Coronavirus COVID-19 Update

 

Effective as of 7/1/2020

As we continue to strategize and make business decisions in response to the Covid-19 pandemic, our focus remains on providing timely access to health care services to our members. We appreciate your patience during this time as we strive to keep you informed of revised dates, decisions and guidelines.

 Please review the following information. You’ll find revised dates highlighted in yellow on previously communicated information about layoffs, closings, eligibility changes, grace periods for premium payments and other information relevant to your business.

 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 July 31, 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 July 31, 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 July 31, 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 July 31, 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.

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 July 31, 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 June 30, 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 August 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 June 30, 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 August 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 July 31, 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 July 31, 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 July 31, 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 July 31, 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 July 31, 2020.*

*Current “Emergency Declaration” is set to end July 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 July 31, 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 July 31, 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

 YOUR MCLAREN HEALTH PLAN COVERAGE DOES NOT EXCLUDE AUTOMOBILE ACCIDENTS.

 YOUR COVERAGE HAS 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 less than $6,000 per covered individual 

 YOUR MCLAREN HEALTH PLAN COVERAGE DOES NOT EXCLUDE AUTOMOBILE ACCIDENTS.

 YOUR COVERAGE HAS 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.