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Health Plan Options |
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Commercial Bulletin: December 15, 2020
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Stay informed about COVID-19
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Geisinger.org/coronavirus is full of the most up-to-date information about the latest on COVID-19 including vaccine FAQs, our safety checklist, community resources and much more. Want the latest updates sent right to your inbox? Simply scroll down until you see the blue email sign-up box.
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Reminder: our employer coverage FAQs have been updated
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Deadlines extended to February 28, 2021 and a vaccine update
Q: When the COVID-19 vaccine becomes available, can my employees get it?
A: When the COVID-19 vaccine is available, there will be no cost sharing for Geisinger Health Plan’s members. More information on availability will be forthcoming.
Q: Is COVID-19 antibody testing covered?
A: COVID-19 antibody testing will be covered if a member:
- Experienced symptoms consistent with COVID-19 infection but tested negative; or
- Recovered from a documented COVID-19 infection and is now considering plasma donation; or
- Is a child with suspected Multisystem Inflammatory Syndrome in Children (MIS-C)
We are waiving member cost sharing for antibody testing for both in- and out-of-network. If a member does not have an out-of-network benefit, antibody testing will be covered and cost sharing for it will be waived as well.
Q: Are early pharmacy refills available?
A: Through Feb. 28, 2021, we are allowing early refills for 30- or 90-day prescriptions at retail pharmacies. We encourage our members to ask about and use home delivery when available for their prescriptions. We are also allowing early refills on 90-day prescriptions from our mail-order pharmacy, which delivers directly to the member’s home at no extra cost. Early refills are available for controlled substances but will not apply for prescriptions that contain opioids outside of certain conditions.
Q: Will Geisinger Health Plan allow extending coverage to dependents who would otherwise be terminated for turning 26?
A: Upon a group’s request, Geisinger Health Plan will extend coverage for dependents who turn 26 in Apr. 2020 through Jan. 2021, provided that premium is paid. If a dependent turns 26 in Apr. 2020 - Jan. 2021, coverage may be extended through Feb. 28, 2021. Contact your customer care team or your account executive service specialist.
Q: My plan is fully insured. If I lay off part of my workforce in response to the COVID-19 crisis, can the company continue to cover those employees?
A: Yes. Through Feb. 28, 2021, Geisinger Health Plan is relaxing its requirement that employees be actively working to be eligible for coverage and will allow you to continue coverage for laid-off employees. Note that this is subject to all monthly premiums being paid and coverage offered on a uniform, non-discriminatory basis. You may not choose only certain people for whom you continue coverage and pay premium.
Q: My plan is fully insured. If I must lay off my entire workforce in response to the COVID-19 crisis, can the company continue to cover those employees?
A: If at least one person remains employed by the company and covered by the plan (e.g., the owner or a management employee), the company can continue to cover laid-off employees through Feb. 28, 2021 if premium is paid. Note that you must offer this coverage on a uniform, non-discriminatory basis. In other words, you may not choose only certain people for whom you continue coverage and pay premium.
Q: What happens to COBRA continuation coverage if my plan is self-insured?
A: If your group is subject to COBRA and one person remains actively employed, employees may elect to continue coverage under COBRA under the normal notice and election procedure. If Geisinger Health Plan is your stop-loss carrier, we will not limit the number of COBRA participants under the stop-loss policy through Feb. 28, 2021. If GHP is not your stop-loss carrier, check with your stop-loss carrier about any rules it may have regarding minimum enrollment of active employees for stop-loss coverage. If the plan has no active employees, the plan is terminated, and COBRA is not an option. In that case, employees would have a special enrollment period to enroll in individual or other coverage (e.g., through a spouse).
Q: If my group’s enrollment drops by more than 15% as a result of the COVID-19 situation, will my rates/premiums be subject to change?
A: Through Feb. 28, 2021, if the loss of enrollment is a result of the COVID-19 pandemic, rates and premiums will not be adjusted due to enrollment change.
View the full employer coverage FAQ on the brokerHUB.
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This just in: Pennie extends OE shopping deadline for coverage effective Jan. 1, 2021
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Customers now have until Dec. 22 to enroll in a plan at pennie.com for coverage that begins New Year’s Day. More things to know:
- All customers will continue to be able to shop for coverage effective Jan. 1, 2021 through 11:59pm EST on Dec. 22, 2020.
- The extended deadline is automatically available to all customers and will be reflected when they log in and shop for plans.
- Customers will not be able to enroll in coverage effective Feb. 1, 2021 until Dec. 23, 2020 (although they will be able to anonymously shop for Feb. 1 coverage from Dec. 16 - 22).
- Customers enrolling for Jan. 1 coverage after Dec. 15 should remember to make a prompt binder payment to ensure that their coverage is in effect on Jan. 1. Any delays could result in the customer not having all their member materials in hand on Jan. 1.
- If you have any questions, Pennie’s broker/assister call center can be reached at 844-844-4440. Customers can be directed to 844-844-8040.
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Reminder: appointment processing for broker appointments
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If you are already appointed to sell individual Marketplace plans on behalf of Geisinger Health Plan (GHP), or are seeking a new appointment for individual sales, remember that those sales are not commissionable unless we have received your FFE certification for remaining 2020 business and Pennie training certification for 2021. We will not be requiring any additional GHP product training for individual commercial business.
Need to make sure you’re good to go? Send your certifications to brokers@thehealthplan.com to make sure you’re ready to sell.
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An updated small group summary detail is available
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We have updated the Small Group ACA HMO 10/20/0 SBC to reflect a corrected charge within the 2021 small group summary detail document. The Outpatient Opioid Detoxification value was changed from $200 per stay after deductible to 0% after deductible. An updated SBC for this plan has been incorporated into the 2021 small group plan detail document, now available of the brokerHUB.
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The limitations of ad hoc bills – the more you know
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Please be aware that at this time, we cannot request and print ad hoc bills. In order to obtain one, the requesting broker or group will need to wait until our next monthly bill run to get an updated bill. Contact your account representative with any further billing questions.
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Stay safe during your holiday shopping excursions
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December is Safe Toys and Gifts Month and this year it has additional meaning. Not only should we focus on the safety of the toys we are purchasing, but we also need to focus on how to shop safely during the holidays. This holiday season we also need to focus on our own health and safety while shopping for safe toys and gifts. This can be done by:
- Avoiding peak shopping days and last-minute shopping.
- Always wearing a mask over your mouth and nose while shopping.
- Keeping your distance from others in the store.
- Using online services when possible.
- Avoiding touching items you do not plan on purchasing.
- Using hand sanitizer after leaving stores.
- Washing your hands with warm soapy water as soon as you get home.
- Giving untraditional gifts like ordering food to be delivered to a loved one or donating to a charity.
- Looking for gifts at stores you are already running errands at and avoiding going to different stores.
- Many stores have virtual gift card options, and when giving gift card, encourage people use it online if possible.
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Keep the brokerHUBs close with bookmarks
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Save these links to your web browser’s bookmarks or wherever you can easily access them and enter with just a click:
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- President-Elect Joe Biden formally announced his choice for Secretary of Health and Human Services: California Attorney General Xavier Becerra.
This week’s fast facts are brought to you by the National Association of Healthcare Underwriters.
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**If you choose to share this information with others, be mindful. Please take care to avoid altering or modifying the original messaging in this bulletin, or any Geisinger communications, in any way.** |
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