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Virtual Health is Saving Lives During Coronavirus

How Virtual Health Services are Saving Lives During the Coronavirus Crisis

With the outbreak of COVID-19 healthcare workers and providers have had to come up with better ways to diagnose and treat patients. The number of patients who need to be seen for health issues both related to and peripheral to the coronavirus has put a strain on our hospitals.  It is in this environment that Telemedicine has found its spotlight. Telemedicine or Virtual Health Care is the practice of performing virtual appointments and check-ups for patients. Especially now, this keeps both patients and healthcare workers safe while continuing to provide care for those in need. This is only the beginning of how virtual health is saving lives during the Coronavirus pandemic.

Virtual healthcare has slowly been taking hold as more and more of the norm in recent years. The cost savings alone make virtual care the right choice for many doctors, hospitals, and patients.  $7 billion of physicians’ time can be saved by switching in-person visits to virtual appointments.

These days, in quarantine, many people need the ability to have their doctor’s appointments at home. Even during the best of times, for many, the convenience is key to successful follow up appointments and check-ins.  Telemedicine allows for a safe environment to ask questions, get simple diagnoses and to get prescriptions from your doctor while remaining at home.  

Doctors around the country have implemented telemedicine and online appointments to help keep all patients safe from COVID-19. Patients with a smartphone or computer can visit a provider in a secure network. Dr. Chris Davis, Medical Director for UCHealth’s Virtual Urgent Care says, “COVID-19 is quite infectious, so if you can stay home and get medical advice, that gives you two advantages. First, if you’re sick, you’re not going to be bringing your illness into a doctor’s office or a hospital. Second, you won’t be exposed to other patients.”

These changes to what we have thought of as normal healthcare have given people affordable, manageable options to care for themselves and others throughout this uncertain time. As we work to navigate COVID-19, the best thing we can do is keep ourselves and others safe from harm by ensuring we do everything we can to stop the spread.

Insurance Coverage and Coronavirus Testing

Will My Insurance Cover the Cost of Coronavirus Testing?

As we continue to navigate through the effects of COVID-19, many questions arise when it comes to insurance coverage. Does your specific insurance cover testing? Does it cover treatment? How can I find out my coverage options? 

The short answer is it depends on your coverage. Health insurance coverage varies widely, depending on where you live and how you obtain your coverage. Almost half of Americans receive their insurance coverage from their employers. Those plans are managed by both the federal and state guidelines, which depend on the group size and whether or not the plans are self-insured or fully-insured. So how does Coronavirus coverage fit into these health plans?

Let’s begin with testing. The Families First Coronavirus Response Act states the Medicare, Medicaid, and private health insurance plans are required to cover the cost of Coronavirus testing, without cost-sharing or pre-authorization requirements. This is including lab service costs and provider fees at doctor’s offices, urgent care clinics, and emergency rooms where tests are given. Because this act is federal law, self-insured and fully-insured plans apply to this rule. However, the testing coverage requirements that are imposed on some states are only applicable to fully-insured plans.

Plans that are not considered minimum essential coverage, for example short-term health plans, fixed indemnity plans, and healthcare sharing ministry plans, are not required to cover COVID-19 testing. Some of these plans do volunteer to cover COVID-19 testing, so look to your plan for specifics.

Some states, like Washington, have extended their testing coverage requirements to include these short-term plans, but most states have not imposed further requirements for these plans.

If you are uninsured, states can use their Medicaid programs to cover COVID-19 testing to cover their uninsured residents. There is $1 billion in federal funding to reimburse providers to cover COVID-19 testing for uninsured patients.

Now, let’s get into treatment coverage. As of right now, there is no specific treatment for COVID-19, most people will not need treatment, but around 20% of patients will be hospitalized, and 20% of those patients will need intensive care. This inpatient care is considered an essential health benefit for all ACA-compliant individual and small group health plans. Large group plans are technically not required to cover essential health benefits, but they are required to provide “substantial” coverage for inpatient care.

Even with coverage, inpatient care is expensive. The ACA states that all non-grandfathered/grandmothered plans must have in-network out-of-pocket maximums that can reach up to $8,150 for a single individual. Most COVID-19 treatment costs will not exceed this amount, but many health plans out-of-pocket limits are below that amount. Which leaves patients that need hospitalization with a four-figure invoice.

Some states, like New Mexico and Massachusetts have required state-regulated insurers to cover treatment and testing without cost-sharing. Minnesota is encouraging their providers to do the same. 

Most states are both encouraging and requiring state-regulated providers to allow testing and treatment as in-network, whether or not the medical providers are in the plan’s network. Patients may still be subject to balance billing because out-of-network providers do not need to accept the payment as payment-in-full.

Here are some ways to ensure that you are protected during these uncertain times:

  • If you are uninsured there is a COVID-19 special enrollment period in some states. If your state is included, an ACA-compliant plan is a great option. If you have a low income, you could also be eligible for Medicaid.
  • If you currently have health insurance, understand what your plan covers, and how your cost-sharing responsibilities for in-patient and out-patient care may apply.
  • Look at your health plan to see how it handles prior authorizations.
  • Look at the details of your health plan’s provider network. If you see in-network providers you have a better chance of avoiding balance billing.
  • Check to see if telehealth is covered, for less-severe cases, this is the best way to help prevent the spread of COVID-19. Some health plans are eliminating or reducing cost-sharing for telehealth services.
  • If you have an HSA-qualified plan, you can devote your pre-tax money to your account for the year. The money you contribute to your plan is able to be withdrawn tax-free for out-of-pocket health care expenses.

What is the Families First Coronavirus Response Act?

In March 2020, President Trump signed into law the Families First Coronavirus Response Act, the initial coronavirus relief bill aimed at assisting families living in the United States. The new law requires small employers—those with fewer than 500 employees—to provide limited paid-leave benefits to employees who are affected by the coronavirus emergency. Small employers receive new tax credits and federal payroll-tax relief to pay for the new mandatory benefits.

Mandatory employee paid leave.

The Act requires emergency paid sick leave. It is limited to $511 per day for up to 10 days (up to $5,110 in total) for an eligible employee in coronavirus quarantine or seeking a coronavirus diagnosis. An employee can also receive emergency paid sick leave of up to $200 per day for up to 10 days (up to $2,000 in total) to care for a quarantined family member or a child whose school or child-care location has been closed due to the pandemic.

The Act also requires that small-business employees obtain the right to take up to 12 weeks of job-protected family leave if the employee or a family member is in coronavirus quarantine or if the school or child-care location of the employee’s child is closed due to the coronavirus. The employer must pay at least two-thirds of the employee’s usual pay, up to a maximum of $200 per day, subject to an overall per-employee maximum of $10,000 in total family-leave payments.

Small-employer tax credits

The Act grants a new tax credit to small employers to cover the now-required payments to employees who take time off under the new law’s emergency sick-leave and family-leave provisions.

Specifically, a small employer can collect a tax credit equal to 100% of qualified emergency sick-leave and family-leave payments made by the employer according to the Act. However, the credit only covers leave payments made during the period beginning on a date specified by the Secretary of the Treasury and ending December 31, 2020. The beginning date will be within 15 days of March 18, 2020, when the Act became law.

The credit increases to cover a portion of an employer’s qualified health-plan expenses that are allocable to emergency sick-leave and family-leave wages.

The new credit offsets the Social Security tax component of the employer’s federal payroll-tax bill. Any excess credit is refundable, meaning the government will issue a payment to the employer for the excess.

Warning: The credit is not available to employers that are already receiving the pre-existing credit for paid family and medical leave under Internal Revenue Code Section 45S.

Small-employer FICA tax relief

Sick-leave and family-leave payments mandated by the Act are exempt from the 6.2% Social Security tax component of the employer’s federal payroll tax that generally applies to wages. Employers must pay the 1.45% Medicare tax component of the federal payroll tax, but they can claim a credit for that outlay.

The Families First Coronavirus Act is just the first step of many that are sure to be taken by the U.S. government as they continue to face the COVID-19 outbreak. You can read answers to common questions, apply for aid, and more on the Department of Labor’s Q&A page here.

For a list of COVID-19 resources, click here.

What Employers Need to Know About FFRCA and Benefits

The Coronavirus pandemic has had a massive impact on the financial health of thousands of companies in the United States. These employers have seen the enormous reduction in business and the effect it has on their employee benefit programs, and adjust them to meet the needs of both their employees and their business. These adjustments still carry certain obligations the employer must meet under federal legislation. So what do employers need to know about FFRCA and benefits?

Employers have had to reduce or terminate a portion of their workforce, put furloughs in place, and reduce hours and compensation for their employees in response to the crisis. All of these changes impact the employee’s benefit plans and policies, so an employer must review said plans and policies and make adjustments accordingly. Here’s what to consider while doing so:

Service provider contracts for employee benefit plans

Review the terms for existing contracts with multiple service providers, as the fees related to administrative contracts can be determined by the number of participants on your plan. Any reduction in workforce or hours for your employees would affect the total number of eligible employees, which could result in additional fees within the contract. The stay-at-home order may affect a service providers ability to meet their obligations within the contract, as well. Many of these contracts will contain a “Force Majeure” clause that excuses a party for nonperformance due to extraordinary events. Each of these provisions is contract-specific — be sure to review yours. A service provider’s nonperformance in regard to ERISA plans could pose a problem for employers. Employers should seek legal advice in terms of navigating their service providers contracts during this unprecedented time.

Emergency Paid Sick Leave and FMLA Expansion

On March 18, 2020, The Families First Coronavirus Relief Act was enacted. It requires employers with fewer than 500 employees to provide paid sick leave and additional FMLA benefits to their employees. Because of the added cost to employers, the FFRCA provides a quarterly payroll tax credit which is equivalent to 100% of qualified sick and leave wages paid to employees as emergency paid sick leave and emergency family and medical leave.

Health and Welfare Plans

  • COVID-19 Specific Coverage: The FFCRA requires group health plans to cover COVID-19 diagnostic testing related costs, healthcare provider services, and facility costs without the participant’s deductibles, copay, or coinsurance. The FFCRA also ensures that prior authorization and other medical management requirements be waived regarding COVID-19 services. In addition to the FFCRA, the CARES Act requires group health plans to cover preventive services and vaccines related to COVID-19.
  • Reduction in hours (or furloughing): Specific plan or policy terms determine whether furloughed employees or employees with a reduction of hours can keep their health coverage. Many plans require employees to uphold a minimum amount of hours to maintain coverage. Employers might be able to amend their plan or alter the policy to expand coverage or modify procedures for employee premium payments, but must seek approval from their insurance provider before any changes take place. 
  • COBRA Continuation Coverage: COBRA continuation coverage is offered to employees who have been terminated or have reduced hours. Employers can provide a subsidy to help their employees cover the COBRA continuation costs. Be sure to consider any discrimination issues that may arise if the subsidy is not offered throughout your company. 
  • ACA Employer Mandate: ACA requires employers with 50 or more full-time employees (who average 30 hours a week or more) provide minimum essential coverage to their employees.
  • HIPAA: employers who are covered under HIPAA and their associates must remember that HIPAA applies during the COVID-19 pandemic. With changing work conditions, ensure that you review and update HIPAA privacy practices to ensure your safeguards are in place.
  • Cafeteria Plan Elections: There cannot be any change in mid-year election choices based on employment status change. 
  • Premium adjustments: The potential reduction or change in your workforce could affect the employee eligibility for health insurance policies, which could bring about premium adjustments. 
  • Value of welfare benefits: Welfare benefits and their value is tied to employee compensation, reducing their compensation can reduce the value of these benefits for those employees. 

Retirement Plans

  • There are fiduciary responsibilities under ERISA in a market similar to the one COVID-19 has caused. ERISA plans should pay specific attention to fiduciary duties, like acting prudently, diversifying plan assets, and complying with plan provisions. 
  • Participant Access to Retirement Plan Accounts: 
    • The CARES Act permits multiple situations for employees. Employers can expand participant access to specific retirement accounts for “coronavirus-related distribution,” without subjection to 10% early withdrawal penalties and must be repaid over a 3-year period. 
    • The CARES Act also allows employers to increase the maximum loan amount for qualifying individuals if their 401k plan allows participant loans. 
    • Hardship Withdrawals: Most plans allow for hardship withdrawals in areas that are federally declared disaster areas. These withdrawals are still subject to the 10% withdrawal penalty who have not reached the age of 59 ½ and are taxable in the year they are withdrawn. 
    • In-Service Distributions: If the employee has reached the age of 59 ½, many plans allow their participants to receive in-service distributions without a withdrawal penalty. In light of the crisis, employers should consider a plan amendment to expand or add in-service distribution to defined contribution plans or benefit plans.
  • Reducing or Freezing Benefits and Contributions: Employers may be looking to reduce operating costs by reducing or freezing benefits or suspend employer matching or nonelective contributions. This requires at least a 45-day notice before the reduction is put into effect. Discretionary employer matching and nonelective contributions may be suspended or reduced prospectively and may or may not require a plan amendment. Consider the IRS rules that prevent cutbacks in benefits.
  • Funding Relief for Single-Employer Defined Benefit Plans: The CARES Act gives single-employer benefit plans more time to meet funding obligations by delaying the due date until January 1, 2021, with interest on the delayed payment. CARES Act also allows a single-employer defined benefit plan sponsor can elect to treat the plan’s different funding target attainment percentage to the last plan ending before January 1, 2020.
  • Voluntary Termination of Qualified Retirement Plans: Due to the change in economic circumstances some employers may feel they need to terminate their qualified plans. All participants must be fully vested in their accounts under the plan during termination. However, there is a rule that employers who terminate a 401k plan may not establish a new plan within 12 months of the termination. Participants and beneficiaries must receive a special notice at least 45 days prior to the effective date of termination.
  • Partial Termination of Qualified Retirement Plans: Reducing your workforce by 20% or more of qualified retirement plan participants in a plan year that is not considered routine turnover could end up in partial termination of the plan. All participants who have been affected must be fully vested in their accounts. 
  • Deadlines for 403(b) Plans and Pre-Approved Defined Benefit Plans Extended: The IRS is extending the last day of the initial remedial amendment period for 403(b) plans from March 31, 2020, to June 30, 2020. They also are extending both the April 30, 2020 deadlines for an employer to adopt a pre-approved defined benefit plan and submit a determination letter application under the second 6-year remedial amendment cycle and the April 30, 2020 end of the second 6-year remedial amendment cycle for pre-approved defined benefit plans deadline until July 31, 2020.

Incentive Compensation/ Non-Qualified Deferred Compensation Plans

There are strict rules that Code Section 409A adheres to regarding the time and type of payment incentive compensation and other non-qualified deferred compensation a company puts in place. This could include penalties for both the employer and the employees. As you work to navigate potential liquidity issues through the COVID-19, ensure that you navigate Code Section 409 A properly by addressing these issues:

  • Paying Annual Bonuses by March 15th: If you missed the March 15th deadline due to COVID-19 related issues with administrative duties or if the payment jeopardized the employer’s ability to continue, the payment may be made as soon as possible after the unforeseen circumstances are alleviated.
  • Cancellation of Deferrals/ Unscheduled Distributions: In the event of an unforeseeable event, an employee’s deferral election may be canceled, if the plan allows. Employers can also allow a participant to receive distributions if their plan contains these distributions. The employee still must show that emergency expenses cannot be covered by insurance, liquidation of assets, or ceasing deferrals under their plan. The distribution will also be limited to the amount needed to satisfy the participant’s financial needs. 
  • Scheduled Distributions/Distributions Payable Upon Separation From Service: Most non-qualified deferred compensation plans provide payment upon an employee’s separation from service. Separation of service includes termination or a reduction in hours, and the employee would be entitled to a distribution from their plan.
  • Equity Award Considerations: Employers should consider if they should update their stock option valuation that considers the COVID-19 pandemic. This could affect the issuance of equity compensation.
  • Termination of Non-qualified Deferred Compensation Plans: Section 409A does allow a voluntary plan termination and distribution of benefits under specific circumstances, but these rules do not allow termination in connection with a downturn of employers’ financial status. This would require similar non-qualified deferred compensation arrangements to be terminated, and payments would be delayed 12 months after the plan is terminated. Once this is done, the employer cannot adopt a new non-qualified deferred compensation arrangement of the same type for 3 years.

As an employer, there are many things to consider with the changing economic times. For more information visit our site.

Health Insurance Options for Coronavirus Job Loss

As COVID-19 continues to impact our daily lives, unemployment has reached a record high, jumping to 14.7% as of April 2020. There are many things to consider when assessing these new statistics and, as an employer or an employee, it’s important to ask yourself this question: What health insurance options are there for those that have experienced job loss due to Coronavirus?

If you’ve lost your job due to Coronavirus or have experienced a reduction in hours, here’s what you can do:

If you’ve lost your health plan through your job you may qualify for a Special Enrollment Period. If you have lost your coverage within the past 60 days, or you expect to lose coverage in the next 60 days, you are also eligible for a Special Enrollment Period. 

If you have experienced a reduction of hours and are part of a Marketplace plan, you should update your application to report any household income changes within 30 days. This may lead to more savings than you’re getting now.

If you have experienced a furlough, depending on the status of your coverage, you might be eligible for a Special Enrollment Period. You might also qualify for a premium tax credit to assist your Marketplace coverage payment.

For people with COBRA continuation coverage, you may be able to qualify for the Special Enrollment Period. Based on your pre-COBRA coverage, you have 60 days to enroll in Marketplace coverage. You may also qualify for premium tax credits, only if you end your COBRA continuation coverage. 

If you have lost your job, but your company did not offer coverage, you typically do not qualify for a Special Enrollment Period. Job loss on its own does not make you eligible for a Special Enrollment Period.

If you are unable to pay your insurance premiums due to Coronavirus there are some things to consider: First, check with your insurance providers to see about extensions. Usually, there is a grace period determined by state law. If you receive financial assistance with your premiums, there is a three-month grace period where your plan cannot be terminated for failure to pay premiums. 

If you know that you qualified for a Special Enrollment Period, but missed the deadline due to Coronavirus impact, there is a chance you can be eligible for another Special Enrollment Period. 

As employers continue to understand how to effectively run their businesses throughout Coronavirus, we want to help you understand how to remain covered and safe. Here is a list of our COVID-19 resources that may be helpful as you work to understand what’s next for you and your company. 

What is the Employee Tax Credit?

The Employee Retention Tax Credit was rolled out as part of the CARES (Coronavirus Aid, Relief, and Economic Security) Act. It was enacted to encourage employers to retain employees throughout the Coronavirus pandemic. As our country begins to understand the full scope of COVID-19, this credit could allow employers to keep employees on their payroll and keep their doors open.

What is the Employee Retention Tax Credit?

The tax credit is a refundable tax credit that is meant to incentivize employers to keep employees on their payroll. For all businesses working to keep their staff on the payroll, 50% of qualified wages must be paid to the employees from March 12, 2020, to January 1, 2021. Including credit for qualified health plan expenses. 

An employer can claim up to $10,000 in wages paid if the employer’s business is entirely or partially suspended because of coronavirus and if their gross receipts also decrease by more than 50%.

What makes someone eligible for the Employee Retention Tax Credit?

The ERTC is available all employers, including tax-exempt organizations. The only organizations that are not eligible for the ERTC are state and local governments and their instrumentalities and any small business that has taken a Small Business Loan. Those who are self-employed are also not eligible for the ERTC.

An employer must be a business that has been fully or partially suspended by the coronavirus government orders, to qualify for the tax credit. If they do not meet that requirement, they may also be eligible if the employer has gross receipts below 50% of the same quarter in 2019. If the employer’s gross receipts go beyond 80%, they are no longer eligible for the tax credit after the quarter ends.

Employers with fewer than 100 employees may receive a tax credit for all employees. Those with more than 100 employees can receive credit for the employees who are being paid but are not working due to coronavirus cutbacks.

How can I claim the Employee Retention Tax Credit?

The ERTC cannot be combined with any other tax credit. If you are counting wages toward the Families First Coronavirus Relief Act tax credit, you cannot count those same wages toward the ERTC.

To begin your ERTC claim, employers should report their total qualified wages and other credits quarterly. Form 941 allows businesses to report their income, along with their Social Security and Medicare taxes withheld from employee’s paychecks. 

If an employer reduces the amount of payroll taxes they withhold from employee’s wages, they can be immediately reimbursed. 

As businesses continue to adjust their business plans in the face of coronavirus, there are many ways they can find relief through various programs. The ERTC is a good option for employers who are trying to keep their employees on their payroll. Visit our COVID-19 resource page for more information on programs that can benefit your business.

How to Offer Remote Workers Benefits

Due to changes caused by the Coronavirus outbreak, many people have made the transition to working from home. This new reality has changed the way most people do business — from holding meetings over Zoom to dealing with distractions at home, this new reality has been an adjustment for just about everyone involved. For employers, this has meant adjusting where they allocate resources and how they operate on a day-to-day basis. As companies continue to keep their employees working remotely, it’s important to understand the effects this change will have on employee insurance benefits.

Most Americans rely on their workplace to offer their health insurance options. As we adjust to a new way of working, it’s important as an employer to ask: Should I make adjustments to the benefits I offer my employees?

The answer to this question is almost always: Keep offering benefits! 

In order to retain employees and save company time and money, offering insurance is imperative. Health insurance is an important consideration most people take when deciding whether or not to take a job. Offering competitive health insurance options gives you a competitive advantage. 

When employees feel their best and know they are protected if anything happens, they are more likely to work harder for the company. Employees with insurance are more likely to go to the doctor for annual check-ups to ensure their health. If you give your employees insurance, they will likely take less time off for illness, which will benefit your company in the long run. 

Especially during these uncertain times, offering insurance and peace of mind to your employees allows them to focus on things other than their well-being. Virtual healthcare is also a great option for most employers, as the effects of COVID-19 drive many people to stay home as often as possible. If that is not included in your program now, consider adding it. Most people will want to be able to contact a doctor while adhering to the social distancing measures still in place.

As companies adjust to the “new normal,” they must consider how this could change their benefit programs for their employees. Ensure that you are giving the best options possible to all your employees, and giving them a piece of mind during this uncertain time. Contact us for more information on how you can best serve your employees with the best possible benefits.

Coronavirus and the Rise of Telemedicine

Coronavirus has flipped our lives upside down in more ways than one. One of the biggest changes is the expectation that nearly everyone stays at home as much as possible. Social distancing measures are currently being enforced in order to slow the spread of the virus, which has caused a major spike in the use of telemedicine resources.

Despite the emphasized concern for those infected by COVID-19, people with healthcare concerns and issues still need to regularly see their doctor, as well. This is where telemedicine can come into play — people who do not need to receive treatment in a hospital or doctor’s office are able to talk to their doctor and get what they need virtually from the safety of their homes.

Doctors’ needs for additional resources to treat and see their patients have put the spotlight on telemedicine in a big way. Doctors are now able to use secure, virtual consultations to keep both their patients and themselves safe. Coronavirus has made it imperative that health care workers are able to keep in touch with their patients in a way that keeps both of them safe from any unnecessary contact with others. 

Government leaders, public health authorities, insurers, and hospital systems have all been working diligently to give people as many health care services as possible virtually. This will likely become one of the new normals we will see after the pandemic is over. 

Telemedicine and virtual healthcare have been around for years, but the coronavirus is forcing people to utilize this great tool and is driving employers and insurance agencies to include this technology in their plans.

As a society, our acceptance of technology as an integral part of our everyday lives has made it possible for telemedicine to eventually replace in-person preventative medical visits completely. As our dependency on technology continues to grow, telemedicine will gain more and more traction with the vast majority of patients. 

In order to keep everyone safe, we need to continue implementing social distancing measures. For more information on virtual health services and how you can start using it, visit us!

How Coronavirus is Affecting Healthcare Costs

Coronavirus has disrupted quite a few industries over the last few months. One of the industries that it will continue to affect for the foreseeable future is the healthcare system. As it continues to spread, and we continue to see the effects of coronavirus, insurance programs will likely see a rise in health care costs. Here is an overview of how we think coronavirus could affect health care costs:

The first place we will likely see a rise in healthcare costs is with testing and treatment. As the number of coronavirus cases is still unknown and potentially growing, public health will be vital to limiting and eliminating the spread of coronavirus. There are mixed messages on whether or not we have reached the peak number of cases in the U.S, and some say that there may be another spike in cases shortly if social distancing is relaxed. 

The cure for coronavirus is still unknown, but the usage of current treatments are a way to support those who are infected. Once an effective treatment is established, there will likely be a reduction of strain on healthcare systems. Still, additional costs of implementing new drug treatments will cause the overall cost of care to increase along with a new vaccine treatment as an added cost in the near future. 

Around 15% of people infected with coronavirus require some kind of hospitalization, which typically includes needing ventilation. Costs associated with these procedures can be extremely expensive. Ventilation treatments can cost anywhere from $34,223 to $88,1114, depending on how long a person is on the ventilator. 

Many healthcare providers are concerned about the possibility of seeing an influx in people using healthcare services after stay-at-home orders lift. It is likely that the low demand for healthcare now will cause a delayed demand that could be overwhelming for providers and insurance companies later down the road. This sudden influx could quickly drain hospital resources if they are not adequately prepared. In some parts of the country, hospitals could not have enough beds for the number of patients needing care.

Hospitals have already begun canceling elective procedures. Though they are considered elective and therefore not urgent, these procedures almost always improve the patient’s daily life and prevent early death. These delayed procedures will likely be scheduled for next year, which would raise overall healthcare costs for 2021. Foregoing these procedures could also cause health outcomes to decline, as well as higher spending for the individual later due to complications. 

Medicare

Because the older populations are at high risk for contracting COVID-19 and potentially having complications related to coronavirus, the Medicare program could be affected. An increase in Medicare spending could potentially spill-over into the beneficiaries’ out-of-pocket spending in years to come. The out-of-pocket expenses will show up as an increase in premiums, deductibles, and other cost-sharing programs. 

Another consideration that may affect Medicare spending is telehealth services. Under the CARES Act restrictions on telehealth services, which could cause a decline in doctor’s office visits and the costs associated with holding in-person appointments.

Medicaid

Medicaid programs will also likely be affected by COVID-19. The costs of the program will likely increase as unemployment increases, and people are losing coverage provided by their jobs. Medicaid spending and enrollment increases in times of economic downturn. As more people enroll and the costs dealing with testing and treatment increase, the pressure on Medicaid costs will also increase.

As we continue to understand the effects of coronavirus, there are many implications to consider. Contact us to get the right coverage for you and your company.

The Telehealth Revolution and Coronavirus

The demand for telehealth services has skyrocketed in the wake of the coronavirus pandemic. Still, an increase in consumer demand over the past several years can guarantee that telehealth options are here to stay. 

Public health officials are encouraging consumers to utilize contact-less telehealth services to stay safe and slow the spread of COVID-19. Not only does this form of healthcare keep the user safe from germs, but it also can help give doctors quick access to patients who need care urgently, but may be located in other parts of the country. While there is a lot to understand when it comes to telehealth services, here are the things we consider to be the most important:

How are people responding to telehealth services?

According to a survey from Accenture, 74% of those surveyed were happy with their telehealth experience. About 75% of people said they would use telehealth services to access healthcare after hours. Two-thirds said they would use this service for follow-up appointments rather than seeing a healthcare professional in person. 

So, how does telehealth work?

Email, video conferencing, and video chat services are used to receive care from the comfort of your own home. The healthcare professionals responding to consumers either respond in real-time or giving consumers a place to find their answer.

The costs associated with telehealth services are dependant on the insurance plan coverage. Programs like Medicare cover telehealth services. Consumers can also pay out-of-pocket for their telehealth services. These services can cost anywhere from $50 to $80, or a potential annual membership fee.

As far as security goes, patient privacy is protected if the providers are operating in good faith. But if these services use avenues, like Zoom or Skype, the security may be a little riskier. At SBMA, we offer 24/7 access to doctors with no cost to you, as well as behavioral health services with a $50 copay. 

Telehealth services also give doctors the ability to send in a prescription to a pharmacy. Our telehealth services cover generic physical and behavioral prescriptions with a $10 or $25 copay.

While telehealth services cannot diagnose or treat coronavirus, they can offer quarantine and self-care tips to implement while you are home. If you are unsure whether or not to go to the hospital, you can use telehealth services to help decide whether or not you need to. 

For more information on telehealth services and how you can offer them or receive them, contact us!