In response to the current conditions surrounding the COVID-19 pandemic, IRS Notice 2020-18 postpones the April 15, 2020 due date for filing federal income tax returns, deferring payments to July 15, 2020. The IRS has added information regarding this notice under “Filing and Payment Deadlines Questions and Answers” which addresses contribution extensions for those in Health Savings Account plans.
The $2.2 trillion Coronavirus Aid, Relief, and Economic Security Act (CARES) was signed into law on March 27, 2020 with the purpose of helping employees out with benefit-related items during the COVID-19 crisis. The CARES Act repeals the Affordable Care Act’s exclusion of over-the-counter (OTC) medications from the definition of “qualified medical expenses”. The bill is over 880 pages long, but to review the new rules regarding OTC provisions, see Sec. 3702 of the CARES Act.
The new California Law, SB 1375, was signed by Governor Brown on September 22, 2018 and will affect many small firm’s group health insurance. SB 1375 changes the Health Insurance Code to reclassify certain small employer groups as individuals. The affected firms will have to obtain individual health insurance in 2019, rather than the small employer group plans they currently have. Individual health insurance is typically more expensive with less provider network and benefit plan choices than small group plan offerings.
Fortunately, for CalCPA members and their firms, CalCPA Health received certain exemptions from SB 1375, which generally allows us to treat the affected firms as groups, and not as individuals. Commercial carriers (Blue Shield, UnitedHealthcare, Anthem, etc.,) must comply with the new regulations and reclassify these groups as individuals.
SB 1375 defines groups that consist entirely of owners/partners, and/or W-2 employees that are spouses of owner/partners, as not eligible for group health coverage. Even though these entities may be classified as employer/employees by other regulations, (e.g. Workers’ Comp, payroll tax, etc.,) SB 1375 specifically states they do not qualify for group health coverage and may only purchase individual plans.
Anthem is taking action to help people affected by the wildfires in Lake, Mariposa, Mendocino, Napa, Riverside and Shasta counties by revising medical and pharmacy guidelines that will help ensure members can continue care and access needed prescription medications. The items pertaining to pharmacy apply to Anthem’s relationship with Express Scripts. It’s important that our members know what Anthem is doing for our members in the above mentioned areas during this critical time.
For impacted members, Anthem is:
- Relaxing time limits for prior authorization, pre-certification and referral requirements – there will be no late penalties.
- Suspending early refill limits for prescriptions.
- Allowing replacement of medical equipment or supplies.
- Extending filing deadlines for claims.
These medical and pharmacy guidelines are effective from July 26, 2018 until August 25, 2018, unless further extended.
For additional questions, members should call the phone number on the back of their membership card as associates are standing by to help.
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