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COVID-19 Impact on Businesses & Brokers

We know there are many ongoing questions regarding coronavirus disease 2019 (COVID-19) and how it impacts everything from your businesses, your employees and even your own families.

We will waive out of pocket costs for COVID-19 medical testing, diagnosis and treatment for our fully insured employer groups through the declared state of emergency and will also work with our self-funded customers who want to implement a similar approach, so that these members’ needs can also be met during this time of concern.

Please know that we are dedicated to understanding the most recent developments and we will share information with you as soon as we are able. Because this is a fast-changing event, the U.S. Centers for Disease Control and Prevention (CDC) website continues to be the best resource for up-to-date information.

We are also in contact with local, state and federal health officials regarding regulations that remove cost barriers to care for members.

Please contact your broker or sales consultant for information specific to your business, and we will provide updates on this ever-changing situation.

Employer News Updates

Broker News Updates

NYS Cluster Zone Lookup Tool

We're With You As You Get Ready to Reopen

We’ve been by your side as our schools, favorite restaurants and places of employment closed to slow the spread of the coronavirus. Of course, we’ll be with you as our communities and businesses reopen.

While each region will open on a different timetable based on their ability to meet certain criteria, there are some guidelines we should all be practicing now, and in the future, to keep ourselves, our coworkers and our families safe. The following guidance provided by the Centers for Disease Control and Prevention (CDC) since the pandemic began still holds true. Everyone should continue to:

  • Stay at least 6 feet from other people.
  • Wear a cloth face covering over your nose and mouth when in public.
  • Cover your cough or sneeze with a tissue, then throw it in the trash and wash your hands.
  • Wash your hands with soap and water for at least 20 seconds. If you don’t have soap and water, use a hand sanitizer that contains at least 60 percent alcohol. Cover all surfaces on your hands and run them together until they dry.
  • Do not touch your eyes, nose and mouth.
  • Clean and disinfect frequently touched objects and surfaces.
  • Stay home when you are sick, except to get medical care.

​As we head back to work, there’s no doubt things—and people—will look different. There are some additional things to remember.

Cloth Face Coverings GuidanceHelpful Links for Reopening NYS
Cloth Face Coverings Guidance

Our new normal now includes covering our mouth and nose when out in public. Cloth face coverings can be fashioned from household items or made at home from common materials at low-cost, and should be used as a public health measure, beyond social distancing.

  • Make sure it fits snugly and covers your nose and mouth.
  • Change it frequently and wash when soiled or wet.
  • And remember, it may not prevent you from becoming infected, but it might help slow the spread to someone else.
Financial Relief for Small Groups Experiencing Hardship

For small groups who require it, we’re providing up to a two-month grace period for premium payments. This extended payment period is not a complete waiver of payment, but it will allow you to delay your April and May payments until June 1, 2020, without negatively impacting your account standing or credit history.

If you believe this would be helpful to your business, please complete a hardship verification form:

  1. Complete the form with the requested information.
Download Hardship Verification Form
  1. Save the form as your company name.
  2. Email the form to enrollment@sgenu.com and include your company name in the subject line. This email address is maintained for special enrollment requirements. Your email will go directly to the Univera Healthcare sales administration team.
    Univera Healthcare
    12 Rhoads Drive
    Utica, NY 13502

Please return the form by April 30, 2020. If you have any questions or would like to discuss billing or alternative payment arrangements, please call 1-800-427-8490 and select option 1, or connect directly with your broker. Agents and brokers who procured a policy for an individual, small group, or student plan must also provide notice to the policyholder by April 21.

Cost Relief Available With Mid-Year Plan Changes For Groups

Univera Healthcare wants to ensure as many of our group members as possible can maintain their health insurance benefits. Through the national state of emergency, we are allowing mid-year plan changes to allow for lower cost employer and employee plans to accommodate the COVID-19 impacts on both parties.

Groups can allow their employees to switch to a lower cost existing plan or buy down to a lower cost plan. Additionally, employees who waived coverage and now want health insurance will be able to sign up for a plan through their group during our special open enrollment throughout the federal state of emergency.

Contact your broker or account representative if you would like to take advantage of any of these options or for more information on how we can help.

Small Business Administration COVID-19 Guidance and Loan Resources

During these uncertain and challenging times, our Univera Healthcare team is here to provide access to resources to help your business and employees. The Small Business Administration (SBA) has programs and initiatives in place as a result of the Coronavirus Aid, Relief and Economic Security (CARES) Act, passed on March 27, 2020 should your business need assistance.

These programs include:

  • Paycheck Protection Program - Assistance to cover the cost of retaining employees
  • Emergency Economic Injury Grant - Grants to help cover your business now
  • Small Business Debt Relief Program - Relief from keeping up with payments on your current or potential SBA loan

For more information and to learn how to apply for one of these programs and other initiatives that may be able to provide assistance, visit the Small Business Administration’s website.

Effective Immediately: Member Benefit Changes
  • Prior authorizations will be waived for diagnostic tests and for covered services that are medically necessary and consistent with CDC guidance for members if diagnosed with COVID-19 through June 18, 2020.
  • Coverage of medically necessary diagnostic tests that are consistent with CDC guidance related to COVID-19 at no cost share to the member.
  • During the duration of the state of emergency all telemedicine visits will be covered in full for fully insured groups. Members will have no cost share while this is in effect.
  • Members will have coverage with no out-of-pocket expense to them, for provider office visits, urgent care visits and emergency room visits resulting in testing for COVID-19. If an in-network provider is not available, the Health Plan will cover testing at an out-of-network provider with no out-of-pocket expense to the member.
  • Members with high deductible health plans will not be responsible for copayments, coinsurance and deductibles for 2019 Novel Coronavirus (COVID-19)-related testing even if the deductible has not been met, under new guidance from the Internal Revenue Service. This also means that an individual with an HDHP that covers these costs may continue to contribute to a health savings account (HSA).
  • We will provide coverage for COVID-19 vaccines in accordance with applicable state and federal guidance. Because no FDA-approved vaccine is available, much is still unknown and we continue to monitor the situation as it develops.

For all our members, we are making dedicated clinical staff available to address inquiries related to medical services, ensuring timeliness of responses related to COVID-19. We will also ensure that patient testing and any subsequently needed care are done in close coordination with federal, state and public health authorities.

COBRA Programs and FAQ

For those groups who offer COBRA, all COBRA processing will be continuing as usualTo ensure employees receive the necessary paperwork to continue their benefits through COBRA in a timely manner, please submit your new COBRA qualified beneficiary information and/or terminations as you typically have through one of the following methods:

  • Via bulk daily file feeds after employment status change has been processed
  • Via regularly scheduled file feeds directly from the group
  • Via the COBRA employer portal on our partner, Lifetime Benefit Solutions’ (LBS) website
  • Via email from the group administrator

Employers: Download the Individual Coverage Options Beyond COBRA toolkit from UniveraforBusiness.com for a ready-to-send employee email and coverage options flyer.

Subsidizing COBRA Premiums for those Impacted by COVID-19
We understand this is a difficult time for many, including those whose employment has been impacted by the COVID-19 pandemic.  To help alleviate some of the concern and financial stress in these circumstances, some groups may decide to subsidize the COBRA premiums for those employees.  In these instances, LBS will set the qualified beneficiary up with a subsidy and send a monthly invoice to the group to pay for the portion of the premium that is being subsidized.  Please see the FAQs section below for more information on subsidizing COBRA premiums.
Frequently Asked Questions

The COVID-19 situation is rapidly evolving, and the Health Plan is in contact with local, state and federal health and other officials, and is implementing applicable orders, regulations and requirements as they become effective.

The FAQs provided below are specific to offering COBRA coverage to your members and any impacts on this benefit due to the COVID-19 pandemic. It is our hope that these circumstances will be temporary, and that businesses will be able to return to normal operations soon.  We will continue to update this information as the situation changes.

Will Univera Healthcare be extending COBRA coverage beyond 18 months?

As of now, regulations have not changed regarding COBRA coverage time periods and we will be following existing guidelines, which in some cases may extend coverage up to 36 months.  More information can be found on the Department of Financial Services’ (DFS) website

When cancellations are processed in the Univera Healthcare system due to reduction of hours or layoff, how do we make sure the member’s COBRA letter says reduction of hours and not termination?  

For those that typically process employee status changes through the Univera Healthcare system that are sent as a bulk daily file feed to LBS, the only options currently in the system are for “termination”. Please note, if an employee experiences a reduction of hours that make them no longer eligible for benefits, selecting “termination” through this process will have no impact on the timing or process of their COBRA benefits.

For those that typically use the LBS employer portal to submit employee status changes, there are a few event types, including reduction in hours and reduction in force, that the group or broker can choose.

If a small group goes out of business, will we continue to offer COBRA coverage to the members?

Unfortunately, at this time, we are unable to continue to offer COBRA coverage to COBRA qualified beneficiaries of businesses that are no longer active.  We will continue to follow local, state and federal health officials’ guidance regarding this circumstance as information is made available.

If a company lays off staff or reduces hours due to COVID-19, resulting in the group not meeting subscriber eligibility guidelines, laws or regulations, what is Univera Healthcare’s position at this time?

We are actively working with groups who are experiencing changes to their eligibility in order to accommodate the coverage needs of our customers and community.

Can a client/group enroll a member in COBRA without a signed election form from the member with client’s/groups permission?

This is not currently allowed but is being reviewed given the unique circumstance. We will provide more information as it becomes available.

What are the latest COVID-19 updates regarding regulations that will impact COBRA?

On May 5, 2020, the Department of Labor announced that from March 1, 2020 until 60 days after the end of the National Emergency, all timeframes must be suspended. After this time period, standard timeframes will commence.

Can we differentiate traditional COBRA members from COVID-19 COBRA members? 

Yes, LBS can track COVID-related COBRA events from traditional COBRA Events. Members should be reported to LBS through the normal input channel. There will be an additional group and broker requirement to email a member roster for those where COVID-19 tracking is required to LBSTeamPurple@lifetimebenefitsolutions.com.

As the COBRA administrator, LBS, bills the COBRA member directly, will there be an option for the group to be billed if the group chooses to pay either all or part of the COBRA premium?

Yes, if the employer chooses to subsidize the member premium, LBS can accommodate this arrangement.  An email requesting this should be directed to LBSTeamPurple@lifetimebenefitsolutions.com. The email must include the member(s) name, last 4 digits of the SS# and indicate the amount of subsidy to apply to the member. Full dollar or percentages can be utilized.

If COBRA is required and the group uses LBS as their COBRA administrator will there be a change in how quickly the COBRA enrollment packet is mailed?

Initial member notifications are processed automatically once loaded into the system. We do not anticipate any delays in mailing enrollment paperwork currently. There is a possibility that individual carriers may experience delays affecting coverage changes due to anticipated increases in volume.

If a company pays for part of the deductible on an HRA do they have to pay for the COBRA HRA portion as well? 

No, the member is typically required to pay their HRA COBRA premium. It can be subsidized by the employer as mentioned above.

Does the COBRA administrator, LBS, have the capacity to handle an influx of COBRA enrollments, notices and new participants?

Yes, LBS has secured additional resources to process the anticipated influx of COBRA activity.

What forms of payment is are accepted for COBRA premium payments?

LBS will continue to accept all forms of payment. Members can pay via check, through the LBS online COBRA portal via recurring ACH, via the LBS online COBRA portal via one-time credit card payment* or by calling the dedicated LBS customer service line at (800) 828-0078.

*The third-party vendor that LBS uses to process one-time credit card payments charges a $20.00 processing fee per single transaction. However, you can avoid this fee by (1) mailing a physical check, (2) establishing a recurring ACH payment online, or (3) by calling the LBS customer service department at (800) 828-0078. Dedicated LBS customer service representatives can process a one-time credit card payment for you over the phone at no additional cost.

What is the LBS non-payment cancellation policy and will exceptions be made due to COVID-19?

Department of Labor announced that from March 1, 2020 until 60 days after the end of the National Emergency, all time frames must be suspended. After this time period, standard time frames will commence.
Employer COBRA Portal Resources
In partnership with Lifetime Benefit Solutions (LBS), we are making helpful tools and resources available to our employer groups to assist in processing new qualified beneficiaries for COBRA. If you typically submit employee status changes via the COBRA employer portal on LBS’ website, we have step-by-step tutorial videos available in case you need assistance with performing common tasks or actions within the portal.
Stay Informed: Create a Member Account
The best way to stay informed and have access to your coverage is online. Let’s get you set up online today. For help or questions with your insurance plan, call the number on your Member Card for personalized care, or contact us.
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