2024 Pay or Play Affordability Percentage

Additional Guidance Provided for COVID-19-related Changes to Health Plans

Due to the urgent need to help facilitate the nation’s response to the current public health emergency posed by COVID-19, the Departments of Labor, Health and Human Services and the Treasury have provided answers to a second set of frequently asked questions (FAQs Part 43).

This FAQ document provides guidance regarding implementation of the Families First Coronavirus Response Act (FFCRA) and the Coronavirus Aid, Relief and Economic Security (CARES) Act, as well as topics related to health plan coverage.

For example, the FAQs:

  • Provide that COVID-19 testing for surveillance or employment purposes is not subject to the coverage mandate under the FFCRA and CARES Act;
  • Confirm that the FFCRA and the CARES Act generally prohibit balance billing for COVID-19 diagnostic testing;
  • Allow health plans to revoke the temporary COVID-19-related coverage changes without satisfying certain notice deadlines — provided participants are notified within a reasonable time frame in advance of the reversal of the changes; and
  • Allow large employers to offer coverage for telehealth and other remote care services to employees who are not eligible for any other group health plan offered by the employer during the public health emergency.

The Departments’ FAQs have been published to assist employers with implementing such health plan changes. To review all current COVID-19-related FAQs, click here.

For questions regarding this information, contact the Creative Benefits Team at 866-306-0200 or solutions@creativebenefitsinc.com.