WHAT'S NEW IN INSURANCE

PPE Is Now a Qualified Medical Expense – 04-20-2021

According to new guidance from the IRS, the personal protective equipment (PPE) people use to help stop the spread of COVID-19 is now a deductible medical expense under IRC Section 213(d). Common items that we all need to buy, like masks, hand sanitizer and sanitizing wipes, could now be part of someone's medical-expense deduction on their personal income tax return. These items could also count as reimbursable expenses under certain account-based health coverage options. Employers that offer employees access to health FSAs, HRAs, Archer MSAs and/or qualified high-deductible health plans (HDHPs) that pair with HSAs need to take note of this change. Now, plan participants may be able to use funds from those accounts to pay for PPE. Another consideration for group plan sponsors is that if coverage offerings include either an HRA, a health FSA or both, then a plan amendment could be necessary to make PPE a reimbursable expense. Employees with HSAs and Archer MSAs will automatically be able to use their HSA or MSA monies to pay for PPE, but health FSA and HRA participants will need their employer to decide if PPE is on the reimbursable-expense list.

Source – National Association of Health Underwriters

 

Coronavirus Vaccines Are on the Way but Are States Ready for Them? 12-04-2020

With Pfizer’s and Moderna’s coronavirus vaccines on their way to FDA approval, Americans should anticipate widespread deployment of at least one company’s concoction over the next few months. A limited number of COVID-19 vaccine doses may start to become available as early as this month, with more doses available over time. There is, however, one major question: Are states ready?

Pfizer expects to ship half of the COVID-19 vaccines it originally planned for this year because of supply-chain problems, but still expects to roll out more than 1 billion doses in 2021. That’s 1 billion doses of a vaccine that must be stored at about -70° C (-94° F), a temperature cold enough to harden ice cream into a spoon-breaking block of ice. Large medical centers and urban centers are the most likely to have the resources necessary for ultra-cold storage, but those living in rural areas, nursing homes and developing nations may have to wait. Cold-storage requirements are just one of many concerns that state governments have as the vaccine deployment begins. 

Just over half of state plans report having database systems in place that are described as being (at least fairly) comprehensive and reliable; in the other state plans, that information is unclear. Most states report still having to develop or add functionality to their existing immunization registries to be prepared for COVID-19 vaccine administration. Several states raise concerns about the ability to report certain CDC-recommended data elements to federal systems or meet CDC time requirements for reporting. States also mention limitations in collecting race and ethnicity data on individuals vaccinated.

Another roadblock states will need to reckon with is general skepticism among the population. More than one-third of Massachusetts adults would be unlikely to get the vaccine for COVID-19, according to new poll results, with adults who feel that way citing a lack of trust in the approval process and concerns about side-effects. Pollsters found similar results in both North Carolina, with 34 percent saying they would not take the vaccine and 27 percent unsure. Just over 18 states’ plans include at least one mention of addressing vaccine misinformation, but most of these states do not provide specific strategies for countering misinformation.

Governor Andrew Cuomo announced earlier this week that New York expects to receive the first 170,000 doses of Pfizer’s vaccine on December 15. The Empire State’s immunization plan prioritizes nursing home residents and essential workers. Cuomo voiced his personal concern about residents’ hesitance to get the vaccine. “Very few people refuse a COVID test. It’s not a frightening test. It’s a nasal swab. Now you’re asking a person to take two vaccines, which is a more elaborate medical process, and they’re distrusting about the vaccine going in,” Cuomo said, adding, “This would be the largest governmental operation undertaken since World War II, in my opinion.”

Discussions surrounding another stimulus package have resumed on Capitol Hill, and the latest news is that a new potential $908 billion package would include support for small-business loans, state and local government, education, unemployment insurance, healthcare and distribution of a COVID-19 vaccine. Talks of sending more aid to state governments, however, have been going on for several months and state governments are not holding their breath.

Source – National Association of Health Underwriters

 

Executive Order 20-112 Phase 1 Recovery FAQ – 05-06-2020

Please click to view the PDF Document from the Florida Governor's Office.

Families First Coronavirus Response Act Passed into Law 03-18-2020

On Wednesday, President Trump signed the Families First Coronavirus Response Act into law. The Act includes several provisions to protect American workers and assist employers in providing emergency paid sick leave, as well as paid family leave in the case of school closures, for working families impacted by COVID-19. This is considered to be the second phase in the federal government’s response to COVID-19, and the Senate is currently working on a trillion-dollar package to follow this one.

The FFCRA requires employers with up to 500 employees to provide paid sick leave and paid family leave while providing a refundable payroll tax credit to employers to cover 100% of the cost of wages. There is also a refundable income tax credit made available for self-employed individuals. Employers with less than 50 employees that may find these requirements a burden to their business may apply for a hardship exemption from the mandate. Employers must offer two weeks (10 days) of paid sick leave for COVID-19-related reasons. If the sick leave is for an employee who is sick or seeking a diagnosis, the benefit must replace all of the employee's wages up to a maximum benefit of $511 per day. If an employee is caring for another individual who is sick, the benefit must replace at least two-thirds of the employee's wages up to a maximum benefit of $200 per day. The paid sick leave credit offsets 100% of employer costs for providing mandated paid sick leave. The credit also offsets, uncapped, the employer contribution for health insurance premiums for the employee for the period of leave. 

Employers must offer 12 weeks of paid family leave for employees who have been employed for at least 30 days with a minor child in the event of the closure of the child's school or place of care. The first 10 days are unpaid, but the employee can overlap this with the 10 days of paid sick leave. This benefit must replace at least two-thirds of the employee's wages up to a maximum of $200 per day. The paid family leave credit offsets 100% of employer costs for providing mandated paid family leave. The credit also offsets, uncapped, the employer contribution for health insurance premiums for the employee for the period of leave. 

Under FFCRA, self-employed individuals are provided similar credits as refundable income tax credits in an amount of what self-employed workers would have received if they had been an employee receiving paid leave benefits pursuant to the mandates. For a given day that a self-employed worker could not work, they can claim a "rough justice" tax credit in the amount of their average daily self-employment income for the year. 

Source: National Association of Health Underwriters (NAHU)

CMS Issues Guidance for Medicare Advantage and Part D Plans Response to COVID-19 – 03-13-2020

CMS released guidance this week to try to ensure that patients have access to critical healthcare services they need as the Coronavirus continues to spread throughout the U.S. In the memorandum issued on Tuesday, CMS outlined the flexibilities MA and Part D plans have to waive certain requirements to help prevent the spread of COVID-19. These flexibilities include:

• waiving cost-sharing for COVID-19 tests
• waiving cost-sharing for COVID-19 treatments in doctor’s offices or emergency rooms and services delivered via telehealth
• removing prior authorizations requirements
• waiving prescription refill limits
• relaxing restrictions on home or mail delivery of prescription drugs
• expanding access to certain telehealth services

“The president directed CMS to make sure Medicare Advantage beneficiaries have access to the healthcare services they need during this time,” said CMS Administrator Seema Verma. “Today we announced guidance to Medicare Advantage and Part D plans to remove barriers that could prevent or delay beneficiaries from receiving care. Medicare beneficiaries are at the greatest risk of serious illness due to COVID-19 and CMS will continue doing everything in our power to protect them.”

These waivers break down barriers to beneficiaries accessing care and allow plans to work with pharmacies and providers to treat patients without burdensome requirements limiting their options during this outbreak. This action is part of the broader effort by the White House Coronavirus Task Force to ensure that all Americans – particularly those at high risk of complications from the COVID-19 virus – have access to the benefits that can help keep them healthy while helping to contain the spread of this disease. To keep up to date with the important work CMS is doing in response to COVID-19, visit the Current Emergencies Website.

Source – National Association of Health Underwriters (NAHU)

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