President Joe Biden recently announced that the COVID-19 national emergency and public health emergency (PHE) will end May 11.
With this deadline set for the national emergency to cease, employers are now faced with examining how their health plans meet COVID-19-related health coverage required for employees such as diagnostic testing services without cost-sharing and limiting to in-network providers.
Current rules on health plan coverage for COVID-19 vaccines, diagnostic testing without cost sharing, stand-alone telehealth benefits and Medicaid eligibility will no longer apply. Captive health insurance may benefit small and midsize businesses looking to find alternative insurance that can secure coverage for these instances.
"We’ve developed a purpose-built high performance health insurance captive that’s nimble enough to navigate the foggy path ahead while designed specifically to help your mid-size employer clients achieve industry-leading stability and performance," Everlong Captive Insurance said.
According to a blog post from Scottsins.com, "During the COVID-19 national emergency and public health emergency (PHE), health plans and health insurance issuers must cover COVID-19 tests and related services without imposing any cost sharing or prior authorization or other medical management requirements. Health plans and issuers will no longer be required to provide this first-dollar coverage when the PHE ends. Non-grandfathered group health plans and health insurance issuers must cover coronavirus preventive services, including recommended COVID-19 immunizations, without cost-sharing requirements."
Prior to the end of the PHE, services could be provided by a network and out-of-network providers. The May 11 deadline will require the services only to be provided by in-network providers. Healthcare and health plan providers will also see an increase in the cost of COVID-19 vaccines, boosters, treatment and press due to federal funding being depleted. Medicaid disenrollment will begin on April 1 and employers can expect an increase in mid-year enrollments due to loss.
Captive health care insurance allows employers to choose their coverage, their provider, preventative services and other options for their employees' insurance. Traditional health insurance does not allow for the same flexibility and decision-making as captives health insurance.
"Health insurance captives are designed to allow for proactive claim reduction efforts through innovative solutions to control plan costs and improve employee health," Everlong's blog "What You Need To Know About Captive Health Insurance" said. "This forward-thinking framework provides the employer with the ability to exercise more control over costs by proactively improving the health outcomes of their employee population, resulting in lower claims overall.
With a health insurance captive, "businesses can reduce their taxes, select vendors that offer affordable drug costs to their employees, lower premiums and provide employees better access to wellness programs – such as mental health or telehealth services," Everlong said.