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Utah Insurance Commissioner Strongly Urges Insurers to Expand Coverage for COVID-19, Including Telehealth Services

Insurers should strive to offer Utahns stability and support

Insurance Commissioner Todd E. Kiser is urging all Utah health insurers to expand coverage for COVID-19 including telehealth services.

“In these unprecedented times, I have asked Utah’s health insurers to expand their operations to offer Utahns increased stability and support,” said Kiser. “COVID-19 is a significant concern to many people and offering them some peace of mind will be welcomed by the community.”

In a bulletin sent to health insurers on March 17, Commissioner Kiser requested the following coverage enhancements:

  • Member Support — Health insurers should devote resources to providing members accurate information about their benefits, responding to inquiries, and informing members about telehealth options.
  • Testing for COVID-19 — Lab tests, including tests for COVID-19, are an essential health benefit and must be covered under individual and small group comprehensive health policies. The Insurance Department encourages insurers to waive cost-sharing, co-pays, deductibles, and coinsurance for insureds seeking a medically necessary COVID-19 screening. Insurers are also asked to waive cost-sharing for visits to in-network providers, urgent care centers, emergency rooms, and calls to telehealth outlets.
  • Telehealth Services — Insurers should review their telehealth provider networks to be sure they can meet increased demand as the COVID-19 event continues.
  • Network Adequacy and Access to Services — Health insurers should verify that their provider networks can handle an increase in need for health care services and COVID-19 tests. This may include offering access to out-of-network services where appropriate and required. If a health insurer’s network does not have health care providers with appropriate training and experience to meet the particular needs of insureds at this time, insurers are asked to make exceptions to provide access to out-of-network providers at the in-network cost-sharing.

Commissioner Kiser also requested that insurers waive preauthorization requirements for COVID-19 testing and treatment, offer lenient prescription drug refill practices, and accept the highest in-network reimbursement rate for out-of-network patients to avoid surprise medical bills.

“Some people may have significant worries about the effects that COVID-19 is having on their communities and the world,” said Commissioner Kiser. “Anyone who feels a need to process such feelings should contact their health insurer to see what mental health options are available. In many cases, online mental health visits may be appropriate.”

Press Release
Utah Insurance Commissioner Strongly Urges Insurers to Expand Coverage for COVID-19, Including Telehealth Services
Bulletin 2020-1: Coverage for COVID-192020-1

What to Know About Coronavirus & Your Insurance

For the most up-to-the-minute updates about COVID-19 in Utah, visit coronavirus.utah.gov.

It’s important to know that the immediate risk from the coronavirus is low, but the CDC believes that the public health threat will be significant. Utahns can help the community stay healthy by washing their hands and avoiding people who appear sick — just like they would during any other flu season. If you or someone you know is diagnosed with COVID-19, your insurance company will be able to help.

Below are the actions Utah’s health insurers are taking to assist people affected by the coronavirus.

Bridgespan

Cigna

Cigna is waiving all co-pays and cost-shares for COVID-19 testing when recommended by a health care provider. Cost-sharing for office visits and telehealth screenings for COVID-19 will be waived through May 31, 2020. It is also providing free home delivery of up to 90-day supplies of maintenance medications and have set up a 24-hour toll-free help line for consumers who are feeling high stress and anxiety.

CVS Health/Aetna

CVS/Aetna is waiving member costs for diagnostic testing for COVID-19 at authorized locations. Members diagnosed with COVID-19 will receive a care package. It is also operating a crisis response line for members experiencing coronavirus-related anxiety and a 24-7 nurse line.

EMI Health

Humana

Humana is waiving out-of-pocket costs associated with COVID-19 testing for patients who meet CDC guidelines at approved laboratory locations. It is also waiving telemedicine costs for urgent care for the next 90 days and is allowing early refills on prescriptions.

LifeMap

Molina Healthcare

Molina Healthcare is waiving COVID-19 testing costs for members. It is monitoring the coronavirus on a daily basis and working to ensure that it is prepared to assist its members.

MotivHealth

National Foundation Life Insurance Co.

National Health Insurance Co.

PEHP

PEHP is covering COVID-19 testing without preauthorization under the member’s normal benefits. It is also allowing members to acquire 90-day supplies of maintenance medications from retail and mail order pharmacies, and early refills for Diabetes Savings Program members.

Regence BlueCross BlueShield of Utah

Regence is covering the cost of a COVID-19 test with no cost to fully insured members if a provider determines the test is necessary. Members who are diagnosed with COVID-19 will be provided personalized support. Medication policies have been loosened (except for opioids) so members can have needed medications on hand.

SelectHealth

SelectHealth is covering in-network COVID-19 testing with no copays, coinsurance, or deductibles. It is also educating members about the proper way to triage their concerns related to COVID-19, including telehealth visits through Connect Care. Early refills of 30-day medications are allowed when the medication is 60% finished, except for opioids.

UnitedHealthcare

UHC is waiving copays, coinsurance and deductibles for COVID-19 testing at approved locations and for visits associated with COVID-19 testing, including visits to a doctor’s office, urgent care, or emergency room. It is also allowing early prescription refills, expanding access to telehealth options, and offering a 24-hour emotional support help line that is free for anyone to call, not just members.

 

Other Resources

Coronavirus rendering courtesy of CDC/ Alissa Eckert, MS; Dan Higgins, MAMS

UID Releases 2019 Health Insurance Market Report

For most people, health insurance is the financing mechanism to manage personal health care costs. Health insurance protects against the risk of financial loss that can occur from unexpected accidents and illnesses. It also provides a way for chronic health problems to be treated and managed in ways that many people could not otherwise afford. Because health insurance is so important to the citizens of Utah, it is in the interest of the State to monitor and maintain a stable health insurance industry.

An important purpose of the Insurance Department is to ensure that Utah has an adequate and healthy insurance market. The purpose of this report is to provide an annual evaluation of Utah’s commercial health insurance market as required by Utah Code § 31A-2-201.2.

The 2019 Health Insurance Market Report is available on the Department’s Reports page and is linked below.

PDF Version
2019 Health Insurance Market Report

Notice of Company Applying to Become a Utah Certified Reinsurer

January 7, 2020 — New Reinsurance Company LTD (CR-1460100), a Switzerland insurance company, has applied to become a Certified Reinsurer in the State of Utah. If you have any questions or concerns, please contact Jay Sueoka with the Utah Insurance Department at 801-538-3814 or by email at jsueoka@utah.gov no later than February 7, 2020.

Utah PMN Posting

Insurance Help & Tips for Utahns Affected by the Gun Range Fire

State agency is here to answer questions and help with the claims process

Bountiful and Centerville residents affected by the Gun Range Fire should begin by contacting their insurer or insurance agent to verify their coverage for fire, smoke, and water damage. Your insurance card will have a phone number for filing claims printed on it. You can also contact the Utah Insurance Department for help finding the right contact.

“If you have a question about your policy or what your insurer or agent has told you, please call the Utah Insurance Department at 801-538-3800,” said Utah Insurance Commissioner Todd E. Kiser. “We have staff on hand to help you understand and navigate the claims process.”

Residents who had property damaged or destroyed by the fire should ask their insurer or insurance agent what the next steps should be. They can give you advice about how to prevent further losses and begin the process of repairing the damage.

Keep in mind that costs incurred during evacuation may be reimbursable. Money you spend on making short-term repairs to prevent further damage may be recoverable as well. Keep your receipts and include them when filing a claim.

Commissioner Kiser recommends that all Utahns take this opportunity to review their policies, property, and possessions to be sure they’re covered in the case of a similar event. “Knowing what you own is a critical factor in filing a loss claim,” said Commissioner Kiser. “Take a few minutes today to photograph your possessions whether or not you’re near a fire hazard area.”

Making a home inventory is as simple as taking photos or video inside your home and around your property with a camera or smartphone. Save them on a portable computer, USB drive, or in the cloud (think services like Google Drive or iCloud). These photos can be used as evidence of your claims when the insurer is determining the value of your overall claim.

Commissioner Kiser notes that all homeowners policies include coverage for fires, but they don’t always cover the same things. “It is critical for homeowners to read their insurance policies so they understand what is covered. Some policies cover other structures on the property, while others don’t. Some policies replace destroyed items, while others pay fair market value. Your insurance agent can help you understand how your policy applies to your situation.”

Press Release
Insurance Help & Tips for Utahns Affected by the Gun Range Fire
Post-Disaster Claims Guide

Notice of Company Applying to Become a Utah Certified Reinsurer

May 30, 2019 — Wilton Reinsurance Bermuda Limited (AA-3190878), a Bermuda insurance company, has applied to become a Certified Reinsurer in the State of Utah. If you have any questions or concerns, please contact Jay Sueoka with the Utah Insurance Department at 801-538-3814 or by email at jsueoka@utah.gov no later than July 12, 2019.

Utah PMN Posting

Purchase Flood Insurance Before Flood Season Starts

Heavy winter snows create potential for flooding in Utah neighborhoods.

A number of powerful snowfalls in early 2019 brought plenty of snow to Utah’s mountain ranges. The state’s snowpack totals are averaging more than 130 percent of normal, and as spring temperatures increase, the potential for flooding increases with it. The threat is serious enough that Governor Gary R. Herbert declared March to be Flood Safety Awareness Month. For many Utah homeowners, even a small flood could mean disaster.

“Many homeowners don’t realize that flood coverage is not included in their home insurance policy,” said Utah Insurance Commissioner Todd E. Kiser. “Flood insurance is a separate policy that must be added onto an existing homeowner’s policy, and it becomes effective 30 days after the policy is added.”

Flood season in Utah generally runs from April through May as mountain snow starts to melt. Homeowners should act now to protect their property from excessive spring runoff. “Unfortunately, there’s no way of knowing when flooding will start in any given year,” says Kiser. “That makes it critical for homeowners to talk to their insurance agent about flood coverage well in advance of a spring thaw.” Not all insurance agents write flood insurance, but the National Flood Insurance Program (NFIP, floodsmart.gov) has resources to help you find an agent who does.

Now is a good time to create a home inventory. A home inventory can help you determine the types and level of coverage you need before disaster strikes, and it can make it easier to file a claim after a major loss. Creating an inventory can be as simple as taking photos of your belongings and writing them down in a spreadsheet. (The National Association of Insurance Commissioners has a good one available at insureuonline.org).

Press Release
Purchase Flood Insurance Before Flood Season Starts

Insurance Checklist for the New Year

Five policies to review as you head into 2019

The start of a new year is a great time to reevaluate your insurance coverage needs. Changing circumstances may require updated policies. Did you have a baby? Get married? Purchase a new home or car? If so, you’ll want to check whether you have the right protection.

“It’s a good idea for everyone to review their insurance needs with their agent at least once a year,” says Utah Insurance Commissioner Todd E. Kiser. “Needs and situations can easily change during the course of a year. Your agent can help determine whether your coverage is adequate or if you need to make adjustments.” Even if you haven’t experienced a life changing event, you could be eligible for discounts or new insurance products that may better serve your needs.

Life Insurance

Changes — such as a birth, divorce, remarriage or even a new mortgage or new job — are indicators that you might need to make changes to your life insurance. Read your policy carefully and answer these questions:

  • Do the total benefits grow over time?
  • Do premiums change over time?
  • What happens if I quit paying premiums – do I maintain some of the benefits?
  • Can the policy be converted into another form of insurance or annuity?

In the case of the birth of a child or a new marriage, you may want to consider increasing your death benefit. Check with your agent to see if your insurance company requires a physical exam before increasing your coverage levels.

Homeowners/Rental Insurance

Make sure you’re properly covered for disasters such as floods, earthquakes and wildfires. These disasters can be costly, and may not be covered under a standard policy. Discuss the possibility of adding coverage for these perils with your agent or insurance company.

The start of a new year is also a great time to update your home inventory and make sure your homeowners or rental policy is up-to-date. Take photos or video of your prized possessions and include as many details as you can. You may need special coverage for valuable antiques, artwork or jewelry, so call your agent to discuss changes for your policy.

Auto Insurance

Tell your agent about any changes in your driving habits to ensure your auto policy will cover you in case of an accident. Also take some time to check your auto insurance policy by following the guidelines below:

  • Make sure your coverage is appropriate for your life situation. If your liability insurance is too low, you may be legally exposed for any damages above your liability limits.
  • Review your deductibles for comprehensive and collision coverage. This is the amount you will pay if your car is damaged or totaled without fault of another driver. Raising or lowering this amount can affect your premium.
  • Make sure you have a copy of your insurance card and your insurance agent or company’s number in your vehicle at all times.

Health Insurance

You may have recently enrolled in or changed your health insurance through your employer, Medicare or Healthcare.gov. Make sure you have new insurance cards and paperwork before you visit a doctor.

  • Check your provider lists to make sure your doctor and any specialists are still covered by your policy, as in-network or preferred provider lists change from year to year.
  • Read through your documents and make note of co-pays for in-network and out-of-network providers to avoid surprises.
  • If you’re planning a vacation, check with your insurance carrier to identify urgent care centers and hospitals that accept your insurance coverage. Ask your carrier about applicable co-pays and deductibles if care is needed.

When purchasing an insurance policy:

  • Ask for copies of everything you sign and keep a copy of the initial policy payment receipt or check you gave the agent or company.
  • Call the insurance company if you don’t receive a copy of the insurance policy outlining your coverage and its limitations within 30 days of your purchase.
  • The best way to protect yourself from insurance fraud is to research the agent and company you’re considering. Before writing your check or signing the contract, call us at 801-538-3800 to make sure they’re licensed in Utah.

Find more information about your insurance needs and tips for choosing the coverage that is best for you and your family at insurance.utah.gov.

Press Release
Insurance Checklist for the New Year