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We are committed to continue serving our community, members and valued brokers throughout this quickly changing health crisis. The following frequently asked questions have been drafted and will continue to be updated as appropriate to provide you with helpful guidance and reliable resources.  If your question is not addressed below or you wish to discuss any of the following, please contact us at grouphealth@coxhealthplans.com or your dedicated Cox HealthPlans representative.

GENERAL QUESTIONS

What is COVID-19?

Coronavirus Disease 2019 (COVID-19) is a respiratory illness that has spread to several countries, including the United States. Most cases are mild, but severe cases can be fatal.  According to the Centers for Disease Control and Prevention:

  • 80 percent of the population may experience mild symptoms, such as fever or flu-like symptoms that they treat at home
  • 15% may seek medical care, such as visiting an Urgent Care or Emergency Department
  • 5% may require critical care, meaning being admitted as an inpatient
  • 1.6% of confirmed cases (confirmed cases representing between 5-10% of all infections in the community) will die.

The current situation is dynamic and evolving. Prevention is key. Communities and community members can engage in precautions to protect yourself and our community, even if you are not ill and don’t have symptoms. 

In this video, Dr. Robin Trotman with Infectious Diseases at CoxHealth, shares information about the virus, including some misconceptions around it.

For updates and general information in our community, visit:

What can I do to help prevent it?

Take everyday precautions:

  • Avoid close contact with people who are sick.
  • Clean your hands often. Wash your hands often with soap and water for at least 20 seconds, especially after blowing your nose, coughing, sneezing or having been in a public place. If soap and water are not available, use a hand sanitizer that contains at least 60 percent alcohol.
  • To the extent possible, avoid touching high-touch surfaces in public places (elevator buttons, door handles, handrails, handshaking with people, etc.). Use a tissue or your sleeve to cover your hand or finger if you must touch something.
  • Clean and disinfect your home to remove germs. Practice routine cleaning of frequently touched surfaces (i.e., tables, doorknobs, light switches, handles, desks, toilets, faucets, sinks and cell phones).
  • Avoid crowds, especially in poorly ventilated spaces. Your risk of exposure to respiratory viruses like COVID-19 may increase in crowded, closed-in settings with little air circulation if there are people in the crowd who are sick.

Source: https://www.coxhealth.com/coronavirus/

Are telehealth services available for assessments?

For dates of service beginning March 30th, Cox HealthPlans will waive the member cost share for medically qualified telehealth (video+audio) visits conducted by in-network providers for our fully insured individual plans, employer plans, short-term plans and level-funded plans for 60 days. 

This includes visits for mental health or substance abuse disorders but excludes therapy visits (PT, ST, OT).

Cost sharing will be waived for members utilizing CoxHealth's Virtual Visit platform and eVisits for this period.

Not everyone needs to be tested for COVID-19. Learn more from Dr. Tim Jones, President of CoxHealth Medical Group, about what risk factors would cause someone to need a test in this video.

What is the stay at home order? Who does it affect?

Springfield Mayor Ken McClure and Greene County Presiding Commissioner – in consultation with Health Department Director Clay Goddard and health care system partners - issued a “Stay at Home” Order, requiring Springfieldians to stay at home except for “essential activities” as our community continues working to slow the spread of COVID-19. Grocery stores, pharmacies, gas stations, health care facilities and government services are examples of those which will remain open. View Greene County’s Stay at Home Order.

Stay at home order:

Will Cox HealthPlans be open for business during the stay at home order?

Our offices are closed to the public and any payments or applications will be accepted via our drop box outside the front door of our office.

Phone calls and emails will still be answered by our staff as they are received during our normal working hours of 8:00am - 5:00pm, Monday - Friday. If you need assistance that cannot be handled by phone or email, please contact your CHP representative to schedule an online meeting.

Will Cox HealthPlans continue accepting Short-Term applications?

Yes - we will continue to receive applications and follow standard underwriting process. 

How is my insurance going to pay for testing and treatment of COVID-19?

Cox HealthPlans (CHP) is waiving any member cost-sharing for the CDC approved COVID-19 diagnostic test for all of its commercial, fully-insured and level funded plans and will work with each of its self-funded groups to determine their stance.

CHP also confirms that prior authorization is not required for the CDC-approved diagnostic test nor any other diagnostic services related to COVID-19 testing. Services received beyond the CDC approved diagnostic test will be covered according to the member’s health plan benefits. Should a COVID-19 immunization become available then CHP will assess any further changes to benefits at that time.

Telehealth (Virtual Visits) is covered in all of CHP’s plan designs.

CHP is coordinating closely with CoxHealth on COVID-19. If you have any other questions please contact Member Services by e-mail at members@coxhealthplans.com or by telephone at (417) 269-2900.

How can I get my prescriptions filled?

CHP encourages members to utilize the service delivery option or prescription mail order.  To get your prescriptions set up for mail order, contact EnvisionRx Mail Order at 1-844-293-4761 or visit https://www.envisionrx.com/Login.

Another option is to ask your pharmacist about the option to fill your prescription(s) for a 90-day supply at retail.

Can I get my prescriptions refilled early?

Pharmacies are considered “essential businesses” and are open to fulfill prescriptions. Currently, we have not been made aware of any local or national drug shortages.  We will review individual member needs as they arise for one-time emergency overrides for those that need a refill sooner than their normal allowable refill time. 

What happens to my employee’s insurance if I have to put them on a leave of absence?

Please be aware that employees on a temporary leave of absence or temporary layoff have different rules affecting their coverage and reinstatement of coverage than employees that have been terminated.

Condensed from CHSIC PPO Group Certificate of Coverage: Section 9 pages 40-41*:

*An employee will be deemed Actively at Work if the Employee is on a leave of absence or temporary layoff, for reasons other than Disability, for a period exceeding the end of the policy month following the policy month during which the leave of absence or layoff commences.

Example: Employee is laid off or asked to not show up to work on 3.26.20. The employee will have coverage (barring employer terming group or employee coverage or not paying premium) until the end of the following month – in this case 4.30.20. The employee would be eligible for COBRA on 5.1.20.

Please refer to the plan document applicable to your policy to verify this coverage.  Other CHP coverage documents include:

  • CHSIC EPO Group: Section 9 pages 46-47
  • CHSIC SMGRP: Section 9 pages 47-48
  • Level Solutions: Section 10 page 66

Rehiring Terminated Employees:

The enrollment waiting period for rehires can be dependent on the amount of time from termination or break in coverage to rehire date and the size of the group.

All groups: If an employee has less than 31 days break in coverage, we will reinstate them without a break of coverage. This is dependent on the group allowing no break in coverage. The group must apply the rule uniformly to all members – they cannot force a break in coverage for an hourly employee but not enforce a break in coverage for salary employees. 

Groups 50+: If the break in coverage is less than 13 weeks we would follow the ACA rules and not apply a waiting period. 

Small groups 2 – 50:  We allow the group to determine if a waiting period applies to a rehire within 6 months of the termination date. The group must indicate the policy they will follow. The group must apply the rule uniformly to all members – they cannot force a waiting period for an hourly employee but not enforce the waiting period for a salary employee.

COBRA Eligibility

If the employee is still eligible for coverage and waiving coverage for their dependents, the dependents would not be eligible for COBRA. If the employee has a reduction in hours and no longer meets the eligibility requirements then that would be a COBRA event for themselves/dependents.

How will this affect my group’s open enrollment?

Group health plan Open Enrollment periods are applicable during the month prior to and the month of the policy anniversary. At this time this has not been adjusted however with the situation changing daily, we are keeping all options open.

Are there other health insurance options for employees who lose coverage due to being terminated or working less than the minimum hours required to be eligible for group coverage?

Losing coverage is a qualifying event for special enrollment on the federal marketplace. Visit healthcare.gov to see plans available in your area.

Additionally, Cox HealthPlans offers short-term plans for those that qualify. Visit coxhealthplans.com to see available options.

What are some resources for me to get accurate information about the virus and my community?