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, your clients and others. We’ve included links to resources below that can provide additional information. We will update this page as information becomes available in this ever-changing situation.
Recently Security Health Plan Vice President of Sales Strategy Chris Bruni teamed up with Jeff Tucker, Vice President of Business Development and Care Innovation for Marshfield Clinic Health System, for a discussion on COVID-19 and how Security Health Plan and Marshfield Clinic Health System are helping you and your clients through this pandemic. If you were unable to join us for the webinar, you can access a PDF of the presentation below or click the button to view a recording of the webinar.
COVID-19 benefit information
Security Health Plan will cover many testing, testing-related and treatment services related with COVID-19. Use the table below to see which benefits are covered for the different plan types listed in the left column of the table below.
Security Health Plan 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 | Inpatient and observation treatment related to COVID-19 | Out-of-network coverage | Telehealth | |
|---|---|---|---|---|---|
| Medicare Advantage HMO-POS |
Covered at 100% | Covered at 100% | Covered at 100% |
Services at out-of-network facilities will have the same cost share as in network. |
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 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 |
| Ally Rx D-SNP | Covered at 100% | Covered at 100% | 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.
|
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% | Covered at 100% | Covered at 100% | 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 |
| Medicare Select: Senior Security | Covered at 100% | Covered at 100% | Covered at 100% | If a network provider is not available due to the COVID-19 emergency, COVID-19 services, supplies and treatment by out-of-network providers will be covered the same as in network. | 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 |
| Large employer group | Covered at 100% | Covered at 100% | Covered at 100% | If a network provider is not available due to the COVID-19 emergency, COVID-19 services, supplies and treatment by out-of-network providers will be covered the same as in network. | An expanded list of services* 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% | Covered at 100% | Covered at 100% | If a network provider is not available due to the COVID-19 emergency, COVID-19 services, supplies and treatment by out-of-network providers will be covered the same as in network. | An expanded list of services* 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% | Covered at 100% | Covered at 100% | If a network provider is not available due to the COVID-19 emergency, COVID-19 services, supplies and treatment by out-of-network providers will be covered the same as in network. | An expanded list of services* 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% | Covered at 100% | Covered at 100% | COVID-19 testing and treatment received at out of network facilities will be covered the same as in network. | 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% | Covered at 100% | Covered at 100% | Please call Security Administrative Services at 1-800-570-8760 for details. | An expanded list of services* 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% | Covered at 100% | Covered at 100% | Please call Security Administrative Services at 1-800-570-8760 for details. | An expanded list of services* 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% | Covered at 100% | Please call Security Administrative Services at 1-800-570-8760 for details. | If a network provider is not available due to the COVID-19 emergency, COVID-19 services, supplies and treatment by out-of-network providers will be covered the same as in network. | Please call Security Administrative Services at 1-800-570-8760 for details. |
| Non governmental self-funded groups | Covered at 100% | Covered at 100% | 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. |
*The expanded list of services available via telehealth includes, but is not limited to behavioral health, office visits/consultations, care management and outpatient therapy.
Experiencing symptoms?
COVID-19 Helpline now available
CMS announces special enrollment period (SEP) for COVID-19
The Centers for Medicare and Medicaid Services announced that the COVID-19 pandemic qualifies for an exceptional condition SEP in line with the SEP for weather-related emergencies or major disasters. The COVID-19 SEP is available nationwide beginning March 1, 2020, for four months through June 30, 2020.
Get details on the COVID-19 SEP and how to make it work for your clients who have a current election period. Learn more
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/
- Assistance available to employers with 500 employees or less.
- Provides tax credits for the cost of providing paid sick or family leave related to COVID-19.
- Effective through Dec. 31, 2020
- The link above includes eligibility, fact sheets and other resources that can help employers take advantage of this Act.
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:
- Employers are encouraged to review their benefit-eligible employee definition:
- Full-time status with numbers of hours required to be benefit-eligible
- Please note Security Health will not be allowing current ineligible classes to be added for coverage without a qualifying event. COVID-19 has not been deemed a qualifying event at this time.
- Employers may add a clause for furlough. For example:
- During furlough with intent to reinstate, we will continue health benefits for “X” days as long as you pay your employee portion to the employer. After “X” number of days, your benefits will be terminated and you will be eligible for COBRA, state continuation or marketplace coverage. Some employees may even qualify for Medicaid in the state of Wisconsin. x = 60 days or x =90 days.
- Termination coverage:
- During layoff without intent to rehire, employers may change the policy to extend the coverage beyond what they currently offer. If employers choose to extend coverage for “X” number of days to your employees, upon expiration of benefits a COBRA, State Continuation or Special Enrollment Period for Marketplace coverage would begin.
- Rehires
- Employers may add a clause for rehires if they choose to waive the standard benefit-eligibility waiting period for a rehired employee who was terminated due to COVID-19.
- Full-time status with numbers of hours required to be benefit-eligible
- Please note, a change to the employers' benefit eligible employee definition will not allow non-covered employees to enroll on the employers' plan unless they have a qualifying event.
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:
- Catch-up: Employer may delay employee’s premiums until they return to work. Upon return, the employer starts deducting additional premium to catch up. There are limitations on how much can be deducted from a paycheck at one time. A problem with this method is if an employee does not return after leave collecting their share of premiums may be difficult or impossible. Consult your legal or HR advisor for additional guidance.
- Pre-pay: If you are aware of a planned absence, an employer may pre-collect premiums prior to the leave. If the leave is anticipated to span more than one plan year, the employer cannot pre-collect premiums because of cafeteria rules.
- Pay-as-you-go: During the leave, the employer may require the employee to pay their portion of premium to maintain coverage. Premium collected is on an after-tax basis unless the leave is paid. Collecting premium on a monthly basis is best practice.
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
For patient safety and as a precautionary measure for health care workers, Marshfield Clinic Health System patient care is making adjustments for non-essential and elective appointments and procedures. Those patients who will be impacted are being contacted to discuss their needs and either schedule via telehealth or reschedule.
If you or your clients are experiencing symptoms of a fever, cough or shortness of breath, or are concerned that you may have been exposed to COVID-19, please call the 24-hour Nurse Line at 1-800-549-3174 before visiting a doctor’s office, urgent care, hospital or emergency room.
Telehealth available from multiple providers
Many providers have delayed routine, non-emergent appointments, but are now offering telehealth services.
- What is telehealth?
- Telehealth is an appointment with a health care provider done virtually. These appointments are conducted over a secure two-way interactive video connection or telephonically.
- Learn more about telehealth from the Marshfield Clinic Health System at www.marshfieldclinic.org/services/telehealth
- Security Health Plan members may be able to have a doctor visit using telehealth technology. Any services that are covered by Security Health Plan will be covered if done via a virtual visit for any members of Security Health Plan.
- Members are advised to contact their provider’s office to ask if a telehealth appointment is available.
- Care My Way virtual visits continue to be offered for free to most Security Health Plan members.
Marshfield Clinic Health System closures
The Marshfield Clinic Health System website includes a link to facility closures. If you have questions about Marshfield Clinic Health System location closures, 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
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.
The COVID-19 pandemic is a fluid situation, policies and information are changing quickly as we work together to address the health and safety of our communities. We will continue to do our best at reaching out to our partners and our clients as changes are made.
Last updated: Wednesday, May 13, 2020.