The ongoing COVID-19 pandemic has created new and unique challenges for employers and their employees. Group health plans and other employee benefit plans are one area of concern during these times. UST HR Workplace powered by ThinkHR has been on the front lines, supporting employers with HR and Benefits advice and compliance guidance through their online resources and on-demand advisors.

Here are some of the most-frequently asked questions received about COVID-19 and benefit plans:

Do all medical plans cover COVID-19 testing? Yes, the Families First Coronavirus Response Act (FFCRA) requires that all medical plans provide 100% coverage of COVID-19 testing. There are no deductibles, copays, or coinsurance. This federal mandate took effect March 18, 2020 and applies to insurance plans and employer self-funded plans, including grandfathered plans. It does not apply to retiree-only plans.

All testing-related services and services, such as consultative visits to doctors (including telehealth), emergency rooms and urgent care centers that lead to an order for testing, and the administration of tests, are covered. Preauthorization is not required and coverage is not limited to in-network providers.

Is treatment of COVID-19 also covered at 100%? It depends. The FFCRA mandate for 100% coverages applies only to services and supplies related to testing. Once diagnosed, however, coverage for any treatment of COVID-19 will depend on each medical plan’s terms and conditions, including any provisions for deductibles, copays, coinsurance, and use of network providers.

Additionally, insured plans are subject to state laws that may be broader than the new federal mandate. A number of states now require that medical insurers cover COVID-19 treatment at 100% (in addition to testing). Many carriers also have agreed to provide 100% coverage even if not required by law. For details, contact your carrier or check the America’s Health Insurance Plans (AHIP) website for the latest updates.

Is a high deductible health plan (HDHP) that waives the deductible for COVID-19 testing still compatible with a Health Savings Account (HSA)? What about coverage for treatment? HDHP must cover COVID-19 testing at 100% per the FFCRA mandate. HDHPs also may be amended to cover treatment of COVID-19 as a first-dollar benefit without deductibles. On March 11, 2020, the IRS announced that pre-deductible coverage of testing and treatment does not cause the plan to lose its status as an HSA-compatible HDHP and does not interfere with the covered person’s eligibility to make HSA contributions.

Many employees are working from home now instead of coming to the office. Can they continue using their Dependent Care FSAs for childcare expenses? Yes, employees can continue using their Dependent Care FSAs provided that the childcare is required for the employee to be able to work. For instance, employees working full time may need the same childcare whether working from home or the office. If, however, the employee or spouse can care for the child while the employee works, the expenses are not reimbursable.

Can employees change their Dependent Care FSA election due to the COVID-19 issues? The IRS rules for Dependent Care FSAs set forth a list of permissible election changes. (Ref: 26 CFR § 1.125-4.) Assuming the employer includes all IRS-permissible change events in its plan document, employees may start, stop, increase or decrease their Dependent Care FSA contribution on account of specific events. Examples of events that are likely to come up due to COVID-19 issues include:

• The dependent care center or provider is no longer available;
• The employee needs childcare because the schools are closed; or
• The employee’s or spouse’s employment status or work hours are changed.

Can employees change their commuter benefits since they are now working from home? Section 132(f) plan, often called pretax commuter benefits, allow employees to change their election, or start or stop contributing, for any reason. Generally, changes made by the middle of the month take effect the first of the next month, but employees will want to confirm their plan’s procedures with the administrator. Note that there is no use-or-lose provision for commuter benefits, so any unused balance now will be available for the employee’s use when they get back to commuting to work.

Many employees have been put on reduced hours or furloughed. Can the employer continue covering them on the group health plan? Many employers and workers are concerned about maintaining group health coverage when work hours are cut due to the current COVID-19 outbreak. Each employer’s case is different, so we suggest the following steps:

1. Review the group policy or plan document. If the plan limits eligibility to employees who are regularly scheduled to work 30 hours or more per week and states that coverage ends when the employee ceases to be eligible (unless protected by the FMLA or similar law), then reduced hours or furloughs will cause the employee to lose coverage. Plans must be administered according to their terms, so the employer cannot continue reporting that employee (and dependents) as active on its eligibility file to the carrier.

1. If the employer wants to continue eligibility for reduced-hours employees or furloughed employees, contact the carrier regarding options to amend the policy. Many carriers are agreeing to changes, and a number of states are requiring carriers to give employers the option of maintaining active coverage for furloughed or reduced-hours employees.

1. If the plan is self-funded, the employer may amend its plan as long as the plan does not discriminate in favor of highly compensated employees. If the employer has stop-loss insurance, that policy also may need to be amended to ensure its terms are consistent with the underlying self-funded plan.

1. Is the employer an applicable large employer (ALE) that uses the look-back measurement method to determine eligibility for group health (medical) coverage? If so, employees who are deemed full-time employees for a stability period will not lose eligibility during that stability period even if they are furloughed or their work hours are cut (if they remain employed).

1. If the employee’s coverage ends, note that loss of coverage due to reduced work hours or furlough is a COBRA qualifying event. The federal COBRA rules apply plans sponsored by employers with 20 or more workers (except certain church plans). Insured plans also may be subject to state insurance continuation laws (often called mini-COBRA).

Q&A provided by ThinkHR, powering the UST HR Workplace for nonprofit HR teams. Have HR questions? Sign your nonprofit up for a free 60-day trial here.

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Question: Some of our employees have said they don’t feel safe returning to work. Can we just permanently replace them?

Answer: We recommend extreme caution when deciding to replace an employee who refuses to work because of concerns about COVID-19. Generally, employees do not have a right to refuse to work based only on a generalized fear of becoming ill if their fear is not based on objective evidence of possible exposure. However, under the current circumstances, where COVID-19 continues to be a threat across the country, we think it would be difficult to show that employees have no reason to fear coming in to work, particularly but not exclusively in a location with a shelter-in-place rule. Returning employees may also have certain rights under state and federal law. Here are few things to keep in mind:

• Recalled employees may have a right to job-protected leave under a city ordinance, state law, or the federal Families First Coronavirus Response Act (FFCRA). See our overview of the FFCRA.
• Employees who are in a high-risk category — either because they are immunocompromised or have an underlying condition that makes them more susceptible to the disease — may be entitled to a reasonable accommodation under the Americans with Disabilities Act (ADA) or state law if their situation doesn’t qualify them for leave under the FFCRA (or if they have run out of that leave). It would be a reasonable accommodation under the circumstances to allow the employee to work from home or take an unpaid leave, if working from home is not possible.
• Employees who live with someone who is high risk are not entitled to a reasonable accommodation under federal law, but we strongly recommend allowing them to work from home if possible or take an unpaid leave. Otherwise, they may decide to quit and collect unemployment insurance. If you want to keep them as an employee, being compassionate and flexible is your best bet.
• Under Occupational Safety and Health Administration (OSHA) rules, an employee’s refusal to perform a task will be protected if all of the following conditions are met:
  • Where possible, the employee asked the employer to eliminate the danger, and the employer failed to do so;
  • The employee refused to work in “good faith,” which means that the employee must genuinely believe that an imminent danger exists;
  • A reasonable person would agree that there is a real danger of death or serious injury; and
  • There isn’t enough time, because of the urgency of the hazard, to get it corrected through regular enforcement channels, such as requesting an OSHA inspection.

Check state and local law to see if additional protections may apply.

Instead of replacing employees who express fear at this time, we recommend that you consider methods to encourage employees to come to work and to help put their minds at ease. Consider emphasizing all of the safety methods you have put in place (such as scheduled handwashing, frequent disinfection of surfaces, social distancing rules, reduced customer capacity, staggered shifts, or more extreme measures if warranted by your industry). We recommend relying on the Centers for Disease Control and Prevention (CDC) and local health department guidance for establishing safe working conditions at this time. You might also consider offering premium pay (a.k.a. hazard pay) or additional paid time off for use in the future to employees who must come to work.

Q&A provided by ThinkHR, powering the UST HR Workplace for nonprofit HR teams. Have HR questions? Sign your nonprofit up for a free 60-day trial today.

As nonprofit organizations prepare to return to business as usual, there are quite a few new safety protocols being put in place to ensure that employees return to a safe work environment. The Center for Disease Control – CDC continues to release updated guidelines for employers to help prevent and slow the spread of COVID-19 in the workplace. When making decisions around business operations, two main components should be factored in: (1) the level of disease transmission in your community and (2) how prepared your business is to protect both your employees and customers.

Employers are encouraged to coordinate with their state and local health officials to acquire timely and accurate information to provide updates to employees as needed. If your nonprofit’s business operations were put on hold, or are gearing up for workforce re-entry, this is an opportunity to update your COVID-19 preparedness, response and control plans.

When making the appropriate updates to your organization’s COVID-19 plans, the following items should be included:

• It must speak specifically to your workplace environment
• It must mention all possible job tasks and areas in the workplace that could lead to possible exposure to COVID-19
• It must include the appropriate measures that will be taken to eliminate or reduce these exposures

Be sure to take the time to communicate with your employees of any changes and ask for their input—their questions and concerns can ensure all your bases are covered when creating the COVID-19 plan for your organization. Educating our employees on the severity of taking the necessary precautions to keep themselves and others safe is vital. To protect themselves while at work and at home, new policies and procedures related to illness, cleaning and disinfecting should be followed.

To ensure a safe workplace environment, employers should advise their employees of the following:

• If an employee is sick, they should stay home except if they are going to a doctor’s appointment to receive medical care
• If an employee’s family member is sick at home, they must alert their supervisor
• Avoid working in other employees’ work spaces and avoid using their office equipment
• Practice social distancing and avoid large gatherings while maintaining a distance of 6 feet
• Wash their hands regularly with soap and water for 20 seconds or use hand sanitizer
• Avoid touching their face with unwashed hands
• Clean and disinfect frequently touched surfaces or objects

While there is much more to learn about the severity and characteristics of this virus, as a nonprofit employer, you can do your part to follow important guidelines to create a safe and healthy working environment for your dedicated employees.

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This short employer guide shares valuable insights and key strategies for securing your brand during times of crisis, including: 

• Equipping your staff with the tools they need to stay productive at home
• Supporting employee mental health and well-being during a time of uncertainty
• Preparing to re-enter the workplace

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Nonprofit employers have faced unimaginable challenges in the wake of the COVID-19 pandemic. Now, as states start permitting businesses to reopen, nonprofits across the country are trying to figure out what that looks like for them, their employees and the communities they serve.

This informative webinar recording provides helpful tips for preparing to welcome employees back to the office while maintaining compliance with state and federal regulations related to the Coronavirus. Watch now to discover:

• Important workplace health and safety measures
• Ways to return employees to the office in phases
• How to handle common areas in the office
• And more general best practices

For additional COVID-19 employer resources and FAQs, please visit our COVID-19 Resource Center today!