Allowable Plan Changes

Effective immediately, we will honor all requests we receive to revise the Plan for the below items:

  • Coverage of physician-ordered COVID-19 testing with no deductible/copay/coinsurance required from the plan participant
  • No requirement for preauthorization for COVID-19 testing
  • No specific limitations on telemedicine visits
  • Enabling plan participants to obtain up to a 30-day supply of prescriptions in advance

Crum will allow its policyholders to make the above changes to their plans by either submitting a plan amendment or by submitting written documentation of changes approved by an executive officer of the policyholder.

Grace Periods

We understand the COVID-19 crisis creates challenges for all of us and we are committed to supporting you and your employees. Given the disruption, we are extending our standard policy grace period to 60 days, should you need it, on all coverages. There is no need to contact us, as this extension will be granted automatically and no policies will be cancelled for nonpayment of premium during this extended period.

For any state that requests a grace period that extends beyond 60 days, we will follow such guidelines.

We are continuing to monitor activity from our state regulators, and may further extend the grace period as required by applicable state departments of insurance.

NOTE: In the event, there is a policyholder nearing the end of the 60-day grace period, please do NOT cancel or non-renew until referring it to us for review and consideration.

Please also note that regardless of whether or not a plan is revised in-writing to meet the new federal standard, Crum & Forster A&H will not deny claims for losses stemming from compliance with the new requirements. However, premium will be required before claims may be paid.

Changes to the Definition of “Employee” or “Actively at Work”

If a plan participant was considered to be a “covered person” and actively at work the day prior to a COVID-19 related event that no longer allows them to meet the eligibility requirements of the plan, Crum & Forster A&H will allow the policyholder to consider such person to have this same status for a timeframe that aligns with the policyholder’s business practices provided the appropriate premium is received. Please notify us in writing as soon as possible if such an accommodation will be needed, and please submit a Plan amendment implementing these changes as soon as practically possible.

Will Accept If a Revised Contract is Received

For any changes other than those listed above, Crum & Forster A&H will consider such requests on a case-by-case basis, subject to the receipt of a Plan amendment.

IRS and DOL Regulations

Crum & Forster A&H (C&F) continues to monitor developments related to COVID-19 and the guidance provided by federal and state regulatory agencies. We have reviewed the recent ruling issued jointly by the US Department of Labor and the Department of the Treasury (IRS) on April 28, 2020. This ruling requires that the “outbreak period” (the period from March 1, 2020 through 60 days after the end of the National Emergency Period) be disregarded when applying certain deadlines relative to COBRA continuation coverage, special enrollment periods, claims for benefits, appeals of denied claims, and external reviews of benefit claim appeals (please see the regulations and notice for specific requirements).

This ruling is likely to impact the majority of our valued policyholders; therefore, we would like to provide the following guidance:

  • The stop loss policy shall follow the minimum requirements of the ruling that apply to a Plan that is subject to this ruling, and to Plans that may not be subject to the ruling but wish to follow the guidance provided by this ruling. C&F will be happy to review any plan document amendment submitted implementing this change; however, please note that we will not deny eligible claims for losses solely on the basis that the plan was not amended to reflect these new federal requirements.
  • Eligible claims will continue to be subject to the terms of the stop loss policy including the stated Policy Basis/Benefit Period.
  • In the event of a request for reimbursement resulting from the Extension of Timeframes rules, we may request additional details on eligibility documentation. This could include (but is not limited to) details on the relevant dates, the circumstances, and confirmation that required premiums have been paid and are current on behalf of the claimant and the plan.