CORONAVIRUS (COVID-19) UPDATE: 03/17/2020
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The COVID-19 (Corona) Virus is obviously of top concern for the health of our families and friends, but is increasingly raising concerns for the growing impact to the nation’s workforce. The Ashley Group is dedicated to providing advice on how to navigate the effect of the pandemic on your health plan management program, and also to providing answers for your employees.
What Government Rulings Cover COVID-19?
The Trump Administration has designated diagnostic testing for COVID-19 as an essential health benefit under the Affordable Care Act. Each carrier will provide information to its members on their plan coverage and costs, and we have provided links to each carrier’s specific policy on COVID-19 below.
Additionally, the IRS has ruled (Notice 2020-15) that high deductible health plans (HDHPs) can pay for COVID-19 testing and treatment before plan deductibles have been met. Notice 2020-15 further states that any COVID-19 vaccination costs will be considered as preventive care and can be paid for by an HDHP without cost sharing.
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Is COVID-19 Covered as a Short-Term Disability?
You should refer to your carrier for their specific ruling regarding coverage under your policy. Employees may be eligible for benefits if they are diagnosed with the illness and are unable to perform the major duties of their job due to the sickness. Eligibility would be determined based on medical documentation.
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Are There Compliance Issues Related to COVID-19 for Employers?
Employers are obligated to maintain a safe and healthy work environment for their employees and are also subject to a number of legal requirements protecting workers. For example, employers must comply with the Occupational Safety and Health Act (OSH Act), Americans with Disabilities Act (ADA) and Family and Medical Leave Act (FMLA) in their approach to dealing with COVID-19.
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Employers need to take precautions to keep any communicable disease from spreading through the workplace. It is recommended that employers establish a written policy and response plan that covers communicable diseases readily transmitted in the workplace.
Employers can require employees to stay home from work if they have signs or symptoms of a communicable disease that poses a credible threat of transmission in the workplace, or if they have traveled to high-risk geographic areas, such as those with widespread or sustained community transmission of the illness. When possible, employers can consider allowing employees to work remotely. Employers may require employees to provide medical documentation that they can return to work.
Note: Under HIPPA laws, employers should not disclose the name of any infected employee(s) to their co-workers or any information regarding their medical condition.
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There is no specific Occupational Safety and Health Administration (OSHA) standard covering COVID-19. However, some OSHA requirements may apply to preventing occupational exposure to COVID-19. In addition to the General Duty clause, OSHA’s Personal Protective Equipment (PPE) standards and Bloodborne Pathogens standard may apply to certain workplaces, such as those in the healthcare industry.
It is also important for employers to consider what preventative measures they can take to maintain safety and protect their employees from potentially contracting COVID-19.
OSHA requires many employers to record certain work-related injuries and illnesses on their OSHA Form 300 (OSHA Log of Work-Related Injuries and Illnesses). OSHA has determined that COVID-19 is a recordable illness when a worker is infected on the job. Establishments that are required to complete an OSHA 300 log should be sure to include all COVID-19 infections that are work related.
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The Equal Employment Opportunity Commission (EEOC) has said that sending an employee home who displays symptoms of contagious illness would not violate the ADA. An employer may send employees home, or allow employees to work from home, if they are displaying symptoms of a contagious illness.
The ADA requires that information about the medical condition or history of an employee, obtained through disability-related inquiries or medical examination, be collected and maintained on separate forms and in separate medical files and treated as a confidential medical record. Employers should refrain from announcing to employees that a coworker is at risk of or actually has a disease. Instead, employers should focus on educating employees on best practices for illness prevention.
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An illness like COVID-19 may qualify as a serious health condition under the FMLA if it involves inpatient care or continuing treatment by a health care provider. Employees may also be entitled to FMLA leave when taking time off for medical examinations to determine whether a serious health condition exists.
At this time, a diagnosis without certification by a doctor of a serious health condition, a quarantine order, a need to self-quarantine due to lowered immunity, or the need to care for a child due to school closures would not qualify under the FMLA.
HOWEVER, recent legislation is making its way to the President's desk that may expand FMLA and add a new paid sick leave program.
Watch for an FMLA update once we are alerted.
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Among the many issues employers are facing in the wake of the spread of COVID-19 is the possibility of furloughs, temporary office and location closings, and short-term layoffs. A furlough involves reducing the days or weeks that an employee may work. A layoff can be temporary or permanent. Employers may also consider reducing the daily hours of some employees.
It may be too soon for you to know if COVID-19 will bring longer term workplace impacts that would require workforce reductions or temporary layoffs. Workplace practices are shifting on a daily basis. Many companies are initiating work from home strategies, cancelling travel and event plans, and limiting work group interactions.
It's important to create and adhere to a workplace reduction/layoff policy that is standard. Avoid creating a policy carve-out specific to COVID-19, which may leave you open to protests or lawsuits.
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The Ashley Group and all our carrier plans encourage the use of telemedicine to improve health outcomes and lower costs for many situations. Telemedicine, or virtual screenings, offer significant advantages with COVID-19 and other communicable diseases.
- It is much more convenient for people to be screened in their homes rather than having to visit an emergency room or urgent care center. The convenience should lower the barrier to screening.
- From a public health standpoint, telemedicine screening can help avoid inundating healthcare settings with patients who are at low risk of having COVID-19, which maintains capacity to treat patients who are at high risk.
- The telemedicine screening can help prevent the spread of COVID-19 because as long as patients are not critically ill, they can be triaged at home rather than visiting an emergency room or clinic, where other people could become infected.
- The telemedicine screening lowers the cost barrier to getting a COVID-19 assessment.
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Carrier Specific Updates on COVID-19
The following fully-insured providers have notified TAG that they are covering all
diagnostic testing
for the virus at 100%, as long as it is ordered by a medical provider. Refer to the carrier links below for specific information regarding member cost sharing for related office visits and treatment.
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Effective immediately, and through May 31, 2020, Paramount will waive member deductibles, coinsurance and co-pays for coronavirus (COVID-19) diagnostic testing. This new policy applies to all Paramount commercial clients, and includes HSA-qualified high deductible plans.
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