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IMPORTANT! Employee Benefits Update

Published:  June 25, 2020

The Families First Coronavirus Response Act (Families First Act) and the Coronavirus Aid, Relief, and Economic Security Act (CARES Act), and other supplemental Federal guidance has provided the ability to implement enhanced benefits in health plans and other health related benefits.  As a result, the following changes and enhancements are available for County employees and their dependents, where eligible.

  • Waiving Copays for COVID-19 Testing and Screening

    All County-sponsored employee medical plans, including deductible plans, cover test items and services related to testing for COVID-19 without cost sharing. The requirements took effect on March 18, 2020, and apply for the duration of the COVID-19 public health emergency. The Federal public health emergency will expire on July 25, 2020, unless extended.
  • Telehealth/Virtual Visits (Non-Coronavirus Related)

    All County medical plans, including deductible plans, cover telehealth as noted below:
    • Kaiser Permanente covers telehealth 100%
    • Sutter Health Plus covers telehealth 100% effective April 1, 2020 to December 31, 2020
    • County Health Plan covers telehealth at a regular office copay
    • Western Health Advantage covers telehealth at a regular office copay
  • Changes to Items Eligible for Reimbursement Under Health FSA
    • Over the counter (OTC) (e.g. allergy relief, aspirin, ibuprofen), medications are now reimbursable under Flexible Spending Accounts without requiring a prescription or completing a Letter of Medical Necessity Form. This provision is retroactive to January 1, 2020.
    • Menstrual care products are now reimbursable as eligible expenses, including tampons and pads (Expenses incurred after December 31, 2019).
  • Extended Deadlines

    County-sponsored health plans will disregard the “Outbreak Period” — the period that began on March 1, 2020, when a National Emergency related to COVID-19 was declared and will end 60 days after the end of the emergency (or on another date issued in the future). The extended deadlines are related to:
    • HIPAA special enrollment (e.g. adding a new dependent to your health plan)
    • COBRA continuation coverage (election periods and premium payment due dates)
    • Claims and appeals extensions
  • Mid-Year Health FSA and Dependent Care FSA Election Changes

    Employees are eligible to make a one-time only mid-year change to their FSA elections without a qualifying event.  The new election is effective the first of the month following the date HR Benefits Unit receives the FSA Election/Change Form.  The following changes are allowed:
    • Revoke an election*
    • Make a new election
    • Decrease an existing election*
    • Increase an existing election

      * Requests to revoke or decrease an election will not be approved when the FSA balance is or will remain negative through the end of the plan year.

      Please go to FSA-Changes-Due-to-COVID-19 for additional information
  • New Health FSA carryover is $550, instead of $500 beginning 2021

All County-sponsored Employee Medical Plans Waiving Copays for COVID-19 Treatment

Zero member out-of-pocket costs for services related to a positive COVID-19 or suspected COVID-19 diagnosis. Members who are diagnosed with COVID-19 will not have to pay co-pays or other cost-share related to their medical care and treatment of COVID-19.  This waiver of member out-of-pocket costs will apply to all places of service including, but not limited to, Hospitalization, Office Visit, Telemedicine, Emergency Room and Urgent Care. This waiver also applies to inpatient medical, inpatient pharmacy, outpatient medical, and transportation costs associated with the treatment of a COVID-19 diagnosis. Effective dates of this waiver varies by medical plan, as follows (unless superseded by government action or extended by medical plan):

  • Kaiser Permanente – April 1, 2020 to December 31, 2020
  • Sutter Health Plus – April 1, 2020 to September 30, 2020
  • Western Health Advantage – February 1, 2020 to September 30, 2020
  • County Health Plan PPO and EPO – April 1, 2020 to December 31, 2020               

For additional information, regarding the above information contact the Health Plan Provider or Human Resources Benefits Unit through email or (707) 565-2900.

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