Employee Benefit Guidance & Compliance Solutions

Important notice concerning guidance on the COVID-19 vaccination has been released by the Departments of Labor (DOL).  This is extremely important to your business, as new advances are being made on the vaccination daily. PF Compass will continue to update on any new information found to keep you and your business updated and informed!

The Scoop

 

On Nov. 6, 2020, the Departments of Labor (DOL), Health and Human Services (HHS), and the Treasury (Departments) published an interim final rule requiring Medicare, Medicaid, and private insurers to cover a COVID-19 vaccine without any cost-sharing, once the Food and Drug Administration (FDA) authorizes and approves a vaccine. COVID-19 Vaccine Coverage for Private Health Plans.  The interim final rule implements the requirement in the Coronavirus Aid, Relief and Economic Security (CARES) Act that non-grandfathered group health plans and health insurance issuers offering non-grandfathered group or individual health insurance coverage provide coverage, without cost-sharing, for qualifying COVID-19 preventive services, which includes COVID-19 immunizations.

The rule shortens the period of time in which coverage of qualifying COVID19 preventive services is required. This coverage must be provided within 15 business days after the recommendation relating to a qualifying COVID-19 preventive service is made. Coverage of recommended COVID-19 immunizations must be provided, even if not listed for routine use on the Immunization Schedules of the Centers for Disease Control and Prevention (CDC).

In addition, during the COVID-19 public health emergency, plans and issuers must cover qualifying COVID-19 preventive services without cost-sharing, regardless of whether an in-network or out-of-network provider delivers the services. Plans and issuers subject to Section 2713 of the Public Health Service Act must also cover, without cost-sharing, items and services that are integral to the furnishing of recommended preventive services, including the administration of COVID-19 immunizations.

Highlights

  • In anticipation of when a COVID-19 vaccine is available, the interim final rule requires Medicare, Medicaid, and private insurers to cover the vaccine without cost-sharing.
  • Coverage of qualifying COVID-19 preventive services must be provided within 15 business days after the recommendation is made.
  • During the COVID-19 public health emergency, this coverage must be provided for both in-network and out-of-network providers.

Wrapping it up

PF Compass will continue to update you on any new changes and important information concerning guidance on the COVID-19 vaccination and the guidelines that are set for your business. If you want to stay informed, please contact us!

PF Compass works with clients who primarily reside up and down the Eastern Corridor. We work with all types of businesses, large and small, across a wide range of industries. Over the years we have created a reputation for providing quality group benefits and unmatched service for all our clients. As a result, we are proud to say that many of our clients have become loyal and continue to work with us for years to come.

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