Skip To Main Content

Employers & Producers

Coronavirus (COVID-19) Information

EMPLOYERS

Log in to get up-to-date information on benefits for your employees.

PRODUCERS

Get answers to your questions about Anthem’s benefits and Coronavirus under the Online Resources section.

Resources for Reopening the Workplace
As workplaces begin to reopen, we remain committed to offering solutions that help employees gain timely access to care and services, while also helping employers support a healthy and safe transition back into the workplace.


About Coronavirus and
COVID-19

Anthem is and will remain compliant with all state and federal grace period mandates.

Effective through July 31, 2020, if the loss of enrollment is a result of the COVID-19 crisis, rates and premiums will not change. This increases Anthem's risk, but is an appropriate measure to take in the near-term given the difficult and unique situation our customers are facing.

Effective through July 31, 2020, if the loss of enrollment is a result of the COVID-19 crisis, rates and premiums will not change solely as a result of the COVID-19 loss of enrollment.

Fully Insured

Yes. Anthem's requirement for employees to be actively working in order to be eligible for coverage will be relaxed through July 31, 2020as long as the monthly premium payment is received.

Coverage must be offered on a uniform, non-discriminatory basis to all employees and employee premium contributions must be the same or less than what they were prior to the layoffs.

Self-Funded

Yes. Payment of administrative fees, claims cost and stop loss premium is required to continue coverage for laid-off and furloughed employees who are not actively at work. This flexibility will remain in place through July 31, 2020.

Coverage must be offered on a uniform, non-discriminatory basis to all employees and employee premium contributions must be the same or less than what they were prior to the layoffs.

If Anthem is not a customer’s stop loss carrier, Anthem recommends verifying coverage with the customer stop loss carrier.

If an employee’s hours fall below the minimum, these employees will be treated as if they are on an approved leave of absence and will remain eligible for coverage within the plan they were in prior to the reduction in hours. Premiums must continue to be remitted to Anthem for the original amount of insurance prior to the reduction in hours.

Coverage eligibility will be based on the number of the hours working as of the end of the month prior to the date of the reduction in hours. For those benefits based on salary or wages as of the last date worked, we will utilize the salary or wages as of the end of the month prior to the date of the reduction in hours. This accommodation will be effective March 1, 2020 through July 31, 2020. We will continue to monitor this situation and will provide additional guidance as it becomes available.

Depending upon each group policy, coverage may continue but will be subject to the terms outlined in the policy that relate to temporary layoffs and leaves of absence. Furloughs will be similarly considered.

Yes, premiums are required to continue coverage. Employers are required to collect and remit premiums from their employees. Non-payment of premium will result in termination of coverage.

We are relaxing our policy through July 31, 2020, to allow for coverage in this scenario if part or all of an employer’s workforce is laid off or not working in response to the COVID-19 crisis. Members should check with their employer for additional details. For continuance of coverage, premium must continue to be paid, without interruption.

Anthem recommends employers work with their employees to assess coverage options and eligibility by sharing the COVID-19 Coverage Option Hotline at 1-888-832-2583 where they will be guided through their options. Some examples of options include Medicaid or qualifying event for a special enrollment period for an ACA compliant plan. If Medicaid or ACA compliant plans is not a fit for your employee, they may also consider a short-term plan if available in their state. Also, COBRA or state continuation should be made available as well.

Anthem’s comprehensive enterprise wide business continuity program includes recovery strategies for critical processes and supporting resources, automated 24/7 situational awareness monitoring for our footprint and critical support points, and Anthem’s Virtual Command Center for Emergency Management command, control and communication. In addition, Anthem has established a team of experts to monitor, assess and help facilitate timely mitigation and response where it has influence as appropriate for the evolving novel coronavirus threat.

  • Anthem maintains a comprehensive enterprise wide business continuity program that aligns business requirements of our operating units and related support areas to help us meet our commitments following an “unplanned event.”
  • This plan includes strategies for a “People Unavailable” event, including a pandemic, to help us continue critical business processes to meet our customer commitments.
  • Response to and mitigation of such an event can include leveraging our broad geographic footprint, work from home capability, increased personal hygiene and additional building hygiene measures and frequency, travel restrictions, isolation of personnel, and limiting access to and travel between our facilities.
  • All of this is documented in established policies and procedures to support crisis response measures, such as during a pandemic threat.

Anthem is committed to working with and supporting its contracted providers. Our benefits already state that if members do not have appropriate access to network doctors that we will authorize coverage for out-of-network doctors as medically necessary.

In addition, Anthem’s telehealth provider, LiveHealth Online, is another safe and effective way for members to see a doctor to receive health guidance related to COVID-19 from their home via mobile device or a computer with a webcam.

  • IngenioRx is carefully monitoring the global drug supply for any disruptions related to COVID-19 and, at the present time we have not identified any disruptions that would affect members’ abilities to fill their prescriptions through either our mail order facility or our retail networks.
  • Additionally, the Food and Drug Administration is closely monitoring medications for any potential supply chain disruptions.
  • Given the evolving nature of the outbreak, we will continue to monitor the situation and will work to address issues as they arise.

Anthem is committed to delivering our renewals within our normal schedule and meeting deadlines on delivery of quotes.

The CARES Act:

Requires coverage without cost sharing of COVID-19 diagnostic tests that are in addition to the test required by the Families First Act.

  • Tests approved by the FDA, a state, or other methods approved by the Secretary of Health and Human Services must be covered. In addition, a test that is or will be under an active emergency use authorization request to the Food and Drug Administration must also be covered.
  • Plans must cover testing at the in-network provider negotiated price or, if the plan does not have a negotiated price with the provider, the cash price as listed by the provider on a public Internet website.

Requires coverage without cost sharing of any qualifying preventive service for COVID-19.

  • Coverage required 15 business days after a favorable recommendation from the United States Preventive Services Task Force or the Advisory Committee on Immunization Practices of the Centers for Disease Control and Prevention.
  • A qualifying preventive service includes an item, service, or immunization intended to prevent or mitigate COVID-19.

Amends the Health Savings Account, or HSA rules.

  • A high deductible health plan with an HSA beginning on or before December 31, 2021, can cover telehealth services and other remote care services prior to an HSA-eligible individual reaching the deductible.
  • This change only extends to 2020 and 2021 plan years.

As always, Anthem health plans will follow mandates from public health emergency mandates, which generally apply to fully-insured, Medicaid and Medicare plans.

Anthem is committed to help our members gain timely access to care and services. Our actions should reduce barriers to seeing a doctor, getting tested and receiving treatment.

Anthem is waiving:

  • Cost-sharing for the treatment of COVID-19 from April 1 through May 31,2020 for members of its fully-insured employer, Individual, Medicare Advantage and Medicaid plans. We encourage our self-funded customers to participate and these plans will have an opportunity to opt in.
  • Cost-sharing for COVID-19 diagnostic and serology tests for members of our employer-sponsored, individual, Medicare and Medicaid plans.
  • Cost-sharing for visits to get the COVID-19 diagnostic test, regardless of whether test is administered, beginning March 18 for members of our employer-sponsored, individual, Medicare and Medicaid plans.
  • Cost-sharing for telehealth visits, including visits for behavioral health, for our fully-insured employer, individual, and Medicare Advantage plans, and where permissible, Medicaid plans for 90 days, beginning March 17. We encourage our self-funded customers to participate, although these plans will have an opportunity to opt out.
  • Cost-sharing for FDA-approved medications or vaccines when they become available

The cost-sharing waiver includes copays, coinsurance and deductibles.

For additional services, members will pay any cost shares their plan requires, unless otherwise determined by state law or regulation. Members can call the number on the back of their identification card to confirm coverage. Providers should continue to verify eligibility and benefits for all members prior to rendering services.

Anthem’s waiver of member cost share associated with COVID-19 treatment would apply to FDA-approved medications or vaccines should they become available. At the present time, there are no medications that have FDA approval for use in the treatment of COVID-19.

Because there is insufficient data to fully support the safety and efficacy of using any existing drugs in the treatment of COVID-19, using them in this manner is considered outside of FDA approval, or “off label,” and members would be responsible for any cost share.

Tests samples may be obtained in many settings including a doctor’s office, urgent care, ER or even drive-thru testing. Laboratory diagnostic tests for COVID-19 at both in-network and out-of-network laboratories will be covered with no cost sharing for members.

While a test sample cannot be obtained through a telehealth visit at this time, a telehealth provider can help members get to a provider who can do so.

Cost shares associated with testing and related services may be waived for members enrolled in high-deductible health plans, or HDHP with HSAs. Based on IRS guidance, such cost share waivers will not jeopardize the status of the plan as an HDHP. In addition, benefits can be provided for treatment before having to meet the HDHP deductible.

If an in-network provider is not available, Anthem will work with members to find an out-of-network provider and then the waivers would apply.

Telehealth (video and audio)
For 90 days effective March 17, 2020, Anthem will waive member cost shares for in-network and out-of-network telehealth visits, including visits for mental health or substance use disorders, for our fully-insured employer plans, individual plans, Individual Medicare Advantage plans, Group Retiree Solutions plans and Medicaid plans, where permissible.

Cost sharing will be waived for members using Anthem’s authorized telehealth service, LiveHealth Online, as well as care received from other providers delivering virtual care through internet video and audio services.

Self-insured plan sponsors may opt out of this program.

Telephonic-only care
For 90 days effective March 19, 2020, Anthem will cover telephonic-only visits with in-network providers. Out-of-network coverage will be provided where required. This includes visits for behavioral health, for our fully insured employer plans, individual plans, Medicare plans and Medicaid plans, where permissible.

Cost shares will be waived for in-network providers only.

Telemedicine (video + audio via app): Starting March 17, 2020, Anthem began waiving member cost sharing for telemedicine (video + audio) visits including covered visits for mental health and substance use disorders, for our fully insured employer plans, Individual plans, Medicare plans and Medicaid plans, where permissible. This applies to use of our LiveHealth Online platform, as well as for care received from other providers delivering virtual care through internet video and audio services. Self-insured plan sponsors may opt out of this program.

This will remain in place for 90 days or as long as the emergency New York rule is in effect. Members can call the number on the back of their identification card to confirm coverage. Providers should continue to verify eligibility and benefits for all members prior to rendering services.

Telehealth visits (phone with video capability): Starting March 19, 2020, Anthem began waiving member cost sharing for telehealth visits with in-network and out- of-network providers acting within the scope of their license. This includes covered visits for behavioral health and substance use disorders and medical services, where medically appropriate if other requirements for a covered health service are met. This applies to fully-insured employer plans, individual plans, Medicare and Medicaid plans, where permissible. Self-insured plan sponsors may opt out of this program. Phone/video delivery must be HIPAA compliant. This will remain in place for 90 days or as long as the emergency NY rule is in effect.

Note: Telehealth does not include the use of facsimile, telephone-only, or email.

Telephonic-only care

For 90 days effective March 19, 2020, Anthem will cover telephonic-only visits with in-network providers. Out-of-network coverage will be provided where required.

  • This includes visits for behavioral health, for our fully insured employer plans, individual plans, Medicare plans and Medicaid plans, where permissible.
  • Cost shares will be waived for in-network providers only. Self-insured plan sponsors may opt out of this program.
  • Exceptions include chiropractic services, physical, occupational, and speech therapies. These services are not appropriate for telephone-only consultations. Self-insured plan sponsors may opt out of this program.

Phone delivery must be HIPAA compliant.

To meet the needs of Anthem members who may be struggling during this time, Anthem is promoting digital solutions to help.

  • Anthem’s affiliated health plans and Beacon Health Options are collaborating with Psych Hub, mental health advocates and other national health insurers to develop a free digital resource site to help individuals and care providers address behavioral health needs resulting from the COVID-19 pandemic.
  • Anthem is providing full access for all members to our Employee Assistance Program web site with COVID-19 tools and informational resources (click log-in, enter company code: EAP Can Help).
  • Anthem is increasing the ability of providers to deliver behavioral health services via the telephone and encouraging members to use existing telehealth services for behavioral health, as well as to embrace services delivered digitally.
  • Anthem health plans with Employee Assistance Programs offer individual and employer-sponsored members up to six free sessions with a behavioral health counselor.

Anthem’s telehealth provider, LiveHealth Online, offers LiveHealth Online Psychology and LiveHealth Online Psychiatry, a confidential and effective way for members to see a behavioral health professional, such as a therapist, psychologist or psychiatrist, during these stressful times and receive behavioral health support from their homes via smart phone, tablet or computer-enabled web cam.

In addition, myStrength is an app that delivers 24/7 access to personalized online and mobile resources to help members manage symptoms such as stress, anxiety, depression, substance use, chronic pain and sleep. myStrength was already available to members who have Anthem’s Employee Assistance Program, other employer-based programs and Medicaid members in Florida, Texas, Washington and Washington D.C.

Sources

Centers for Disease Control and Prevention: About Coronavirus Disease 2019 (COVID-19) (accessed March 2020):
cdc.gov/coronavirus/2019-ncov/about/index.html

Centers for Disease Control and Prevention: Frequently Asked Questions and Answers (accessed March 2020):
cdc.gov/coronavirus/2019-ncov/faq.html

Centers for Disease Control and Prevention: Interim Guidance for Implementing Home Care of People Not Requiring Hospitalization for 2019 Novel Coronavirus (2019-nCoV) (COVID-19) (accessed March 2020):
cdc.gov/coronavirus/2019-ncov/hcp/guidance-home-care.html