Plan Provisions

Should the Employer choose to amend their plan for the changes listed below, under the Excess Loss Policies without a rate increase.  A rate increase could apply to other changes requested by the Plan. The Plan amendments can be back dated to 3/1/2020 for a maximum of 90 days, if the Employer (or TPA on its behalf) notifies the Company in writing that the Plan amendment is in process of changing.  The below changes could be changed by Federal and State Mandates.  The Plan amendment must be received by the Company no later than May 31, 2020.

  • COVID-19 testing as prescribed by a medical professional will be allowed with no cost to the covered individual under the Excess Loss Policy.
  • Telemedicine visits related to COVID-19 symptoms with no cost to the covered individual under the Excess Loss Policy.
  • Removal of Prescription refill limitations on maintenance medications to assure up to a maximum 90-day supply is available.
  • An approved leave of absence will be allowed for Plan participants to remain on the health plan for up to 90 days due to the national pandemic for COVID-19 as long as Excess Loss Policy premiums are paid for the Plan participant; however, should the employee not return to work at the end of 90 days standard cobra and/or continuation notices of right to continue coverage will need to be sent by the Plan sponsor and according to their regulatory and legal obligations as an employer.  Approved leave of absence must be offered to all Plan participants.
  • Excess Loss Policy Premiums - grace period extended up to 60 days from the due date for the Excess Loss Policy.