NY State of Health, together with the New York State Department of Financial Services (DFS), recently announced that New York will make a Special Enrollment Period available to New Yorkers during which eligible individuals will be able to enroll in insurance coverage through NY State of Health and directly through brokers like the North Country Chamber of Commerce. This step is being taken in light of the Coronavirus pandemic to further protect the public health of New Yorkers.
NY State of Health, DFS, and New York State health insurers are taking this action so that individuals do not avoid seeking testing or medical care for fear of cost.
Individuals who enroll in Qualified Health Plans through Ny State of Health or the North Country Chamber of Commerce insurance department between March 16th and April 15, 2020 will have coverage effective starting April 1, 2020. Individuals who are eligible for other NY State of Health programs (ex. Medicaid, Essential Plan and Child Health Plus) can enroll year-round.
NEW ANNOUNCMENT: Special Enrollment Allowed for Group Policies
Effective immediately, to support our community in response to COVID-19, most insurance companies are offering Open Enrollment for all commercial groups of all funding arrangement types.
Commercial members can enroll in their respective employer group medical and dental plans where they don’t already have coverage today.
- Currently, this applies to new subscriber adds and dependent adds who do not have coverage today.
- New subscribers and dependents can be added into an existing group plan without a qualifying event.
- Rehires: We will enroll them without a waiting period if the employer requests; use their original date of hire.
- New hires: This COVID-19 special enrollment period overrides new hire probationary periods.
- The effective date options are 4/1/2020 (prospectively) or 3/1/2020 (retroactively). Normal retroactive guidelines apply at this time.
- At this time, benefit changes outside of the normal OE are not allowed.
- Dental enrollments are also allowed, but the standard timely entrant logic will apply.
What does your company need to know about group health insurance and the COVID-19 Pandemic?
At this time you should refer to and implement your company's internal policies regarding keeping employees on your health insurance during a lay off or a medically imposed quarantine. Your internal company policy should dictate whether an employee can keep their health insurance during a lay off or if it needs to be cancelled. It is the company's obligation to collect the employee’s portion of the premium.
Premium payments are still required to keep policies active, there may be a grace period, but you must contact your Health Insurance's Accounts Recieveable department for details or to set up payment options beyond that grace period. This is considered on a case by case basis. Premiums are not being waived at this time.
COBRA insurance will be offered to any employee you remove from your policy. COBRA is the same plan you currently offer your employees at the same rate, but they are responsible for the premium payment.
- Employees need to be aware that when they have a loss of insurance coverage they get one special enrollment period. If they use that to enroll in COBRA they cannot then decide later to move to the NYS Individual Marketplace unless they qualify for other reasons – such as reduced income making them eligible for a state funded plan such as Medicaid or the Essential Plan which offer year round enrollment.
ATTENTION BUSINESS OWNERS: Guidelines for Health Insurance Cancellation
If you have reduced your workforce and need to cancel insurance benefits for those employees, be sure to reach out to your broker or contact from the insurance company if you do not have a broker.
You will need to provide a written request – an email or termination form to cancel coverage including your group number, the names of individuals laid off and the date you want the coverage to be cancelled. Individual cancellation paperwork is not necessary.
If you have access to your group account online cancellations can also be made online electronically.
- Your company policy will dictate when you cancel coverage – such as the date of lay off or the end of the month etc.
Contact Lisa Bedard-Dupee for additional questions or to enroll today!
TELEMEDICINE: Need medical attention, but don't want to go out?
Other things you should know:
- Insurance Companies Waiving Co-Pays for Tele-Health visits
- If you have questions or concerns about health insurance costs related to COVID-19 tests or care, please call the OAG’s Health Care hotline: 1-800-428-9071.
- NYS Department of Financial Services Health Insurance FAQ
- If you need help navigating the NYS Marketplace and can't reach Lisa. We suggest you contact Adirondack Health Institute at1.866.872.3740, or visit the EASE web page to request a free telephone appointment.
Fidelis can answer your questions and help you enroll in health insurance or renew your coverage by phone call 1-866-435-9521.
**Please remember, all New York insurers will have waived cost-sharing for a COVID-19 testing!**
For more information on other Coronavirus related topics, visit our home page HERE.
Have questions? Let us know! Email us and we will do our best to find the answer.