Q: Will my GMS plan pay for the COVID-19 testing (Codes U0001 and U0002)?
A: Yes. GMS will waive member cost share for these tests when administered by in-network providers in accordance with the CDC guidelines.
Q: Will my GMS plan cover the treatment for COVID-19?
A: Yes. Treatment for COVID-19 is eligible under the normal provisions of the plan when following CDC guidelines.
Q: If I lay off part of my workforce in response to the COVID-19 crisis, can the company continue to cover those employees?
A: Yes. As long as you continue to pay premiums, you may continue to cover laid-off employees even though they are not actively at work. Please note that you must administer the plan on a uniform, non-discriminatory basis. In other words, you may not choose to pay premiums for only certain people.
Q: If I have to lay off my entire workforce in response to the COVID-19 crisis, can the company continue to cover those employees?
A: Yes, as long as one person remains actively employed by the group. If you continue to pay premiums, you may continue to cover laid-off employees even though they are not actively at work. Again, this must be administered on a uniform, non-discriminatory basis.
Q: What about continuation of coverage?
A: As long as one person remains actively employed, employees may be offered COBRA and may elect to continue coverage under COBRA under the normal notice and election procedure.
* If the plan has no active employees, the plan is terminated and COBRA is not an option. In that case, employees would have a special enrollment period to enroll in individual coverage or could purchase a short-term plan that is subject to medical underwriting.
Q: If I have to terminate coverage for my employees in the middle of a month, will I receive a refund of my premium for the rest of the month?
A: While your contract states that GMS will not refund a partial month's premium, we will refund the proportional amount of premium should you terminate your coverage before the end of the month given the gravity of the current situation.
Q: In light of the COVID-19 crisis, can I get a grace period extension on paying my premium?
A: Yes. GMS is offering to extend the grace period for your next monthly premium payment by up to 60 days.
Q: Will employees who are laid off temporarily as a result of COVID-19 concerns be permitted to rejoin the plan without a waiting period when they return to work?
A: Yes. There will be no waiting period for current employees who are rehired by May 31, 2020. New hires are subject to any waiting period the plan requires.
Q: Will I lose my job-based group-health coverage?
A: You may qualify for tax credits that can lower your monthly premiums and for lower out-of-pocket costs. Please inquire with your Benefit Account Manager if you have any questions.
*For more details on COBRA coverage and the Marketplace, click the link below.
LINK: COBRA vs. Marketplace
Q: Is our GMS pharmacy plan through MedTrakRx going to allow early re-fills on prescriptions if necessary?
A: MedTrak has relaxed its refill-too-soon edits for non-opioid and non-specialty medications. These are not changes that will happen automatically and will occur at the discretion of dispensing pharmacists.
Q: What does the Families First Coronavirus Response Act mean to covering testing for Covid-19?
A: On March 18, 2020, President Trump signed the second coronavirus relief measure into law – the Families First Coronavirus Response Act (Act). Effective immediately, the Act requires group health plans and health insurance issuers to cover COVID-19 testing without imposing any cost sharing (such as deductibles, copayments, or coinsurance) or prior authorization or other medical management requirements. During this public health emergency, health plans and issuers must cover FDA-approved diagnostic testing products for COVID-19, including any items or services provided during a visit to a provider (in-person or telehealth), urgent care center or emergency room that relate to COVID-19 testing. This coverage cannot be subject to any plan deductible, copayment, or coinsurance. This coverage mandate does NOT require health plans and issuers to cover COVID-19 treatment at no charge. Exact coverage details for COVID-19 treatment, including any cost-sharing amounts, will vary by plan.
Q: Will private health plans cover the cost of COVID-19 diagnostic testing that occurs prior to April 2?
A: Yes, this section of the legislation is effective from the date of enactment, March 18, 2020, through the end of the national emergency period. The Act states that “a group health plan and a health insurance issuer offering group or individual health insurance coverage shall provide coverage, and shall not impose any cost sharing (including deductibles, copayments, and coinsurance) requirements or prior authorization or other medical management requirements” for specific items related to testing or related health care provider visits.
Q: What can I do about prescription medication if I lost coverage?
A: Cigna and Express Scripts are stepping up to help Americans who lose their coverage as a result of COVID-19 afford their prescription medications. In response to this crisis, we are introducing Express Scripts Parachute RxSM, a temporary program available to anyone who is newly unemployed and without insurance as a result of the COVID-19 pandemic.
Parachute Rx offers deep discounts on thousands of prescription medications. A 30-day supply of generic medications will cost patients $25 or less, and brand medications will cost $75 or less. Enrollees can choose to have their medications delivered to their home from the Express Scripts Pharmacy, or any one of more than 50,000 participating retail pharmacies.
“If you have friends or family members who have lost their prescription drug coverage, please let them know we can help”
The program, which will be available for a limited time, is not health insurance and does not require an enrollment fee or commitment to participate. Eligibility information and a list of covered brand-name medications are available at express-scripts.com/parachuterx.
We worked with pharmaceutical manufacturers and retail pharmacies to make Parachute Rx possible. The program is administered by Express Scripts’ InsideRx® discount card program, a subsidiary of Express Scripts specializing in prescription drug discount programs for self-paying consumers.
There are two easy ways eligible consumers can take advantage of Express Scripts Parachute Rx:
- Go to express-scripts.com/parachuterx to check medication prices, choose home delivery, and find participating pharmacies near you.
- Ask your local pharmacist if Parachute Rx discounts are available for your prescription.
Customer service is available seven days a week at 877.644.0212.