CurrentAlabama Department of InsurancePolicy 2020-07

Flexibility of Health Insurance Coverage in light of COVID-19

Customize your policy alerts

Sign up for Alabama Department of Insurance Policy 2020-07 alerts

Get alerted when Policy 2020-07 changes without checking for updates manually.

Monitor payer policy activity

Receive email alerts as soon as relevant payer policies are published or updated.

This bulletin provides non-binding recommendations to insurers writing health insurance in Alabama on flexibilities to maintain employee coverage and adjust policy practices during the COVID-19 public health emergency; it affects health insurers and employers in Alabama.

Policy Summary

PayerAlabama Department of Insurance

PolicyFlexibility of Health Insurance Coverage in light of COVID-19

Policy CodePolicy Policy 2020-07

Change TypeGuidance bulletin (no mandatory coverage change)

Effective DateApr 17, 2020

Next Review Date

Key ActionInsurers should exercise flexibility to keep employees on health plans during the State of Emergency, including maintaining eligibility despite reduced hours and waiving 'actively at work' requirements.

SourceLink

POLICY UPDATE CHANGES

No material clinical or coverage changes in this revision.

Immediateeffective action requested

State of Emergencybasis for flexibility

No enforcementregulatory forbearance

Recommended Coverage Flexibilities

OpenPayer is powered by Trek Health's payer performance platform. Trek continuously ingests, validates, and normalizes Transparency in Coverage data alongside payer policies and other commercial payer data to create a structured payer intelligence foundation. OpenPayer uses this foundation to deliver personalized search results, dynamically generated policy pages, and tailored policy monitoring based on each user's payers, specialties, billing codes, and areas of interest. The same intelligence powers broader payer performance workflows, including reimbursement benchmarking, contract evaluation, payer negotiations, and financial decision-making.

CurrentAlabama Department of InsurancePolicy 2020-07

Flexibility of Health Insurance Coverage in light of COVID-19

Customize your policy alerts

Sign up for Alabama Department of Insurance Policy 2020-07 alerts

Get alerted when Policy 2020-07 changes without checking for updates manually.

Monitor payer policy activity

Receive email alerts as soon as relevant payer policies are published or updated.

Policy Summary

PayerAlabama Department of Insurance

PolicyFlexibility of Health Insurance Coverage in light of COVID-19

Policy CodePolicy Policy 2020-07

Change TypeGuidance bulletin (no mandatory coverage change)

Effective DateApr 17, 2020

Next Review Date

SourceLink

POLICY UPDATE CHANGES

No material clinical or coverage changes in this revision.

Immediateeffective action requested

State of Emergencybasis for flexibility

No enforcementregulatory forbearance

Recommended Coverage Flexibilities

Recommended coverage flexibilities

Suggested insurer practices to preserve coverage during the emergency:

Insurers should consider keeping employees on group health plans even if they would otherwise become ineligible due to a decrease in hours worked per week.

Insurers are encouraged to waive or relax 'actively at work' or similar eligibility requirements to avoid termination of coverage.

Insurers are encouraged not to increase premium rates, if possible.

Insurers must comply with their responsibilities under COBRA and are encouraged to assist employers with those obligations.

The Commissioner will refrain from enforcement action with respect to filed forms and rates against insurers that adjust policies, practices, and notice periods consistent with this bulletin.

Recommended Insurer Actions During the COVID-19 Emergency

Prior Authorization

Insurer flexibility to preserve employee coverage during COVID-19 State of Emergency

During the State of Emergency declared for COVID-19, insurers are recommended to exercise flexibility to maintain employee health plan coverage — keep employees on group policies even if they would otherwise become ineligible due to reduced hours, waive or relax “actively at work” or similar eligibility requirements, and avoid increasing premium rates where possible. Insurers should also remember COBRA responsibilities and assist employers. The Commissioner will refrain from enforcement action against insurers that adjust forms, rates, practices, and notice periods consistent with this bulletin.

Keep employees on group health plans despite decreased hours worked per week.
Waive or relax “actively at work” or similar eligibility requirements to avoid termination of coverage.
Avoid increasing premium rates if possible.
Assist employers with COBRA responsibilities.
The Commissioner will not take enforcement action regarding filed forms and rates for insurers that implement these flexibilities.

Key Definitions

State of Emergency due to COVID-19

Official declaration dateGovernor Kay Ivey declared a state of public health emergency on March 13, 2020 due to COVID-19.

Scope of declarationState of Emergency applies statewide in Alabama; supplemental declarations and local shelter-in-place or curfew orders have also been issued and more could follow.

Effective statusThe bulletin notes the duration is uncertain — it is not certain when the public health emergency will be canceled.

Policy action promptedThe Commissioner recommends insurers consider flexibilities to keep employees on health plans during this State of Emergency.

Document referenceAlabama Department of Insurance Bulletin No. 2020-07, dated April 17, 2020.

Policy Summary

PayerAlabama Department of Insurance

PolicyFlexibility of Health Insurance Coverage in light of COVID-19

Policy CodePolicy Policy 2020-07

Change TypeGuidance bulletin (no mandatory coverage change)

Effective DateApr 17, 2020

Next Review Date

SourceLink

On This Page