COVID-19 and Your Insurance COVID-19 and Your Health Insurance For Providers Podcasts (5/6/21 & 5/12/21): Information on HRSA and how to submit claims and receive payment R21-03: Order Relating to COVID-19 Vaccinations and Treatments to Health Insurers offering Health Care Insurance policies in the state of Alaska Fact Sheet: COVID-19 Vaccination Cost Fact Sheet for Health Care Providers Information about the COVID-19 Coverage Assistance Fund Telehealth Information for Healthcare Providers The Division of Insurance has received numerous calls and emails regarding telehealth services during the public health disaster emergency declaration related to COVID-19. The following information is intended to address these questions. HB29 – AS 21.42.422 Telehealth Insurance Mandate HB29 became effective March 17, 2020. This legislation permanently expands the telehealth insurance mandate (previously limited to mental health services) to include medical services. The law was not intended to include every medical procedure as some covered health care services cannot be provided remotely. For example, it may not be clinically appropriate for chiropractic manipulations to be provided over audio-visual technology. The statute is applicable in-network and out-of-network. No in-person visit is required prior to using telehealth services and so new patients are eligible for telehealth services. The Division also notified insurers in Bulletin 20-07 that the statutes does not require health care providers to use a particular technology platform in order to have telehealth services covered. Health care providers are encouraged to contact insurers or other payers to verify telehealth coverage for services. The insurers maintain clinical guidelines under which a service would be covered (e.g. Medicare, Medicaid, etc.). For physical therapy, occupational therapy and other therapies, the provider should confirm coverage for services as some insurers may cover evaluations, but not treatments offered via telehealth. For mental health services, the statute change did not affect the offering and coverage of telehealth services. Health care providers should be aware that the law does not provide for parity of payment between in-person and telehealth services. It should also be noted that Title 21 of the Alaska Statutes only apply to insured plans which account for about 15% of the health care market. Many patients may be covered by health plans that are not required to comply with AS 21.42.422. For example, large employers may be self-funded and exempt from the telehealth mandate. COVID-19 Expanded Services During the COVID-19 pandemic, insurers are following the lead of the Federal Centers for Medicare and Medicaid Services in providing unprecedented flexibility for telehealth services. We are seeing such flexibilities as telehealth services via audio only, expanded lists of covered codes for telehealth services, and increased reimbursement levels. Some insurers recognize that some visits normally would only be provided in-person and are paying telehealth services at the same rates as in-person visits. Health care providers and their billing staff should carefully review communications from insurers related to billing for such services. Some insurers request that providers bill using the relevant telehealth code. Other insurers are requesting that in-person codes be used even if the service is provided via telehealth. Health care providers may have additional flexibility during the COVID-19 pandemic to provide services through alternative communication means through the suspension of penalties under HIPAA issued by the Office of Civil Rights. However, providers should confirm coverage with a payer. Insurers have been called upon to provide greater flexibility and coverage during the COVID-19 pandemic. Services that can appropriately be offered through telehealth in order to avoid unnecessary exposure to the virus and prevent regression of symptoms are expected to be covered by insurers. Insurers should be communicating these expanded coverages to providers and consumers as soon as possible. Additional Resources The Division encourages health care professionals to review the COVID-19 resources on the ASHNHA website including the Alaska Quick Start Guide to Telehealth. If health care providers receive insurance denials for reasonable telehealth services, they are encouraged to contact the Division of Insurance to complete a provider complaint. Consumer services can be reached at 907-269-7900. COVID-19 Related Expanded Health Benefits and Resources This is not a recommendation or endorsement of any facility, provider, payer, organization, or entity. It is only an accommodation for consumers and medical professionals to provide relevant information about the COVID-19 pandemic. Expanded Special Enrollment / COBRA Premiums Waived / New Tax Credit Eligibility You may benefit from The American Rescue Plan of 2021 if you are seeking to enroll in health insurance, change your health insurance selections, are interested in applying for greater tax credit, or if you would like assistance with COBRA premiums. The American Rescue Plan of 2021 expands open enrollment April 1st through August 15, 2021 DOI Press release - Individual Market Open Enrollment Extended to August 15 HHS press release - Reduced Costs & Expanded Access Available for Marketplace Health Coverage Federal Marketplace Information on Special Enrollment Consumers may choose a new plan during the Special Enrollment Period. If consumers choose a plan with a new insurer, they will need to meet a new deductible and pay other cost sharing. If consumers switch plans with their existing insurer through the same marketing method, they will not start over on a new deductible. For example, if the consumer has a plan purchased directly from an insurer and they switch to a plan from that same insurer on the marketplace through healthcare.gov, the consumer will start a new deductible. If they have a plan from healthcare.gov and switch to a plan with the same insurer on healthcare.gov, they do not have to start a new deductible. Special Enrollment information from CMS Where to get more information about this Special Enrollment Period Visit HealthCare.gov to learn more and start an application or update an existing one Call the Marketplace Call Center at 1-800-318-2596. TTY users can call 1-855-889-4325 PREMIUM TAX CREDITS Those newly enrolling Federal Marketplace (healthcare.gov) may see greater tax credits under the American Rescue Plan of 2021. Those who are already enrolled may find increased tax credits by reviewing their account through healthcare.gov Consumers with incomes 100 – 150% of FPL will have $0 premiums (except for plans with benefits in excess of the benchmark plan, e.g., dental or abortion coverage). Consumers over 400% FPL who previously were not eligible for a premium tax credit are now eligible. Consumers in this category may want to reevaluate their coverage for 2021. Additional information can be found at healthcare.gov Most consumers will be eligible for a new tax credit amount. Consumers may log-in to their healthcare.gov account to update their application to see their new tax credit amount. Consumers who do not update their applications will be able to get the additional credit amount when they file taxes next year. Healthcare.gov’s system is not retroactive; consumers may want to make the update to their application ASAP. Anyone with a week or more of unemployment income in 2021 will be considered to have an income of 133% FPL. For more information, please see the following links: Healthcare.gov: More Savings COBRA PREMIUM ASSISTANCE Premium Assistance for COBRA Continuation Coverage For Individuals And Their Families under the American Rescue Plan Act of 2021 The American Rescue Plan includes a program to fully subsidize COBRA premiums for consumers starting April 1, 2021, and continuing until September 30, 2021. The ability to enroll in COBRA coverage has been expanded also. If you previously declined coverage or if you enrolled and subsequently disenrolled, under the American Rescue Plan, you may be able to enroll/reenroll for COBRA benefits. Plan administrators or insurance companies will be notifying individuals who qualify for this COBRA expanded enrollment opportunity. More detailed information can be found on the DOL website at: www.dol.gov/cobra-subsidy Click here for more information about The American Rescue Plan of 2021. For more information about health insurance, visit Insurance.Alaska.Gov/Consumers/Health.aspx Aetna – Extra benefits to help you We’re here to help with resources for Members, Employers, and Providers Frequently-updated COVID-19 Resource Center Moda Health – What you need to know in Alaska Moda has received questions and concerns about the novel coronavirus (respiratory illness), COVID-19 and would like to keep you informed with the most-up-to-date information as it relates to your health and benefits. Visit our website at: www.modahealth.com/community/covid-19 Premera Blue Cross Blue Shield of Alaska - Help to get the care you need Learn more about Premera's response to the COVID-19 outbreak for our customers. Premera wants to help you get the care you need for the coronavirus that causes COVID-19. Information for Employers: www.premera.com/ak/employer/coronavirus-19-faq Getting Care for COVID-19 www.premera.com/ak/visitor/outbreaks UnitedHealthCare – Expanded access to care, support, and resources We are expanding your access to care, support, and resources to help you navigate through this unprecedented time. We are committed to helping protect your health by enabling you to get access to the right care including from the comfort of your home. To learn more about resources available to you, visit our website at www.uhc.com/health-and-wellness/health-topics/covid-19 Health Insurance Enrollment for Workers Laid Off due to COVID-19 Closures In response to business closures across the state of Alaska due to COVID-19, the Division of Insurance is reminding workers who lost their jobs that they are eligible to enroll in health insurance to cover themselves and their dependents. COBRA: For businesses with more than 20 employees, employees and their dependents are typically eligible for COBRA continuation coverage under federal law. If eligible, your employer should provide information for how to continue coverage. Employees who lose job related health coverage also will qualify for Special Enrollment Period. Consumers can contact insurers directly or shop on the marketplace at Healthcare.Gov. Some workers might be eligible for premium tax credits available through Healthcare.Gov. For more information, visit Insurance.Alaska.Gov/Consumers/Health.aspx COVID-19 and Your Property Casualty Insurance Consumer Advisory Alert: Business Interruption Insurance Consumer Advisory Consumer Advisory Alert: Does Coronavirus Have you Worried about Pet Insurance? Consumer Advisory Guidance for Licensees Related to COVID-19 On Wednesday, March 11, Governor Mike Dunleavy signed an emergency disaster declaration related to the COVID-19 (coronavirus) pandemic. The Division of Insurance continues to monitor the developing situation as it relates to insurance licensing. We continue to strive for operational continuity while complying with government mandates and official recommendations. As the situation continues to evolve, we are encouraging licensees to renew their licenses as early as possible in order to avoid any potential delays in processing. Alaska insurance licensees can renew their licenses as early as ninety days prior to the license expiration date. In most cases, you can renew online at NIPR.com. To check your license expiration date, please utilize the licensee lookup tool located at: statebasedsystems.com For Alaska resident licensees, we are requesting that you complete your Continuing Education (CE) requirements well in advance of your license expiration date as Alaska approved CE providers have ten (10) days following completion of the course to report CE credits earned to the division. There are many internet-based and distance learning courses that are approved to be offered for CE in the State of Alaska. You can search for any Alaska approved CE course at: statebasedsystems.com The Division is sensitive to the continually changing and challenging dynamic of the COVID-19 spread, and its potential effect on all licensees. Following the above recommendations will assist with license applications being processed in a timely and efficient manner. If you have any questions, please contact the Alaska Division of Insurance at 907-465-2515 or email at: Insurance@Alaska.Gov NIPR Licensing Tips: Stay ahead of your licensing process Pearson VUE Limited Reopening The Division of Insurance (DOI) has been notified that our third-party insurance exam vendor, Pearson VUE, is now open at some locations and in a limited capacity. For more details, please contact Pearson VUE at 907-222-1821 or through their online form located at: www.home.pearsonvue.com/Test-takers/Customer-service/Email/Americas-regulatory.aspx Alaska Insurance Licensing Exam Changes Bulletin B20-17 Don't Let COVID-19 Infect You With Insurance Fraud! Fraud & Scam Protection: The Department of Justice is remaining vigilant in detecting, investigating, and prosecuting wrongdoing related to the crisis. Find out how you can protect yourself and helpful resources on DOJ’s Coronavirus Fraud Prevention website. The Federal Trade Commission has also established a website with helpful information to help consumers avoid coronavirus-related scams. How to Avoid COVID-19 Vaccine Scams FBI Urges Vigilance During COVID-19 Pandemic Coronavirus Advice for Consumers from the FTC Top 5 Covid-19 Scams Defend Against COVID-19 Medical ID Cyber-Fraud Consumer Protection-Related Covid-19 Bulletins, Orders, and Alerts COVID-19 and Your Insurance B20-21 (supersedes B20-06): Extended Review Period for Rate, Form, and Advertisement Filings B20-15: Waiver of Onsite Review Requirements B20-12: Temporary Suspension of Certain Utilization Review and Notification Requirements B20-11: Requirements for Group Health Plans, Claims, and Telehealth Related to the COVID-19 (Coronavirus) Public Health Disaster Emergency Consumer Advisory Alert: Business Interruption Insurance R20-04: Order Protecting Consumers During COVID-19 Public Health Disaster Emergency R20-03: Order Providing Premium Relief for Property and Casualty Insurers R20-02: Waiver of External Healthcare Review Deadlines Additional COVID-19 Related Bulletins and Orders B20-06: Extended Review Period for Rate Form and Advertisement Filings NAIC Alerts and Consumer Education Materials NAIC Insurance BRIEF COVID-19 and Insurance Information about Travel Insurance COVID-19: Resources Beyond Insurance Understanding the virus and finding non-insurance resources This is not a recommendation or endorsement of any facility, provider, payer, organization, or entity. It is only an accommodation for consumers and medical professionals to provide relevant information about the COVID-19 pandemic. These links are not the property of the Division of Insurance, their content is not subject to the Divisions of Insurance oversight. Get Free At-Home Testing Additional At-Home Testing Information Free COVID-19 Testing, Treatment and Vaccines for the Uninsured English Spanish COVID-19 in Alaska For Alaska specific information and resources see the Department of Health and Social Services website. COVID-19 Testing Locations To see daily COVID-19 testing results for the State of Alaska or a specific area in the state, please see the Department of Health and Social Services website. COVID-19 Vaccine COVID-19 general vaccine information COVID-19 vaccine information for healthcare workers Coronavirus Information from the State of Alaska Protect Yourself & Others, Health Mandates and Alerts www.dhss.alaska.gov/dph/Epi/id/Pages/COVID-19/default.aspx" State of Alaska COVID-19 Information Web Page COVID19.Alaska.Gov Department of Health and Social Services COVID-19 Information Web Page dhss.alaska.gov/dph/Epi/id/Pages/COVID-19/default.aspx State of Alaska COVID-19 Vaccination Information for Consumers and Providers Consumers Providers Mental Health Resouces Natural disasters – including such pandemics as the coronavirus outbreak – can be overwhelming and also can seriously affect emotional health. The Substance Abuse and Mental Health Administration’s (SAMHSA) Disaster Distress Helpline, 1-800-985-5990 (or text TalkWithUs to 66746), provides 24/7, 365-day-a-year crisis counseling and support to anyone who is seeking help in coping with the mental or emotional effects caused by developments related to the coronavirus pandemic. Learn more about the Disaster Distress Helpline here: Online: www.samhsa.gov/find-help/disaster-distress-helpline Call toll-free: 1-800-985-5990 Homeowners There are hardship programs in place to help homeowners who have been directly or indirectly affected by the coronavirus and are struggling to make their mortgage payments. The Federal Housing Finance Agency, which oversees Fannie Mae and Freddie Mac, encourages homeowners adversely impacted by the coronavirus who are having difficulty paying their mortgages to reach out to their mortgage servicers as soon as possible. The Consumer Financial Protection Bureau advises that you can find the number for your mortgage servicer on your monthly mortgage statement or coupon book. FHFA has established a dedicated webpage with relevant updates and resources. Additionally, Fannie Mae and Freddie Mac have their own dedicated webpages for homeowners, with online tools for determining if your mortgage is owned by Fannie Mae or Freddie Mac. Federal Housing Finance Agency Consumer Financial Protection Bureau The COVID-19 global health outbreak is causing a financial hardship for millions of Americans. These difficulties include a job loss, reduced income, and illness that impact the ability to make timely payments. Fannie Mae is here to help with reliable information and resources to provide financial relief. Explore your options. Fannie Mae: Here to Help Fannie Mae Mortgage Loan Lookup Freddie Mac: Extending help to homeowners impacted by COVID-19