Trustmark - IMPORTANT UPDATE! Benefit Changes Due to the Coronavirus
|
As the situation with the coronavirus (COVID-19) continues to
evolve, we have been proactive in announcing benefit changes being made to
self-funded group major medical benefit plan designs (Trustmark
HealthyChoicesSM, Trustmark HealthyEdgeSM and Trustmark Healthy
Incentives® plan designs) administered by Star Marketing
& Administration, Inc.
NEW! On Wednesday, March 18, 2020, a
new federal law was enacted, requiring coverage of testing for the
coronavirus without any cost sharing, prior authorization or other medical
management requirements.
President Donald Trump signed the Families First Coronavirus
Response Act, effective March 18, 2020, through Dec. 31, 2020, which requires1 the following:
· Self-funded ERISA
and church group major medical benefit plans must cover testing for the
coronavirus without cost sharing, i.e., deductible, copay or coinsurance.
· Prior authorization
or other medical management requirements, such as medical necessity determinations
and out-of-network penalties, must not be imposed.
· The mandates apply
to items and services furnished during a visit at healthcare providers
offices, urgent care centers, emergency rooms , or via telehealth
consultations (whether by Teladoc® or another provider) that result in an
order for or administration of a test for the diagnosis of COVID-19.
1This section of the
law does not apply to federal or other governmental benefit plans.
In addition to mandated benefit changes from the new federal
law, we previously announced telemedicine benefit changes to major medical
benefit plan designs administered by Star Marketing & Administration,
Inc.:
· Teladoc®: The consult fee
for Teladoc telemedicine services will be $0 through June 30, 2020. Teladoc
provides covered employees and their dependents with access to a U.S.
board-certified doctor through the convenience of phone and video consults
for non-urgent care. In 2019, Teladoc was ranked #1 in telehealth by J.D.
Power.1 We announced this
change on March 13, 2020.
· Claims for virtual
care/telemedicine visits with any non-Teladoc doctor, such as your primary
care physician: Except for the testing mandate as explained above, these claims
will be processed as a physician office visit in accordance with your plan’s
provisions. Copays or deductibles will apply, if applicable. This benefit
change was announced in a notification you should have received by March 18,
2020, and is valid through June 30, 2020.
Contact your Account Manager at 800.522.1246, ext. 35382, by end
of the day Friday, March 20, 2020, if you do not want your health benefit
plan to offer the two bulleted benefit changes regarding telemedicine.
Early refills of prescriptions
Early refills of prescription drugs will be allowed to ensure an
uninterrupted supply. Some drugs may be prohibited from early refills by
federal regulations.
HDHPs Can Cover Coronavirus Costs
The IRS announced that high-deductible health plans (HDHPs) can
pay for COVID-19-testing and treatment, without jeopardizing their status.
This also means that an individual with an HDHP that covers these costs may
continue to contribute to a health savings account (HSA).
Please share this information with your covered employees.
With questions, call your Account Manager at 800.522.1246,
ext.35382.
For more information about your plan, log in at TrustmarkSB.com.
1TeladocTM Health website, Teladoc Ranks
First in Inaugural J.D. Power Telehealth Study, https://teladochealth.com/en/newsroom/press/release/teladoc-health-ranks-first-in-inaugural-j-d-power-telehealth-study, Oct. 31, 2019
|