The many unknowns and challenges continue when it comes to keeping your business running while protecting your employees and customers. The Centers for Disease Control and Prevention (CDC) and your local health department continue to be the best resources for COVID-19 information, but our in-house experts are here to help you, as well.
We will continue to waive out of pocket costs for COVID-19 medical testing, diagnosis and treatment for our fully insured employer groups through December 31, 2021. We will work with our self-funded customers who want to implement a similar approach, so that their members’ needs can also be met during this time of concern. We are also in contact with local, state and federal health officials regarding regulations that remove cost barriers to care for members.
Please contact your broker or sales consultant for information specific to your business, and we will provide updates on this ever-changing situation.
Your Business
- Coverage of medically necessary diagnostic tests that are consistent with CDC guidance related to COVID-19 at no cost share to the member. Please refer to the Covid-19 Viral and Antibody Testing Policy.
- Please Note: COVID-19 testing for those who do not have symptoms, but who are required to have testing by their employer, school or a government or public health agency, is not covered. Free COVID-19 testing is available at any of the 700+ testing sites throughout New York state operated by the New York State Department of Health (NYSDOH). Anyone can get tested and you do not need to show symptoms of COVID-19, although appointments may be required. To find a NYSDOH testing site, please call the health department’s 24-hour hotline at 1-888-364-3065 or refer to the New York Department of Health website. For COVID-19 hot spot areas, please refer to the NYS Cluster Zone Lookup Tool.
- Members will have coverage, with no out-of-pocket expense to them, for provider office visits, urgent care visits and emergency room visits resulting in testing for COVID-19. If an in-network provider is not available, the Health Plan will cover testing at an out-of-network provider with no out-of-pocket expense to the member.
- Members with high deductible health plans will not be responsible for copayments, coinsurance and deductibles for COVID-19-related testing even if the deductible has not been met, under new guidance from the Internal Revenue Service. This also means that an individual with an HDHP that covers these costs may continue to contribute to a health savings account (HSA).
- COVID-19 vaccines that are authorized by the FDA for emergency use will be provided at no cost to our members.
For all our members, we are making dedicated clinical staff available to address inquiries related to medical services, ensuring timeliness of responses related to COVID-19.
For those groups who offer COBRA, all COBRA processing will continue as usual. To ensure employees receive the necessary paperwork to continue their benefits through COBRA in a timely manner, please submit your new COBRA qualified beneficiary information and/or terminations as you typically have through one of the following methods:
- Via bulk daily file feeds after employment status changes have been processed in the Excellus BCBS system
- Via regularly scheduled file feeds directly from the group
- Via the COBRA employer portal on our partner, Lifetime Benefit Solutions’ (LBS) website
- Via email from the group administrator
Employers: Download the Individual Coverage Options Beyond COBRA toolkit from ExcellusforBusiness.com for a ready-to-send employee email and coverage options flyer.
The COVID-19 situation is rapidly evolving, and the Health Plan is in contact with local, state and federal health and other officials, as well as the Blue Cross Blue Shield Association, and is implementing applicable orders, regulations and requirements as they become effective.
The FAQ provided below is specific to offering COBRA coverage to your members and any impacts on this benefit due to the COVID-19 pandemic. It is our hope that these circumstances will be temporary, and that businesses will return to normal operations soon. We will continue to update this information as the situation changes.
Will Excellus BCBS be extending COBRA coverage beyond 18 months?
As of now, regulations have not changed regarding COBRA coverage time periods and we will be following existing guidelines, which in some cases may extend coverage up to 36 months. More information can be found on the Department of Financial Services’ (DFS) website
When cancellations are processed in the Excellus BCBS system due to reduction of hours or layoff, how do we make sure the member’s COBRA letter says reduction of hours and not termination?
For those that typically process employee status changes through the Excellus BCBS system that are sent as a bulk daily file feed to LBS, the only options currently in the system are for “termination”. Please note, if an employee experiences a reduction of hours that make them no longer eligible for benefits, selecting “termination” through this process will have no impact on the timing or process of their COBRA benefits.
For those that typically use the LBS employer portal to submit employee status changes, there are a few event types, including reduction in hours and reduction in force, that the group or broker can choose.If a small group goes out of business, will we continue to offer COBRA coverage to the members?
Unfortunately, at this time, we are unable to continue to offer COBRA coverage to COBRA qualified beneficiaries of businesses that are no longer active. We will continue to follow local, state and federal health officials’ guidance regarding this circumstance as information is made available.
If a company lays off staff or reduces hours due to COVID-19, resulting in the group not meeting subscriber eligibility guidelines, laws or regulations, what is Excellus BCBS’ position at this time?
We are actively working with groups who are experiencing changes to their eligibility in order to accommodate the coverage needs of our customers and community.
Can a client/group enroll a member in COBRA without a signed election form from the member with client’s/groups permission?
What are the latest COVID-19 updates regarding regulations that will impact COBRA?
What are the regulatory changes?
What are the time periods for continuation of coverage with the regulatory change?
Are the extensions retroactive and when do they end?
Are there COBRA subsidies available?
This subsidy made available to qualified beneficiaries who had an involuntary termination or reduction of hours, ends September 30, 2021.
View more information on the IRS website. Contact your account representative or LBS administrator if you have any questions.
Can we differentiate traditional COBRA members from COVID-19 COBRA members?
As the COBRA administrator, LBS, bills the COBRA member directly, will there be an option for the group to be billed if the group chooses to pay either all or part of the COBRA premium?
If COBRA is required and the group uses LBS as their COBRA administrator, will there be a change in how quickly the COBRA enrollment packet is mailed?
If a company pays for part of the deductible on an HRA do they have to pay for the COBRA HRA portion as well?
Does the COBRA administrator, LBS, have the capacity to handle an influx of COBRA enrollments, notices and new participants?
What forms of payment are accepted for COBRA premium payments?
LBS will continue to accept all forms of payment. Members can pay via check, through the LBS online COBRA portal via recurring ACH, via the LBS online COBRA portal via one-time credit card payment* or by calling the dedicated LBS customer service line at 1-800-828-0078.
*The third-party vendor that LBS uses to process one-time credit card payments charges a $20.00 processing fee per single transaction. However, you can avoid this fee by (1) mailing a physical check, (2) establishing a recurring ACH payment online, or (3) by calling the LBS customer service department at 1-800-828-0078. Dedicated LBS customer service representatives can process a one-time credit card payment for you over the phone at no additional cost.
What is the LBS non-payment cancellation policy and will exceptions be made due to COVID-19?
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