Plan Documents & Eligibility

Union Labor Life understands that Plans may revise normal eligibility rules as a result of the Coronavirus pandemic. In order for our Company to accept such changes to the Plan’s eligibility rules, we will need to receive a formal Plan amendment which describes the changes to the eligibility rules, including the effective date and applicable time period covered by the changes.

If a formal Plan amendment cannot be provided, then we will need a written description of the changes to the eligibility rules from an authorized representative of the policyholder.

Once the Plan amendment or written description is received by our Company, then we will review to determine if the proposed changes to the eligibility rules can be accepted under our policy.

Once our determination is made, then we will provide a written response to the policyholder and document our files.

Claim Filing Time Limits

Union Labor Life will extend the time to submit claims for benefit payments to an additional 60 days from the date they would otherwise be due.

Early Rx Refills

Policyholders who decide to allow waiving of preauthorization for prescriptions and covered participants to receive early prescription refills to ensure they have a 30-day supply will be allowed to apply these costs as eligible expenses under their Stop Loss policy without prior notification.

Telemedical & Virtual Visits

Policyholders who decide to waive cost-sharing for telemedicine and virtual healthcare visits for covered participants will be allowed to apply these costs as eligible expenses under their Stop Loss policy without prior notification.

Cost Share

Policyholders who decide to waive preauthorization for medical necessity, the cost of deductibles, copays, and cost-sharing for COVID-19 testing, treatment and vaccinations for covered participants will be allowed to apply these costs as eligible expenses under their Stop Loss Policy without prior notification.

We do ask during these times, that any plan notify us of any claimant that has been found positive of the virus.

Grace Periods and Claim Submission Extensions

Effective immediately, Union Labor Life will extend the grace period for payment of premiums. In addition, we are extending the time to submit claims for benefit payments. Respectful due dates and categories are noted below.

Please contact your SLIS representative with any questions about the extended grace periods and extension for submission of claims.