Plan Documents & Eligibility

Vista will not require a plan amendment regarding COVID-19 testing or treatment expenses covered by the stop-loss policy.

Vista does kindly ask for written clarifications of the intended plan changes. If the stop-loss policy is amended to cover the diagnostic testing for COVID-19, Companion Life could adjust rates and/or factors, but have elected not to adjust the rates or factors for this benefit change.

Layoffs & Furloughs

Vista will follow the Policyholder's determination to keep otherwise actively-atwork participants on active status.

Plan participants considered actively-at-work the day prior to closure of the business will be considered actively-at-work.

Vista will honor employers offering continued eligibility to a plan participant who is quarantined and not actively at work.

Plan participants must return to work immediately following a quarantine period in order to continue active at work status.

In the event they do not return to work, Vista would expect the Plan to follow all normal Plan language related to continuation of coverage.

Actively at Work & No Scheduled Shifts

Please see "Layoffs & Furloughs" section above.

Employees who were actively at work on the day prior to closure due to the COVID-19 outbreak will be eligible through June 30, 2020, at which time Vista will determine whether to extend the date. Please let Vista know as soon as possible if such an extension may be needed.

Policy Administration & Wet Signatures

During this time, "wet" signatures on policy forms, applications etc. can be substituted with confirmation emails until companies return to work.

Claim Reimbursements & Timely Filing

Given the circumstances of the COVID-19 pandemic, Vista will do everything possible to offer extensions on filing limits when appropriate.

Vista will need to receive prior authorization from the Stop Loss carrier in order to offer an extension and ask that the group send formal communication
detailing the circumstances and reason for the request so they can work with their carriers as quickly as possible to grant approval.

At this time, Vista is strongly encouraging all policyholders to remit premium and claim reimbursements via ACH.

The entire claims department is fully operational and working remotely from the safety of their own homes, but anticipate zero disruption to any claims reimbursements or adjudication due to current circumstances.

Federal & State Mandates

Vista is monitoring all state mandates, and will adhere accordingly even if a release is not automatically distributed

Early Rx Refills

Upon request from the employer, Vista will allow for a 30 day supply of maintenance medications to assure an adequate supply in the event of potential quarantine situation, as long as they have been recommended or prescribed by a Physician.

Telemedicine & Virtual Visits

Telemedicine will be covered with no deductible, coinsurance or co-payment.

Cost Share

COVID-19 testing will be covered with no deductible, coinsurance or copayment effective immediately.

Vista is committed to reviewing each plan amendment submitted on behalf of clients, at which time Vista will determine whether to accept the proposed provisions.

Please remember that coverage must be offered on a uniform, nondiscriminatory basis to all current enrolled employees.

Rate or Coverage Changes

Vista has agreed not to re-rate when participation varies by more than 10% from March 1, 2020 through June 30, 2020, at which time they will determine whether to extend the date.

Special Enrollment Periods

In regards to allowing a special period in which enrolled individuals were given the opportunity to change plans mid-year, Vista is not approving requests to hold said special enrollment period at this time.

If legislation is passed requiring self-funded plans to offer a special open enrollment period, Vista will provide further direction at that time.

Grace Period Extensions

Companion Life/ Vista will work with clients to provide premium payment flexibility in accordance with the terms of our policy and applicable state insurance department guidance.

In the event premium payment flexibility is needed, Vista asks that the client notifies them as soon as possible to discuss payment options that may be available. All requests must be received by June 30, 2020.

Aggregate Accommodation

Vista will consider adding Monthly Aggregate Accommodation, but it will be on a case-by-case basis and it would only be on a go-forward basis.

COBRA Extension Guidelines

Our position is that we are complying with all federal rules including the new COBRA language.  We just ask that any plan amendments (if updated) are submitted for our files.