HORIZON UPDATE: Health Insurance – March 25, 2020
We received word from Horizon that we are free to share the following updates about furlough. A formal brief from Horizon is expected later today.
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We received a few responses as it relates to COVID-19 Horizon administrative inquiries- below please find some initial guidance on some of your questions below:
Q Can employer groups keep furloughed employees or employees with reduce work hours on their group coverage?
A: For all fully insured commercial group market segments, Horizon is waiving the “actively at work” requirement under applicable health policies issued by Horizon BCBSNJ. The waiver is for a limited duration and for employers impacted by COVID-19. Under this proposal, furloughed employees or employees whose work hours may have been reduced can maintain coverage under the employer’s written COVID-19 business continuity plan that will be applied uniformly to all staff in the same class of employees. Coverage will remain active for those furloughed or otherwise temporarily laid off employees assuming the employer group continues to meet premium payments. If staff is permanently terminated, COBRA or New Jersey continuation of coverage rules may apply.
Q. Will this apply to self-funded employer groups?
A. Horizon will honor any self-funded customer’s request to adopt a similar approach.
Q If an employer group’s enrollment drops due to COVID-19, will the group be re-pooled or re-rated?
A: No, not for their health care benefits. It should be noted that this is a temporary suspension of the process and normal guidelines will be reinstated after 60 days
Q: Is there a time limit for how long a furloughed employee can remain on the plan?
A: At this time we are allowing furloughed employees to stay on the plan for the next 60 days. The group should document their policy as a special COVID-19 business continuity plan to help ensure no discrimination.
Q: What happens if an employer extends coverage during the layoff? Will allow them to come back on the plan without having to meet the eligibility-waiting period? If so, how long could one be laid off and not have to meet the waiting period?
A: It is the group’s discretion to waive the waiting period upon return to work. As long as employers apply the waiver of such waiting period uniformly, Horizon will recognize each employers request. At this time, we are extending this waiver for the next 60 days to aid our group customers to combat the growing public hazard and hardship placed on their employees. We request that each group customer clearly document their policy as a special COVID-19 business continuity plan to help ensure no discrimination.
As you are aware, these are just some of the changes and accommodations that Horizon has made to help meet the needs of our mutual clients during this unprecedented crisis. If the timing needs to change (60 days) due to COVID-19, we will remain flexible and will continue to keep you updated.
