Accident & Health COVID-19 FAQ

This document provides our positions, policies and procedures related to the COVID-19 pandemic.

The COVID-19 Public Health Emergency, originally declared on March 13, 2020, officially expired May 11, 2023. The following information is effective July 10, 2023, 60 days after the expiration of the Public Health Emergency.

What is the overall impact of the end of the COVID-19 Public Health Emergency (PHE)?

The end of the COVID-19 PHE will usher in sweeping changes in several areas:

• Payment changes for many COVID-19 related services (See TESTING section)
• Varying timelines for reinstating and implementing regulatory requirements
• Changes in how health systems and hospitals utilize expansion sites to care for COVID-19 patients and/or isolate non-COVID-19 patients
• Return of regulatory requirements that were waived at the height of the COVID-19 pandemic in order to alleviate the burden on the health care system (see Federal Rules Extending COBRA, HIPAA and Claims Appeal Timelines section)

Will Swiss Re Corporate Solutions continue to accept Policyholder coverage of COVID-19 testing at 100% coverage with no plan deductibles, coinsurance and/or co-payments? If so, will there be any change required to current in-force premium rates or aggregate factors?

Effective July 10, 2023, we will no longer reimburse COVID-19 tests free of charge, including serological testing for antibodies and associated costs. Cost-sharing such as plan deductibles, co-insurance, and co-payments will apply pursuant to the terms of the Plan. We currently do not anticipate changes to premium rates or factors attributable to this position.

That said, we will follow Plan provisions, including amendments, accepted by us for coverage under the Stop Loss Insurance Policy relative to COVID-19 testing.

Will Swiss Re Corporate Solutions accept Policyholder coverage of COVID-19 vaccination at 100% coverage with no plan deductibles, coinsurance and/or co-payments? If so, will there be any change required to current in-force premium rates or aggregate factors?

COVID-19 vaccines, including updated boosters, are now considered preventive. Therefore, expenses for COVID-19 vaccines and updated boosters, including administration thereof, recommended by the Centers for Disease Control's Advisory Committee on Immunization Practices (ACIP) will be reimbursable pursuant to the terms of the Plan and Stop Loss Policy.

This is irrespective of whether the vaccine is under an emergency use authorization or is fully approved by the U.S. Food and Drug Administration (FDA).
 

Will Swiss Re Corporate Solutions accept Policyholder coverage of COVID-19 treatment, including hospitalization, at 100% coverage with no plan deductibles, coinsurance and/or copayments? If so, will there be any change required to current in-force premium rates or aggregate factors?

We will rely on the Policyholder and their Claims Administrator to determine coverage for COVID-19 treatment, including hospitalization, under their Plan Document. We will follow Plan provisions relative to COVID-19 treatment, subject to the terms and conditions of the stop loss policy.

Will Swiss Re Corporate Solutions accept the removal of prescription refill limitations on maintenance medications to assure an adequate supply in the event of potential quarantine situation?

Refill limitations have been reinstated, subject to the provisions of the Plan.

Will Swiss Re Corporate Solutions accept Policyholder coverage of Telemedicine and video presence with no plan deductibles, coinsurance or and/or copayment for any diagnostic and necessary medical treatment? If so, will there be any change required to current in-force premium rates or aggregate factors?

Yes, we will accept Policyholder coverage of Telemedicine and video presence pursuant to the provisions of the Plan.

Will Swiss Re Corporate Solutions reimburse treatments and services that might be effective for treating COVID-19 but fall under the Plan’s E&I exclusion (e.g., convalescent plasma, Tocilzumab and Remdesivir)?

We will continue to rely on the Policyholder and their Claims Administrator to determine Claims eligibility under the Plan. We will follow Plan provisions relative to E&I, subject to the terms and provisions of the stop loss policy.

Will Swiss Re Corporate Solutions extend Policy premium provisions due to payment delays resulting from COVID-19?

Premium payments will be due in accordance with the provisions outlined in the stop loss Policy.

Will Swiss Re Corporate Solutions extend timely filing requirements for claims which are delayed as a result of COVID-19, including administrators' inability to process claims timely, PPO networks repricing claims timely, and/or medical providers inability to bill timely?

Please refer to the terms of your Stop Loss Policy for claims filing requirements and timelines.

Will Swiss Re Corporate Solutions extend Policyholder reimbursement deadlines?

Our Claims reimbursement processes, procedures, requirements, and Policy provisions remain unchanged.

Will Swiss Re Corporate Solutions accept suspension of utilization review management and notification ("UR") requirements?

We are no longer accepting suspension of utilization review management and notification requirements.

Will Swiss Re Corporate Solutions allow Policy changes or enhancements off anniversary such as Monthly Aggregate Accommodation or addition of Terminal Liability Option?

We currently do not allow such Policy changes and/or enhancements off anniversary.

Will Swiss Re Corporate Solutions follow federal rules extending certain deadlines regarding COBRA, HIPAA and claims appeals?

Extended deadlines for COBRA elections and HIPPA special enrollment requests end on July 10, 2023 (sixty [60] days after the end of the Public Health Emergency). Additionally, any relief provided pursuant to the Department of Labor (DOL)/Internal Revenue Service (IRS) joint rule will also end July 10, 2023, including but not limited to the end of its Outbreak Period extensions.

Any accommodations with respect to the aforementioned extensions will also end on July 10, 2023.

Will Swiss Re Corporate Solutions accept plan members that join the plan, or change or revoke plan coverage, through mid-year election changes pursuant to IRS Notice 2020-29?

IRS Notice 2020-29 expired December 31, 2022. While the Consolidated Appropriations Act of 2021 reinstated many of the provisions within IRS Notice 2020-29, they did not reinstate the provision for mid-year election changes.

Please contact your regional Business Development Manager if you have any questions.