Frequently Asked Questions

Health Plan Questions For COVID-19 Business Disruption

州长迈克·德万最近宣布了暂停或修改商业运营的政策，以帮助遏制COVID-19(冠状病毒)的传播. 以下我们将解答一些常见问题，以帮助您更好地了解与员工持续健康保险有关的健康计划选择.

这部分常见问题是由医疗互助提供的，答案将反映具体的医疗互助计划的答案.

My plan is fully insured. If I lay off part of my workforce in response to the COVID-19 crisis, can the company continue to cover those employees?

是的. Through May 31, 2020, 医疗互助公司(Medical Mutual)正在放宽其要求，即员工必须积极工作才能有资格获得保险，并允许你为下岗员工提供保险, as long as you pay the monthly premium. 请注意，您必须在统一、非歧视的基础上提供这种保险. 换句话说，你不可能只选择某些你继续支付溢价的人.

My plan is fully insured. If I have to lay off my entire workforce in response to the COVID-19 crisis, can the company continue to cover those employees?

If one person remains employed by the company and covered by the plan, e.g. the owner or a management employee, 只要支付保险费，公司就可以继续为下岗员工提供保险. 请注意，您必须在一视同仁的基础上提供这种保险. 换句话说，你不可能只选择某些你继续支付溢价的人.

If I lay off a significant part of my workforce today, will coverage extend until the end of the month?

If premiums have been remitted for the month of March, coverage will continue through the end of March.

如果由于COVID-19疫情，我的小组入学率下降10%以上, will my rates/premiums be subject to change?

Through May 31, 2020, if the loss of enrollment is a result of the COVID-10 situation, rates and premiums will not be adjusted.

What about continuation coverage if my plan is fully insured?

If your group is subject to COBRA, as long as one person remains actively employed, 雇员可根据正常通知和选举程序选择继续按COBRA投保. 如果该计划没有在职员工，该计划将被终止，COBRA也不再是一个选项. In that case, 雇员将有一个特殊的注册期来参加个人保险，或者可以购买一个受医疗保险影响的短期计划.

If your group is not subject to COBRA (for example, it employs fewer than 20 people), as long as one person remains actively employed, 雇员可以根据俄亥俄州的延续法令选择继续投保12个月. 小雇主应该在下岗员工被解雇时通知他们这一权利. 如果te计划没有在职员工，该计划将被终止，不能继续执行. In that case, 雇员将有一个特殊的注册期来参加个人保险，或者可以购买一个受医疗保险影响的短期计划.

My plan is self-insured. If I lay off part of my workforce in response to the COVID-19 crisis, can the company continue to cover those employees?

是的. If Medical Mutual is your stop loss carrier, as long as you continue to pay administrative fees and claims costs, along with your stop loss premium, 你可以继续为下岗员工提供保险，即使他们没有积极地工作. 请注意，您必须在统一的、非歧视的基础上管理该计划. 换句话说，你不可能只选择某些人，你继续支付索赔. If Medical Mutual is not your stop loss carrier, 你应该向你的止损保险公司查询是否为那些没有积极工作的下岗员工提供保险.

My plan is self-insured. If I have to lay off my entire workforce in response to the COVID-19 crisis, can the company continue to cover those employees?

是的, as long as one person remains actively employed by the group. 如果医疗互助是你的止损承运人，你继续支付行政费用和索赔费用与你的止损保费, 你可以继续为下岗员工提供保险，即使他们没有在积极工作。请注意，你必须穿着制服管理这个计划, non-discriminatory basis. 换句话说，你不可能只选择某些人，你继续支付索赔. If Medical Mutual is not your stop loss carrier, 你应该向你的止损保险公司查询是否为那些没有积极工作的下岗员工提供保险

What about continuation coverage if my plan is self-insured?

If your group is subject to COBRA, as long as one person remains actively employed, 雇员可根据正常的通知和选举程序，选择继续按COBRA投保. If Medical Mutual is not your stop loss carrier, 您应该确保与您的止损承运人检查任何规则，它可能有关于最低登记在职员工的止损保险.

如果该计划没有在职员工，该计划将被终止，COBRA也不再是一个选项. In that case, 雇员将有一个特殊的注册期来参加个人保险，或者可以购买一个受医疗保险影响的短期计划.

If I have to terminate coverage for my employees in the middle of a month, will I receive a refund of my premium for the rest of the month?

虽然你的合同上说医疗互助公司不会退还部分月保费, given the gravity of the current situation, 如果您在月底前终止投保，我们将按比例退还保费.

My plan is self-insured with 100+ employees. 如果为了应对COVID-19危机，我不得不裁掉相当一部分员工, will I need to change to a fully insured arrangement?

No, as long as the layoffs are temporary in response to the COVID-19 crisis.

Will renewal rate actions be delayed as a result of the COVID-19 situation?

No. 医疗互助公司已经全面运营，所以续签将会及时发布. However, payment plans are being offered to assist customers on an as-needed basis.

考虑到新冠疫情，我的保险费能否得到宽限期。?

是的. 医疗互助公司提供将你下一个月保费支付的宽限期延长30天. 有了这个扩展，拖欠通知将被暂停，您的覆盖将不会被中断. To extend your payment grace period, 请致电1-与支付专家，谁可以处理您的请求和回答您可能有任何问题.

医疗互助公司能够为那些在失业后失去医疗保险的员工提供帮助吗?

医疗互助公司可以为那些被解雇的人提供个人短期和符合aca规定的健康保险计划. Interested individuals should contact 1- to speak with an advisor who can assist. They can also visit Med Mutual.com to apply directly.

How soon will coverage be effective for those who enroll in an ACA-compliant plan?

For plans sold on the federal exchange (the marketplace), government rules require coverage take effect the first of the next month. For off-exchange policies, 医疗互助将放弃正常的特殊登记期程序，并允许申请人获得保险, effective the day after the loss of their employment. 请注意，保费补贴可能适用于在联邦市场购买的保险. Premium subsidies are not available for off-exchange plans.

How soon will coverage be effective for those who enroll in a short-term plan?

如果申请人通过核保，短期计划可在提交申请后的第二天生效.

如果会员已经满足或支付了其团体保险的部分免赔额, “医疗互助”是否会根据他们在该年内已经花费的金额，为他们的新个人计划申请免赔额?

可以，但前提是该会员之前的保险属于医疗互助计划. If the member had coverage under another carrier, they can still enroll in a Medical Mutual individual plan, but they will start their new plan with $0 applied toward the deductible.

是否允许因COVID-19担忧而暂时下岗的员工在重返工作时无需等待一段时间就重新加入该计划?

是的. 2020年5月31日之前重新聘用的现有员工将没有等待期. New hires are subject to any waiting period the plan requires.