COVID-19 Coverage for ASO Groups Regarding FFCRA and Telehealth Expansion

27 de marzo de 2020

As an ASO customer, you have some choices about how we administer COVID-19-related coverage for your employees.

The Families First Coronavirus Response Act (FFCRA), which was enacted on March 18, 2020, requires self-funded businesses to provide coverage (FFCRA coverage) for COVID-19 testing and related services as outlined in Table A. (The federal mandate will remain in effect until the public health emergency is declared over by the federal government.)

To maximize the effectiveness of this coverage and serve as many members as possible, the benefit coverages outlined here will apply for all dates of service on or after March 18, 2020, and until the public health emergency is declared over.

In addition to the FFCRA coverage being added, expanded coverage of telehealth services provided through an already contracted vendor or physician will also be available, at no cost share to members, through April 30, 2020. This Telehealth Expansion benefit is described in Table B. Between now and April 30, we will consider whether to extend the timeframe of this temporary cost-sharing change.

Action Needed: ASO Group Choices
You will need to notify your producer or Blue Cross and Blue Shield of Texas (BCBSTX) account executive by April 1, 2020, if you only want to offer the FFCRA coverage. Otherwise, we will set up your group consistent with the standard coverage of FFCRA coverage + Telehealth Expansion. This benefit coverage will be in place for dates of service on or after March 18.

Important Notice to Our ASO Group Customers: BCBSTX is working to assist and support our ASO group plan sponsors and members during this COVID-19 public health emergency. As part of this assistance and support, we are adding benefits and services that you are required by law to provide under your health plan and are making benefits and services available that you are encouraged by the federal government to provide, as part of an effort to combat and reduce the spread of COVID-19. This communication is our notice to you of our approach to processing benefit claims for your members under our agreement with you. Unless you contact your BCBSTX account executive to instruct us to not add the Telehealth Expansion, or FFCRA coverage described here, we will consider you to have authorized BCBSTX to add such coverage to your health plan. Nothing in this communication modifies or relieves ASO group plan sponsors of their obligations under the law, nor does it impact or change BCBSTX’s role as claims administrator.

Additional Coverage Notes:

• HDHP plans may participate in FFCRA coverage or FFCRA + Telehealth Expansion.
• Participation in FFCRA coverage or FFCRA + Telehealth Expansion does not impact a plan’s “grandfathered” or “grandmothered” status.
• A telehealth visit that results in the order for or the administration of a COVID-19 test must be covered at no cost share to the member as part of FFCRA. Further expansion of telehealth coverage and/or cost share is not required beyond the former statement as part of FFCRA.