Dear TPSC partner:
As you may be aware, the Governor has issued a public health emergency in Washington related to the coronavirus (COVID-19). As a result, the Office of the Insurance Commissioner (OIC) has mandated that fully insured plans in Washington cover the in-network testing and treatment for the virus with no cost sharing (paid at 100% with no deductible, copay or coinsurance).
Per the order, insurers must also:
||Allow a one-time early refill for prescription drugs
||Suspend any prior authorization requirement
for coronavirus testing or treatment
In addition, if an insurer does not have enough medical providers in its network to provide testing and treatment for coronavirus, it must allow enrollees to be treated by another provider within a reasonable distance at no additional cost.
The order is effective immediately and applies to all state-regulated health insurance plans and short-term limited duration medical plans until May 4, 2020 (the order will be reassessed at that time).
What Does This Mean for Your Plan?
Since your plan is self-funded, it is not directly impacted by the OIC mandate. However, you do have the option to adopt these short-term plan changes—which we encourage you to do.
For those on an HSA plan, it will take federal intervention to have the deductible waived and, at this time, this has not occurred. HSA members will still have to pay the deductible, but you can waive the coinsurance.
We are closely monitoring this situation and will notify you of any changes as soon as possible.
Please complete the brief form below indicating whether or not you would like the terms of the OIC order applied to your self-funded plan.
Would you like the terms of the OIC
order applied to your self-funded plan?
If you have any questions, please don’t hesitate
to contact us at 800.426.9786.