Update: COVID-19 Coverage for ASO Groups Regarding FFCRA and Telehealth Expansion
ASO customers have some choices about how we administer COVID-19-related coverage for their employees.
The Families First Coronavirus Response Act (FFCRA), which was enacted on March 18, 2020, requires ASO groups to provide coverage (FFCRA coverage) for COVID-19 testing and related services as outlined in Table A. (The federal mandate will remain in effect until the public health emergency is declared over by the federal government.)
To maximize the effectiveness of this coverage and serve as many members as possible, the benefit coverages outlined here will apply for all dates of service on or after March 18, 2020, and until the public health emergency is declared over.
In addition to the FFCRA coverage being added, ASO customers can also offer expanded coverage of telehealth services provided through an already contracted vendor or physician, at no cost share to members, through April 30, 2020. This Telehealth Expansion benefit is described in Table B.Between now and April 30, we will consider whether to extend the timeframe of this temporary cost-sharing change.
Action Needed: ASO Group Choices ASO customers will need to notify you and you will need to notify us by April 1, 2020, if they only want to offer the FFCRA coverage. Otherwise, we will set the group up consistent with the Blue Cross and Blue Shield of New Mexico (BCBSNM) standard coverage: FFCRA coverage + Telehealth Expansion. This benefit coverage will be in place for dates of service on or after March 18.
Important Notice for ASO Group Customers: BCBSNM is working to assist and support our ASO group plan sponsors and members during this COVID-19 public health emergency. As part of this assistance and support, we are adding benefits and services that ASO customers are required by law to provide under their health plan and are making benefits and services available that plans are encouraged by the federal government to provide, as part of an effort to combat and reduce the spread of COVID-19. We have notified ASO customers and this is our notice to ASO customers you represent of our approach to processing benefit claims for ASO customers under our agreement with them. Unless you or your ASO customer contacts their BCBSNM account executive to instruct us to not add the Telehealth Expansion, or FFCRA coverage described here, we will consider the ASO customers you represent to have authorized BCBSNM to add such coverage to their health plan. Nothing in this communication modifies or relieves any ASO group plan sponsors of their obligations under the law, nor does it impact or change BCBSNM’s role as claims administrator.
Additional Coverage Notes:
HDHP plans may participate in FFCRA coverage or FFCRA + Telehealth Expansion.
Participation in FFCRA coverage or FFCRA + Telehealth Expansion does not impact a plan’s “grandfathered” or “grandmothered” status.
A telehealth visit that results in the order for or the administration of a COVID-19 test must be covered at no cost share to the member as part of FFCRA. Further expansion of telehealth coverage and/or cost share is not required beyond the former statement as part of FFCRA.
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Blue Cross and Blue Shield of New Mexico, a Division of Health Care Service Corporation, a Mutual Legal Reserve Company, an Independent Licensee of the Blue Cross and Blue Shield Association