COVID-19 FAQs for Group Health Insurance

Employee Enrollment

Can employers keep enrolled employees listed as full-time and eligible for benefits during this time that they may have reduced hours, be furloughed or temporarily laid off due to the COVID-19 pandemic? 

Yes. Employees may remain eligible for coverage if they remain as active employees (not formally terminated) during periods of reduced hours and/or temporary layoffs through June 30, 2020. This applies to most health insurance carriers.

Will COBRA and/or State Continuation Coverage be available for employees who have been furloughed?

Yes. As long as one person remains actively employed and covered and the monthly premium payment is received, the group plan will remain in-force. Members losing coverage may elect to continue coverage under COBRA and/or New York State Continuation of Coverage by following the normal notice, election and direct member payment procedures.

Are groups able to maintain their benefit plans if the entire workforce is furloughed or laid off in response to the COVID-19pandemic? 

Yes. If one person remains actively employed and covered, the group plan will remain in-force as long as the monthly premium payment is received. If no one remains actively employed and covered under a plan, the group plan will be considered terminated.

If temporarily laid off or furloughed employees return to work, will they be eligible to obtain coverage without a waiting period?

Yes. If one person remains actively employed and covered, the group plan will remain in-force as long as the monthly premium payment is received. If no one remains actively employed and covered under a plan, the group plan will be considered terminated.

Employer Payments

Where can in-force groups send monthly premium payments? 

EFT (electronic fund transfer) payments are strongly encouraged

Is my health insurer willing to extend the grace period for premium payment?

New York State released guidance related to the extension of premium payment due to the COVID-19 pandemic.

Businesses experiencing financial hardship were able to request a premium payment extension through June 1, 2020. We emailed the information and request details to our clients on April 21, 2020.

Tax Documents & Financial

Given that the IRS pushed the 2020 business filing deadline from April 15, 2020 to July 15, 2020, will Health Insurers be extending deadlines to receive these documents (quarterly wage reports, owner tax forms, etc.)?

No. There are no extensions for submitting business tax documents for new business or renewals. We will accept 2018 Schedule C and/or K1s. The deadline for Q1 2020 NYS Quarterly Wage (NYS-45) Reporting has not been extended and we will start accepting those as of May 1, 2020. Notations for employee employment status are still required. Source: https://www.tax.ny.gov/bus/wt/duedates.htm.

How do Health Insurer you plan to monitor eligibility during this pandemic?

Group and employee eligibility are reviewed before the group becomes active for both new business and renewals. The medical participation requirements are still required.. Good news, health insurers will be relaxing full-time wage requirements for eligible employees earning lower wages due to reduction in work hours during Q1 2020.

Group minimum participation requirements can vary widely from 20% to 75% and recommend you work with us closely. For a one-on-one review contact us at info@medicalsolutionscorp.com or 855-667-4621.

All information contained above is accurate as of 5/25/2020.