The developing COVID-19 situation has understandably generated significant media, much of which Canadians both need and want to know. There have been releases from the insurance and private healthcare industries too and maybe these should be receiving more press.
The Canadian Life and Health Insurance Association and its members have been releasing communications throughout the outbreak and updating their websites, beginning with travel advisories and extending to clarifications of health and disability coverage, virtual services and changes in renewal dates. While plan sponsors, members and insurers are working to make the best of a bad situation, other stakeholders are bringing forth some much-needed good news.
In this blog we’ve summarized some of the news around COVID-19 and some of the issues the industry is facing right now. Look for a number of virtual events from Connex as we all navigate this pandemic, because it’s not just about what we are all facing now, but what we will face next week, next month and next year. See below for links to our next Benefits Breakfast Club webinar on COVID-19 on May 7, 2020, and the first of our new weekly podcast series on April 17, 2020.
Back in late 2019 and into early 2020 most Canadians weren’t paying too much attention to the situation in Wuhan, China, but the situation across the world, escalated rapidly. On April 7, 2020, The New York Times reported that the virus had spread to at least 177 countries, killing more than 75,000 and infecting more than one million over a short period of time. By April 13th the number of deaths due to COVID-19 was over 100,000. Few of us across the globe remain unaffected, whether through illness, job loss, loss of benefit coverage, stay at home orders, or separation from friends and loved ones.
Here are some common themes based on insurer bulletins. Check with individual insurers for their current policies and provisions*:
While there may be some outstanding questions from travellers, postings on insurer websites and bulletins are clear. If you left before Government of Canada Travel Guidelines to “avoid all non-essential travel” outside of Canada (level 3 advisory) came into effect, coverage for trip interruption and emergency medical remains intact. In some cases, coverage has been extended when there is difficulty in securing travel to return to Canada or because of quarantine. Specific dates and time periods vary, so check with each insurer. Those who booked after the advisory came into effect should check with their insurance carrier if they need to cancel their trip or before travel because medical coverage may be affected.
There are a number of coverage issues related to layoffs. Of particular concern is reinstatement of coverage when terminated on layoff.
- Extension of coverage – generally speaking, most carriers have taken the position that coverage can be extended with premium payment during a layoff because of the extenuating business circumstances around COVID-19. The time period for extension of coverage varies and some carriers may require a policy amendment before this can take effect. Check with your insurance carrier, particularly for absence and disability provisions.
- Termination of coverage – this can get complicated. In addition to loss of income, without coverage individuals taking medications for a chronic disease, including those who are on specialty medication, will be particularly hard hit. We’ve been told that many of these patients are already struggling to find funding and patient assistance programs are being overwhelmed. In terms of disability, individuals who become disabled during layoff will not be eligible for benefits when employees are recalled if they are not able to return to work. A pre-existing conditions clause may apply. Check with your insurer.
If coverage is being continued during layoff or if employees are still at work, there have been several changes to extended health benefits. Check with your carrier for specifics:
- Prescriptions drugs – maximum 30-day supply for most prescriptions are being dispensed as agreed by pharmacy regulators, associations and health ministries to ensure an adequate supply. Several carriers are also encouraging the use of mail order or pharmacy delivery services to reduce risk of exposure to COVID-19.
- Virtual services – are available for the first time or have been expanded by some carriers – check with your insurer
- Employee Assistance Plans
- Doctors, Nurse Practitioners, Registered Nurses – including services from Dialogue and Maple
- Paramedical and other registered health professionals including audiologists, chiropractors, naturopaths, optometrists (most but not all), osteopaths, podiatrists, psychologists, physiotherapists, dietitians, speech therapists
- Insurer authorization – continuation of prior authorization and special authorization approvals is being offered by some carriers, including drug exception forms.
Most insurers have waived the elimination period for STD for those individuals who have been tested and have a confirmed diagnosis of COVID-19. This does not apply if an individual has symptoms of COVID-19 but has not been tested and confirmed. Therefore it is up to each individual to press for testing to ensure their elimination period is waived.
So that was our quick overview, but there is lots more happening in the insurance industry. In some cases there will be long-term changes in how we do business. There are links below to a number of other news items and resources on COVID-19 plus information on our upcoming online events where we will talk more about COVID-19, including our new podcast. You’ll be able to listen to our podcast through the link that will be set up Friday, April 17th on the home page of our website. Look for these most weeks, on Fridays, in addition to our usual Benefits Breakfast Club live morning webinars.
Denise Balch, Principal Consultant and President, Connex Health