May 29, 2020
To Our Valued Clients and Partners,
This is our 11th COVID-19 update. We transitioned this update to a bi-weekly cadence earlier this month. We exit the month of May with COVID-19 claiming over 100,000 deaths in the United States in less than four months, nearly 1.3M Americans with active COVID-19 diagnoses, and nearly 375,000 of our citizens have fought COVID-19 and recovered. Every state has begun the process of re-opening including in-person healthcare service. Companies large and small face challenges previously unimaginable. We are here to help you and your members stay healthy and sane while navigating your path back to work. 
Today's update topics include:
  • Return to work webinar series
  • How to participate in the IRS relief for FSAs and other cafeteria plans
  • Provider personal protective equipment (PPE) surcharges
  • Unemployment fraud update
  • Trends we are seeing 
Return to work webinar series
We are launching a series of return to work focused live webinars this month and beginning next week. You will have the opportunity to hear from experts and ask your burning questions. Our first webinar topic is Returning to Work, COVID-19 testing, screening, and resources.
Join us from 1:00 – 2:00 PM PT on Thursday, June 11th where our Chief People Officer, Sherrie Gietzen, will host an information-filled discussion with several special expert guests from Lab Corp, one of the top COVID-19 testing labs in the United States.

Do you have questions about testing or screening your workforce for COVID-19? Should you conduct onsite temperature testing? Should you send your people for antibody testing before they return to work? Should you test everyone for COVID-19 even if they are not symptomatic? How can you test non-benefits-eligible employees? These are just a few of the questions we've heard over the last few weeks and we want to connect you with the experts to answer these perplexing questions and explain some of the options, costs, and resources available to you.

Special Guests from LabCorp include:

Chris Garcia, MD, Medical Director, Clinical Informatics, LabCorp

Dr. Christopher Garcia is a medical director for the hospitals and health systems group at LabCorp Diagnostics and is also a co-discipline director of Digital Pathology within the company. He is board-certified in both Anatomic and Clinical Pathology, and completed a 2-year pathology informatics fellowship at Massachusetts General Hospital. He is actively involved in LabCorp’s COVID-19 efforts.

Dr. Garcia will also be joined by Dan Hardy, Managed Care Executive, LabCorp , and Dawn Irby, Business Development Executive, LabCorp Employer Services.
As of this writing, the FDA has granted emergency use authorization to 113 COVID-19 tests including 100 molecular diagnostic tests, 12 antibody tests, and 1 antigen test.
The current thinking is that any re-opening strategy must combine continued social-distancing, mask-wearing, frequent hand-washing, surface disinfection, testing, and contact tracing.
In yesterday’s White House press conference, The Trump Administration doubled-down on its role in testing referencing back to its Testing Blueprint published in late April. The White House provides COVID-19 testing guidance and acts as the supplier of last resort. Each state must develop its own testing plans and rapid response programs including the sourcing of testing and laboratory supplies and the expansion of testing platforms and capacity.
The state of Washington Secretary of Health issued an order yesterday requiring all residents and staff at assisted living facilities by June 12 th , 2020, and all memory care units by June 26 th , 2020, to undergo testing for COVID-19 except for facilities that completed a COVID-19 point prevalence survey on or after April 1, 2020. The state will provide tests and PPE at no cost and will pick up lab costs not covered by Medicare or Medicaid for staff at these 4100 facilities across the state. Currently, 4.5% of Washington residents have had a COVID-19 test. 
The Oregon Health Authority publishes a daily COVID-19 update . Nearly 120,000 Oregon residents have been tested for COVID-19 since the end of January. This means that 3% of Oregon’s population has been tested.
Idaho is taking action to increase testing capacity. According to the Johns Hopkins University States Comparison Report , Idaho has tested roughly 2.5% of its population. The Big Country News Connection reported on May 26 th that Governor Brad Little of Idaho plans to increase Idaho’s testing capacity from approximately 20,000 tests per week to 150,000 tests per week. 
Utah continues to lead the Western US, testing nearly 6.5% of its population and was one of the first states in the nation to launch a contact tracing app. 
How to participate in the IRS relief for FSAs and other cafeteria plans
We’ve received many questions this week from employers and members about how to participate in the IRS relief for FSAs and other cafeteria plans. The most common question we’ve received is how employees can make changes to their health or dependent care FSAs elections. If you are not familiar with this topic we encourage you to review this great blog post published this week by our consumer-directed health savings partner, HealthEquity, summarizing the COVI9-19 relief and guidance notices published earlier this month by the IRS. The new guidance is especially relevant for health and dependent care FSAs. Additionally, today, HealthEquity published a detailed one-pager with updates and next steps for FSA and HRA spending accounts.

It’s important to note that employers have a choice. Many employers who decide to extend relief recognize that COVID-19 has changed their members’ financial situation even though that change may not qualify as a ‘change-in-status’ event. If you have questions or want to make changes to your FSA or cafeteria plan based on the IRS guidelines, please reach out to HealthEquity’s Employer Services team Monday – Friday, 7:00 AM – 7:00 PM CT at 866.382.3510 . The HealthEquity team can help groups on a plan by plan basis navigate appropriate changes and initiate amendments where needed. 
Provider personal protective equipment (PPE) surcharges
With the re-opening of many dental and health care offices this month, providers are reaching out to their regular patients with ‘Welcome Back’ texts or emails to notify them of additional fees to expect during their next visit to cover the cost of PPE.
Before COVID-19, providers typically did not submit claims for PPE used during outpatient services, especially for dental care. We are seeing a wide range of fee surcharges from $10 per visit and up. For now, members may be asked to pay these PPE fee surcharges upfront. Again, this is new and there are no cost benchmarks and no coding standards for PPE in these situations. We are currently assessing the situation and will advise further on this topic in the near future. 
Unemployment fraud update
In our May 15th COVID-19 Update, we alerted you to the rampant unemployment fraud occurring in Washington state. Since then, law enforcement has shared that the fraud has been traced to a large crime ring in Nigeria. The FBI has now identified similar fraud crime schemes in multiple states.
Employment security departments across the country are inundated with claims for unemployment assistance and are struggling to keep up with demand, which creates a prime scenario for fraudulent activity. Fraudulent unemployment claims are a significant concern for both employers and employees. Unemployment insurance ratings are driven by unemployment claim filings, which means the more claims the more unemployment insurance costs for both employers and employees. Perhaps more critically is that a fraudulent unemployment claim is a sign that an individual’s identity has been stolen. Identity theft is a real threat that has long-term implications for individuals.
Some simple recommendations for employers to help combat unemployment fraud, include:
  • Make sure that any official Employment Security Department notifications that you receive are quickly routed for processing – don’t let them sit on a desk that won’t be touched for several days or weeks.
  • Make sure the person reviewing unemployment claims has visibility into who is currently on payroll and is aware of recent departures or reductions in hours.
  • Carefully scrutinize the claim and who the claimant is. Make sure that the individual is someone who would have legitimately filed for unemployment and not someone who is still actively working full-time.
  • Review your insurance coverages to see if any of your corporate policies, EAP, or ancillary coverages offer extra perks like credit monitoring services or support for employees who have been the victim of identity theft. Those can be invaluable benefits to promote and offer to employees if they are needed. 
  • Consider proactively notifying your employees and empower them to likewise be on the watch for official correspondence from Employment Security Departments. Encourage them to be proactive, if they haven’t filed a claim for unemployment benefits, but they receive paperwork that says they have, then they are victims of identity theft. They will need to contact the Employment Security Department and look into other actions that might be necessary to protect themselves from further identity theft. ( see suggestions below)
  •  If you or an employee suspects that fraud has occurred, immediately contact your State Employment Security Department’s fraud team. The U.S. Department of Labor has links for all 50 states for the public and employers to report claimant fraud.
  •  The victim should file a police report with their local law enforcement jurisdiction and record the police report case number keep records of related information. Please reference our May 15th COVID-19 update for additional reporting recommendations for fraud victims. 
Trends we are seeing
As our nation begins returning to work, the US Department of Labor’s Occupational Safety and Health Administration (OSHA) is gearing up with a flurry new guidance for employers to protect workers. They published several updates yesterday. Make sure that you are checking OSHA’s COVID-19 news and updates and the CDC’s worker safety support page regularly.
We’ve received questions about the timing of a COVID-19 vaccine. We want you to know that while several vaccine trials are underway and being fast-tracked, any mention of a vaccine timeline at this point is speculative. We know that some sources are saying that a vaccine is possible this fall. Please know that we do not expect a vaccine to be available for the general public for at least nine months. Additionally, be wary of advertisements for vaccines or medications to treat coronavirus which are not recommended by the CDC, your local health department, or your physician. This week the FDA issued warning letters to several companies for selling fraudulent products that claim to prevent, treat, mitigate, diagnose or cure COVID-19.
Claims for COVID-19 testing remain steady. In the last week, we’ve seen a surge in the scheduling of elective procedures. Hospitals and outpatient surgical centers in most states are now opening and eager to fill their schedules to make up for lost revenue. We anticipate significant demand for elective and deferred medical procedures from August to December of this year. We also expect (and encourage) members who had to cancel regular preventive care visits to reschedule those appointments now.
We’re Here for You  
Our focus, dedication, and support remain steadfast as we navigate these unique times with you. Know that our Care Management nurses are reaching out to those members diagnosed with COVID-19  to help them access the care and resources they need to recover safely. Thank you for your continued trust in our organization. We are in this with you and hope that you and yours stay safe and healthy. Please reach out to your Account Manager if you have any questions or if there’s anything we can do to help. 
Best Regards,
Lindsay Harris
Interim President
RGA - Proving What’s Possible in Healthcare ®