OptiMed Value-Adds Proving Invaluable
Even More Help On The Way!
In the recently constructed era of social distancing, the utility of telemedicine reverberates across the land. Many OptiMed Health members are thankful this benefit is included as one of many value-added non-insurance benefits.
“Telemed Tackling COVID-19” was delineated a week ago (please contact your OptiMed Sales Representative to ask about our TeleMedicine product), but there is even more value to excavate from the OptiMed value-added benefits.
The COBRA Reality
An unfortunate consequence is that many companies have slashed payroll or will soon do so. Companies will have a choice, either furlough employees and keep their benefits active, or layoff employees. Laid off employees will be offered COBRA. OptiMed has always performed COBRA services for groups. OptiMed provides COBRA administration that includes all the required activities:
- Processing elections,
- Tracking coverage periods,
- Collecting payments,
- Remitting to carriers
- Providing both COBRA and HIPAA notices.
Companies with 20 employees are required to offer COBRA, and it applies to not only fully and self-insured medical plans but also dental, vision, EAPs, telemedicine, HRAs, and FSAs in which contributions exceed reimbursements issued. COBRA coverage must be extended to all qualifying beneficiaries.
It’s probably a good idea to help your employers review their SPDs and employee handbooks for policies and procedures relating to transitioning onto COBRA.
If Termination Is Temporary
With government help expected to arrive soon, many employers may be furloughing instead of terminating but even those who have terminated may be figuring on hiring back once America reopens for business. Some states allow employers to pay the former employee’s COBRA premiums and then recoup the money once the employee is back on the payroll.
If an employee returns to the payroll in less than 13 weeks (or 26 weeks for educational organizations), coverages can pretty much pick up where they left off. A longer layoff means treating them as a new employee. In such a case, the employer would not be subject to a penalty for the first three months of employment for the rehired FTE as long as affordable and minimum value coverage is offered at the end of the 3-month period.
Eligibility Matters
Employers will be tempted to leave non-working former employees on its benefits plan, but unless there is a government waiver of some kind, this amounts to an ERISA fiduciary liability. Insurance carriers, including stop-loss insurers, may not cover claims by individuals who were not satisfying the eligibility rules of the plan.
This could also occur with a reduction in hours.
More Help Is On The Way
As robust as the list of value-added benefits may be, there is more to come.
A WorkPlace Wellness program will be announced next week. It will be rolled into the value-added benefits package at no additional charge, offering a level of nutrition counseling and exercise coaching free to group members and their immediate family, with discounted pricing on more personalized counseling or orchestration of group programs such as a 12-Week Weight Loss contest.
Check back here for full details.
Contact OptiMed Sales Rep
Brokers needing assistance in these uncertain times should consult with their OptiMed sales rep for assistance. In addition to conquering COBRA, taking advantage of Telemedicine, or elevating wellness throughout the workplace, the sales rep can also advise you and your groups on benefits to derive from:
- A Wellness Advice Line staffed by registered nurses
- An Employee Assistance Program (EAP) that offers an array of life management tools
- Setting up Section 125 POP plans
- Connecting you to OptiMed’s exceptional customer service
Download the attached PDF document for bulleted highlights of these services, which you may also choose to share directly with your groups.
In this challenging time, turn to OptiMed.
