business closes, temporarily lays off employees, or cuts hours for employees due to the COVID-19 outbreak. At this time, coverage may only continue through June 30, 2020. It is the employer’s decision whether to continue to offer benefits – not McLaren Health Plan’s. Employers must continue to pay premiums according to current payment policy to maintain coverage. McLaren Health Plan will continue to monitor and evaluate the situation over the coming weeks.

Will McLaren Health Plan require employers to immediately move laid off employees to COBRA?
If an employer opts to provide coverage for employees on temporary layoff, the employer will not be required to move the employees to COBRA. At this time, coverage may only continue through June 30, 2020. It is the employer’s decision whether to continue to offer benefits – not McLaren Health Plan’s. Employers must continue to pay premiums according to current payment policy to maintain coverage. McLaren Health Plan will continue to monitor and evaluate the situation over the coming weeks. COBRA will apply upon loss of coverage. 

Will McLaren Health Plan have a set time period for which employees who are laid off can remain on an active policy vs. being moved to COBRA?
The employer determines eligibility. If the employer chooses to provide coverage and continues to pay premiums according to current payment policy, the employees will be covered through June 30, 2020. 

Will McLaren Health Plan waive underwriting requirements to allow employers to pay for benefits while employees are receiving unemployment benefits? 
Yes. McLaren Health Plan will waive underwriting requirements through June 30, 2020. We will continue to monitor the situation and adjust accordingly as needed. 

Will McLaren Health Plan waive waiting periods for workers returning to work after furlough or layoff as a result of the COVID-19 pandemic?
Yes. McLaren Health Plan will waive the waiting period to reinstate employees if the employer did not elect to continue coverage during layoff or furlough.

NEW - If an employer is unable to make eligibility changes, i.e., add or remove employees and/or dependents due to qualifying life events within the 30 days required due to COVID-19, what can they do?
McLaren Health Plan will work with employer groups to allow changes past the 30-day timeframe through June 30, 2020 for fully funded employers.

Is there a requirement to alter any group provisions/policies if it is a result of the COVID-19 emergency mandates?
No. At this time we will not require any changes to plan documents or policies due to the declared state of emergency. McLaren Health Plan will continue to assess as new information becomes available.

 PREMIUM INFORMATION-click to expand  

Will McLaren Health Plan provide any grace period for premium payment for individuals or employer groups?
McLaren Health Plan is committed to supporting our groups and members. Since premium is prepaid, groups are currently paid through May 31, 2020. For fully insured customers, we currently have a 30-day grace period. McLaren Health Plan will extend this by an additional 15 days, so customers will have until July 15, 2020 to remit payment. This also applies to individuals insured with McLaren Health Plan off the Exchange. On-Exchange individuals will follow the normal process. 

Will McLaren Health Plan permit any leniency related to premium payments if small businesses are forced to close part of their business due to the Governor’s orders?
McLaren Health Plan is committed to supporting our groups and members. Since premium is prepaid, groups are currently paid through May 31, 2020. For fully insured customers, we currently have a 30-day grace period. McLaren Health Plan will extend this by an additional 15 days, so customers will have until July 15, 2020 to remit payment. This also applies to individuals insured with McLaren Health Plan off the Exchange. On-Exchange individuals will follow the normal process. 

 COVERAGE QUESTIONS-click to expand  

Will McLaren Health Plan waive copays, deductibles and coinsurance during the COVID-19 pandemic?
Yes. McLaren Health Plan will waive copays, deductibles and coinsurance for diagnoses related to COVID-19 for all lines of business through June 30, 2020.* This may not apply to self-funded or high-deductible health plans. 

*Or earlier, if businesses resume normal operations.


Will McLaren Health Plan cover virtual visits if a provider office is only doing online visits?
A telemedicine visit is a visit that can be done over the phone with a doctor. This is a good way to help prevent the spread of infections like COVID-19. COVID-19 testing related services received through telemedicine are a covered benefit for McLaren Health Plan members with no cost-sharing. The doctor will determine if the member needs the COVID-19 test and will tell the member what to do next. 

Telemedicine visits are also covered with your doctor for healthcare needs not related to COVID-19. These visits are subject to your normal office visit cost-share responsibility.


Will McLaren Health Plan waive the online office visit copay through Virtuwell for someone who uses it for symptoms of the coronavirus? 
McLaren Health Plan’s online office visit option, www.virtuwell.com allows members to have a virtual office visit with a board-certified nurse practitioner. The office visit copay will be waived through June 30, 2020* for services related to COVID-19.

*Or earlier, if businesses resume normal operations.


How will McLaren Health Plan cover testing for COVID-19?
McLaren Health Plan will cover the cost of medically necessary COVID-19 tests for all members with no member cost-sharing for both in-network and out-of-network providers, including those with high deductible health plans through June 30, 2020.* The most recent IRS guidelines allow for this coverage. https://www.irs.gov/newsroom/irs-guidance  
For all members, McLaren Health Plan will cover the two codes released by the Centers for Medicare & Medicaid Services (CMS), U0001 and U0002 and 87635, for laboratory testing. We will cover these two codes at 100% of allowed charges with no member cost sharing through June 30, 2020.* McLaren Health Plan will also waive the costs of items and services related to the furnishing or administration of the testing provided to an individual during a health care provider office visit, urgent care center, an emergency room visit, or through a telehealth visit through June 30, 2020.*

*Current “Emergency Declaration” is set to end June 16, 2020. If lifted early or extended, this date could change.  


How will McLaren Health Plan cover treatment of medically necessary services related to coronavirus or COVID-19?
McLaren Health Plan will waive all cost-sharing for treatment or medically necessary services related to coronavirus or COVID-19 through June 30, 2020.*

*Or earlier, if businesses resume normal operations.


Is McLaren Health Plan waiving other pre-authorizations related to COVID-19?
Yes. McLaren Health Plan is removing the requirement for prior authorizations for services related to COVID-19.

Is there a provision for early prescription refills during this time?
McLaren Health Plan will be waiving or removing the early refill edit for all lines of business for all medications (except for controlled substances) through June 30, 2020.

*Or earlier, if businesses resume normal operations.

 AUTO REFORM-click to expand  

Today, Michigan drivers are required by law to have a no-fault automobile insurance policy that includes Personal Injury Protection (PIP) benefits. While several states in the U.S. also have no-fault requirements, Michigan’s no-fault law is unique in that the PIP coverage provides for unlimited medical benefits for the lifetime of the injured person when those injuries result from an auto accident. 

On July 2, 2020, many changes to the existing no-fault auto insurance law will take effect, including giving Michigan drivers a choice in their level of PIP coverage. To make this choice, drivers will have many questions and might contact McLaren Health Plan (MHP), their employer or you for information about their health care coverage. 

In preparation, MHP has researched the auto insurance law. While we will not personally advise anyone about what decision to make, we’ve educated our customer service representatives and provided them with letters to send members upon request who ask if their health care is “qualified coverage.” 

The letters contain the following points:

For members with an annual deductible of $6,000 or less per covered individual:
If you have “Qualified Health Coverage,” you may be able to limit the medical benefit coverage on your auto policy.
You may have “Qualified Health Coverage” if 
- your health insurance does not exclude coverage for motor vehicle accidents and
- you have an annual deductible of $6,000 or less per covered individual 

For members with an annual deductible of more than $6,000 per covered individual:
If you have “Qualified Health Coverage,” you may be able to limit the medical benefit coverage on your auto policy.
You may have “Qualified Health Coverage” if 
- your health insurance does not exclude coverage for motor vehicle accidents and
- you have an annual deductible of more than $6,000 per covered individual 

We’ve updated our website to include FAQs about the auto reform law. We’re directing members to https://www.michigan.gov/autoinsurance for information or telling them to contact their auto agent for specific questions related to selecting coverage.


MEDICARE SUPPLEMENTAL HOUSEHOLD DISCOUNT-click to expand  

McLaren Health Plan is offering a family discount effective April 1, 2020 for Medicare Supplement members who live at the same address. Existing members were mailed a letter in early May that contained a Medicare Supplement Application for Family Discount form to return to take advantage of the discount.

Members were advised that adjustments will be made to their EFT or they will be sent new coupons if they have already renewed.

MHP STAFF CHANGES-click to expand  

McLaren Health Plan Director of Sales Louann Hinton is pleased to announce the addition of Craig Geiger, MBA, to the MHP sales team. Craig brings a broad base of health care experience to MHP, from the carrier, agent and broker perspective. He comes to us most recently from Aliera Healthcare, Inc., where he was a group sales advisor.