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DOL Clarifies FFCRA and CARES Act COVID-19 Testing Coverage Requirements

… today issued another set of FAQs that address employers’ ongoing obligations to cover certain testing expenses under their group health plans; however, return-to-work COVID-19 testing is not required to be covered by a group health plan. COVID-19 Testing FFCRA generally requires group health plans to provide benefits for certain items and services related to diagnostic testing to detect SARS-CoV-2 or diagnose COVID-19. Plans must cover these costs with no cost sharing (including deductibles, copayments and coinsurance), prior authorization or any other medical management requirement, when furnished on or after March 18, 2020 (FFCRA …

https://www.epicbrokers.com/insights/covid-19-testing-coverage-requirements/

Traditional Insurance Carriers Are Reimagining Healthcare – They Have To

For more of our coronavirus coverage, visit epicbrokers.com/coronavirus  Viewpoints from Craig Hasday Blue Shield of California has introduced a new program, called “Health Reimagined.” Their press release indicates that “they couldn’t just incrementally improve on a system that’s fundamentally dysfunctional.” Trying to address the needs of increasingly stressed providers, and patients who continually complain about healthcare costs and frustrations with the system, Blue Shield of California is experimenting with a clinic model. It’s no surprise that this initiative is based in California, the operational base of Kaiser Permanente, one of the most successful HMOs ever …

https://www.epicbrokers.com/insights/traditional-insurance-carriers-are-reimagining-healthcare-they-have-to/

Covering Coronavirus: Risk Considerations Volume 1, Issue 16

EPIC Risk Advisory Bulletin Volume 1, Issue 16 The global COVID-19 (coronavirus) pandemic remains both dynamic and fluid. We continue to see unprecedented disruptions at home and abroad. In this issue, we take a focused look at: General Information on Coronavirus Supply Chain and Business Risks Emergency Exemption Extension for Commercial Drivers Insurance Products and Coverage Information Commercial Property Coverage for Riots Hurricane Preparation Checklist News of Note Human Resources and Employee Benefits WC Presumptive Compensability Legislation Update Monitoring Remote Workers Insights from Across the Firm General Information on Coronavirus It has been nearly three months since the coronavirus …

https://www.epicbrokers.com/insights/covering-coronavirus-risk-considerations-volume-1-issue-16/

Cost Modeling Projections

Introduction The cost impact to the U.S. healthcare system by the COVID-19 pandemic has been estimated by reputable studies in a range of 6%-15% of U.S. healthcare spend in 2020. These studies are of special interest to self-insured employers, health plans, and reinsurers for pricing and planning purposes. An important feature of these models is that they do not attempt to quantify the behavioral changes of beneficiaries who are unable or unwilling to seek care during times of social distancing and hospital resource scarcity. EPIC calculates that in 2020, COVID costs for the U.S …

https://www.epicbrokers.com/insights/cost-modeling-projections/

Reactive vs. Proactive Benefits - Don’t Get Caught in the Trap

… some things have not changed. Like the need to be strategic in planning for your employee benefits program. I was reminded of this in a recent 2021 strategic planning meeting with a new client who mentioned they’d never had a discussion like this before. That comment explained why their benefits plans were so dysfunctional; too expensive, poorly communicated, ineffective, and out of compliance. Does this sound like your program? It’s a simple concept – most employee benefit plans react, rather than plan. Medical rate increase? Reduce benefits or find a new carrier. Salesperson calls with a new product offering …

https://www.epicbrokers.com/insights/reactive-vs-proactive-benefits-dont-get-caught-in-the-trap/

Why Now Is the Time to Address Your Employees’ Mental Health

For more of our coronavirus coverage, visit epicbrokers.com/coronavirus  Viewpoints from Craig Hasday The COVID-19 pandemic no doubt has and will take its toll on mental health. In the United States, there has been a 1,000% increase in mental health calls to federal helplines. And the complete impact will take time to manifest. Pre-existing mental health conditions will be exacerbated, as we shared in a recent post from our Coronavirus & Workplace Wellbeing series. I recently listened to a presentation by Dr. John Rott at Kaiser Permanente Medical Group on mental health issues related to the pandemic …

https://www.epicbrokers.com/insights/now-is-the-time-to-address-your-employees-mental-health/

IRS Releases Much Requested PCORI Fee Update

The Internal Revenue Service (IRS) has released Notice 2020-44 (Notice) under which it has announced the Patient-Centered Outcomes Research Institute (PCORI) fee rate that applies to plan years that end on or after October 1, 2019, and before October 1, 2020. The notice also describes transition relief for calculating the average number of covered lives (as part of calculating the applicable fee) for plan years that end within this timeframe. Applicable PCORI Fee Rate The Notice provides that the applicable PCORI fee rate for plan years ending between October 1, 2019, and September 30, 2020 is $2.54 …

https://www.epicbrokers.com/insights/irs-releases-much-requested-pcori-fee-update/

Onsite or Virtual Events – the Fall Wellness Season Conundrum

Now that the upheaval of spring wellness events and the mad dash to go virtual have subsided, we’re immediately shifting our focus to fall. However, this fall will not look like it did last year – many of our clients, especially those in New York City and other hard-hit areas, are canceling onsite wellness events or shifting them to virtual. With so much uncertainty and no end to it in sight, clients are taking a better-safe-than-sorry approach. No one wants a wellness event to cause more stress than it relieves. For more of our coronavirus coverage …

https://www.epicbrokers.com/insights/onsite-or-virtual-events-the-fall-wellness-season-conundrum/