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Information from your health plan about COVID-19 (coronavirus disease)

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COVID-19 Updates for brokers

This webpage includes answers to questions you may have about coronavirus (COVID-19), along with resources you can use to help protect yourself, your family and others. We will update this page as information becomes available.  There will be no out-of-pocket cost to Security Health Plan members for the COVID-19 vaccine. The Wisconsin Department of Health Services determines who is eligible to receive the COVID-19 vaccine. Click the button to learn more.

Did you miss our past webinars?

You're in luck; the most recent webinars are listed here.  To view the complete list, click the button below.

View all webinars

Level-funded health plans - a smart choice (September 1, 2021)
The importance of health care in rural areas (August 4, 2021)
Exploring the legality of COVID-19 vaccine mandates (July 21, 2021)
COVID-19 vaccine - answers to common questions (June 30, 2021)
Medication therapy management: A "win-win" for employers and employees (May 12, 2021)
Long-haul COVID-19: A new challenge (April 28, 2021)
Better health with Business Health Solutions - DC Everest case study (March 17, 2021)
Breaking down insurance pricing and how COVID-19 has affected it (March 3, 2021)
Helping employees transition to Medicare (February 17, 2021)
Usability testing: a case study in billing statements (February 3, 2021)
Engaging our employees in physically distant and virtual workplaces (January 20, 2021)
Cancer and employers' health care costs (January 7, 2021)
Industrial Athlete Program: keep your team of employees healthy (December 16, 2020)
Dry needling alternative pain management (December 2, 2020)
How to approach worker’s compensation at your business (November 18, 2020)
Cost savings through medication management services (October 28, 2020)
Dealing with flu season during a pandemic (October 14, 2020)
Recovery Friendly Workplaces (September 30, 2020)

 

We’ve got you covered

Please find your client’s plan in the left column of the table below to see the COVID-19 benefits and services included with their plan. If your client has any questions they should call the phone number on their back of their ID card or our general Customer Service line at 1-800-472-2363.

Certain COVID-19 benefits shown in the chart below are applicable until the end of the National Health Emergency.

Security Health Plan members other than Medicare Advantage HMO-POS members who need to get care from an out-of-network provider during the COVID-19 health emergency should contact a Security Health Plan Nurse Navigator at 1-800-472-2363.

 
  Active COVID-19 testing and testing-related services Serological or antibody testing and testing-related services COVID Vaccines, preventive service/items Inpatient and observation treatment related to COVID-19 Out-of-network coverage Telehealth
Medicare Advantage HMO-POS
Covered at 100%4

Until the end of the National Public Health Emergency 
Covered at 100%

Until the end of the National Public Health Emergency 
Covered at 100%2 Covered at 100%

Until the end of the National Public Health Emergency 

Members can use an out-of-network doctor, hospital or service provider that accepts Medicare and pay the same costs they would pay to see an in-network provider for Medicare-covered services. This coverage is not affected by COVID-19 guidelines.

 

All Medicare-covered, medically necessary telehealth services will be covered the same as if the visit was in the office. You have free, unlimited coverage for Care My Way services.
Secure Saver MSA
Covered subject to plan deductible Covered subject to plan deductible
Covered at 100%2 Covered subject to plan deductible MSA plan members may use any provider that accepts Medicare.

All Medicare-covered, medically necessary telehealth services will be covered the same as if the visit was in the office. You have free, unlimited coverage for Care My Way services.

Until the end of the National Public Health Emergency

Ally Rx D-SNP

Covered at 100%4

Until the end of the National Public Health Emergency 

Covered at 100%

Until the end of the National Public Health Emergency 

Covered at 100%2 Your Security Health Plan and Medicaid coverage will coordinate to cover at 100%

Services at out-of-network facilities will have the same cost share as in network.

Until the end of the National Public Health Emergency 

All Medicare-covered, medically-necessary telehealth services will be covered. Your Security Health Plan and Medicaid coverage will coordinate to cover at 100% without member cost share. You have free, unlimited coverage for Care My Way services.
Medicare Supplement

Covered at 100%4

Until the end of the National Public Health Emergency 

Covered at 100%

Until the end of the National Public Health Emergency 

Covered at 100%

Covered at 100%

Until the end of the National Public Health Emergency 

Medicare Supplement members may use any provider that accepts Medicare.

All Medicare-covered, medically necessary telehealth services will be covered the same as if the visit was in the office. You have free, unlimited coverage for Care My Way services.

Until the end of the National Public Health Emergency 

Medicare Select: Senior Security

Covered at 100%4

Until the end of the National Public Health Emergency 

Covered at 100%

Until the end of the National Public Health Emergency 

Covered at 100%

 

Covered at 100%

Until the end of the National Public Health Emergency 

 

All Medicare-covered, medically necessary telehealth services will be covered the same as if the visit was in the office. You have free, unlimited coverage for Care My Way services.

Until the end of the National Public Health Emergency 

Large employer group

Covered at 100%4

Until the end of the National Public Health Emergency

Covered at 100%

Until the end of the National Public Health Emergency

Covered at 100%3

Covered at 100%

Until the end of the National Public Health Emergency

Contact Customer Service for specific plan benefits.

An expanded list of services1 may be provided via telehealth and will be subject to the same copay or coinsurance as if the visit were in office. Includes free, unlimited coverage for Care My Way services.


Small employer group

Covered at 100%4

Until the end of the National Public Health Emergency

Covered at 100%

Until the end of the National Public Health Emergency

Covered at 100%3

Covered at 100%

Until the end of the National Public Health Emergency

Contact Customer Service for specific plan benefits.

An expanded list of services1 may be provided via telehealth and will be subject to the same copay or coinsurance as if the visit were in office. Includes free, unlimited coverage for Care My Way services.


Individual and Family Plan (IFP)

Covered at 100%4

Until the end of the National Public Health Emergency

Covered at 100%

Until the end of the National Public Health Emergency

Covered at 100%3

Covered at 100%

Until the end of the National Public Health Emergency

Contact Customer Service for specific plan benefits. An expanded list of services1 may be provided via telehealth and will be subject to the same copay or coinsurance as if the visit were in office. Includes free, unlimited coverage for Care My Way services.
BadgerCare Plus (Medicaid) Covered at 100%4 Covered at 100% Covered at 100%3 Covered at 100% COVID-19 testing and treatment received at out of network facilities will be considered emergent and covered the same as in network indefinitely.

All covered services may be provided via telehealth at no cost to you. You have free, unlimited coverage for Care My Way services.

Marshfield Clinic Health System employees (self-funded non-governmental employer)

Covered at 100%4

Until the end of the National Public Health Emergency

Covered at 100%

Until the end of the National Public Health Emergency

Covered at 100%3

Covered at 100%

Until the end of the National Public Health Emergency

Please call Security Administrative Services at 1-800-570-8760 for details. An expanded list of services1 may be provided via telehealth and will be subject to the same copay or coinsurance as if the visit were in office. Includes free, unlimited coverage for Care My Way services.
Marshfield Clinic Health System-Beaver Dam employees (self-funded non-governmental employer)

Covered at 100%4

Until the end of the National Public Health Emergency

Covered at 100%

Until the end of the National Public Health Emergency

Covered at 100%3

Covered at 100%

Until the end of the National Public Health Emergency

Please call Security Administrative Services at 1-800-570-8760 for details. An expanded list of services1 may be provided via telehealth and will be subject to the same copay or coinsurance as if the visit were in office. Includes free, unlimited coverage for Care My Way services.
Governmental self-funded groups

Covered at 100%4

Until the end of the National Public Health Emergency

Covered at 100%

Until the end of the National Public Health Emergency

Covered at 100%3 Please call Security Administrative Services at 1-800-570-8760 for details. Please call Security Administrative Services at 1-800-570-8760 for details. Please call Security Administrative Services at 1-800-570-8760 for details.
Non governmental self-funded groups

Covered at 100%4

Until the end of the National Public Health Emergency 

Covered at 100%

Until the end of the National Public Health Emergency 

Covered at 100%3 Please call Security Administrative Services at 1-800-570-8760 for details. Please call Security Administrative Services at 1-800-570-8760 for details. Please call Security Administrative Services at 1-800-570-8760 for details.

1 The expanded list of services available via telehealth includes, but is not limited to behavioral health, office visits/consultations, care management and outpatient therapy.

2 The COVID vaccine and its administration are covered by the Centers for Medicare and Medicaid Services (CMS) for 2020 and 2021. Providers will submit claims directly to Medicare. Please have your red, white and blue Medicare card with you when you get your COVID vaccine. You must provide your Medicare number or Social Security number to the provider so they can bill Medicare directly. If you refuse to provide your traditional Medicare insurance information to the provider for billing purposes, you may become financially liable for the service.

3 The cost of the COVID-19 vaccine is covered by the federal government. The cost to administer the vaccine will be paid by Security Health Plan. 

4COVID-19 services not received on the same day as a COVID-19 test (unless admitted to inpatient/observation) will apply to your plan’s normal cost-sharing.


Experiencing symptoms?

Anyone experiencing symptoms of a fever, cough or shortness of breath, or concerned they may have been exposed to COVID-19, are encouraged to call the 24-hour Nurse Line at 1-800-549-3174 before visiting a doctor’s office, urgent care, hospital or emergency room.

COVID-19 Helpline

For NON-SYMPTOMATIC questions regarding COVID-19, call the Marshfield Clinic Health System COVID-19 helpline at 1-877-998-0880. This line is open 24 hours a day, 7 days a week.

COVID-19 Vaccine Coverage

The COVID-19 vaccine will be covered in full with no member cost sharing for all plans.

IRS Notice Allows for Changes to Plan Elections During National Emergency

On May 12, 2020, the IRS released Notice 2020-29 which provides much needed plan year election relief for participants in Section 125 plans in general. The Notice was in response to the COVID-19 National Emergency as the pandemic altered the funding needs for many participants.

During the national emergency period, Security Health Plan will allow employees one plan election change to revoke their current group health plan election for 2020 and select another health plan option that Security Health Plan offers. Additional changes after this one time election option are only allowed during the employer group’s open enrollment period or if the employee has a qualifying life event.

If an employer decides to allow employees to make enrollment changes regarding this IRS Notice, Security Health Plan requests written confirmation from the group to allow for such changes.

COBRA Deadlines Extended for National Emergency

Due to the COVID-19 National Emergency, deadlines to take action regarding COBRA/State Continuation elections and make payments have been extended. The period of time from March 1, 2020 until sixty (60) days after the announced end of the National Emergency is the “Outbreak Period” and does not count toward the deadlines for COBRA/State Continuation election timeframes, special enrollment timeframes, as well as claim procedure and external review process timeframes. It is unknown when the national emergency will expire.

Specifically, Security Health Plan will no longer count days during the Outbreak Period towards the:

Group Health Plans

All ERISA Plans

Fully Insured and Self-funded Benefit Coverage

Details noted on COVID-19 benefit chart.

Premium billings

Premium payments are subject to our current non-payment policy.   

Families First Coronavirus Response Act: Employee Paid Leave Rights

Department of Labor resource link: https://www.dol.gov/agencies/whd/pandemic/

Furloughs and Layoff Policies

Security Health Plan will allow for adjustments to employee eligibility and termination policy during the COVID-19 pandemic.

Each employer's handbook defines who is eligible for benefits. Security Health Plan will follow employers' definition of benefit-eligible employees. We will continue to follow what is in the Group Insurance Policy and employer handbook. If employers would like to make changes to their policies, we will need them to consider the following and present us with an amendment to their handbook.

Eligibility and termination guidelines during a pandemic:

Employee Premium Payment During Leave

If eligibility is maintained during a furlough, the employer may collect the employee’s share of premium to maintain coverage during leave of absence.

Premiums may be collected in one of the following manners:

Remind your Individual and Family Plan (IFP) clients to keep their applications current

Many Wisconsinites have had a change in their income due to various precautions taken to help fight the spread of COVID-19. It is important that anyone with an IFP plan from the Federally-facilitated Exchange (FFE), also known as the Marketplace, keeps their application up to date.  If their income goes down, they could see their monthly premiums decrease. Likewise, if their income increases they not qualify for as much financial assistance and will be expected to return that money when they file their 2020 taxes.

If your clients have created an account on HealthCare.gov when they enrolled, they can update their application online or over the phone. Click here to see a recent email we sent to our current Individual and Family Plan members who purchased a plan on the FFE. Feel free to share this information with your clients in case they missed the email from us.

According to the Centers for Medicare and Medicaid Services (CMS) the economic impact payment that is part of the Coronavirus Aid, Relief and Economic Security (CARES) Act does not impact eligibility for financial assistance for health care coverage through the FFE. The Internal Revenue Service (IRS) is currently distributing payments of up to $1,200 per taxpayer and $500 for each qualifying child as part of the CARES Act. This economic impact payment will not affect eligibility for Medicaid or the Children's Health Insurance Program (CHIP). Additionally, your clients do not need to include this payment in the income they report for financial assistance on the FFE. 

The extra $600/week that will be paid to those who file for unemployment benefits is considered income for federal and state tax purposes. Wisconsin plans to start making these Federal Pandemic Unemployment Compensation (FPUC) payments the week of April 26, 2020.

Click here for more information about the CARES Act. 
Click here for more information about the FPUC payments.

Handling Medicare Advantage sales appointments during the COVID-19 pandemic

During this time, we encourage you to conduct sales calls over the phone with any client to avoid face-to-face interactions. It is important to remember that if you complete a Medicare Advantage application over the phone with your client, the call must be recorded and you must use the CMS-approved enrollment script for the product. The recorded call must be kept on file for 10 years. We shared the approved phone scripts with our agents in the April issue of Agent eNews.

If you prefer, when you have a client ready to enroll you can have your client contact us and we can complete the enrollment over the phone on your behalf. We will credit you with the client's enrollment. To accomplish this, simply transfer your client call to us or have your client call us directly at 1-844-679-9733. Have your client let us know they are working with you. We will do all that we can to assist you during this time of social distancing.

Additionally, if you are able to meet with your clients remotely over the internet, we have five Medicare plan presentations for your use. These were also shared in the April issue of Agent eNews. You'll want to choose the appropriate presentation for each situation. All five presentations include the Secure Saver MSA and Medicare Supplement plans, which are sold statewide.

If you have any questions please contact our Consumer Sales Team at 1-844-679-9733.


Patient Care at Marshfield Clinic Health System

Marshfield Clinic Health System patient care is contacting patients to reschedule previously delayed appointments and procedures. Appointments are being made for in-person or telehealth appointments as appropriate for each patient’s care needs.  Visit Marshfield Clinic's COVID-19 webpage.

Anyone  experiencing symptoms of a fever, cough or shortness of breath, or  concerned they may have been exposed to COVID-19, please call the Marshfield Clinic Health System Nurse Line at 1-844-342-6276 (or 1-800-549-3174 for Security Health Plan members), before visiting a doctor’s office, urgent care, hospital or emergency room.

Telehealth available from multiple providers

Many providers are offering telehealth services.

Marshfield Clinic Health System updated hours of operation

The Marshfield Clinic Health System website includes a link to facility hours of operation. If you have questions about Marshfield Clinic Health System location hours, go to: https://www.marshfieldclinic.org/patient-resources/covid-19-temporary-location-closings.

Marshfield Clinic Health System Occupational Health, Wellness and Employer Onsite Care Services

As Wisconsin businesses re-open, Marshfield Clinic Health System Occupational Health and Security Health Plan Business Health Solutions teams are offering a full range of on-site and consultative services to help create safer worksites and safely get their employees back to work during the ongoing COVID-19 situation. Services include:

This may not impact your clients, but we do want you to be aware that  we are also taking precautionary measures with our Marshfield Clinic Health System occupational health, wellness and onsite care programs:

We will continue to see employees at Marshfield Clinic Health System clinics for:

1.     Audiometry, hearing conversation programs
2.     Department of Transportation drug screens
3.     Respirator fit testing, PFTs, and medical clearance
4.     Mine Safety Health Act physicals (pre-placement, monitoring, and termination physicals), police preplacement, Occupational Safety and Health Administration required medical surveillance program physicals (pre-placement, monitoring, and termination physicals)
5.     Certified Driver Medical Examinations
6.     Initial Worker’s Compensation visits
7.     Worker’s Compensation follow-ups
8.     MCHS employees and volunteer Occupational Health services
9.     Employer requested drug screens
10. Pre-placement exams
11. Certain onsite wellness programs

We will work with employers to determine if they need onsite services continued at their facilities during this time.

We are postponing new requests for Care My Way @ Work demonstrations and installations until the public health emergency is completed.

 

 Last updated: Feb. 17, 2021