Jun 29, 2020
Employees with reduced work hours, or who have been furloughed or laid off, can remain on a group plan.
If an employee was laid off, furloughed, or had reduced work hours below eligibility requirements during the COVID-19 outbreak, and premiums were not paid during this time, reinstatement for coverage is possible without the standard waiting period (if re-enrolled within six months of when coverage ended).
Plan selection downgrades will be allowed through September 30, 2020
To help provide options for employers concerned about the impact of COVID-19 on their financial situation, Blue Shield of California will offer the ability to downgrade to a leaner plan design off-anniversary.
Small Group: Buy-down selections must be consistent with the current plan type offered by the group: PPO plan to PPO or HMO plan to HMO. If a group changes plan selections, employees can choose from any of the plan offerings as long as they are choosing a downgraded plan. The rates for employees who choose a buy-down plan off-cycle will be based on the age of the member at the time of the change.
Large Group: Buy-down options are for portfolio plans only. Group plan down-grades off-anniversary are not an open enrollment opportunity; employees will remain in their same plan type with the down-graded benefits. An exception to this is made for groups offering Trio HMO and/or Tandem plans, for which employees may take advantage of the opportunity to change their plan election and enroll in Trio or Tandem.
The option to buy-down to leaner benefits applies for medical plans, dental plans, and vision plans.
The Special Enrollment Period (SEP) has been extended through September 30, 2020.
Blue Shield will continue allowing Special Enrollment Period (SEP) for COVID-19 through September 30 for small businesses. The COVID-19 SEP for large groups (101+) will end June 30, 2020. Self-funded plan sponsors typically determine the eligibility of group coverage, which is described in their Plan Document.
- This special enrollment for small groups applies only to employees who previously waived coverage for themselves and/or their dependents, allowing enrollment without any of the standard qualifying life events.
- Enrollment requests must be received on or before the 1st of the month for which enrollment is being requested.
- This applies to all enrollment for medical plans, dental plans, and vision plans.
Contact your LISI Regional Sales Manager for more information.
