The ComPro team has adopted the hashtag #dothenextrightthing as our core value as we help our clients navigate COVID-19 and its impact on health insurance and health care. Employers, those with individual health plans, and Medicare beneficiaries are concerned about keeping their benefits and the cost of testing and treatment for COVID-19. Across all plan types, the costs for medically necessary testing and treatment for COVID-19 will not be the responsibility of the individual. The copays, deductibles, and co-insurance benefits of your health insurance will not be applied.
Employer Groups—Businesses that have had to close or reduce their work force are also faced with how to manage their employee benefit plans, especially group health insurance benefits. The guidelines have been modified to help businesses and employees keep their health insurance. Most insurance companies have relaxed the full-time status requirement, furloughed employees can stay on the health insurance plan, and employers can continue to contribute to the cost of health insurance, regardless of employment status.
Employers that have received a loan from the SBA through the Paycheck Protection Program can use the money for payroll, benefits, and taxes on compensation. Up to 25% of the loan may be used for interest, rent, and utilities. To get the entire loan forgiven, two criteria must be met: 1) the full-time employee headcount cannot decline from 2019 to 2020; and 2) employers cannot cut wages.
Individuals—FAQs from self-employed, early retirees, those that work for employers not offering health insurance, and those who have lost their job and health insurance with no expectation of being recalled:
Q: Am I eligible for Healthcare.gov if I lost my employer coverage?
A: Yes, in most situations.
Q: Do I need to adjust my income on healthcare.gov because of the stimulus payment I received?
A: No, the stimulus payment is NOT taxable income.
Q: Do I need to adjust my income on healthcare.gov due to a reduction in income?
A: Maybe. Are you eligible for unemployment?
Q: Do I have to report Unemployment Compensation as taxable income?
A: Yes. It may impact your income estimate on healthcare.gov based on the change in your total income for the year.
Medicare beneficiaries—The coverage of out-of-pocket expenses for COVID-19 testing and treatment is the big news for Medicare beneficiaries. Telehealth services have been expanded. Other rules have been relaxed concerning hospital services and skilled nursing.