Page last updated on 11/17/2020
Continue to check this page for updates. We will be providing new information as it becomes available.
During this unprecedented time, as the coronavirus disease known as COVID-19 is causing disruptions in everyday life, Medical Mutual recognizes the toll this could take on your business. As your trusted partner for health, life, dental and vision coverage, we want to support you and your employees. Below is information regarding Medical Mutual’s response during this pandemic.
Extended Grace Period for Premium Payments
All fully insured group plans, individual plans, Medicare plans, stop loss customers, MEWAs and non-federal governmental health plans, have the option of deferring premium payments, interest free, for up to 60 calendar days from the original premium due date. There are no additional extensions beyond the 60 days. If your group elects to defer payments and you are set up to have premiums paid via ACH, you must contact Medical Mutual at 1-800-384-2184 no later than October 28 for the November 1 ACH draw.
Relaxing Actively-at-Work Requirements
Through December 31, 2020, or the end of the state of emergency in Ohio declared by Governor DeWine on March 9, 2020, whichever is later, for all fully insured product lines, Medical Mutual is relaxing its requirement that employees must be actively working to be eligible for coverage and will allow you to cover laid-off employees, as long as you pay the monthly premium. Please note that you must offer this coverage on a uniform, non-discriminatory basis. In other words, you may not choose only certain people for whom you continue to pay premium.
For self-insured plans, if Medical Mutual is the group’s stop loss carrier, as long as the group continues to pay administrative fees and claims costs, along with stop loss premium, it may continue to cover an employee even though the employee is not actively at work. Please note that the group must administer the plan on a uniform, non-discriminatory basis. In other words, the group may not choose only certain people for whom it will continue to pay claims.
If Medical Mutual is not your stop loss carrier, you should check with your stop loss carrier about covering laid-off employees who are not actively at work.
Contact your Medical Mutual representative for any other plan types and with any questions.
Testing and Treatment for COVID-19
For testing, per the Families First Coronavirus Response Act signed into law by President Trump on March 18, 2020, all testing for COVID-19 and services associated with the testing must be covered with no member cost sharing. Self-funded groups cannot opt out of covering COVID-19 testing with no cost sharing.
For our fully insured plans, Medical Mutual is waiving cost sharing for inpatient treatment related to COVID-19, including hospitalizations and ground ambulance transfers for individuals with a positive COVID-19 diagnosis, through December 31, 2020. In addition, Medical Mutual will permanently cover FDA-approved medications and vaccines when they become available.
Self-funded plans must contact your Medical Mutual representative to change your benefits. If your plan does not have Medical Mutual stop loss coverage, you must contact your stop loss carrier to ensure coverage before making any benefit changes.
Contact your Medical Mutual representative with any questions.
Extended Grace Periods for COBRA Election and Premium Payments
On April 28, 2020, the Department of Labor (DOL) issued Employee Benefits Security Administration (EBSA) Disaster Relief Notice 2020-01, and on May 1, 2020, the DOL and the Internal Revenue Service issued a Final Rule, which extends COBRA grace periods for eligible plan participants. These grace period extensions apply retroactively to March 1, 2020, the effective date of the national emergency declared by the president. This extended grace period applies to both the COBRA election time frames, as well as monthly COBRA premium payments. The extended grace period will continue for 60 days after the end date of the national emergency.
COBRA Options – brought to you by Medical Mutual will send letters to the affected plan participants to let them know about these extended grace periods. If COBRA Options is not your COBRA vendor, you should check with your vendor to determine how they are handling the extended grace period.
Please note that the COBRA election extension does not change the time frame for members to move to individual coverage under a special enrollment period. Employees still have only 60 days from loss of coverage to elect individual coverage.
If you have questions, contact your Medical Mutual representative.
Medical Mutual is maintaining a COVID-19 page with information for our members. The page is frequently updated with information on benefits, prevention and frequently asked questions.