Benefits Plan Supports for COVID-19

Supports Available to Employees/Retirees Covered Under the FCPS Benefits Plans

FSA Special Enrollment/Change Period will end on September 30, 2020! (posted 9/10/20)

As you may recall, new guidance was issued earlier this year by the Internal Revenue Service (IRS) to temporarily allow mid-year change opportunities for FSA participants who did not have a qualified family status change. The opportunity to make changes under the Special Enrollment Period will end on September 30, 2020.  For more information, please visit the FSA Mid-year Change Opportunities website.

 

Important Updates for Leave of Absence (LOA) Requests (posted 7/13/20)

In response to the COVID crisis, FCPS has evolved the LOA approach and will be accepting leave requests for less-than-12 month employees for the upcoming school year up until July 31, 2020. FCPS is adding a new designated reason for LOA requests as COVID-related for employees who may need LOAs based on COVID-related reasons, such as a lack of childcare/private school closures or a serious health conditions of a household member. The LOA Request form (HR-136) can be found on the Benefits Forms website. Posting of Regulation 4822 will be accomplished as soon as administratively feasible. For additional information about the LOA process, please visit the Leave of Absence website

 

IRS Expands Mid-Year Change Opportunities for FSA Plans (posted 7/10/20)

New guidance has been issued by the IRS to permitting mid-year change opportunities for FSA participants for the remainder of 2020. Employees may elect to participate, increase, or decrease their election(s) under the Health Care and Dependent Care FSA without having a qualifying event, as long as the election is applied prospectively. For more information, please visit the FSA Mid-year Change Opportunities website.

 

Certain over-the-counter (OTC) medical products restored as FSA qualified medical expenses (posted 4/1/20)

The CARES Act recently passed by Congress restores the ability to use FSAs to purchase certain over the counter medical products, like Tylenol, Claritin and Pepto-Bismol, etc., without a doctor’s prescription. Additionally, menstrual care products are now considered qualified medical expenses for payment or reimbursement with an FSA. We are awaiting more guidance from the IRS and will post when the information becomes available. These changes apply to claims incurred on or after January 1, 2020. 
 

Health Plan Updates (updated 1/4/21)

CareFirst continues to waive member costs through March 31, 2021 for services related to the diagnosis and treatment for COVID-19, including telemedicine services provided through CareFirst Video Visits. Effective August 31, 2020, the applicable member cost share applies to CareFirst Video Visits for non-COVID related services and treatment.

CVS Pharmacy is waiving charges for home delivery of eligible maintenance and acute prescription medications. Free 1-2-day Rx delivery via USPS has been extended indefinitely. Visit CVS.com to set up free 1-2-day Rx home delivery.

Kaiser Permanente continues to waive member costs through March 31, 2021, for services related to the diagnosis and treatment for COVID-19, where COVID-19 is the primary diagnosis.

 

Important notice for Flexible Spending Account (FSA) Participants (posted 3/24/20)
As of this date, no new guidance has been issued by the Internal Revenue Service (IRS) relative to FSA deadlines and qualifying events. Please keep in mind the following:

  • 2019 Claims Filing Deadline is 3/31/2020. Go to www.optumbank.com to file your 2019 claims. Remember, unused dependent care monies are forfeited after that date. Only $500 of unclaimed health care expenses can roll over to 2020. 
  • Change in Your Day Care Situation? Dependent Care participants who have had a recent change in their child care situation have a qualifying event to reduce their annual election. Changes must be filed within 30 days of the qualifying event. Please complete the FSA Enrollment/Change Form (HR-135) and return to the Office of Benefit Services 

 

Health Plan Supports (updated 12/30/20)

  Aetna/Innovation Health & 
Aetna Medicare Advantage
CareFirst Kaiser & Kaiser Medicare Advantage
Cost Waivers & Plan Supports

Copays and deductibles are waived for the testing1, diagnosis, and treatment of COVID-192. If a member would like to pursue in-person testing for the COVID-19 virus, the member can visit www.aetna.com for testing locations. 

Prior authorization requirements are waived for diagnostic tests and covered services that are medically necessary and consistent with CDC guidance for members diagnosed with COVID-19.

For more Information, contact Member Services
  - Aetna/Innovation Health: 1-888-236-6249 
  - Aetna Medicare Advantage: 1-855-524-6027 (TTY 711)

Through March 31, 2021, copays, coinsurance, and deductibles are waived for the testing1, diagnosis and treatment of COVID-192.

Prior authorization requirements are waived through March 31, 2021, for diagnostic tests and covered services that are medically necessary and consistent with CDC guidance for members diagnosed with COVID-19.

For more information, contact Member Services:
1-800-296-0724

Through March 31, 2021, copays are waived for testing1, diagnosis, and treatment of COVID-19.

For more information, contact Member Services: 
  - Kaiser Permanente Signature HMO: 1-800-777-7902 (toll free) or TTY 711
    
  - Kaiser Permanente Medicare Advantage:
       1-888-777-5536 or TTY 711

Telemedicine & 
Nurse Advice Services

Copays, coinsurance, and deductibles will be waived for all in-network outpatient behavioral and mental health telemedicine services through December 313; for AIH, regular plan cost share will apply for all other telemedicine visits.  

For Aetna Medicare Advantage, out-of-pocket costs for telehealth visits and in office (for any reason) will be waived through December 313. Beginning January 1, 2021, telehealth visits will remain covered under the plan. Members should contact their doctor for information on what telehealth services they offer and how to schedule a telehealth visit.

To access TelaDoc, register first at:
www.teladoc.com (or call 1-855-TELADOC)

Informed Health (Nurse Advice) Line: 1-800-556-1555 

 

CareFirst Video Visit:
Through March 31, 2021, copays, coinsurance, and deductibles will be waived for telemedicine accessed through CareFirst Video Visit for services related to COVID-19.  Effective August 31, 2020, the applicable member cost share will apply to CareFirst Video Visits for non-COVID related services and treatment. 

Provider-Sponsored Telemedicine Visit:
Through March 31, 2021, copays, coinsurance and deductibles will be waived for In-Network provider-sponsored telemedicine visits for services related to COVID-19.  Member may be subject to balance billing when using an Out-of-Network provider.  

24-Hour Nurse Advice Line:
The Nurse Advice Line provides support and guidance for any non-emergency situation. The service is personal, confidential and available at zero member cost.    

To schedule a CareFirst Video Visit, register first at: 
- www.carefirstvideovisit.com; or download the
CareFirst Video Visit app

CareFirst 24-Hour Nurse Advice Line:
1-800-535-9700

Video Visits and 24/7 Nurse Advice Line are covered at $0 copay.

To schedule a Kaiser Permanente Video Visit, register first to My Health Manager at www.kp.org, or download the Kaiser Permanente app, or call 24/7 at 1-800-777-7904 (TTY 711).

Kaiser Permanente 24-Hour Nurse Advice Line:  1-800-777-7904 (TTY 711)

Pharmacy Supports

CVS Commercial (members enrolled in CareFirst BlueChoice Advantage or Aetna Innovation Health): Beginning August 1, 2020, CVS Caremark will no longer waive early refill limits on 30-day prescriptions for maintenance medications;  you must use 75% of your medicine before requesting a refill.

SilverScript (members enrolled in Aetna Medicare Advantage): CVS Caremark continues to waive early refill limits on 30-day prescriptions for maintenance medications at any in-network pharmacy.

Get 1- 2-day free Rx home delivery from CVS Pharmacy
CVS Pharmacy is waiving charges for home delivery of eligible maintenance and acute prescription medications. Free 1-2-day Rx delivery via USPS has been extended indefinitely. Visit CVS.com to set up free 1-2-day Rx home delivery.

Ask your pharmacy about home delivery options
Many retail pharmacies are offering home delivery service. Check with your pharmacy to find out if they offer home delivery and whether there are delivery fees.

For more information, contact:
    - CVS Member Services:  1-888-217-4161.
    - SilverScript Member Services (for Medicare covered members): 1-877-321-2597

 

Notes:  

  1. Members who have concerns that they may have been exposed to COVID-19 or may have symptoms of COVID-19 should contact their physician or the Health Department of the jurisdiction in which they reside. The treating physician will make a determination whether testing is in order for COVID 19.          
  2. Aetna and CareFirst will cover those diagnostic tests that are consistent with CDC guidance related to COVID-19.
  3. Refer to the AIH and Aetna Medicare Advantage plan documents for full plan details.