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Employer Group COVID-19 Update

  • Category: COVID-19
  • Posted On:

5.15.20 Update: FHCP is extending the timeline to pay premiums, $0 cost-share for COVID-19 testing & treatment, and $0 cost-share for Doctor-on-Demand medical services.

Florida Health Care Plans (FHCP) is actively engaged alongside Florida Blue in the COVID-19 public health emergency and is committed to supporting our members and our communities as this difficult situation evolves. Accordingly, FHCP is aligning with Florida Blue on the following initiatives:

  • To ensure FHCP members who need care and can better focus on their health, the following cost-share reductions are in place from March 15 through April 21, 2021:
    • FDA approved appropriate COVID-19 testing and any ordered medical services treating COVID-19 will be at a $0 cost-share.
    • FHCP is waiving the cost-share for the treatment of any member with a positive COVID-19 diagnosis to include in-patient and observation hospital admissions.
      • FHCP will assist self-funded plans regarding any changes to the cost-share for COVID 19 treatment to help them meet the needs of their employees during this health crisis.
    • Doctor-on-Demand general medical telehealth visits will be a $0 cost-share through April 21, 2021, for our Small Group, Large group, Individual Under 65, and Medicare members. Self-funded members should consult with their HR team regarding their telehealth provider’s response to COVID-19.
      • FHCP is also offering $0 cost virtual visits with an FHCP employed PCP and only if the doctor has the virtual visit capability through July 31, 2020.
  • FHCP will work closely with providers and physicians to ensure members are not balance billed for any covered services related to COVID-19 treatment.
  • FHCP is allowing premium payment deferrals through6/30/20, as listed below. Members and groups are still required to make their regular monthly payments to avoid delinquency. If delinquent, claim holds will apply as follows:
    • Small Employer Groups(2 – 50) that are delinquent will have medical and pharmacy claims pended for their employees beginning on 4/10/2020.
    • Large Employer Groups(51+) FHCP is currently evaluating options to determine if medical and pharmacy claims will be pended.
    • Self-Fundedgroups will be allowed an additional 60 days to pay their administrative fees and will still be responsible for funding their claims.

NOTE: All outstanding premiums and administrative fees are expected to be paid in full by 7/1/2020. FHCP will provide additional communication if the deferral period is extended.

  • FHCP has adopted a non-enforcement policy for employees to be able to retain coverage as if they were active employees in the event they are furloughed or drop below minimum hours worked through 5/31/2020.
    • However, it is advisable that employers should be applying consistent policies regarding offering active employees and furloughed employees or those experiencing a reduction in hours.
    • Employers are encouraged to consult with their employment counsel on extending employment benefits such as health insurance to furloughed and/or employees that experience reductions in hours to ensure compliance with federal and state labor laws.
  • In response to CDC guidelines of encouraging individuals who are ill or at higher risk for COVID-19 to remain home, members may fill prescriptions and have them mailed with free shipping.
  • We are strongly encouraging our members to go to one of our 8 COVID-19 testing locations. Florida Health Care Plans testing sites will give our members much faster results and will include treatment recommendations and follow-up care if necessary. For a list of the locations please click here. Questions regarding this bulletin can be emailed to marketing@fhcp.com

Questions regarding this bulletin can be emailed to marketing@fhcp.com