Trump Signs Executive Order Permanently Expanding Telehealth Benefits

President Donald Trump recently signed an executive order aimed to improve telemedicine and rural health care access. The order expands telehealth benefits for Medicare recipients past the public health emergency (PHE) declaration for the coronavirus (COVID-19) pandemic, particularly addressing health care access in rural communities.

Previously, Trump had expanded Medicare telehealth coverage, which offered expanded benefits and suspended restrictions on 135 health care services offered via telehealth to Medicare beneficiaries. This temporarily allowed recipients to receive a wider range of services. This executive order extends these flexibilities and moves to expand telehealth benefits permanently, and increase access and choices for seniors.

The Centers for Medicare & Medicaid Services (CMS) Releases Proposed Rule

Shortly after the executive order, the CMS issued a press release proposing a rule which reduces the clinician burden in rural areas. The CMS notes that telehealth can help address current health care challenges. "Telemedicine can never fully replace in-person care, but it can complement and enhance in-person care by furnishing one more powerful clinical tool to increase access and choices for America's senior," according to CMS Administrator Seema Verma.

The CMS’ proposal permanently allows for some services to be done via telehealth, including certain types of home visits. The proposed adjustments also help to ensure that the CMS appropriately recognizes the types of care where clinicians need to spend more face-to-face time with patients, including primary care and complex or chronic disease management. The CMS’ recent press release notes that these efforts help address health care challenges in rural areas, where access to health care providers often is limited.

According to a press release, the Centers for Medicare & Medicaid Services (CMS) is proposing to allow specified services to be offered via telehealth permanently.

The Expansion of Telemedicine

According to the U.S. Department of Health and Human Services (HHS), Medicare primary care visits have shifted toward the telehealth format, with 43.5% of Medicare primary care visits taking place virtually in April—less than 1% had been virtual in February. As the use of virtual health care has expanded in response to COVID-19, many health care providers have advocated for expanded use of telehealth after the PHE declaration. Though details regarding how telemedicine will impact Medicaid recipients continue to adjust, this executive order takes a step in the direction of expanding access to telemedicine services.

Preparing for an Unprecedented Open Enrollment Period

Open enrollment following the COVID-19 pandemic will be unlike any other in recent memory. Many organizations are still trying to recover from extended closures and maintain safe working environments—open enrollment is the last thing on their minds. Yet, procrastinating on enrollment planning can actually cause more issues than it solves. This article explains what employers can expect this enrollment period and how to prepare.

Open Enrollment Trends to Watch

Expect major disruptions to open enrollment this year. From an operational standpoint, COVID-19 might surge in the fall and force states to reclose businesses. From a personnel standpoint, employees may not be comfortable returning if they feel unsafe in the workplace. These are two worst-case scenarios, but they exemplify the multitude of potential disruptors stemming from COVID-19 this enrollment period.

In fact, many organizations are expected to hold entirely virtual open enrollments due to health-related fears. Virtual enrollment has been trending for several years, and the COVID-19 pandemic is helping to solidify its prominence. A virtual enrollment process typically includes an online enrollment platform for selecting benefits, remote meetings between employees and HR, and downloadable benefits resources.

While virtual enrollment will almost certainly be the new standard, it’s not necessarily the solution for everyone. Employees’ technology skill levels, language barriers and past expectations will all influence what open enrollment looks like across different organizations. It’s up to individual employers to decide how to pair virtual enrollment solutions with other resources to meet the unique needs of their employees and the organization as a whole.

Many employers are meeting these challenges through supplemental health plans with an emphasis on overall well-being. Since the beginning of the COVID-19 pandemic, employers have been looking for ways to control costs while providing employees with meaningful mental health resources to curb burnout. Adding optional health benefits can be a way to limit additional employer spending and provide assistance to employees who need it.

Employer Next Steps

Preparation will be the key factor for a successful open enrollment this year. Employers should talk to stakeholders early and prepare to answer any employee questions. Employees will need to know exactly how they will be enrolling, when enrollment is happening and where they can find help. Solidifying this information early will help keep everyone on the same page.

Employers should consider reaching out to employees to determine what kind of enrollment process will work best for them. However, it should be clear that these suggestions must fit in with larger workplace operations. For instance, in-person meetings may not be an option.

Ways Employers Can Prepare

Open enrollment isn’t always a clear-cut process. Something that’s successful for one organization won’t necessarily work for another. Employers should review the following strategies and consider how similar initiatives might improve their own open enrollment efforts:

·         Confer with management about any operational restrictions that may influence open enrollment (i.e., if in-person staff is limited within the workplace, in-person enrollment is likely not an option).

·         Meet with stakeholders to solidify what the enrollment process will look like, including whether it will be entirely virtual, in-person with social distancing or some other combination of strategies.

·         Debrief managers early in the enrollment process, and encourage them to communicate regularly to employees about the upcoming open enrollment.

·         Inform all stakeholders (anyone to whom an employee may reach out about open enrollment questions) about the enrollment process. They should know where to find the answers to any topic, including:

• Benefits effective date

• Enrollment period

• What happens to furloughed employees’ benefits

• How plan contributions work during extended closures

·         Communicate to employees about open enrollment through multiple channels. Consider using videos, mail-home postcards, PDFs and other materials to ensure employees have all the information they need.

While many organizations are finding success with these efforts, they are not the only strategies that work. Speak with Coffman Insurance Agency, Inc. to discuss an open enrollment process that meets the unique needs of your organization.

Remote Verification of Form I-9 Documents Extended to August 19th.

The U.S. Department of Homeland Security (DHS) has announced that the exemption for the physical inspection of Form I-9 documents has been extended to Aug. 19, 2020. According to the DHS, this will serve as the final extension.

Physical Inspection

Employers must complete and sign Section 2 of Form I-9 within three business days of the employee’s first day of employment. Employers are required to physically examine the documents the employee presents from the list of acceptable documents to prove his or her employment eligibility.

Remote Verification

Because of COVID-19,  DHS is allowing employers that are operating remotely to conduct a remote verification of approved I-9 documents. The exemption also applies to new hires affected by quarantine or lockdown protocols. The exemption does not apply to employers that have employees physically present at a work location.

Under the exemption, employers must complete a remote inspection of approved documents within three business days and enter “COVID-19” as the reason for the physical inspection delay. Employers that use this exemption must also keep written documentation of their remote onboarding and telework policy for each employee.

Within three days of when normal operations resume, all employees who were onboarded using remote verification must present their approved documents for a physical inspection. Employers should add “documents physically examined” with the date of inspection to affected I-9 forms.

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.

States Update Employee Leave Requirements for Coronavirus

In response to the coronavirus (COVID-19) pandemic, states have passed new laws and issued new regulations and guidance about employee leave taken for COVID-19 reasons. These provisions are in addition to the federal Emergency Paid Sick Leave and Emergency Family and Medical Leave Expansion requirements passed on March 18 as part of the Families First Coronavirus Response Act (FFCRA).

In general, employee leave permitted under new state COVID-19 rules and guidance varies with respect to factors like the employers and employees covered by the leave, the length and purpose of the leave, whether the leave is compensated and at what rate, and whether the leave is provided under a new law or rule, or covered under an existing provision.

This Compliance Bulletin briefly describes new state employee leave provisions and guidance enacted or issued in response to the COVID-19 pandemic, along with links to government resources providing further information. Information about similar measures in select major cities is also included. The document will be updated with additional new employee leave rules in this rapidly changing compliance area.

California

The California Labor Commissioner has issued FAQs on employee leave options, compensation and salary in the context of COVID-19. In addition, Governor Newsom issued an executive order requiring large employers to provide up to 80 hours of paid leave for food sector workers for certain COVID-19-related reasons. Covered workers include farm workers, grocery workers and food delivery workers, among others. The measure was intended to provide paid leave for employees not covered by FFCRA’s paid leave provisions. Click here for more information.

The following entries describe select local leave laws enacted in response to the COVID-19 emergency. Additional localities (such as San Mateo County and Santa Rosa) have passed similar measures. Employers should familiarize themselves with the leave laws that apply in their county, city or town.

·         Long Beach—Effective May 19, 2020, a Long Beach ordinance imposes a paid sick leave requirement on employers that have 500 or more employees nationally, and that are not required to provide FFCRA emergency paid sick leave. Under the ordinance, full-time employees are entitled to 80 hours of paid leave, and part-time employees are eligible for paid leave in an amount equal to their average number of work hours over a two-week period, for specified COVID-19-related reasons. As with the FFCRA, different rates of compensation apply, depending on the reason for leave. The ordinance also contains pay caps and employee and employer exceptions, such as for health care worker and emergency responder employees (as defined in the ordinance).

·         Los Angeles—Mayor Eric Garcetti has issued a public order, effective April 10, 2020, requiring up to 80 hours of supplemental paid sick leave for certain workers for specified COVID-19-related reasons. The order applies to private employers with 500 or more employees within the city of Los Angeles, or 2,000 or more employees within the United States. The order includes employer and employee exemptions, and pay caps apply. The city has issued rules to implement the order.

·         Los Angeles County—Under an urgency ordinance, employees in unincorporated areas of Los Angeles County are entitled to 80 hours of supplemental paid sick leave for specific COVID-19-related reasons, retroactive to March 31, 2020. Part-time employees receive paid sick leave equal to their average two weeks’ pay. Pay is capped at $511 per day and $5,110 total.

The ordinance applies to employers with 500 or more employees nationally, but employers covered by the FFCRA or the state order requiring paid leave for food sector employees are exempt. Employees who are emergency responders or health care providers, as defined in the ordinance, are not entitled to the leave.

·         Oakland—On May 12, 2020, Oakland passed a law requiring employers with 500 or more employees to provide their workers with emergency paid sick leave for specified COVID-19-related reasons, including employees at least 65 years old or at other risk of serious illness from COVID-19 exposure. The law took effect immediately upon passage. Full-time workers receive 80 hours of leave, while part-time workers are entitled to an amount of leave equal to their average work hours over a 14-day period, based on hours worked during the period Feb. 3 - March 4, 2020. Pay caps and exemptions, including for health care worker and emergency responder employees, apply.

·   Sacramento—Under a city ordinance effective June 30, 2020, employers must provide employees up to 80 hours of supplemental paid sick leave for specified COVID-19-related purposes. The ordinance applies only to employers that have 500 or more employees nationally and are exempt from FFCRA paid sick leave requirements. Exceptions apply for employees who are emergency responders or health care providers, and employers can use certain employee leave provided for COVID-19 purposes as a credit toward the leave required under the ordinance.  As with FFCRA paid sick leave, compensation varies according to the reason for the leave, and daily and aggregate pay caps apply.

·         San Francisco—As of April 17, 2020, the San Francisco Public Health Emergency Leave Ordinance requires employers with 500 or more employees worldwide to provide their San Francisco employees with up to 80 hours of emergency paid sick leave for certain coronavirus-related purposes. Click here for FAQs from the city on the new law.

The city of San Francisco has also passed the Workers and Families First Program, providing $10 million to businesses with employees in San Francisco to provide five days of sick leave beyond employers’ existing policies. The additional sick leave is available only to employees who have exhausted their currently available sick leave, have exhausted or are not eligible for federal or state supplemental sick leave, and whose employer agrees to extend sick leave beyond current benefits. The city has released an employer guide on the program.

The city has also published guidance on San Francisco Paid Sick Leave and the coronavirus.

·         San Jose—San Jose has passed a paid sick leave ordinance, effective April 8 – Dec. 31, 2020, in response to the COVID-19 crisis. The ordinance is meant to fill the gaps left by the FFCRA, and it requires employers to provide eligible employees with up to 80 hours of paid sick leave for specified COVID-19 related reasons. The city has issued FAQs on the ordinance.

All Other States -

Contact Coffman Benefits (info@coffmanbenefits.com) for detailed information.