FAQs about My Alliance Health Plan Benefits

1. Does the Health Plan cover COVID-19 testing?

Yes, the Health Plan covers COVID-19 diagnostic testing ordered by a licensed or authorized health care provider who has determined that the test is medically appropriate for you, without deductible, coinsurance, or copay. Charges for other items and services related to the COVID-19 test (physician or facility fees, other diagnostic testing, etc.) will also be covered without deductible, coinsurance, or copay but, if those items and services are provided by a non-Alliance Direct facility, you may be liable for the difference between the Plan’s allowable charge for those items and services and the provider’s billed charge (known as a “balance bill”). The provision of this coverage without deductible, coinsurance, or copay only applies during the COVID-19 public health emergency.  

 

2. Does the Health Plan cover COVID-19 vaccinations?

The Health Plan covers COVID-19 vaccinations (and their administration) that have received a recommendation from the Advisory Committee on Immunization Practices of the Centers for Disease Control and Prevention (CDC), with such coverage to begin no later than 15 business days after the recommendation is made.  The current list of vaccines can be found at https://www.cdc.gov/vaccines/hcp/acip-recs/vacc-specific/covid-19.html. 

The plan also covers other COVID-19 preventive services that have in effect a rating of A or B in the current recommendations of the United States Preventive Services Task Force. 

This coverage is provided without deductible, coinsurance, or copay, subject to Allowable Charge limitations for non-Alliance Direct facilities. 
 

3. What is the Health Plan's coverage of telemedicine services in response to COVID-19?

Please see the Plan's Telemedicine and COVID-19 policy. This describes the Health Plan’s processing and reimbursement for telemedicine services during the COVID-19 public health emergency.

 

4. How has COVID-19 affected the rules for Flexible Spending Accounts (FSAs)?

To make it easier to use your Health Care FSA and/or Dependent Care FSA during the COVID-19 pandemic, the Flexible Benefits Plan applies the following exceptions for the 2020 and 2021 plan years, as permitted by the Consolidated Appropriations Act, 2021. For more information, call Member Services at (855) 979-5192.

  • Unrestricted carryover through 2022 (both Health Care and Dependent Care FSAs). All unused amounts in your Health Care FSA and/or Dependent Care FSA will be carried over from 2020 to 2021, and from 2021 to 2022. For the Health Care FSA, the annual limit for carryover normally applied by the IRS (e.g., $500 for 2019) does not apply for 2020 and 2021. This exception also applies to the Dependent Care FSA, even though the normal rules do not permit carryover for the Dependent Care FSA. 
  • Mid-year election changes in 2021 for Health Care and Dependent Care FSAs: You can make prospective mid-year FSA election changes in 2021, even if you did not have a qualified change in status (getting married, birth of a child, etc.). This means you can change your FSA election amount or sign up for an FSA outside of the annual Open Enrollment period. Please note that you may not reduce your annual election amount below the amount of your year-to-date contributions or below the amount already disbursed. To make an election change, submit the Flexible Spending Account Enrollment Form to your local HR representative.
  • Certain post-termination reimbursements allowed for 2020 and 2021 (Health Care FSAs only): If your participation in the Health Care FSA ends during 2020 or 2021, you can continue to receive reimbursements from unused amounts in your Health Care FSA for any eligible expenses incurred through the end of the year in which your participation ends. Under this exception, the amount available for reimbursement of expenses incurred after termination is limited to the total amount of your unused contributions and carryovers, not the full annual amount of your election. Unlike reimbursements available under COBRA, this exception does not require that you make further contributions. As under the normal rules, the deadline for filing claims is March 31 of the year after your termination. 

 

5. Have there been changes in eligible expenses for Health Care FSAs?

Over-the-counter drugs and medicines are eligible for reimbursement without a prescription (if they are otherwise eligible for reimbursement), and certain menstrual care products are eligible for reimbursement.  

Amounts paid for personal protective equipment (PPE) for the primary purpose of preventing the spread of the COVID-19, such as masks, hand sanitizer and sanitizing wipes, are also eligible for reimbursement. 

These changes apply for expenses incurred on or after January 1, 2020. Normally, the claims filing period for 2020 claims would have ended on March 31, 2021, but the “Outbreak Period” relief described below provides additional time to file Health Care FSA claims.  Thus, participants with unused 2020 Health Care FSA balances still have time to file a claim for amounts spent in 2020.

For more details about eligible expenses, visit the Navia Health Care FSA List of Eligible & Ineligible Expenses or call Navia FSA Customer Service at (800) 669-3539 to request a paper copy of this list.

 

6. May I change my Health Plan election during 2021?  

You can make a prospective mid-year Health Plan election change in 2021, even if you did not have a qualified change in status (getting married, birth of a child, etc.). This means that you can add or drop Health Plan coverage without a qualified change in status, but you can only drop coverage if you provide a written attestation that you are enrolled in or immediately will enroll in, other comprehensive health coverage not provided by Alliance Coal.  For more information about changing a Health Plan election, call Member Services at (855) 979-5192.

 

7. What time extensions apply to my benefits as a result of COVID-19?

Due to COVID-19, the federal government has required benefit plans to provide additional time for participants to take certain actions, as follows.

  • The 31-day period (or 60-day period, if applicable) to exercise HIPAA special enrollment rights
  • The 60-day election period for COBRA continuation coverage
  • The date for making COBRA premium payments
  • The date for individuals to notify the plan of a COBRA qualifying event or determination of disability with respect to COBRA coverage
  • The dates by which an individual may (i) file a benefit claim under a plan’s claims procedure, (ii) appeal a claim that has been denied, (iii) request an external review of a denied claim or appeal, or (iv) file information to perfect a request for external review.

Specifically, when determining the deadline for these elections and actions, benefit plans are required to disregard the period from March 1, 2020 to the date that is 60 days after the COVID-19 national emergency declaration expires or, if earlier, the date that is 1 year from the original deadline. For more information about how these extensions may affect your situation, call Member Services.

 

8. Have there been changes with respect to COBRA?

The American Rescue Plan Act (ARPA), signed into law March 11, 2021, provides a 100% subsidy of COBRA premiums from April 1, 2021 through September 30, 2021, for employees (and their covered eligible dependents) who are eligible for COBRA during that time period due to the employee’s reduction in hours or involuntarily termination.  

Generally, the subsidy is available to those eligible individuals who are still within their original COBRA coverage period if they 1) elected COBRA, 2) became eligible for COBRA but declined COBRA, or 3) elected but then discontinued COBRA due to nonpayment before April 1, 2021.  The subsidy also applies to those who become eligible for COBRA due to reduction in hours or involuntary termination through September 30, 2021.

The subsidy is not applicable to active employee coverage.  However, if you have questions regarding the subsidy, please contact Navia COBRA Customer Service at 877-920-9675.

 

[Back to Coronavirus (COVID-19) Updates]

 

The novel coronavirus (COVID-19) situation is a rapidly evolving issue across the nation and around the world, with details that are changing daily. For the most up-to-date guidance on the disease and public health practices from the US Centers for Disease Control and Prevention (CDC), refer to coronavirus.gov. This information is not medical advice; employees are encouraged to consult their own doctors or other health care providers for advice specific to their situations.