COVID-19 Employer Playbook

Increasing Supplies of Specialty Medications During the COVID-19 outbreak, when an existing patient needs a refill of their specialty medication, most pharmacies are making available a one-time, 90-day supply of key specialty medications instead of the traditional 30-day supply. This typically does not apply to patients newly initiating specialty therapy, or for certain categories of drugs such as controlled substances. Proactive Communication It goes without saying that employees will have questions and concerns about the availability of their medicines. Accordingly, many PBMs are proactively reaching out to employees who are on maintenance medications (emails and letters) with messaging outlining the special COVID-19 programs and to help quell stress and concern. Mail Order Reminders To support social distancing directives, PBMs are informing employees about the possibility of obtaining prescriptions via home delivery.

Premium Grace Period Extensions

California The California Insurance Commissioner has issued a notice requesting that all insurance carriers extend premium payment grace periods from the standard 30 days to at least 60 days. This request was issued to protect insureds from their policies being canceled for nonpayment of premium during this challenging time. While this notice is a request and not a mandate, most insurance carriers have announced extensions of premium payment grace periods to 60 days or non-termination commitments through a specific date. Employers should be sure to check with their PBM to confirm specific coverage provisions.

Other States Similar actions have been issued in most states across the nation.

Self-Insured Plans While self-insured plans aren’t subject to state insurance department regulation and don’t have “premiums” to pay, per se, many rely on underlying reinsurance contracts that do have premiums and contractual grace periods. Some reinsurance carriers are also offering extended grace periods, but others are not. These reinsurance contracts may be called upon with unforeseen demand, given the intensive nature of COVID-19-related medical treatment. This is a time to make sure that reinsurance premiums are paid in a timely fashion.


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