Frequently Asked Questions regarding Insurance and the Coronavirus

Frequently Asked Questions

We know you have questions and may not have time to call us for every one of them. Our COVID-19 FAQ provides answers on many of the top questions we are being asked, as well as providing the latest updates we received from regulatory bodies, insurance companies, consultants, and internal resources. We will update this FAQ regularly. Be sure to hit the subscribe button on the bottom of our COVID-19 Resource Center page to receive updates when new information is posted.

General Information

The California Department of Insurance has ordered insurance companies to review their policies and adjust premiums if exposures have been reduced due to COVID-19. Other states may follow California’s order. As an example, if your sales or payrolls have been negatively affected by the COVID-19 crisis, insurance carriers can endorse your policy to adjust your exposures and reduce your premium. If cash flow has become a challenge, many insurance companies are extending payment terms out for 30 or 60 days. Also, some personal auto insurers have offered return premiums due to changes in individuals’ driving habits. Please contact your WGB Broker for specific details as insurance carrier responses will vary.
The “disaster” declaration under the Stafford Act triggers the availability of Code Section 139, a little-known provision in the tax code that permits an employer to provide tax-free “qualified disaster relief payments” to employees, if they meet certain requirements. Click this link for more information about qualification criteria.
Many of the carriers have instituted relaxed eligibility for employees furloughed or whose work hours are reduced below the full time equivalent level (i.e. 30 HPW). Keep in mind that Applicable Large Employers (ALEs) must take Affordable Care Act eligibility into account. Your WGB Benefits service team can provide carrier specifics based on your program.
Part of the recently passed CARES Act (COVID-3 Stimulus Bill) has reinstated the coverage for Over-the-Counter (OTC) medications and drugs for reimbursement from HSAs, FSAs, and Archer MSAs (unless your plan excludes OTC items). These items can be purchased with funds from eligible accounts without needing a prescription. Additionally, the bill expands OTC items to include menstrual care products. This change is effective for items purchased on or after January 1, 2020.
View this employer survey that provides insights shared by over 1,400 survey participants.
Trade Credit Insurance is available through a variety of insurance companies. The policy is intended to provide coverage for non-payment of commercial debt. This provides an additional measure of confidence that invoices will get paid. Reach out to your broker to get more information on the coverage and how to obtain quotes.
Per OSHA’s update on April 10, 2020, COVID-19 cases must be recorded by employers if it is a confirmed case as defined by CDC and the case is work-related. Full details can be read here and OSHA recently created a new FAQ on reporting and recording COVID-19 cases. There may be good news on the horizon as the California WCIRB has approved special regulation to exclude any COVID-19 cases from employers’ experience modification rates. The California Insurance Commissioner will need to approve the regulations before being enacted.
It’s important to follow your state’s orders and guidelines for reopening protocols. California has outlined a 6-step plan for modifying the stay-at-home order. The federal government outlined a 3-phase guide for reopening. Once your state allows for your type of business to reopen, understanding the risks you face and developing a deliberate plan for managing those risks is critical. We recommend reviewing resources from your associations, insurance companies, consultants, and vendors to fully assess the risks and methods to mitigate those risks. Please see the document entitled ‘Reopening a Business After The Coronavirus Shutdown’ for initial guidance.
An employee is eligible for paid sick leave if they have been directed/advised to stay home or self-quarantine because:
  1. The health care provider believes that the employee has or may have COVID-19 or is particularly susceptible to COVID-19, and
  2. The employee is not able to work or telework as a result of the self-quarantine advised by the health care provider.
A written doctor’s note or order is not required to substantiate medical advice to self-quarantine. Rather, the employer should document the name of the health care provider who advised the employee, along with the standard documentation of the employee’s name, dates for which leave is requested, the reason for leave, and a statement from the employee that he/she is unable to work for that reason.
Paid sick leave under the Families First Coronavirus Response Act (FFCRA) is not available if the employee unilaterally decides to self-quarantine absent medical advice, even if he or she has COVID-19 symptoms.
An employer may require employees to stay home from work when sick with COVID-19. However, if an employee is eligible for paid sick leave under the EPSLA, an employer may not require the employee to use paid vacation, personal, medical, or sick leave before the paid sick leave required by the EPSLA. Nor may employers require employees to use provided or accrued leave concurrently with the paid sick leave under the EPSLA. On the other hand, if the employer and employee agree, the employee may use preexisting leave entitlements to supplement the amount he or she receives from paid sick leave, not to exceed the employee’s normal earnings. It Is important to note that the employer is not entitled to a tax credit for any paid sick leave that is not required to be paid nor exceeds the limits set forth under the EPSLA.
Yes. Employees working from home due to stay-at-home orders or just being the nature of their job are covered eligible for Work Comp benefits if injured while conducting “work related” activities. “Work related” activities include anything while on the clock, so it’s important to define these activities via job descriptions and telecommuting policies. Location does not matter as well – injuries while working from bed, the car, in the kitchen will be covered if the employee is on the clock.
An employer can exert more control over the employees’ home office and work activities by:
  1. Requiring a designated work area
  2. Provide training and assistance related to work area safety (e.g. no cords impeding your walk or sitting area)
  3. Provide ergonomics training (see our webinar here and share with your employees)
  4. Create a telecommuting policy with specifically defined working hours that employees acknowledge & sign (see the HR Toolkit on our COVID-19 Resources Website for an example)
  5. Create detailed job descriptions
  6. Establish daily or weekly video check ins
A. The Department of Homeland Security (DHS) has issued a temporary policy to allow employers to accept expired List B documents when completing the I-9, beginning May 1. List B documents that expire on or after March 1, 2020, and have not been extended by the state, may be treated the same as if the employee presented a valid receipt for an acceptable document for Form I-9 purposes. Employers should:
  • Record the documentation information in Section 2 under List B, as applicable; and
  • Enter the word “COVID-19” in the Additional Information field.
  • B. If the state HAS extended the document expiration date, the document is acceptable as a List B document for Form I-9 (not as a receipt) during the extension timeframe. In that case, the employer must:
  • Enter the document’s expiration date in Section 2; and
  • Enter “COVID-19 EXT” in the Additional Information field.
  • Helpful questions and answers on temporary I-9 and E-Verify policies have been created by the U.S. Citizenship and Immigration Services and are available here.
    Follow the latest CDC guidelines for ‘Workers Who May Have Had Exposure to a Person with Suspected or Confirmed COVID-19’. Importantly, CDC no longer recommends sending the employee home unless they are experiencing symptoms related to COVID-19. The employee should be coached how to pre-screen and monitor their condition. They should wear a mask and ensure they are social distancing. If they begin to experience symptoms they should be sent home or told to remain home. The employee should be asked if they were in contact with any coworkers within the 2 days prior to the onset on symptoms. Those employees should be informed that they were in contact with a coworker (do not name the employee specifically) who is now experiencing COVID-19 symptoms. The employees should follow the same steps as outlined earlier.
    Insurance companies already are asking for details on compliance with CDC and OSHA standards for maintaining safe workplaces but these are currently considered base level requirements. Having such protections in place will ensure your insurance premiums are no higher than necessary. Companies that aren’t compliant will either not be eligible for insurance with some insurers and/or will receive higher rates due to potential for increased risk for coronavirus infections. If your company implements strategies that are state of the art and well beyond satisfying regulatory standards, share these with your broker as we may be able to influence underwriting decisions.
    Last week, the IRS heeded the requests of employer groups to allow employees greater flexibility in making mid-year changes to their health plan. None of these changes are mandatory, and they are left up to an employer to decide if they will offer any/all of the increased flexibility options. The permitted changes extend to Flexible Spending Accounts (FSA), and include:
    1. Enrollment opportunity for employees who originally opted not to enroll;
    2. Cancellation of coverage for those enrolled who no longer want coverage, so long as they have alternative coverage options;
    3. Switch from one type of plan to another;
    4. Change FSA contributions;
    5. Increase the FSA carryover limit (if applicable) from $500 to $550 or 20% of the maximum FSA contribution limit (i.e. $2,750 in 2020);
    6. Extension of the FSA grace period (if applicable) for employees to use their 2019 carryover balance.
    Notice 2020-29 gives employers and plan sponsors the ability to amend their Cafeteria Plan documents to allow plan beneficiaries to make prospective election changes for the remainder of 2020, absent standardly required “qualifying events.” Specifically, employers may amend their plans to allow employees to:
    1. make a new election on a prospective basis, if the employee initially declined to elect employer-sponsored health coverage;
    2. revoke an existing election and make a new election to enroll in different health coverage sponsored by the same employer on a prospective basis; and
    3. revoke an existing election on a prospective basis, provided that the employee attests in writing that he/she is enrolled, or immediately will enroll, in other health coverage not sponsored by the employee.
    While this wider latitude in responding to the unprecedented impact of COVID-19 is laudable, employers should be aware of the potential impact of such changes to Employer Shared Responsibility Provisions under the Patient Protection and Affordable Care Act (ACA). Employers offering plans that are not deemed “affordable” under the ACA may be especially vulnerable to IRS penalties where employees revoke an existing election and look to, for example, the Health Care Exchanges for coverage.
    Unless an employee was out on job-protected leave, such as FMLA or EFMLA, you are not required to return them to their original position or to an equivalent one. In fact, you are not required to bring them back at all. Given the impact of COVID-19 on business operations across the country, organizations may need to restructure their teams to remain competitive. If you need to restructure an employee’s position, it will be helpful to explain why that was necessary. People are generally much more accepting of change if they understand it, and less likely to claim discrimination if you have given them your business-related reason for the decision. [Source: HRWOW (6/10/20)]
    The Age Discrimination in Employment Act (ADEA) prohibits employment discrimination against individuals age 40 and older. The ADEA would prohibit a covered employer from involuntarily excluding an individual from the workplace based on his or her being 65 or older, even if the employer acted for benevolent reasons such as protecting the employee due to higher risk of severe illness from COVID-19.

    Unlike the ADA, the ADEA does not include a right to reasonable accommodation for older workers due to age. However, employers are free to provide flexibility to workers age 65 and older; the ADEA does not prohibit this, even if it results in younger workers ages 40-64 being treated less favorably based on age in comparison.

    Workers age 65 and older also may have medical conditions that bring them under the protection of the ADA as individuals with disabilities. As such, they may request reasonable accommodation for their disability as opposed to their age. [Source: EEOC (6/11/20)]

    Disclaimer: This website is not intended to provide any legal advice or opinion on any individual situation and should not be relied on to determine insurance coverage or lack thereof as relates the Coronavirus. Insurance forms and endorsements vary based on insurance company, changes in edition dates, regulations, court decisions, and state jurisdiction. The information is based on review of insurance coverages, sources we deem to be reliable and communications we have received from insurance companies and other resources. We make no representation or warranty as to the accuracy of information as applied to individual cases.

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