USHL Coverage Relating to COVID-19

USHL Continues to Help Clients During This Difficult Time

As an essential business, US Health and Life (USHL) is committed to serving our clients during this challenging time, even with Michigan’s governor issuing a Stay Home, Stay Safe directive on Monday, March 23. We have moved our associates to remote operations for their safety and well-being while maintaining our full operations as part of our business continuity plans. We continue to pay claims and perform call center operations and work on billing and enrollment changes.

More details on our continuing operations during the COVID-19 are available to read here.

Enhancements to Member Coverage

Effective March 15, 2020, for a period of 90 days through June 12, 2020 (subject to review), USHL is waiving all deductibles, copays, member cost-sharing and prior authorization requirements for COVID-19 diagnostic testing related to the worldwide outbreak of the novel coronavirus disease.

  • Visits related to COVID-19 provided at a physician office, clinic, urgent care or emergency department will be covered at 100%, without member cost-sharing.
  • Laboratory charges directly related to COVID-19 testing will be covered at 100% with no member cost-sharing, regardless of whether the testing occurs at a physician’s office, clinic, urgent care or emergency departmen

Charges associated with treatment, hospitalization or other care will continue to be covered according to the plan documents. Members with questions about their coverage and benefits should refer to plan documents for details and contact customer service with any questions.

No prior authorization for COVID-19 testing

There are no prior authorization requirements for members to receive COVID-19 testing. If a member requires treatment for COVID-19 then the standard prior authorization requirements will apply, including prior authorization related to hospitalization. For more information about prior authorization, please visit the prior authorization page.

90-day refills

In an effort to help our members avoid exposure to germs, USHL is also allowing 90-day refills on any necessary medications.

Telehealth services

USHL is covering telehealth services, which can also help our members avoid germs.

With telehealth benefits, members can call and receive medical consultations via telephone with their doctors, clinics and other health care providers the same as if members made a visit to a doctor’s office in person.

Telehealth benefits allow members to receive a wider range of medical services remotely, without having to travel to a doctor’s office, clinic, hospital or other medical facilities.

A telehealth “visit” would be covered under the current schedule of benefits – including the benefit changes for COVID-19 – and a member should consult their current benefits information to learn about what cost-sharing would apply to the visit.

If a member needs care due to COVID-19, they should contact their Primary Care Provider (PCP), a clinic or urgent care facility. Members should be encouraged to contact their PCP for care, direction and guidance as not to place an unnecessary burden on emergency department resources.

Preventing the spread of COVID-19

We all can do our part to help reduce the spread of COVID-19. Please review and share our ”What can you do to prevent COVID-19” information.

We are also providing information about steps we as a company are taking to protect members and clients during this pandemic, including what we are doing for avoidance measures, communication and continuation of services to you, our clients, as this document details.

Changes for Employers Relating to COVID-19

US Health and Life (USHL) is sensitive and aware of the needs of our groups during this difficult time. We have made some additional accommodations to address these concerns by extending our grace period for premium payment and extending coverage to laid-off or furloughed employees. These changes are in effect immediately and will be re-evaluated in 90 days.

Extending grace period to 60 days for premium payments

USHL is extending the Grace Period for premium payment from 30 to 60 days.

  • Employers will continue to receive monthly invoices
  • USHL will continue to perform ACH pulls at the same time of the month as the current invoicing process
  • If an ACH pull rejects as NSF, USHL will contact the employer to verify the banking information as well as determine their intent to pay the invoice or take advantage of the extended grace period
  • USHL will not term a group for non-payment of premium sooner than 60 days from the due date
  • Groups and agents will continue to receive late notices for past due premium as the account approaches 60 days delinquent

Covering laid off or furloughed employees

USHL will continue to provide coverage for employees that are laid-off or furloughed during this crisis

  • Employers who have laid-off or furloughed employees may continue to cover them under their group policy
  • USHL will only remove an employee or dependent if the employer requests USHL to terminate them from the plan
  • If the employee is laid-off or furloughed during this crisis, the employer does not need to change their enrollment status other than to terminate the employee, add dependents or terminate dependents
  • The employer must continue to pay all premiums associated with members covered under the plan

Changes based on IRS guidance

These plan changes have been based upon the Internal Revenue Service (IRS) allowing employers to cover all diagnostic and treatment costs associated with COVID-19 without meeting an HDHP deductible and without denying plan members’ and employees’ contributions to Health Savings Accounts (HSA). This information was published by the IRS as Notice 2020-15, at https://www.irs.gov/pub/irs-drop/n-20-15.pdf.

Questions?

Please contact Sales Support to discuss your options as a self-funded customer at 844-828-5968 or through email

COVID-19 Resources

COVID-19 Prevention

Taking Additional Steps to Protect Members and Clients

What you need to know about the coronavirus, COVID-19.
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