Feds Will Require Group Health Plans to Cover At-Home COVID-19 Tests

Beginning January 15, 2022, health insurance companies and group health plans are required to cover the cost of up to 8 over-the-counter, at-home COVID-19 tests per covered person per month. The new coverage requirement means that most health plan participants may buy an FDA-approved COVID-19 rapid test, for their personal use and either get it paid for up front by their health plan or get reimbursed by submitting a claim to their plan.
 
These over-the-counter test purchases will be covered without the need for a health care provider’s order or individualized clinical assessment, and without any cost-sharing requirements such as deductibles, co-payments or coinsurance, prior authorization, or other medical management requirements.
 
Note: Health insurance companies and group health plans are not required to provide coverage of testing (including these at-home COVID-19 tests) that is for employment purposes. Employers that require their employees to vaccinate or be tested cannot use this new reimbursement requirement to satisfy those rules.
 
What Dealers Need to Do:

Dealers should promptly contact their carriers and health plan service providers to discuss the new mandate and ask if they are prepared to comply with this new rule. Dealers will also need to get a sense of the process the carrier or service provider is using to meet this requirement so you can communicate this information to your employees promptly.
 
While the coverage has been widely reported in the news, employees will likely have questions, so a proactive communication strategy can help alleviate an employee’s concerns. The Centers for Medicare & Medicaid Services have provided robust FAQs that provide(s) additional information regarding this new coverage requirement.
 
GNYADA thanks HUB International Northeast, the Association’s official insurance brokerage, for the contents of this Dealer Bulletin. Contact Mike Conway, Executive Director, GNYADA Insurance Brokerage to learn more about how HUB can help meet your dealership’s insurance needs or if  you have any questions regarding this new mandate at 718.746.8100 or mconway@gnyada.com.
 
About Hub International Northeast:
Hub International, is a leading global insurance brokerage that provides property and casualty, life and health, employee benefits, and risk management products and services.  Hub is a full-service insurance brokerage firm with approximately 900 employees working in regional offices located throughout New York, New Jersey, Connecticut, Pennsylvania, and Rhode Island.

January 14, 2022