In the Know

Hospital Indemnity Coverage - A Popular Choice During COVID-19

Approximately 10 percent of emergency room visits result in hospital admission, according to the most recent data from the U.S. Centers for Disease Control and Prevention. It’s no secret that a hospital stay can be extremely expensive, even with high-quality major medical insurance. A hospital indemnity insurance plan can help offset the costs incurred from a hospital stay. This article further explains this type of coverage.

What is hospital indemnity insurance?

Hospital indemnity insurance is a supplemental insurance plan that can be added to an existing health insurance plan to help cover the costs of a hospital stay. This type of plan pays you a predetermined benefit amount per day for each hospital admission, typically up to a year.

What does hospital indemnity insurance cover?

Most hospital indemnity insurance plans cover inpatient hospital, intensive care unit (ICU) and critical care unit (CCU) admissions and stays. Some plans also cover outpatient surgery, ambulance transportation and continuous care expenses.

What can hospital indemnity insurance cash benefits be used for?

Hospital indemnity insurance benefits are paid directly to policyholders. The predetermined benefit amount can be used to pay for almost whatever purpose the beneficiary chooses. For example, it can be used to cover health insurance deductibles, copays, household bills and out-of-pocket costs. 

Are there dependent benefits for hospital indemnity insurance?

In most cases, yes, it is possible to add dependents to a hospital indemnity insurance plan.

Are all hospital indemnity insurance plans the same?

No. You have the ability to customize your plan so that it pays benefits out on maternity visits or ambulance rides, or so that it pays out increased benefits on intense ailments, like strokes or cancer. Adding these features, though, may result in higher premiums.

Is there a waiting period before coverage begins?

Though every policy is different, there is generally a 30-day waiting period before benefits from this type of insurance can be used toward an illness that results in a hospital stay. Talk to your plan agent about the specifics of your plan.

How much does hospital indemnity insurance cost?

The monthly cost of hospital indemnity coverage varies depending on plan choice, age, gender and tobacco use. Premiums typically increase as policyholders age and add dependents to the plan.

Summary

Hospital indemnity insurance helps offset hospitalization expenses that are not covered under major medical plans. As COVID-19 continues to spread across the US, Hospital Indemnity plans are becoming increasingly popular. Contact Coffman Benefits today to find out how this coverage can enhance your benefits package and increase employee satisfaction.

DOL Launches Employee Tool for Assessing FFCRA Leave Eligibility

The U.S. Department of Labor (DOL) has created an online tool to help workers determine whether they qualify for paid sick leave or expanded family and medical leave under the Families First Coronavirus Response Act (FFCRA).

The tool works by posing a series of questions that help employees assess whether the paid leave provisions of the FFCRA apply to their employer. Once employees learn the provisions do apply, the tool then assists them in determining whether they qualify for FFCRA paid sick leave or expanded family and medical leave. The DOL is also developing a similar tool for employers.

Employee Leave Under the FFCRA The FFCRA, enacted on March 18, 2020, created two types of employee leave for coronavirus-related purposes: paid sick leave and expanded Family and Medical Leave Act leave. Paid sick leave provides eligible employees with 80 hours of compensated leave for specified COVID-19 reasons, including:

  • A quarantine or isolation order for the employee or someone the employee is caring for, or medical advice to self-quarantine;

  • When the employee has symptoms of COVID-19; or

  • When the employee’s child’s school or child care facility is closed.

Compensation rates for paid sick leave under the FFCRA depend on the reason for the leave. The expanded family and medical leave provisions of the law allow 12 weeks of partially compensated leave to care for a child whose school or child care facility has been closed due to COVID-19.

California Issues Statewide Order to Wear Face Coverings in Public or High-risk settings

On June 18, 2020, California Gov. Gavin Newsom issued an order requiring Californians to wear face coverings while in various public or high-risk settings—including when shopping, taking public transit or seeking medical care.

The order comes following growing concerns from public health officials that recent spikes in COVID-19 cases are related to residents not taking the proper precautions to help limit the spread of the coronavirus.

Review the following guidance for further information on when face coverings are required and exemptions to the order.

When Are Face Coverings Required?

The order requires Californians to wear face coverings in the following public or high-risk settings:

  • When congregating in outdoor spaces with members of the public and social distancing is not feasible

  • While inside of or in line to enter any indoor public space (e.g., a shopping mall)

  • When obtaining medical services

  • While waiting for or riding public transportation—including taxis, private car services and ride-sharing vehicles

  • When operating any public transportation vehicle while passengers are present

  • While conducting work-related activities, such as the following:

    • o    Interacting with members of the public for work purposes

o    Working in a space that members of the public visit—even if no one is present at the time

o    Working in any area where food is prepared or packaged for sale or distribution

o    Working within or walking through common areas (e.g., hallways, stairwells, elevators or parking facilities)

o    Working within a room or enclosed space where other people (with the exception of members from the individual’s household) are present and not able to social distance

Exemptions to the Order

Californians are exempt from the order in the following circumstances:

  • If the individual is under the age of 2

  • If the individual has a medical condition, mental health concern or disability that prevents them from being able to wear a face covering

  • If the individual is hearing-impaired, communicating with a person who is hearing-impaired or in any other circumstance where seeing the individual’s mouth is essential for communication purposes

  • If wearing the face covering would create additional risks related to the individual’s work (based on local, state and federal workplace health and safety guidelines)

  • If the individual is obtaining a service involving the face or nose and temporary removal of their face covering is needed to perform the service

  • If the individual is dining at a restaurant or other establishment that offers food or drink services and is able to socially distance from members of public

  • If the individual is engaged in outdoor work or recreational activities and is able to socially distance from members of the public

  • If the individual is incarcerated (prisons and jails will utilize specific guidance on face-covering requirements for inmates)

Newsom emphasized that this order is not a substitute for existing COVID-19 prevention guidance, such as social distancing and hand-washing. Newsom’s administration has not yet addressed how the order will be enforced or whether Californians who disobey the order will face citations or other penalties. 

For additional COVID-19 updates and resources, contact Coffman Insurance Agency, Inc. today.

Pandemic Unemployment Assistance Program

Gig workers in California can now apply for Unemployment Benefits through the Pandemic Unemployment Assistance Program.

Covered Individuals

  • Independent contractors

  • Self-employed

  • Individuals without sufficient work history

  • Individuals who have exhausted their regular and any extended UI benefits

  • Must self-certify to be able and available to work except are unemployed due to COVID-19 related reason

Amount of Benefits

  • Minimum weekly benefit amount of $167 (but weekly amount may be higher and equal the amount provided under regular UI, depending on proof of prior earnings)

  • PLUS $600 for weeks between March 29, 2020 to July 25, 2020.**

When Benefits Start

Benefits can be retroactive to weeks starting on or after February 2, 2020, depending on your last day of work due to COVID-19 and regardless of when you submitted your claim application. The effective date of your claim will begin the Sunday of the week when you last worked and became unemployed due to reasons directly related to COVID-19.

How Long?

Up to 39 weeks (minus any weeks of regular UI and certain extended UI benefits). Last week is week ending December 26, 2020.**

** Under the CARES Act of 2020, the $600 additional benefits are available through 07/31/20. However, the U.S. DOL has issued guidance to clarify that, for most Californians, the last full week of benefits will end on 07/25/20. Similarly, the PUA program has a legislative end date of 12/31/20, but for most Californians the last full week of benefits will end on 12/26/20.

How do I know if I am eligible for PUA?

You may qualify for PUA benefits if:

  • You are unemployed, partially unemployed, unable to work or unavailable to work as a direct result of a COVID-19 related reason AND:

    • You are a business owner, self-employed, independent contractor or gig worker (and are not participating in the UI Elective Coverage Program). You will be able to indicate if you have no employment wages (for example, you did not receive a W-2), solely for the purpose of applying for the PUA program (and not to be used for any other purpose).  However, you may proceed with a regular UI claim if you believe you were misclassified and have wages from an employer.

OR

  • You don’t have sufficient work history. This generally means you don’t have enough wages reported as an employee during the last 18 months to establish a regular UI claim.  This could be the case if you are self-employed or an independent contractor.  But this could also be the case if you are an employee with insufficient earnings.  To qualify for PUA based on insufficient work history, you must have been recently employed, which could be satisfied if you had a bona fide offer to start working on a specific date but were unable to start as a direct result of a COVID-19 related reason;

OR

  • You have collected all unemployment benefits for which you were eligible and remain unemployed or partially unemployed as a direct result of a COVID-19 reason. This means that you were qualified for regular UI but have exhausted those benefits, as well as any extended benefits.

More information is available here:

https://www.labor.ca.gov/pandemic-unemployment-assistance-pua-program/

https://edd.ca.gov/about_edd/coronavirus-2019/pandemic-unemployment-assistance/faqs.htm

To file a claim online visit:

https://edd.ca.gov/Unemployment/UI_Online.htm

Mobile friendly version of UI Online is available here:

https://edd.ca.gov/Unemployment/About_UI_Online_Mobile.htm