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Novel Coronavirus (COVID-19) Resources For Brokers

Novel Coronavirus (COVID-19) Resources For Brokers

Helping you answer your client’s questions

At Rocky Mountain Health Plans (RMHP), we are working to ensure we are doing everything possible to support the health of those we serve, and help you and your clients get access to the information and services you need.

We have compiled the below frequently asked questions (FAQs) for Brokers. Please review these important updates, watch for more information, and let us know if you have additional questions.

The Broker FAQs are not designed to be shared with RMHP members. Please direct members to our frequently asked questions for answers to their member-specific questions.

Last update: March 30, 2020, 5:00 p.m. MST


Special Enrollment Period for Individual & Family Coverage

RMHP, working together with the Colorado Division of Insurance, is offering a Special Enrollment Period for Coloradoans in Mesa and Delta County who have lost health insurance coverage or have no coverage during the COVID-19 outbreak.

This Special Enrollment Period will allow uninsured Coloradans to enroll in an RMHP Monument Health Individual & Family plan from Friday, March 20 through Friday, April 3, 2020 with coverage starting April 1, 2020.

Special Enrollment Opportunity for Fully Insured Small Business Clients

To assist employees in accessing care, RMHP is providing fully insured Small Business clients with a Special COVID-19 Enrollment Opportunity to enroll employees who did not previously enroll in coverage.

The opportunity will be limited to employees who previously did not elect coverage for themselves (spouses, children) or waived coverage.

Frequently Asked Questions

 

RMHP’s Eligibility criteria, as outlined in Attachment I of the Group Service Agreement supports the employer’s ability to maintain coverage for employees who have temporarily lost eligibility for coverage. RMHP will allow furloughed or reduced-hour employees to remain covered.

Contracting Party may elect to continue coverage, upon written notice to RMHP. An employer, or a broker on behalf of the employer, should contact RMHP’s Group Management Team to provide notice of their situation and their intent on continuing health coverage

Employees currently eligible for health coverage can remain covered during periods of temporary furloughs and/or reduction in hours per the RMHP Group Service Agreement at the employer’s discretion. RMHP is reliant on employers to notify us of the employment status of their employees. If the employer chooses to continue to pay for coverage for employees who no longer work the hours required in their eligibility criteria, RMHP must be notified with detailed information on the employees impacted. If an employer chooses to no longer offer coverage to furloughed or reduced-hour employees, the group must notify us which employees are no longer offered coverage.

Understanding the uncertainty of the timeline an employer anticipates needing to reduce hours and/or workforce, and the possibility workforce furlough may become a permanent termination, the employer has the ability to make the decision to terminate coverage up to 90 days from extending health coverage. Employer, or a broker on behalf of the employer must send disenrollment notification to RMHP. RMHP will cover the employee through the end of the month in which the termination occurs with payment of premium. (see below FAQs).

Employer must send disenrollment notification to RMHP. RMHP will cover the employee through the end of the month in which the termination occurs with payment of premium. (see below FAQs).

Additionally, if the employer determines their group health plan cannot be maintained, the employer has the ability to terminate their group health plan up to 90 days from extended health coverage. Employer must send termination notification to RMHP's Group Management Team.

RMHP will make an exception to the requirement of contribution changes occurring only on anniversary.

Employers, or brokers on behalf of employers, must provide written notice of their change in contribution to RMHP.

No. RMHP will maintain group coverage regardless of participation until further notice.

Yes. Until further notice, employers who want to put seasonal or part-time employees on their health plan can do so.

Employers, or brokers on behalf of employers, must provide written notice of their change in eligibility to RMHP.

Yes. RMHP will allow a grace period to pay premiums.  Additionally, RMHP will place a temporary moratorium on terminations for non-payment for all groups.

Employers should contact RMHP’s Group Management Team to make this request. 800-453-2981, Option 1. Group_management_team@rmhp.org. Note: this must be requested by the employer.

If your group is subject to COBRA/CCOC, as long as one person remains actively employed and covered, employees may elect to continue coverage under COBRA/CCOC under the normal notice and election process.

Until further notice, groups subject to CCOC can offer continuation coverage to all enrolled employees regardless of the length of time they have been enrolled in the health plan.

If the plan has no active employees, the plan is terminated and COBRA/CCOC is not an option. In that case, employees would have a special enrollment period to enroll in individual coverage.

Yes. If premiums have been remitted for the month, or if the employer has requested a 30-day grace period, coverage will continue for the employee through the end of the month.

Involuntary loss of coverage is a qualifying event to enroll in individual coverage or to be added to a spouse’s group health plan coverage within 60 days of the loss of coverage.

To assist employees in accessing care, we are providing fully insured Small Business clients with a Special COVID-19 Enrollment Opportunity to enroll employees who did not previously enroll in coverage.

The opportunity will be limited to employees who previously did not elect coverage for themselves (spouses, children) or waived coverage.

No. The Special Open Enrollment period is NOT intended to allow members to change plan options.

The Special Open Enrollment is merely waiving policy restrictions on adding new enrollees outside of open enrollment or normal special enrollment period. The employer sponsored group health plan will decide if they want to offer the option for new entrants to the plan.

Yes. During the next 90 days, and one time only, if an employer wishes to buy down their benefit plan, RMHP will allow it. The group’s effective date will not change, and rates will be based on current rates and plan options, not those at the group’s last renewal.

An employer can add the leaner plan, but only new members can join that plan during Special Open Enrollment – we will not allow movement across plans mid-year.

No, RMHP is not changing premium rates off renewal for small business.

No, RMHP is unable to accept credit card payments for group premium at this time.

Yes.

Yes, groups may waive all waiting periods for coverage until further notice. 

Last update: March 30, 2020, 5:00 p.m. MST

We are continuing to monitor policy changes on an ongoing basis, including updates from the Centers for Disease Control and Prevention (CDC), the Centers for Medicare & Medicaid services (CMS), the Colorado Division of Insurance (DOI), and various other federal and state governments agencies. We may have to adjust our business practices, processes, and policies accordingly. Any changes or updates will be posted on our broker resource pages as quickly as possible. We encourage you to contact your RMHP Account Manager with any questions or to verify the most current policies.

RMHP presentation materials and responses to your questions are intended to provide general information and assistance during the COVID-19 public health emergency and do not constitute medical, legal or tax advice. Please contact your medical, legal and tax advisors on how to respond to this situation. The materials and discussion topics do not constitute a binding obligation of Rocky Mountain Health Plans RMHP with respect to any matter discussed herein

Key resources

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We’re listening

We are monitoring the inquires we’re receiving on an ongoing basis and working hard to answer your questions. We will be making updates. Be sure to check back often for the latest information.