The Coronavirus has left many people with many questions regarding unemployment and benefits. The one question we’ve been asked a lot in the past days is what happens to my health insurance? The short answer is its complicated.
"They are not paying their insurance premiums, and your insurance will probably canceled," said Leon Young of Washington, PA
Leon Young and his wife Linda are both not working because of the coronavirus. They filed for unemployment, but wonder do they still have insurance?
Linda Young said it’s been confusing "The company was still in questions, our HR Carrier, couldn't give us definite answers."
People impacted have insurance options if they lose their coverage. But the first thing you should do is talk to your employer.
“You want to be sure to ask your employer or HR representative when the end date of your coverage will be,” said Pennsylvania Insurance Department, Consumer Liaison David Buono. “There is not a specific Pennsylvania law that says how long an employer’s coverage for an employee lasts, typically coverage ends when that employment ends.”
The options you have; COBRA, ACA Marketplace, Medicaid & CHIP.
COBRA is a federal law which requires companies to offer the person the ability to pay - to stay in their company's plan, but the person must pay the full monthly premium.
If that is not the right fit, you have other options. If you lose your job and insurance or have any other major life event, you have 60 days to choose another insurer. CHIP enrollment for kids is open year round to all income levels.
The Department of Human Services Secretary, Teresa Miller says there's been a 23% increase for assistance programs like Medicaid, SNAP and Temporary Assistance.
"If you're income or employment status has changed due to Covid-19 crisis, I urge you to apply for Medicaid, you may qualify without realizing," said Teresa Miller.
We are getting lots of questions from viewers about what happens to employees are that are furloughed and their health benefits? When does Cobra kick in?
The health insurance impact for a furloughed employee will depend on how the employer’s benefit plan is structured. In some cases, an employer may elect to maintain coverage contributions for insurance benefits while employees are furloughed. In these circumstances, employees would remain responsible for making the employee share of premium payments and coverage would continue.
In other circumstances, an employer may end benefits for furloughed employees. Employees have 60 days to enroll in COBRA once benefits end. COBRA is retroactive to the day after prior coverage ends, provided the employee makes his/her premium payments, which will increase substantially as the employer is no longer contributing to the cost of the premium.
The loss of job-based coverage also triggers a Special Enrollment Period for health insurance coverage through the Marketplace. Premium subsidies for insurance plans are available to consumers on a sliding-scale based on income. Navigators are available across Pennsylvania to help individuals enroll in Marketplace coverage.
The loss of employment will also impact an individual’s monthly salary and may qualify the individual for benefits through the Commonwealth’s Medical Assistance program operated by the Department of Human Services.
Is there a Pennsylvania law that requires employers to provide employees with benefits through a given time period? End of the month? Two weeks?
There is not a specific Pennsylvania law specifying how long an employer’s coverage for an employee must last. Typically, coverage ends on the date employment ends. That date also triggers the time period for applying for coverage on the Marketplace through healthcare.gov (through a special enrollment period), or for COBRA coverage.
Also, if you purchase a plan on the marketplace, does it go into effect immediately? Waiting period?
To allow for processing, applications received by the 15th of the month take effect on the 1st day of the next month.
Could you please explain about the request your department made to the federal government about opening enrollment and healthcare.gov?
Governor Wolf announced that his administration has sent a formal letter to U.S. federal agencies requesting a Special Enrollment Period (SEP) for uninsured or underinsured Pennsylvania residents in response to the COVID-19 outbreak.
If a person is Furloughed, what specifically should they ask their employer about insurance and benefits?
The person will likely want to ask about the end date of their coverage, and any options they have for continuing coverage under the employer’s plan, such as COBRA (or Pennsylvania’s Mini-COBRA, if the person worked at a very small business of 2-19 employees).
For people, that may have lost both incomes and have a family – there is assistance options, what are those options? and who should they contact?
The person can go to healthcare.gov or contact the Pennsylvania Association of Community Health Centers (PACHC) or an exchange assister to explore individual marketplace coverage.
Another option is to use COMPASS to sign up for Medical Assistance. COMPASS is an online tool for Pennsylvanians to apply for many health and human service programs like Medicaid and CHIP. Visit COMPASS at www.compass.state.pa.us.
Some people are wondering what they should do if they get sick, will they be left with big bills out of pocket?
The out-of-pocket bills faced by consumers will vary based on insured status and medical treatment. It is important to note that under recently passed legislation, insurers are now required to cover COVID-19 testing at no cost to patients. In addition, the same legislation set aside funding to pay for COVID-19 services for uninsured individuals. Individuals should reach out to a medical professional or to their local health department if they are concerned about their health.
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