This guidance is based on current recommendations and updates from Engage's benefit partners/carriers.
The first step is to re-hire the employee on the Engage portal as a Full Time employee. The employee will receive an email with a link to re-enroll in benefits. The employee will need to satisfy their waiting period before benefits will be effective.
A furlough is “a temporary layoff from work.” People who get furloughed usually get to return to their job after a furlough. In general, people are not paid during furloughs, but they do keep employment benefits such as health insurance.
A “reduction in hours” is a change in the employees’ working hours and pay for a specified period. This is sometimes used as an alternative to a layoff since it allows the company to save money and allows the worker to remain employed.
A “layoff “or “termination” is a permanent separation of employment.
Engage has created three codes for layoffs due to COVID-19.
Please note: COVID-19 is a considered a temporary situation. Any changes to the FT status will result in a loss of coverage. If you intend to restore your employee’s hours and wages after COVID-19, you should NOT change your employee to Part time or Variable. Maintain the Full-Time status for employees in temporary layoff, reduced hours or reduced pay.
If you have trouble finding the codes, please contact your Account Manager or Payroll Specialist. If you think your employee should be moved to part time, please contact your Benefits Specialist.
Benefits premiums – Employee benefits premiums will continue to be deducted from reduced hours or reduced pay employees. If you wish to pay the premiums on behalf of your employee, please contact your Payroll Specialist or Account Manager. We can arrange for you to be billed and track the arrears.You may structure a payment arrangement with the employee when they return to regular hours/wages.
In all instances, enter the status date of the change and/or the last day the employee was actively at work for purposes of disability, workers’ compensation, and unemployment claims.
Once an employee is terminated, COBRA will be offered to covered employees, their spouses, former spouses, and dependent children. Once COBRA is offered, the employee can determine which benefits they want to keep, and the employee would pay for the benefits they choose. COBRA applies only to medical, dental, vision and FSA benefits.
A reduction in hours due to COVID-19 will be coded as COVID19 Reduced Hours. If the intent is that these employees will have reduced hours and wages, then employers should continue paying employees and their benefits through payroll.
These employees should remain in a full time (FT) status. Do not change them to part time.
Note: The employee portion of premiums will be deducted from the reduced wages.
We can assist with this request. Please contact your Account Manager or Payroll Specialist.
Once an employee is terminated, COBRA will be offered to covered employees, their spouses, former spouses, and dependent children. Once COBRA is offered, the employee can determine which benefits they want to keep, and the employee would pay for the benefits they choose. COBRA applies only to medical, dental, vision and FSA benefits.
Yes. As an employer you can subsidize COBRA benefits. Please note there is a 2% COBRA fee is applied to the subsidy rate. Please contact your Benefits Specialist for more information.
Any reduction in salary may trigger the Employer Shared Responsibility penalty. As of 3/26/20, there has been no update to ACA penalties and there is a risk of incurring ACA penalties if an ALE client removes benefits or reduces contribution below the ACA required contributions based on their safe harbor. Engage will provide more guidance on this topic as it becomes available.
A leave of absence, furlough, layoff or reduction in hours is a qualifying event and employees may make changes to their existing benefits. Please contact your Benefits Specialist for more information based on your specific situation.
Yes. An employee may change their commuter deduction. If the employee has unused funds from 2020 but did not elect to add any new funds in 2021 that employee may still spend those funds on commuter expenses. Commuter funds are not forfeited as long as the client and employee are in an Active status. Any requested change would take effect the first of the month following the date of the request.
Yes, in a leave of absence or reduction of hours accommodation, an employee may change their healthcare FSA or Dependent Care FSA contribution. In addition, on December 27, 2020, the Consolidated Appropriations Act 2021 was signed into law. As a result, Engage has adopted the following changes for plan years 2021-2022:
Please contact the Engage at servicecenterteam@engagepeo.com or call 888-780-8807 to coordinate a change. There are some limitations based upon amounts funded and claims processed year to date. The change would take effect the first of the month following the date of the request.
Yes. The change to the HSA would take effect the first of the month following the date of the request.
Aetna members may receive an early refill on 30-day prescription maintenance medications at any network pharmacy with pharmacy benefits administered through CVS Caremark. The free 1-2 day home delivery liberalization has been extended through 2021.
COVID-19 vaccinations will be available at pharmacies as well as doctors’ offices at other clinical sites of care. The initial list of pharmacies participating with the federal government in the administration of the vaccine can be found at HHS.gov.
Our State Resource lookup tool provides links to each state’s health department and vaccine resource page, so you can get the latest information about when and where vaccines will be available in your area.
No. Aetna members will not have to pay any out-of-pocket costs for a COVID-19 vaccine.
For disability or absence claims submitted for disabling flu-like symptoms reportedly due to, or potentially due to, COVID-19, MetLife will conditionally approve 14 calendar days of disability, pending supporting medical evidence, except where prohibited by law. Engage will apply any contractual eligibility provisions. MetLife will re-evaluate their position on 4/30/21.
Each claim received will be reviewed consistent with policy terms and applicable insurance law.
Life Insurance: For Group Life Insurance (Basic, Optional, Dependent, GUL and GVUL), there are no policy limitations that would limit a claim payment resulting from COVID-19, provided the individual met all other certificate requirements.
Accidental Death and Dismemberment (AD&D): AD&D policies do not cover diseases. Therefore, death due to COVID-19 is excluded, as are all deaths caused by disease.
Disability Insurance: There are no policy limitations that would apply for COVID-19. MetLife will evaluate each claim in accordance with the terms of the policy and use claim processes already in place for disability claims.
The disability furlough/layoff exception from 2020 has expired and MetLife will now follow the standard process when considering a claim.
Claimants would not satisfy the definition of disability in the applicable plan solely due to being quarantined. If the claimant develops COVID-19 or some other qualifying sickness while quarantined, the claim would be reviewed per the requirements of the plan.
Claimants are unlikely to satisfy the definition of disability in the applicable plan solely due to being quarantined. If the claimant develops COVID-19 or even some other qualifying sickness while quarantined, and it meets the definition of disability within the policy, benefits would be reviewed for payment.
Employees who are ordered by their employer to stay home are unlikely to be eligible for either disability benefits, unless they also have some qualifying medical condition, even if not COVID-19.
If an employer terminates an employee (even temporarily) and the employee is reinstated they will be treated as a new hire and Evidence of Insurability will not be needed.
The following are the timeframes as stated in the MetLife policy guidelines for how long an employee can stay active with coverage at the employer's option with premium payment to MetLife:
Under the CARES act, a high-deductible health plan (HDHP) with a health savings account (HSA) to temporarily cover "telehealth and other remote care services" prior to a patient reaching the deductible, without regard to whether the telehealth services relate to COVID-19. This provision is effective immediately and will last until December 31, 2021.
OTC changes are effective for expenses incurred after December 31, 2019. These provisions don’t have an expiration date.
Given the economic impact of COVID-19, PayFlex and Engage made members aware of a Health Savings Account (HSA) interest rate update that became effective April 1, of 2020: the HSA interest rate changed to 0.05% across all tiers. New calculated interest rate appeared as of the May 2020 statement. No further changes are anticipated at this time.
Below are the current rates for each tier:
|
HSA Balance |
Current Interest Rate |
New Interest Rate (4/1/2020) |
|
$0.01- $2,000.00 |
0.05% |
0.05% |
|
$2,000.01-$7,500.00 |
0.10% |
0.05% |
|
$7,500.01-$10,000.00 |
0.20% |
0.05% |
|
Over $10,000.00 |
0.40% |
0.05% |
Why is the interest rate changing?
The current economic situation has caused banks and non-bank custodians to take unique action. We’re hopeful this change is temporary, and the interest rates will increase again soon.
Does this change affect HSA investment accounts?
No. Whether you have investments now or plan to open an investment account in the future, this change doesn’t affect HSA investment accounts.
For payment of benefits under a Hospital Indemnity plan, Allstate Benefits requires a room and board charge. Here is more information about specific benefits under our Hospital Indemnity plans:
· Initial Hospitalization Benefit (GIM1/2) - Benefit will be paid on the first confinement to a hospital during a calendar year, provided a benefit is paid under the Daily Hospital Confinement Benefit in the policy. This benefit is payable only once per covered person, per calendar year.
· Daily Hospital Confinement Benefit (GIM1/2) - Daily hospital benefit will be paid for each day a covered person is admitted to and confined as an inpatient in a hospital as a result of sickness or injury.
· Hospital Intensive Care Unit Confinement Benefit (GIM1/2) - Benefit will be paid for each day a covered person is confined to a hospital intensive care unit, provided a benefit is also paid under the Daily Hospital Confinement Benefit. A day is a 24-hour period. This benefit is paid in addition to the Daily Hospital Confinement Benefit.
Yes, employees will have access to benefits during the extended grace period.
If an individual wants to restart coverage after cancelling it because they have returned to work and is being treated as a new hire, they could restart their voluntary benefits.
Allstate Benefits standard portability protocol will be followed. Terminations from payroll billing will trigger portability for all applicable products.
Allstate Benefits sends a letter to employees when portability is automatically triggered or requested. Employees are required to complete and return a form to indicate their desire to continue coverage.
Allstate Benefits customer service and claims departments are fully functional and can be reached at the following phone numbers:
Customer Care Center: 1-800-521-3535 1-800-211-5533 *Se Habla Español Monday-Friday; 8 a.m. to 8 p.m. ET
Please visit https://www.allstatevoluntary.com/covid19/benefits.php for a listing of all available plan benefits that may be covered related to COVID-19.
Group Voluntary Critical Illness plan (GVCI )
While “Infectious disease” is not a covered critical illness, the Allstate Benefits Critical Illness Wellness Benefit/Rider covers a specified list of medical tests. If any of these tests are performed, the benefit will be paid, regardless of why the test may have been ordered. For example, if an insured has a chest x-ray, the Wellness benefit/rider will pay a specified amount regardless if the doctor ordered the chest x-ray over a concern of COVID-19 or bronchitis. The benefit is payable once per covered person, per calendar year.
Group Voluntary Accident plan (GVA 1/2/6)
A visit to a physician outside of a hospital facility could qualify for benefit under the Outpatient Physicians Treatment (OPT) Benefit/Rider. Unlike the Critical Illness wellness benefit which requires a specific medical test, receiving outpatient treatment by a physician, would be payable under the Accident plan.
The following riders may cover circumstances related to COVID-19:
On/Off Job Accident and Sickness Disability Rider (GVA1 only) - Benefit will be paid after the elimination period when an insured employee is totally disabled due to sickness.
On/Off Job Accident and Sickness Disability Rider for Insured Spouse (GVA1 only) - Benefit will be paid if insured spouse is totally disabled, due to an injury or sickness, and unable to perform the substantial and material duties of his or her own occupation due to an accident or sickness.
Outpatient Physician’s Treatment Benefit (GVA1 only) - Benefit will be paid for treatment by a physician outside a hospital for any cause. This benefit is payable for 2 visits per covered person, per calendar year; and a maximum of 4 visits per calendar year if there is family coverage in force.
Outpatient Physician’s Treatment Rider (GVA 2/6) - Benefit will be paid for treatment by a physician outside a hospital for preventative care. The benefit is payable only once per day per covered person; and is limited to: 2 days per covered person per calendar year; and maximum of 4 days per calendar year if the policy if there is family coverage in force.
Continuation of Coverage During a Strike or Layoff Rider (GVA2) - If the insured is laid off from his/her job, the Accident coverage will continue. Layoff means the dismissal of an employee from his or her job by an employer because of business reasons, such as the decision that certain positions are no longer necessary or tightened budgetary constraints or work shortage (not due to poor performance or misconduct).
Return of Premium Benefit Rider (GVA2) - – If the insured is laid off during the first six months of in-force coverage, the total premiums paid for the certificate and all riders attached to the certificate will be returned to the insured, provided that no claims have been incurred. Layoff means the dismissal of an employee from his or her job by an employer because of business reasons, such as the decision that certain positions are no longer necessary or tightened budgetary constraints or work shortage (not due to poor performance or misconduct).
Group Voluntary Hospital Indemnity (GIM1/2)
The Hospital Indemnity plan has benefits that may be payable for treatment or hospitalization related to COVID-19.
The following riders may cover circumstances related to COVID-19:
Initial Hospitalization Benefit (GIM1/2) - Benefit will be paid on the first confinement to a hospital during a calendar year, provided a benefit is paid under the Daily Hospital Confinement Benefit in the policy. This benefit is payable only once per covered person, per calendar year.
Daily Hospital Confinement Benefit (GIM1/2) - Daily hospital benefit will be paid for each day a covered person is admitted to and confined as an inpatient in a hospital as a result of sickness or injury.
Hospital Intensive Care Unit Confinement Benefit (GIM1/2) - Benefit will be paid for each day a covered person is confined to a hospital intensive care unit, provided a benefit is also paid under the Daily Hospital Confinement Benefit. A day is a 24-hour period. This benefit is paid in addition to the Daily Hospital Confinement Benefit.
At Home Nursing Benefit (GIM1) - Benefit will be paid for each day a covered person requires at home nursing care following a hospital confinement covered under the policy. At home nursing services must be required and authorized by the attending physician.
Inpatient Physician’s Treatment Benefit (GIM1) - Benefit will be paid for each day a covered person requires the services of a physician (other than a surgeon) during a covered hospital confinement. This benefit is payable for the number of days the Hospital Confinement benefit is payable.
Outpatient Physician’s Treatment Benefit (GIM1) - Benefit will be paid for each day a covered person is treated by a physician outside the hospital for any reason. The benefit is payable only once per day per covered person; and is limited to 5 days per covered person per coverage year; and a maximum of 10 days per coverage year if Individual and Spouse or Individual and Children coverage; or a maximum of 15 days per coverage year if Family coverage is in force.
Ambulance Benefit (GIM1) - Benefit will be paid each day a covered person is transferred by a licensed ambulance service or hospital owned ambulance to a hospital or emergency treatment center. For air ambulance transport, the benefit amount is twice the amount shown on the Schedule of Benefits
Outpatient Diagnostic X-ray and Laboratory Benefit (GIM1) - Benefit will be paid when laboratory tests are performed for the purpose of diagnosis of an injury or sickness indicated by symptoms that would suggest an injury or sickness has occurred, while the covered person is not hospital confined. This benefit is limited to 1 day per covered person; limited to 3 days per coverage year, per covered person; and not payable if a benefit is payable under the Wellness and Preventive Test Benefit.
Wellness and Preventive Test Benefit (GIM1) - Benefit will be paid when a covered person has a routine physical examination or preventive test performed while not hospital confined. Eligible examinations and tests include a physical examination performed by a physician. This benefit is limited to 1 day per covered person per coverage year; and not payable if a benefit is payable under the Outpatient Diagnostic X-ray and Laboratory Benefit.
Sickness Disability Rider (GIM1) - Benefit will be paid after elimination period when insured employee is totally disabled due to sickness.
Group Voluntary Cancer (GVC3 only)
While “Infectious disease” is not a covered illness, the Cancer plan will provide a benefit for certain hospital stays and a wellness test.
The following riders may cover circumstances related to COVID-19:
Hospital Intensive Care Unit Confinement Benefit - Benefit will be paid for each day of continuous hospital intensive care unit confinement for any illness.
Step-Down Hospital Intensive Care Unit Confinement Benefit - Benefit will be paid for each day of step-down hospital intensive care unit confinement for any illness.
Wellness Benefit - Benefit will be paid for a specified list of tests, regardless of why the test may have been ordered. The benefit is limited to the amount specified in the policy per calendar year, per covered person
If you are enrolled in one or both of these plans, your coverage is active. Legal Shield and ID Shield are available to assist with the following needs: