At Liberty Mutual, we strive to make life easier for our partners in these challenging times. As such, we are taking the following actions in response to COVID-19:
- Extend the waiving of member cost sharing related to COVID-19 testing to also include treatment
- Allow extensions beyond 90 days for extensions due to COVID-19 related temporary closures.
We will honor the following expenses as eligible under the Employer Stop Loss policy with no prior notification. We will require that notice of the change in benefits be provided within 30 days of the change.
- Waiver of deductibles, copays and cost-sharing for COVID-19 testing and treatment
- Waiver of cost-sharing on telemedicine and virtual visits
- Early refills of medication to ensure covered members have a 30-day supply
We will honor the following suspended deadlines of the EBSA Disaster Relief Notice 2020-01 under the Employer Stop Loss Policy with no prior notification:
- COBRA Employer Notice
- COBRA Election Notice
- COBRA Employee Notice of Qualifying Event for Disability Determination
- COBRA Election Notice
- COBRA Initial Premium Deadline
- COBRA Premium Grace Period
- HIPAA Special Enrollment
- Internal Claims and Appeals Deadlines
- External Review Deadlines
Liberty Mutual also understands that some policyholders may be faced with temporary closures due to COVID-19 that result in employees being temporarily placed on non-medical leave.
If the employer chooses to recognize these employees as eligible for benefits during a temporary closure, Liberty Mutual will honor that status subject to the following:
- Employees on non-medical leave should be included in the reported enrollment and proper premiums paid for all covered members
- Reimbursement requests should indicate whether the covered member was included under a non-medical leave extension
- The employer continues to pay their portion of the health insurance contributions
- Any extension due to temporary closure will terminate coverage
For information on Early Rx Refills, Telemedicine, and Cost Share, please see "Plan Documents & Eligibility" section above.
At this time, Liberty & Ironshore (TRU) has not made any formal adjustments to the Right to Recalculate portion of their language. This may be considered on a
case by case basis, should the need arise.
TRU (Liberty Mutual) will not issue any notices of cancellation for non-payment reasons during any approved payment extensions and all existing accountspayable- related notices of cancellation will be rescinded. However, please note that underwriting-related notices of cancellation may still be issued during this period, if permitted under the controlling state regulation.
Typically, state mandates do not apply to self-funded plans. Liberty & Ironshore will review any further mandates that a self-funded plan may choose to adopt as they arise.
TRU (Liberty Mutual) is offering an extension on premium payments for anyone who requests one, and will consider non-standard extensions on an individual basis.
TRU is willing to allow extensions beyond 90 days for extensions due to COVID-19 related temporary closures.
Please connect with your SLIS representative to get more information on Premium Payment Leniency.
Liberty Mutual (TRU) will review each request for mid-term exposure changes on a case-by-case basis.
For policies that were issued non-renewal notices, TRU (Liberty Mutual) will evaluate each account request on an individual basis.
In this ever-changing environment, TRU's premium auditors are being extremely flexible. There is no need to complete premium audits immediately.
However, we want to ensure customers are only paying premiums on the coverage they need. Premium auditors can work with clients to schedule a time in the future that will work best to conduct audits in-person or virtually.
Requests for a special enrollment period must be addressed on a case by case basis.
In general, an illness that arises from COVID-19 will need to meet both elements below to be compensable and result in WC benefit eligibility:
- Illness must arise out of the course and scope of employment.
- Illness must arise out of or be caused by conditions particular to the work and not an ordinary disease of life to which the general public is exposed.
In the case of COVID-19, it is critical to understand the unique job that an employee was performing if/when exposed. Many states have statutory language surrounding specific types of employment.
For example, healthcare professionals, first responders (EMT), hospital workers, and lab technicians often have a lower threshold for connecting the cause/source to the course and scope of their work.
For additional information regarding Workers Compensation plans, please contact your SLIS representative for further detail.