Benefits Changes and Extended Deadlines Due to COVID-19 - Human Resources at Ohio State

COVID-19 HR RESOURCES:

Benefits Changes and Extended Deadlines Due to COVID-19

Ohio State is extending several benefits deadlines and expanding program options to help support employees during the COVID-19 pandemic. We hope these changes make it easier for you and your family to manage your health and wellness needs during this challenging time. The changes detailed on this web page are:

The examples below refer to the outbreak period, defined as starting March 1, 2020, and ending 60 days after the COVID-19 national emergency terminates.

Note: As the pandemic and the government’s response (legislation and additional guidance) evolves, additional changes may be made.

Please see the nondiscrimination statement and language assistance resources if needed.

Deadline Extensions

Ohio State’s Faculty and Staff Health Plan, Dental Plan, Vision Plan and Disability Program

The federal government released new rules that require us to extend deadlines for certain actions if they occur during the period beginning March 1, 2020 and ending 60 days after the COVID-19 national emergency terminates. The actions affected include:

  • Requesting special enrollment changes to medical, dental and vision benefits due to marriage, birth, adoption, placement for adoption, divorce, loss of other group health insurance and loss of Medicaid or Children’s Health Insurance Program (CHIP)
  • Filing claims for medical, prescription drugs, dental, vision, long-term and short-term disability
  • Appealing adverse benefit determinations for medical, prescription drugs, dental, vision, long-term and short-term disability
  • Requesting an external review for medical, prescription drugs, dental and vision
  • Providing notice of a COBRA qualifying event due to divorce, loss of dependent status, or determination of disability by Social Security
  • Electing COBRA continuation coverage
  • Paying COBRA premiums (note: claims incurred after the paid-to-date-of-coverage will be denied unless and until the applicable COBRA premiums have been paid)
  • COBRA Election Notices
Examples and instructions on how to enroll in Ohio State’s Faculty and Staff Health Plan, Dental Plan, Vision Plan or Disability Program
Special enrollment example if you do not currently participate in Ohio State’s health coverage: You can enroll yourself or an eligible dependent in Ohio State’s health coverage. For example, you acquired an eligible dependent on March 31, 2020, due to marriage, birth, adoption or placement for adoption, and missed the 30-day enrollment window. You want to enroll yourself and/or your dependent in Ohio State’s health coverage. Assume the outbreak period ends on September 29, 2020. You may exercise your special enrollment rights until 30 days after September 29, 2020, or by October 29, 2020.

How to enroll: To request enrollment in Ohio State’s health coverage for one of the special enrollment events listed above, complete the Health Election Form. In Section 2, fill in the “Date of Event” and select the applicable “Qualifying Status Change,” and by “Other” write “Special Enrollment.” You cannot make special enrollment elections through Employee Self Service. If you need assistance, please contact Customer Service at 614-292-1050.

Enrollment effective date: Elections for the special enrollment events, listed above, will be effective on the event date and any missed premium contributions will be payroll deducted.

For questions regarding special enrollment contact Customer Service at 614-292-1050. For all other questions contact the appropriate plan administrator:

  • Medical claims, appeals or external review – contact Trustmark at 800-678-6269
  • Prescription drug claims, appeals or external review – contact Express Scripts (ESI) at 866-727-5867
  • Dental claims, appeals or external review – contact Delta Dental at 800-524-0149
  • Vision claims, appeals or external review – contact Vision Service Plan (VSP) at 800-877-7195
  • Disability claims or appeals – contact Unum at 866-679-3054
  • COBRA notices, elections or payments – contact Trustmark at 866-433-0318 ext. 44124

Flexible Spending Accounts

The original Flexible Spending Account (FSA) filing deadline for the 2019 plan year was March 31, 2020, which falls after March 1, 2020, and prior to the end of the COVID-19 national emergency.

You can use this deadline extension to submit a reimbursement request if you had a balance remaining in your 2019 FSA (Health Care or Dependent Care) and incurred eligible expenses between January 1, 2019 and March 15, 2020 that have not been reimbursed.

Claims that were not submitted by the March 31, 2020 deadline must be filed and any claims previously denied must be re-filed with all appropriate documentation. Your Health Care Debit card or TASC Card cannot be used for reimbursement from any remaining 2019 funds. If you need assistance, contact TASC at 855-353-9678.

Examples and instructions on how to file for FSA reimbursement
Example: Assume you had $300 in unclaimed funds left in your 2019 FSA as of April 1, 2020. On December 31, 2019, you incurred an eligible expense but did not file for reimbursement by the March 31, 2020 claims filing deadline. If the outbreak period ends on September 29, 2020, you may file for reimbursement until 31 days after September 29, 2020, or by October 30, 2020.

How to file for reimbursement: File a claim online via Employee Self Service (ESS) or OneSource and click “My FSA/HRA” then “File a Claim” and follow prompts for claim info; scan and upload appropriate receipts. Or you may complete a paper FSA claims reimbursement form.

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Mid-year changes without a qualifying event

Ohio State’s Faculty and Staff Health Plan, Flexible Spending Accounts

Beginning July 1, 2020, certain prospective benefit changes can be made during calendar year 2020 without a qualifying event. Allowable changes are limited to the following:

  • Medical plan enrollment for yourself and your dependents (NOT INCLUDED: plan changes if you are already enrolled)
  • Medical plan termination for yourself and your dependents when accompanied by a required written attestation confirming enrollment in other comprehensive health coverage
  • Health Care FSA contribution increases or decreases (no refund of contributions)
    • You cannot decrease your annual election to an amount below what you have already contributed or been reimbursed, whichever amount is greater.
  • Dependent Care FSA contribution increases or decreases (no refund of contributions)
    • You cannot decrease your annual election to an amount below what you have already contributed.
Examples and instructions on how to make a change to your Ohio State Faculty and Staff Health Plan or Flexible Spending Accounts
Medical plan enrollment example if you are not currently enrolled: Even though you have not had a qualifying event within the last 30 days, you may elect to enroll yourself or a dependent in the medical plan on a prospective basis.

How to enroll: To request enrollment in an Ohio State medical plan, complete the Health Election Form. In Section 2, mark “Other” and write “Medical enrollment without a qualifying event.” Mid-year plan elections without a qualifying event cannot be completed online through Employee Self Service.

Enrollment effective date: A medical plan enrollment without a qualifying event will be effective on the date that the completed Health Election Form is received by the Office of Human Resources and employee payroll contributions will begin.

Medical plan termination example: You are currently enrolled and want to terminate coverage. Even though you have not had a qualifying event within the last 30 days, you may elect to terminate your or your dependents enrollment in the medical plan on a prospective basis.

How to terminate enrollment: To request termination of enrollment in an Ohio State medical plan, complete the Health Election Form. In Section 2, mark “Other” and write “Terminate medical enrollment without a qualifying event.” You must attach a signed statement to the form confirming your enrollment in other comprehensive medical coverage.  Mid-year plan elections without a qualifying event cannot be completed online through Employee Self Service.

Termination enrollment effective date: Medical plan terminations without a qualifying event will be effective on the date that the completed Health Election Form and signed statement are received by the Office of Human Resources and employee payroll contributions stop.

FSA election to stop or decrease contributions example: Assume you made a $1,200 health care FSA election for 2020 and have had $600 in payroll contributions and $800 in reimbursements year to date. You have determined that your annual election is greater than the amount that you now expect to incur in eligible expenses, and you are concerned that you will have to forfeit any remaining funds. Even though you have not had a qualifying event in the last 30 days, you may elect to decrease your annual election amount to an amount that is no less than $800 for the rest of 2020.

How to stop or decrease future FSA contributions: Complete the Flexible Spending Account (FSA) Election Form. Complete Section 1. In Section 2, mark “Other” and write “Stop Future FSA Contributions,” and indicate if the request is for a Health Care or Dependent Care Account. Sign and date the completed form. You cannot enroll online through Employee Self Service.

Contribution change effective date: The change in your contribution amount will occur with the beginning of the first pay period following receipt of the form by the Office of Human Resources.

FSA election to increase FSA contributions example: You elected to contribute $500 to your 2020 Health Care FSA. You have already incurred $500 in eligible expenses and anticipate having an additional $600 in eligible expenses this year. Even though you do not have a qualifying event in the last 30 days, you may elect to increase your annual election amount to an amount that is more than your current $500 election amount.

How to elect to increase FSA contributions: Complete the Flexible Spending Account (FSA) Election Form. Complete Section 1. In Section 2, mark “Other” and write “Increase FSA Contributions,” and indicate if the request is for a Health Care or Dependent Care Account. Sign and date the completed form. You cannot enroll online through Employee Self Service.

Contribution change effective date: The change in your contribution amount will occur with the beginning of the first pay period following receipt of the form by the Office of Human Resources.

If you have questions, please contact Customer Service at 614-292-1050.

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Personal Health Assessment and biometric health screening

Changes are being made to the Your Plan for Health (YP4H) incentive program since the COVID-19 pandemic presented challenges to obtaining biometric screenings. For the remainder of 2020, benefits-eligible faculty, staff and their enrolled spouses only need to complete the Personal Health and Well-being Assessment (PHA) in order to earn full 2021 medical plan premium credit. You no longer need to complete a verified biometric health screening. Please make sure to complete the PHA in the Virgin Pulse portal by December 31, 2020.

If you do complete a verified biometric health screening this year, you will earn bonus YP4H points towards additional rewards. In August, there will be limited-capacity on-campus screening appointments available or you can visit your primary care provider to obtain your biometric health values.

If you completed a PHA this year and are missing premium credits, all missed credits will be applied to a future pay.  For further details on this change, please visit yp4h.osu.edu/update.

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Expansion of qualified medical expenses

Ohio State’s Health Care FSA, Health Reimbursement Account (HRA)

Effective January 1, 2020, the following types of medical care for which participants may be reimbursed from Health Care FSAs and HRAs was expanded to include:

  • Over-the-counter medicines and drugs, whether or not prescribed
  • Menstrual care products

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Coverage of COVID-19 diagnostic tests and related services

Ohio State’s Faculty and Staff Health Plan

Effective February 4, 2020, through the duration of the public health emergency, as declared by the Secretary of Health and Human Services (HHS), the following items and services are covered at 100% without any cost-sharing, prior authorization or network restrictions:

  • In vitro diagnostic tests for the detection of SARSCoV-2 or the diagnosis of the virus that causes COVID-19, and the administration of such a test, that:
    • Is FDA-approved, cleared or authorized
    • The test developer has requested, or intends to request, emergency use authorization under the Food, Drug and Cosmetic Act
    • Is developed in and authorized by a state that has notified HHS of its intention to review tests intended to diagnose COVID19
    • HHS otherwise has approved in guidance
  • Serological tests for COVID-19 used to detect antibodies against the SARS-CoV-2 virus, and are intended for use in the diagnosis of the disease or condition of having current or past infection with SARS-CoV-2, the virus which causes COVID-19.
    • Items and services furnished during a visit to a provider’s office (including via telehealth), urgent care, an emergency room, drive up testing site or other (even nontraditional) provider visit that results in an order for or administration of an in vitro diagnostic test described above, but only to the extent the item or service relates to:
      1. the furnishing or administration of the diagnostic test or
      2. the evaluation of the individual to determine need for the diagnostic test.

Note: The test must still be medically appropriate under the circumstances.

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Expansion of telehealth services

Ohio State’s Faculty and Staff Health Plan

Effective March 18, 2020, until the announced end of the national emergency caused by COVID-19, the types of providers and methods in which telehealth services are delivered have been expanded and now include nontraditional platforms, such as Skype. Coverage under Ohio State’s medical plan for these services will be based on the office visit benefit for the provider’s specialty and according to their network participation under the applicable plan. For more details visit https://osuhealthplan.com/covid-19.

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Addition of teledentistry services

Ohio State’s Dental Plan

Effective March 24, 2020, Ohio State’s dental plan added teledentistry services for dental care evaluations or advice which is provided remotely using videoconference technology.

Teledentistry is covered based on the plan’s preventive services benefit.

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Coverage of prevention services and vaccines for Coronavirus

Ohio State’s Faculty and Staff Health Plan

Effective within 15 business days after the date on which a recommendation is made relating to qualifying coronavirus preventive services, these services will be covered at 100% with no out-of-pocket costs. Network restrictions will apply. These services include an item, service or immunization intended to prevent or mitigate the coronavirus disease and that is:

  • An evidence-based item or service that has in effect a rating of “A” or “B” in the current recommendations of the U.S. Preventive Services Task Force; or
  • An immunization that has in effect a recommendation from the Advisory Committee on Immunization Practices of the Centers for Disease Control and Prevention with respect to the individual involved.

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