Guide to COVID-19 Coverage

HPI is monitoring the coronavirus (COVID-19) outbreak and what it means for our members, clients, business partners and communities.

The Centers for Disease Control and Prevention (CDC) website is the best source for up-to-date information. The outbreak is evolving quickly, and the CDC and health departments in each state are working on public health policies to help prevent the spread of the illness.

Stay safe. If you need to see a doctor, call first. Many providers that you have always seen in person are now offering appointments over the phone. If your doctor or urgent care facility doesn’t offer phone or video visits, you have access to telemedicine through other providers.

Try the CDC’s symptom checker to help you make decisions about seeking appropriate care.

HPI has implemented the following coverage for medically necessary COVID-19-related services at in-network doctor’s offices, urgent care centers, telemedicine providers or emergency rooms:

  • Testing*: covered in full, no member cost-sharing
  • Treatment: covered in accordance with member's plan and applicable member cost-sharing
  • Telehealth services: covered in full, no member cost-sharing
  • Prior authorizations: not required for COVID-19 testing
  • Vaccine**: covered in full, no member cost-sharing

*Cost-sharing for testing received from out-of-network providers also will be waived should the urgent services be unavailable from in-network providers.

**A vaccine will be covered after it has received an A or B recommendation from the United States Preventive Services Task Force (USPSTF) or a recommendation from the Advisory Committee on Immunization Practices (ACIP) of the Centers for Disease Control and Prevention.

HPI will continue to review coverage and cost-sharing policies to ensure that members can receive the appropriate COVID-19 testing and treatment without difficulties.

 

HPI Case Management is here to help

Assistance is available to eligible members who are having difficulty managing their current medical needs during this pandemic. Case Managers can help to obtain currently approved medications, medical equipment or accessing and coordinating needed medical care. Please contact your case manager directly or send an email to casemanagement@healthplansinc.com. Please include your name, contact information and best day/time, and our case manager will attempt to contact you.

If you have health concerns, check in with your health care provider to see if they offer virtual visits from home (via smartphone, tablet or computer). If your provider doesn't offer virtual visits, providers such as Doctor On Demand are covered under all plans. Members can also receive outpatient behavioral health care through virtual visits.

PDF icon Download instructions for registering for Doctor On Demand

Telehealth visits may help limit the spread of the disease and provide crucial behavioral health care to those in need. It may also be an option for individuals in self-imposed quarantine to check in with a health care provider.

HPI is taking steps to ensure all plans provide coverage for telehealth services as follows:

  • All plans, including Qualified High Deductible Health Plans (QHDHPs), will cover COVID-19-related testing, treatment and counseling via telemedicine providers with no member cost-share.
  • All plans, excluding QHDHPs, will cover all other services received via telehealth providers with no member cost-share*.
  • All QHDHPs will continue to cover non-COVID-19 related telehealth services with applicable member cost-sharing, as the IRS has not changed the regulations governing these plans to date.

*This may vary by client. Please refer to the client’s Plan Document to confirm how these services are covered.

United Behavioral Health/Optum offers a Public Crisis Line for those needing emotional support. Open 24/7, this help line is free of charge and available to anyone.
Call (866) 342-6892

SAMHSA’s Disaster Distress Helpline provides 24/7, 365-day-a-year crisis counseling and support to people experiencing emotional distress related to natural or human-caused disasters, and infectious disease outbreaks.
Call (800) 985-5990

Living Well at Home with Virtual Wellness Classes

Well-being programs here for you when you need them the most.

Whether you are looking to shake it up, stretch it out, or get centered, we’ve got you covered with Zumba®, yoga, guided mindfulness, and wellness sessions. All are available at no cost to you and will be easy to access via Zoom.

Note: You will be able to access these webinars immediately if you have Zoom downloaded on your device. If you have not downloaded Zoom, the links will take you to Zoom’s home page to download the tool. Once you’ve downloaded and launched Zoom on your device, you will be prompted to enter your name and email in order to join the webinar, but you are not required to enter your real name or email. Please know that HPI is not responsible for the availability, privacy or security of the Zoom platform. We recommend that you use caution when sharing any personal or identifying information with online meeting applications, including any interactive features.

 

Food as Medicine — Eat to Reduce Inflammation and Feel Great: Three-Part Facebook Live Series

Ready to take control of how you eat and feel in the new year? In this three-part series, you will learn how to activate the power of healthy eating to reduce inflammation, improve energy and mood, get to your ideal weight, support your overall health and feel great! You’ll also learn practical tips to avoid common food traps and create new habits, and easy ways to assemble, cook and flavor tons of healthy foods! These live sessions will be happening via the closed Living Well with Harvard Pilgrim Facebook group.

Session 1: Reduce Inflammation and Feel Great: Create Your 2021 Eat Well Plan – Thursday, February 18, 2021, from 7:00pm to 7:30pm (ET)
Ready to take control of how you eat and feel in 2021? Want to activate healthy eating to reduce inflammation to lose weight, gain energy, feel great and get relief from things like headaches, joint pain and digestive issues? In this 30-minute event, you'll use “food as medicine” to create a healthy eating plan that works for you! You’ll set your goals and leave with the breakfast, lunch and snack ideas you need to kickstart your healthy eating lifestyle!

Session 2: Crowd in THESE Foods to Eat Healthier and Reduce Inflammation: Cooking Skills and Recipes – Thursday, February 25, 2021, from 7:00pm to 7:30pm (ET)
Even in the world of healthy foods, it’s not all the same! You want to move yourself to a place of imbalance, where you eat more of some foods and less of others. In this 30-minute event, you'll learn about the foods you want to crowd into your day to help you reduce inflammation and feel great. You’ll learn ideas for assembling meals quickly and easy cooking and flavoring skills you need to create variety and enjoy eating more delicious healthy foods!

Session 3: Plan to Eat Well Daily: Food Planning and Shopping Skills – Thursday, March 4, 2021, from 7:00pm to 7:30pm (ET)
Want to eat better but finding it hard to make it happen in busy, modern life? In this 30-minute event, you'll learn an easy way to plan your meals for the week that will help you assemble healthy meals your family will love. You’ll leave with the tools you need to make healthy eating happen daily!

» To access these sessions, visit https://www.facebook.com/groups/livewellhphc.

 

Strength Classes

These live classes involve full body workouts that can help you increase strength, mobility and flexibility. Try something new or enjoy a form of exercise you already love.

Chair Yoga – Thursday, February 25, 2021, from 1:00pm to 1:30pm (ET)
Chair yoga is a gentle form of yoga that is beneficial for all ages and abilities. It can be done sitting in any type of chair or using a chair to support and help modify poses. For those who sit at a desk all day or have limited mobility, chair yoga can be a useful tool to help stretch and strengthen muscles. During the four-week series, a yoga instructor will guide you through 30 minutes of poses to increase flexibility and strength and promote good posture.

Barre Classes – Thursdays (March 4 through March 25) from 1:00pm to 1:30pm (ET)
barre3 is a full-body balanced workout combining strength conditioning, cardio and mindfulness. A barre3 class will leave you feeling balanced in body and empowered from within. Please bring two 5-pound weights if you have them!

» To access these sessions, visit https://us02web.zoom.us/j/88213176780.

 

Yoga Classes

Yoga – Mondays and Wednesdays at 5:15pm to 6:15pm (ET)
Breathe in, breathe out and stretch it out with a relaxing yoga practice. These live yoga sessions are accessible to all fitness levels and are the perfect way to whine down after a long day.

» To access these sessions, visit https://zoom.us/j/528276681.

 

Zumba® Classes

Zumba® – Tuesdays and Thursdays at 5:15pm to 6:15pm (ET)
Dance like nobody’s watching! Our Zumba® classes will be the most fun you’ve ever had working out. Enjoy upbeat music and moves anyone can try!

» To access these sessions, visit https://zoom.us/j/959837402.

 

Guided Mindfulness Sessions

Mind the Moment – Tuesdays and Thursdays from 8:30am to 9:00am (ET) 
Mindfulness can help us feel connected and get centered. Experiment with short bursts of mindfulness instruction, followed by mini meditations, led by a team of expert instructors.

» To access the Tuesday sessions, visit https://zoom.us/j/946535238.

» To access the Thursday sessions, visit https://zoom.us/j/580279161.

Access past mindfulness sessions at any time by visiting the Mind the Moment YouTube Channel.

  

Health and Wellness Webinars

Health and Wellness Webinars – Wednesdays from 1:00pm to 1:30pm (ET) 
This series of classes takes a holistic look at health to help you stay physically and mentally resilient.

» To access these sessions, visit https://us02web.zoom.us/j/996948529.

Access past health and wellness webinars at any time by visiting the well-being webinar playlist on YouTube.

PDF icon COVID-19 Client and Broker FAQ

PDF icon January 14, 2021 | Compliance Alert - New Options for Medical Care Reimbursement and Dependent Care Reimbursement Accounts

PDF icon December 17, 2020 | Updated Frequently Asked Questions for HPI Brokers and Clients

PDF icon May 28, 2020 | Compliance Bulletin: Optional Plan Changes Permitted under Newly Issued IRS Guidance

PDF icon May 28, 2020 | Optional Plan Changes Checklist

May 28, 2020 | Sample Attestation Required for Dropping Medical Coverage

PDF icon May 11, 2020 | Compliance Alert - Pandemic-Related Deadline Extensions

PDF icon April 14, 2020 | We're here to support you | A message to our valued brokers

PDF icon April 8, 2020 | Frequently Asked Questions for HPI Brokers and Clients

PDF icon April 3, 2020 | Compliance Alert - COVID-19 Update

PDF icon March 26, 2020 | Revised Compliance Alert - The Families First Coronavirus Response Act (this replaces the Alert distributed on March 24, 2020)

PDF icon March 17, 2020 | Mandated Telehealth Coverage

PDF icon March 11, 2020 | Important Information About Coronavirus

A new federal rule issued on May 4, 2020, entitled Extension of Certain Timeframes for Employee Benefit Plans, Participants and Beneficiaries Affected by the COVID-19 Outbreak, provides participants in certain employee benefit plans* additional time to:

  • Elect COBRA coverage
  • Make COBRA premium payments
  • Notify the Plan of second qualifying events under COBRA
  • File medical, dental, vision, Medical Care Reimbursement Account (MCRA )(aka health FSA), and disability claims for covered benefits/eligible expenses
  • Appeal denials of medical, dental, MCRA and disability claims
  • Make a Special Enrollment Request under HIPAA rules for medical or dental coverage

The deadlines for taking any of the actions described above that would ordinarily have been due on or after March 1, 2020, are now extended to at least until 60 days after the end of the pandemic National Emergency. The pandemic National Emergency was declared by the President to begin on March 1, 2020, and will continue until the President ends it.

 

As of today, the pandemic National Emergency is still in effect. 

You have at least 60 days from today to take an action listed above if the original deadline for the action was on or after March 1, 2020. 

This message will be updated when the pandemic National Emergency has ended.

 

 

What’s not affected

The new rule does not apply to the deadlines related to:

  • Active employees initially enrolling in a plan
  • Change in status events, except a change in status that also qualifies under the HIPAA Special Enrollment rules (see your Plan Document for information about HIPAA Special Enrollment)
  • Claim filing deadlines under Dependent Care Reimbursement Accounts

*Plans sponsored by government entities or churches are not required to extend these deadlines. If you are covered by a government or church-sponsored plan, please call the member service number on your Plan Identification Card to find out if the deadline extension applies to your plan.

Benefits and coverage questions:
Contact the phone number listed on the back of your Member ID Card, or call:

800-532-7575
Monday through Friday, 8am to 5pm (ET)

 

COVID-19 -specific questions:
877-213-5225
Monday through Friday, 8am to 5pm (ET)

If you are not feeling well, please contact your primary care provider to discuss active symptoms.

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