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Updates For Brokers & Employers

September 10, 2021

To Our Valued Clients and Partners,

‘Crisis Standard of Care’ Activated in Response to Overwhelmed Hospitals

On Tuesday, September 7th, The Idaho Department of Health and Welfare announced that it had activated a ‘crisis standard of care’ policy in two public health district including Boundary, Bonner, Kootenai, Benewah, and Shoshone counties in the Panhandle District 1, and Latah, Nez Perce, Lewis, Clearwater, and Idaho counties in the North Central District 2. This means that hospitals are so overwhelmed by COVID patients in northern Idaho that they are rationing care to patients. Boise Public Radio published two stories on Wednesday that explain the situation in more detail:

"Do Not Get Sick:" Idaho Doctors Explain What Crisis Standards Of Care Means For The State | Boise State Public Radio

What The Move To Crisis Standards Of Care Means For Idaho Residents | Boise State Public Radio

Utah may be next with COVID cases spiking over the last two weeks and many ICU units reaching 100% capacity. For more detail: What to do about Utah’s overwhelmed hospitals? Utah leaders seek ideas - Deseret News.

Oregon and Washington are also struggling this week with hospital capacity due to COVID-19. For more detail: OHSU forecasting predicts state could be hitting peak of COVID-19 hospitalizations (msn.com)
As Hospital Capacity Strains, WA DOH Prepares For The Worst (msn.com)

Our Care Management and Customer Care teams are taking high call volumes about elective surgeries being postponed. We are working with your people to help them understand the situation and explore their options.

How can you help your people? Encourage them wear a seat belt and to avoid other risky behaviors that could land them in the E.R. and consider incenting them to get vaccinated.

Across our region, according to each state’s health department, the full vaccination rate for people age 12 and over in Washington is 67%, Utah is 61.7%, and Idaho is 49.4%. In Oregon, the vaccination rate for age 18 and over is 67.2%.

Employer Vaccine Mandates Gaining Popularity

Now that Pfizer has received full FDA approval of its Comirnaty COVID-19 vaccine for people ages 16 and older, vaccine mandates and proof of vaccination are quickly being adopted by employers, sports stadiums, and school systems. President Biden signed an executive order just last night, Sept 9th, mandating COVID-19 vaccinations for all federal employees and contractors.

Exploring Surcharges for Employees Not Vaccinated Against COVID-19

As the number of COVID-19 infections and hospitalizations rise, employers are concerned about the safety of their workforce, as well as the costs of treatment that could be avoided through vaccination. With vaccination rates stagnant, many are looking for ways to incentivize their employees to get vaccinated. Incentives can take many forms, including paid time off, extra pay, or a premium penalties for participants on the employer’s health plan. Although there are several federal statutes which should be considered, employers struggling to increase COVID-19 vaccination rates among their workforce can implement a premium surcharge for non-vaccinated employees as part of an outcome-based wellness program.

There is no current guidance addressing vaccine wellness programs to date, so it is important to review the HIPAA and PPACA regulations on wellness programs when considering a vaccine surcharge for your health plan. A vaccine wellness requirement could be considered an “activity based wellness program,” which allows a surcharge “incentive” of no more than 30% of the of the total cost of an employee’s health insurance premiums.

Incentives in the form of premium discounts may also be offered to vaccinated employees as part of an eligible activity based wellness program. Employers should note that all wellness incentives are cumulative, which means that adding a vaccination wellness incentive could cause your plan to exceed the maximum allowed incentive amount if penalties or rewards are offered with other wellness programs, such as tobacco cessation. In this instance, the plan would be required to reduce or modify other incentives so that no more than 30% of the employee’s total cost is affected.

Before implementing a vaccination wellness program, employers should consider other restrictions, such as collective bargaining agreements, and labor and employment laws. Specific compliance questions about implementing a vaccination wellness program should be directed to the plan’s legal advisors.

From Delta to Mu

The Delta variant is raging and driving the latest tidal wave of COVID-19 cases. It accounted for 99.1% of all COVID-19 cases in the US for the week ending September 4th according to the CDC’s variant tracker. The CDC began publishing variant tracker data in June 2021. For the week ending June 5th, 2021, the Delta variant accounted for only 14.1% of all COVID-19 cases and it had reached 49 states.

While the Mu variant that we hear so much about has reached 49 states, it currently represents only 0.1% of all U.S. cases. However, on August 30th, the World Health Organization (WHO) listed the Mu variant as a “variant of interest” based on its ability to ‘evade antibodies’ as witnessed by its spread in South America. Read more about Dr. Fauci’s comments on the Mu variant in this Sept 2nd New York Times article.

Booster Vaccines Approved…and Coming Soon

On August 18th the U.S. Department of Health and Human Services (HHS) announced, “We have developed a plan to begin offering these booster shots this fall subject to FDA conducting an independent evaluation and determination of the safety and effectiveness of a third dose of the Pfizer and Moderna mRNA vaccines and CDC’s Advisory Committee on Immunization Practices (ACIP) issuing booster dose recommendations based on a thorough review of the evidence. We are prepared to offer booster shots for all Americans beginning the week of September 20 and starting 8 months after an individual’s second dose.”

On September 17th the FDA will meet to discuss Pfizer-BioNTech’s supplemental Biologics License Application for administration of a third (“booster”) dose of Comirnaty (COVID-19 Vaccine, mRNA) in individuals 16 years of age and older. This follows the FDA’s August 12th authorization of an additional vaccine dose for immunocompromised people.

We will continue to closely monitor the FDA’s vaccine approvals and the CDC’s recommendations for COVID-19 vaccine boosters and treatments.

Ivermectin is Not FDA Authorized for COVID-19 Prevention or Treatment

On September 3rd, the FDA published a new webpage titled, Why You Should Not Use Ivermectin to Treat or Prevent COVID-19. If you hear your people talking about this drug, please share this FDA webpage with them. Spoiler alert, there’s a reason it features a picture of a horse and a veterinarian.

  • The FDA has not authorized or approved Ivermectin for use in preventing or treating COVID-19 in humans or animals. Ivermectin is approved for human use to treat infections caused by some parasitic worms and head lice and skin conditions like rosacea.
  • Currently available data do not show ivermectin is effective against COVID-19. Clinical trials assessing ivermectin tablets for the prevention or treatment of COVID-19 in people are ongoing.
  • Taking large doses of ivermectin is dangerous.
  • If your health care provider writes you an ivermectin prescription, fill it through a legitimate source such as a pharmacy, and take it exactly as prescribed. 
  • Never use medications intended for animals on yourself or other people. Animal ivermectin products are very different from those approved for humans. Use of animal ivermectin for the prevention or treatment of COVID-19 in humans is dangerous. 

Regular COVID Reporting Continues

All  clients currently receive regular reporting on their plan’s COVID-related claims and payments. Please connect with your Account Manager to receive your latest report.

Our focus, dedication, and support remain steadfast as we navigate these unique times with you. Know that our Care Management nurses are reaching out to those members diagnosed with COVID-19 to help them access the care and resources they need to recover safely.

Updated COVID-19 Member Information and Resources on Our Website

We update our COVID-19 information and resource pages for members regularly. Many members call us with questions that are of a more clinical nature. We recommend that members consult their primary care physician for clinical questions. For non-clinical questions, please share this page with members where they will find links to additional resources on self-care, vaccines, and other useful information.n.

We’re Here for You 

Our focus, dedication, and support remain steadfast as we navigate these unique times with you. Know that our Care Management nurses are reaching out to those members diagnosed with COVID-19  to help them access the care and resources they need to recover safely. Thank you for your continued trust in our organization. We are in this with you and hope that you and yours stay safe and healthy. Please reach out to your Account Manager if you have any questions or if there’s anything we can do to help. 

Best Regards,

Lindsay Harris, MPP President

Regence Group Administrators

August 12, 2021

  • Employer Vaccine Mandates Gaining Popularity
  • The DOJ and EEOC Updates on Employer-mandated Vaccinations
  • COVID Vaccination Requirements & HIPAA Considerations
  • OSHA Updates on Protecting Workers from the Spread of COVID-19
  • The Raging Delta
  • Booster Vaccines Approved…for Some
  • Public Health Emergencies- Anticipated End Dates and Next Steps
  • Benefit Design – COVID Testing 
  • Benefit Design – Telemedicine Coverage 
  • Telemedicine Reimbursement Rates
  • Regular COVID Reporting Continues
  • Vaccine Costs and Trends Across our Membership
  • Testing Trends Across Our Membership 
  • Treatment Claims Trends Across Our Membership
  • Updated COVID-19 Member Information and Resources on Our Website

June 28, 2021

  • The ‘next normal’, is it here?
  • Public Health Emergencies- anticipated end dates and next steps
  • Do vaccine incentives work?
  • EEOC update on employer-mandated vaccinations
  • OSHA updates on protecting workers from the spread of COVID-19
  • Planning for booster vaccines
  • Telemedicine reimbursement rates
  • PPE Coverage Update
  • Regular COVID reporting continues
  • Trends – current and anticipated
  • Member support

May 28th, 2021

  • The 'next' normal', just around the corner?
  • Overcoming vaccine hesitancy with incentives
  • COntinuing COVID support for our clients
  • Planning for booster vaccines
  • Regular COVID reporting to continue
  • Trends - current and anticipated
  • Member support

‚ÄčApril 29th, 2021

  • The race to vaccinate
  • Is herd immunity possible?
  • Vaccine safety and efficacy
  • Health plan coverage of vaccines
  • Vaccine costs and trends across our membership
  • An update on employer-mandated vaccinations and new OSHA requirements
  • Updated COVID-19 member information and resources on our website
  • Testing trends across our membership
  • Treatment claims trends across our membership

March 26, 2021

  • Latest Update  
  • COVID-19 Variants Pose Surge Risk 
  • COVID-19 Vaccinations
  • Vaccine Efficacy - What You Should Know
  • Vaccine Eligibility and Access 
  • Health Plan Coverage of Vaccines
  • Vaccine Costs and Trends Across our Membership
  • An Update on Employer-mandated Vaccinations
  • Updated COVID-19 Member Information and resources on our Website
  • Testing Trends Across our Membership 
  • Treatment Claims Trends Across Our Membership 

February 26, 2021

  • US and Regional Update
  • COVID-19 Vaccinations 
  • COVID-19 Variants
  • Vaccine Eligibility and Access 
  • Health Plan Coverage of Vaccines
  • Vaccine Costs and Trends Across our Membership
  • An Update on Employer-mandated Vaccinations
  • Updated COVID-19 Member Information and resources on our Website
  • Testing Trends Across our Membership 
  • Treatment Claims Trends Across Our Membership 

January 29, 2021

  • US and Regional Update
  • Testing Trends Across our Membership
  • Treatment Claims Trends Across Our Membership
  • COVID-19 Vaccinations
  • Health Plan Coverage
  • Vaccine Costs
  • Vaccine Access
  • Government-mandated Vaccinations?
  • What About Employer-mandated Vaccinations?
  • Will RGA Provide Reporting on Employees Who Have Been Vaccinated?

December 18, 2020 

  • Testing Trends Across our Membership
  • Treatment Claims Trends Across Our Membership
  • COVID-19 Vaccinations Begin...What to Expect
  • Health Plan Coverage
  • Vaccine Costs
  • Government-mandated Vaccinations?
  • Employer-mandated Vaccine Update
  • Will RGA Provide Reporting on Employees Who Have Been Vaccinated?

November 24, 2020 

  • US and Regional Update
  • Testing Trends Across our Membership
  • Treatment Claims Trends Across Our Membership
  • Member Difficulty Finding Testing
  • Preparing for COVID-19 Vaccinations
  • Employer-Mandated Vaccines?

October 30, 2020 

  • US & Global update
  • Testing trends regionally
  • Outcome trends by state & age Group across regional Covid-19 positive cases
  • Treatment claims trends across our membership
  • Preparing for Covid-19 vaccinations
  • Employer-mandated vaccines?

September 25, 2020 

  • US & Global update
  • Testing trends regionally
  • Treatment claims trends across our membership
  • Testing claims trends across our membership

August 26, 2020 

  • US & Global update
  • Testing trends regionally
  • Treatment claims trends across our membership
  • Testing claims trends across our membership

July 24, 2020

  • US & Global update
  • Testing trends regionally
  • Treatment claims trends across our membership
  • Testing claims trends across our membership

June 26, 2020

  • RGA Open Arms Program launches July 1st
  • COVID-19 updates to our website
  • The CDC expands and updates the list of people at risk of severe COVID-19 illness
  • The joint agencies clarify FFCRA and CARES Act implementation guidance
  • Trends we are seeing

June 11, 2020

  • Return to work webinar series launched this week
  • COVID-19 updates to our website
  • An update no provider personal protective equipment (PPE) surcharges
  • Trends we are seeing

May 29, 2020

  • Return to work webinar series
  • How to participate in the IRS relief for FSAs and other cafeteria plans
  • Provider personal protective equipment (PPE) surcharges
  • Unemployment fraud update
  • Trends we are seeing

May 15, 2020  

  • Taking Care: An emerging mental and behavioral health pandemic
  • Unemployment fraud rampant and how to report it
  • Return to work testing resources
  • Trends we are seeing

 May 8, 2020 

  • Interim Compliance Alert: COVID-19

May 1, 2020 

  • COVID-19 Client Impact Reports now available
  • Benefit change request form reminder
  • Trends we are seeing 

April 24, 2020 

  • $484 billion and more to come?
  • Proclamations & regulatory orders vs health plans – Options for stability in unstable times
  • The heated debate over when and how to return to work

April 17, 2020 

  • Expansion of coverage for COVID-19 and pricing for COVID-19 related claims 
  • Access to non-urgent care during the stay at home orders 
  • Trends, testing, and antibody studies  

April 10, 2020 

  • A preview of COVID-19 reporting
  • More Telehealth and Telemedicine updates
  • Trends we are seeing and how they may affect your health plan

April 3, 2020 

  • How does the CARES Act affect my health plan?
  • An overview of the recent changes to Telemedicine and Telehealth
  • Trends we are seeing and how they may affect your health plan

March 27, 2020

March 20, 2020

March 12, 2020

March 5, 2020

March 2, 2020