Plan Documents & Eligibility

HIIG confirms the following provision will be allowed under the Stop Loss Policy, if covered by the underlying Plan, and subject to conditions stated following: Plans that elect to furlough, or suspend, employees during the COVID-19 coverage, and extend coverage under the Plan during the furlough period, will have their employees recognized as active under the stop loss policy.

  • The extension of coverage would apply under the policy as long as the furloughed employee was covered by the Plan on the date the furlough began.
  • Minimum hour requirements stated in the Plan will be waived. Stop loss premiums must continue to be paid during the furlough period for all affected employees.
  • Notification must be given to HIIG. This notification may be in the form of an email or copy of the notice provided to the furloughed employees offering the coverage extension. A formal plan document amendment will not be required during the COVID-19 exception period* stated below.

For employees who are laid off or otherwise terminated by the employer, the stop loss policy would follow standard Plan provisions, with continuation allowed by COBRA or state mandated extensions.

Layoffs & Furloughs

Please see above "Plan Documents & Eligibility" section.

COBRA EEs & Return to Work

For employees who are laid off or otherwise terminated by the employer, the stop loss policy would follow standard Plan provisions, with continuation allowed by COBRA or state mandated extensions.

Actively at Work & No Scheduled Shifts

Please see above "Plan Documents & Eligibility" section.

Early Rx Refills

HIIG confirms coverage of certain plan provisions allowed under the Stop Loss policy in response to the COVID-19 virus, including early refill of prescriptions, waiving any timing restrictions, on a one-time basis per medication.

Telemedicine & Virtual Visits

HIIG confirms coverage of certain plan provisions allowed under the Stop Loss policy in response to the COVID-19 virus, including unlimited telemedicine for services related to COVID-19.

Cost Share

HIIG confirms coverage of certain plan provisions allowed under the Stop Loss policy in response to the COVID-19 virus, including COVID-19 testing, paid up to 100% without application of copays or deductibles.

Grace Period Extensions

The grace period for payment of stop loss premiums will be extended for an additional 30 days beyond what is outlined in the policy. State and federal mandates will be followed which may further extend the grace period. Please note that claims will not be reimbursed during these grace periods until premiums are paid and up to date.

* HIIG has established a COVID-19 exception period from 31/2020 through 8/31/2020 for which the above policy considerations will be allowed. State and federal mandates could supersede this time frame where applicable. This exception period may be extended if circumstances warrant.