2 minute read:
Many employers are understandably concerned about how to navigate the difficult business environment created by the COVID-19 Pandemic and resulting state and federal mitigation measures.
Below is a quick guide to the healthcare provisions in the CARES Act that impact employer group health plans and modify some of the health care plan requirements from the Affordable Care Act (ACA).
The CARES Act revises and expands the COVID-19 testing provisions of the Families First Coronavirus Response Act (FFCRA). It requires price transparency in the testing and dollar for dollar coverage of the cost of the test by group health plans. Insurers would still be allowed to negotiate prices. This would not affect certain limited benefit plans that were already exempt from the FFCRA’s testing mandate.
The types of covered COVID-19 testing included in the scope of the CARES Act includes:
- FDA approved tests,
- Test for which the developer will or has requested emergency use authorization from the FDA,
- State authorized or developed tests and the state has informed the DHHS regarding, or
- Tests approved by DHHS through published guidance.
Preventive Health Services:
The CARES Act expands the Affordable Care Act (ACA) preventative care coverage mandate to include COVID-19 related care. This means that insurers and group health plans must cover approved vaccines and other preventative care. In addition, coverage needs to begin 15 days after government approval. While there are currently no approved preventative care measures, this provision essentially exempts COVID-19 preventative care measures from the normal 1-year lead time between approval and the requirement to cover under the ACA. Similar to the testing provision, this would not apply to certain limited benefit plans.
Telehealth Safe Harbor for High Deductible Health Plans:
The CARES Act allows, but does not require, high deductible health plans to cover telehealth services without a deductible. The change is effective with the passage of the CARES Act and applies to plan years that begin prior to December 31, 2021.
Menstrual Care Products and Over the Counter Medications:
The CARES Act amends the Internal Revenue Code to expand the definition of ‘medical care’ to include common menstrual products. This change allows HSAs, FSAs, and HRAs to reimburse individuals for the costs of these products. The effective date of the change is December 31, 2019.
The section also made a subtle, but potentially incredibly impactful change to the reimbursement of over the counter medication. It removed the limitation written in by the ACA that only allowed HSAs, FSAs, and HRAs to reimburse medicine if it was a prescription drug. HSAs, FSAs and HRAs may need to be amended before allowing for the reimbursement of over the counter medication.
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