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Pres. Biden Lays Out COVID-19 Plans Includes Future Obligation for GHPs to Cover OTC Testing Costs

The Biden administration has advanced a nine-pronged plan in support of public health that includes potential new requirements expanding coverage for COVID-19 testing under group health plans. Specifics related to the plan are to be provided in clarifying guidance to be issued in the coming weeks. Most notable for group health plan sponsors is a provision providing that “the more than 150 million Americans with private insurance will also be able to get at-home tests reimbursed by their insurance.” Note the following related to this proposed measure:

  • Prior COVID relief packages included provisions requiring group health plans to cover diagnostic COVID tests without cost-sharing if they meet certain criteria, and tests for surveillance or return to work purposes were not included.

  • Now over-the-counter (OTC) diagnostic COVID tests without a physician or clinical requirement are to be covered without cost sharing during the public health emergency.

  • Individuals will have to purchase OTC tests and then submit the receipts for reimbursement.

  • The administration plans to release rules outlining the reimbursement process by January 15.

  • It is unclear if the government will impose limits on the number/frequency of OTC rapid tests that have to be covered without cost-share.

Another provision of the President’s plan continues to call on businesses to “move forward with vaccination or testing programs” to “ensure workers are protected as we head into the winter.” However, the plan provides no new requirements or guidelines associated with any mandated vaccination and/or testing measure.

We are monitoring the new proposed plan closely based on the possible cost and administrative impact to group health plans. We will provide additional updates as more guidance becomes available. Please contact your Conner Strong & Buckelew account representative toll-free at 1-877-861-3220 with any questions on health and group benefits related matters. For a complete list of Legislative Updates issued by Conner Strong & Buckelew, visit our online Resource Center.

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