常见问题

针对COVID-19业务中断的健康计划问题

Governor Mike DeWine recently announced policies suspending or modifying business operations to help stem the spread of COVID-19 (coronavirus). Below we will address a number of frequently asked questions (FAQs) to help you better understand health plan options regarding the continued health insurance coverage for your employees.

This portion of our FAQ was provided courtesy of Medical Mutual and answers will reflect answers specific to Medical Mutual plans.

我的计划全保了. 如果我为了应对COVID-19危机而解雇部分员工, 公司能继续为这些员工提供保险吗?

Yes. 到5月31日, 2020, Medical Mutual is relaxing its requirements that employees be actively working to be eligible for coverage and will allow you to cover laid-off employees, 只要你每月付保险费. Please note that you must offer this coverage on a uniform, 非歧视性的基础. In other words, you may not choose only certain people for whom you continue to pay the premium.

我的计划全保了. 如果我不得不解雇所有员工来应对COVID-19危机, 公司能继续为这些员工提供保险吗?

如果一个人仍然受雇于该公司并受该计划的保护，则e.g. 所有者或管理人员, 只要支付保险费，公司就可以继续为下岗员工提供保险. 请注意，您必须在一视同仁的基础上提供这种保险. In other words, you may not choose only certain people for whom you continue to pay the premium.

如果我今天裁掉一大批员工, 保险范围能延长到月底吗?

如果3月份的保费已经汇出, 覆盖范围将持续到3月底.

If my group's enrollment drops by more than 10 percent as a result of the COVID-19 situation, 我的费率/保费会否有变动?

到5月31日, 2020, 如果入学人数减少是由于COVID-10情况造成的, 费率和保费不会调整.

如果我的计划已全额投保，那续保怎么办?

如果你的团体受到COBRA的约束, 只要有一个人继续积极工作, employees may elect to continue coverage under COBRA under normal notice and election procedure. If the plan has no active employees, the plan is terminated and COBRA is not an option. 在这种情况下, employees would have a special enrollment period to enroll in individual coverage or could purchase a short-term plan that is subject to medical underwriting.

如果你的团体不受COBRA的约束(例如, 员工不足20人), 只要有一个人继续积极工作, employees may elect to continue coverage under Ohio's state continuation statute for up to twelve months. Small employers should notify laid-off employees of this right at the time they are laid off. If te plan has no active employees, the plan is terminated and continuation is not an option. 在这种情况下, employees would have a special enrollment period to enroll in individual coverage or could purchase a short-term plan that is subject to medical underwriting.

我的计划是自我保险. 如果我为了应对COVID-19危机而解雇部分员工, 公司能继续为这些员工提供保险吗?

Yes. 如果医疗互助是您的止损承保人, 只要你继续支付行政费用和索赔费用, 还有你的止损保费, you may continue to cover laid-off employees even though they are not actively at work. Please note that you must administer the plan on a uniform, 非歧视性的基础. In other words, you may not choose only certain people for whom you continue to pay claims. 如果医疗互助不是您的止损承保人, you should check with your stop loss carrier about covering laid-off employees who are not actively at work.

我的计划是自我保险. 如果我不得不解雇所有员工来应对COVID-19危机, 公司能继续为这些员工提供保险吗?

是的，只要有一个人继续积极受雇于集团. 如果医疗互助是您的止损承保人 and you continue to pay administrative fees and claims costs 还有你的止损保费, you may continue to cover laid-off employees even though they are not actively at work Please note that you must administer the plan on a uniform, 非歧视性的基础. In other words, you may not choose only certain people for whom you continue to pay claims. 如果医疗互助不是您的止损承保人, you should check with your stop loss carrier about covering laid-off employees who are not actively at work

如果我的计划是自我保险，那继续保险呢?

如果你的团体受到COBRA的约束, 只要有一个人继续积极工作, employees may elect to continue coverage under COBRA under the normal notice and election procedure. 如果医疗互助不是您的止损承保人, you should be sure to check with your stop loss carrier about any rules it may have regarding minimum enrollment of active employees for stop loss coverage.

If the plan has no active employees, the plan is terminated and COBRA is not an option. 在这种情况下, employees would have a special enrollment period to enroll in individual coverage or could purchase a short-term plan that is subject to medical underwriting.

如果我必须在一个月中终止我的员工的保险, 我是否会收到本月剩余时间的保费退款?

While your contract states that Medical Mutual will not refund a partial month's premium, 考虑到目前形势的严重性, we will refund the proportional amount of premium should you terminate your coverage before the end of the month.

我的计划是自我保险，有100多名员工. If I have to lay off a significant portion of my workforce in response to the COVID-19 crisis, 我是否需要更改为全保安排?

不，只要裁员是暂时的，以应对COVID-19危机.

是否会因新冠肺炎疫情而推迟费率更新行动?

No. 医疗互助已全面运作，因此将及时发布更新. 然而，付款计划正在提供，以协助客户在需要的基础上.

In light of the COVID-19 crisis, can I get a grace period extension on paying my premium?

Yes. Medical Mutual is offering to extend the grace period for your next monthly premium payment by 30 days. With this extension, delinquency notices will be suspended and your coverage will not be interrupted. 延长你的付款宽限期, please call 1-800-384-2184 to speak with a payment specialist who can process your request and answer any questions you may have.

Is Medical Mutual able to offer help to employees who are losing their health insurance coverage after being laid oft?

Medical Mutual can offer individual short-term and ACA-compliant health insurance plans to those who have been laid off. Interested individuals should contact 1-844-606-5393 to speak with an advisor who can assist. 他们也可以访问Med Mutual.网站直接申请.

对于那些参加aca合规计划的人来说，保险要多久才能生效?

在联邦交易所(市场)出售的计划, 政府规定，医保覆盖从下个月1日起生效. 对于外汇外政策, Medical Mutual will waive the normal special enrollment period procedures and allow applicants to obtain coverage, 自失业之日起生效. Please note that premium subsidies may be available for plans purchased on the federal marketplace. 非交换计划不提供保费补贴.

那些参加短期保险计划的人要多久才能获得有效的保险?

Short-term plans can be effective the day after application submission provided the applicant passes underwriting.

If the member has met or paid a portion of their deductible under their group coverage, will Medical Mutual apply a credit to their new individual plan deductible based on what they have already spent during the year?

Yes, but only if the member's previous coverage was under a Medical Mutual group plan. 如果会员有其他保险公司的保险, 他们仍然可以参加医疗互助个人计划, 但他们的新计划将以0美元的免赔额开始.

Will employees who are laid off temporarily as a result of COVID-19 concerns be permitted to rejoin the plan without a waiting period when they return to work?

Yes. There will be no waiting period for current employees who are rehired by May 31, 2020. 新员工需要等待一段时间.