On Dec. 11, 2020, the Food and Drug Administration (FDA) issued an Emergency Use Authorization (EUA) for the Pfizer-BioNTech COVID-19 vaccine.

The next day, the Advisory Committee on Immunization Practices (ACIP) of the Centers for Disease Control and Prevention (CDC) recommended use of the vaccine for individuals 16 years of age and older.

The FDA subsequently issued an EUA for the Moderna COVID-19 vaccine on Dec. 18, 2020. One day later, ACIP recommended the use of the vaccine for individuals 18 years of age and older.

The ACIP recommendation of a vaccine triggers the requirement for non-grandfathered group health plans and health insurance issuers to cover the

vaccine without cost sharing under the Affordable Care Act’s preventive care requirements.

Under the Coronavirus Aid, Relief, and Economic Security Act (CARES Act), this coverage must be provided within 15 business days after the recommendation is made. It is understood that coverage of the Pfizer-BioNTech COVID-19 vaccine must begin no later than Jan. 1, 2021.

Plans and carriers may choose to cover the vaccines before this date. Grandfathered plans may also choose to cover the vaccines, and could be required to do so under state law or pursuant to the terms of an insurance policy.

For more information, contact Deutsch & Associates, LLC today.

Final Rule Allows Greater Flexibility for Grandfathered Plans Under the ACA

On Dec. 15, 2020, the Departments of Labor, Health and Human Services and the Treasury (Departments) published a final rule that provides greater flexibility for grandfathered plans under the Affordable Care Act (ACA).

A grandfathered plan is a group health plan or health insurance coverage that was in existence on March 23, 2010 (the date the ACA was passed), that has not made certain prohibited changes to lose its grandfather status. Grandfathered plans are exempt from certain ACA requirements.

The final rule:

• • Allows grandfathered high deductible health plan (HDHP) coverage to increase fixed-amount cost-sharing

requirements, such as deductibles, to the extent necessary to maintain its status as an HDHP without losing grandfather status; and

• • Provides an alternative method of measuring permitted increases in fixed-amount cost sharing that is intended to allow plans and issuers to better account for changes in the costs of health coverage over time.

This additional flexibility may allow additional plans to maintain their grandfather status, despite certain changes being made to the plan.

Contact us today to discuss the potential impact that the final rule may have on your business. Read More

Everyone occasionally has bouts of sadness, but these feelings are usually temporary. When a person has a depressive disorder, it interferes with daily life. Depression is a common but serious illness.

There is no single cause of depression, but it likely results from a mix of genetic, biochemical, environmental and psychological factors. Depression commonly coexists with other illnesses, such as anxiety disorders or substance abuse. It can affect anyone at any time, including children.

Types of Depression

There are several forms of depressive disorders, the most common being the first two listed below.

• • Major depressive disorder—characterized by a combination of symptoms that interfere with a person’s daily life. It is disabling and prevents a person from functioning normally
• • Dysthymic disorder—also called dysthymia, it is long-term (two years or longer) feelings of depression that are not extremely severe, but still prevent a person from normal functions of daily life.
• • Psychotic depression—occurs in conjunction with a form of psychosis, such as hallucinations or delusions.
• • Postpartum depression—can occur within a year of giving birth. Symptoms include sadness, lack of energy, trouble concentrating, anxiety, and feelings of guilt.
• • Seasonal affective disorder (SAD)—characterized by the onset of depression during the winter months, when there is less natural sunlight.

Symptoms

People with depressive illnesses do not all experience the same symptoms. The severity, frequency and duration will vary depending on the individual and the illness. Symptoms may include the following:

• • Persistent sad, anxious or “empty” feelings
• • Feelings of guilt, worthlessness and/or hopelessness
• • Irritability, restlessness and/or fatigue
• • Loss of interest in activities once found pleasurable
• • A dramatic change in appetite
• • Insomnia
• • Thoughts of suicide

Diagnosis and Treatment

Depression is a treatable disorder. The first step is to visit a doctor for a medical examination to rule out other factors that may be causing the condition, such as medications or a thyroid disorder. Once diagnosed, a person will likely be treated with psychotherapy and/or medication. In the meantime, it is important to exercise regularly, participate in activities, spend time with friends and family, and think positively. It is wise to postpone major decisions, such as marriage or a career change, until feeling better.

Helping Those Affected

In addition to helping a person get an appropriate diagnosis and treatment, you can provide other help:

• • Offer emotional support, patience and encouragement.
• • Be a good listener.
• • Never ignore comments about suicide; report them to the person’s relative(s) or doctor, or call the National Suicide Prevention Lifeline at 800-273-TALK.
• • Invite the person to do things with you; if he or she declines, keep trying, but don’t push.
• • Remind the person that with time and treatment, the depression will lift.

For more information, visit the National Institute for Mental Health website at http://www.nimh.nih.gov. Read More

The coronavirus (COVID-19) pandemic has created massive change and concern for employers and employees across the world. Even as businesses reopen and employees return to their new normal, the risk of becoming exposed to and ill with COVID-19 is still present. When an employee reports they have COVID-19, employers are faced with the difficult task of determining whether the employee’s illness is work-related.

This HR Insights piece will provide an overview of how employers can determine when a COVID-19 case is work-related, OSHA requirements for reporting illness and best practices for responding to an employee’s positive COVID-19 test. As is the case with all inherently legal issues, employers are strongly recommended to seek the guidance of legal counsel when faced with any of the claims discussed herein. This article should not be considered legal advice.

OSHA Requirements

The Occupational Safety and Health Act (the Act) requires employers to report and record work-related injuries and illnesses. OSHA has indicated that COVID-19 infections are recordable injuries if they are work-related and they meet the Act’s recording criteria. Recording requirements apply only to employers with more than 10 employees who are not in an exempt, low-risk industry.

In addition, employers must report incidents that result in an employee’s fatality within eight hours. Incidents that result in inpatient hospitalization,

amputation or loss of an eye must be reported within 24 hours.

OSHA Guidance on Work-relatedness

An injury or illness is work-related if an event or exposure in the work environment either caused or contributed to the resulting condition or significantly aggravated a preexisting injury or illness. Work-relatedness is presumed for events or exposures in the work environment.

Case-by-Case Evaluation

Unfortunately, because the coronavirus is so widespread, determining whether an employee’s illness is work-related can be difficult and should be evaluated on a case-by-case basis. Employers can conduct the following activities when an employee reports a positive COVID-19 diagnosis:

• • Ask how the employee believes they were exposed to the coronavirus.
• • Ask employees about their work-related activities.
• • Ask employees about their out-of-work activities, while being sure to respect their privacy.
• • Conduct a review of the employee’s work environment to identify potential COVID-19 exposure.
• • Review whether the employee’s co-workers have reported a COVID-19 diagnosis or symptoms. Read More

As COVID-19 cases continue to surge across the country amid flu season, telehealth services offer access to quick, convenient and affordable care. In 2020, there was a significant increase nationally in telehealth utilization. Now, many providers and hospitals are encouraging patients to utilize telehealth services instead of coming to the office or hospital for non-life-threatening care.

Benefits of Telehealth

Although it’s a newer type of health care service, the modern telehealth platforms are generally user-friendly and operate similarly to other video call platforms. There are many benefits of telehealth services, which include, but are not limited to:

• • Minimized risk to health care workers and patients by limiting exposure to the coronavirus and other diseases
• • Improved health care outcomes due to increased access to care
• • • Greater ability for patients to follow shelter-in-place restrictions or suggestions
  • • Increased convenience due to receiving care in the comfort of one’s home
  • • Potentially increased cost savings, depending on the health plan

  Educating Employees

  Once telehealth services are explained to employees, they may be more willing to embrace the offering. Using these services can help them stay healthy and access convenient care during these uncertain times. Be sure to provide easy-to-understand educational resources to explain what telehealth is, what it should and shouldn’t be used for, and how your health plan treats telehealth services.

  For more information on telehealth, contact us today. Read More