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 (posted 3/26/20)

Aetna is providing weekly listen-in calls for adults, kids and teens who may be seeking ways to cope with concerns related to COVID-19.  The program, entitled “Call for Community Compassion” provides an opportunity to join virtual listen-in sessions (10 minutes in length), which will include positive readings, guided meditation and grounding practices. Pre-registration is not required, and participants may join as few or as many sessions as they would like. Click here for more information.

CareFirst continues to waive member costs for services related to treatment for COVID-19 for the duration of the public health emergency, including telemedicine services provided through CareFirst Video Visits. Effective August 31, 2020, the applicable member cost share will apply to CareFirst Video Visits for non-COVID related services and treatment. 

CVS Pharmacy is working with the U.S. Department of Health and Human Services, the U.S. Public Health Service to pilot testing sites for the COVID-19 virus. Their first pilot site is in Massachusetts, with a focus on first responders and health care workers who and have potentially been exposed to COVID-19. This pilot is the first step in developing testing sites at other location across the U.S.

Kaiser Permanente has just announced that it will waive copays associated with treatment for members diagnosed with COVID-19.

 

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

  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.

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)

Copays and deductibles are waived for the testing1, diagnosis and treatment of COVID-192.

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:
1-800-296-0724

Copays are waived testing1, diagnosis, and treatment of COVID-19.

Copay waiver also includes vaccine (when available).

For more information, contact Member Services: 
  - Active employees and retirees under 65:
      1-800-777-7902 (toll free) or TTY 711
    
  - Medicare-eligible members:
       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 September 30; for AIH, regular plan cost share will apply for all other telemedicine visits.  

For AMA, out-of-pocket costs for primary care visits via telehealth and in office (for any reason) will be waived through September 303.

If a member would like to pursue in-person testing for the COVID-19 virus, the member should call the local doctor or the state's public health hotline to verify test availability and "let them know before you go". The in-person care facility will direct the member appropriately.

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

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

Copays, coinsurance, and deductibles will be waived for telemedicine accessed through CareFirst Video Visit for services related to COVID-19, during the public health emergency.

Effective August 31, 2020, the applicable member cost share will apply to CareFirst Video Visits for non-COVID related services and treatment. 

For telemedicine services received from other health care providers (not through CareFirst Video Visit), members may be subject to copays, coinsurance, or deductibles. 

No member out-of-pocket cost applies to ‘telephone only’ consultations provided through a primary care provider.

To access the 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 are covered at $0 copay.

To access the Kaiser Permanente video visit, register or sign on through My Health Manager at www.kp.org

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 through December 31, 2020. 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.