Merry New Year!

What’s happening this week? Transamerica says 2021 looks bright and we have a labor attorney weigh in on if employers can make COVID vaccines mandatory. Oh, yes, and we are ringing in the new year!

HEALTH

In response to the pandemic, Covered California extended the enrollment deadline to receive Jan. 1 coverage from Dec. 15 to Wednesday, Dec. 30 (today!). Consumers who sign up by Dec. 30 will need to pay their first bill in order to have their coverage take effect on Jan. 1.   That is only for coverage to start on Jan. 1, though. The open enrollment deadline runs through Jan. 31, however. This may be hard for some people to believe, but right now an estimated 1.2 million Californians are uninsured — even though they are eligible for financial help through Covered California, or they qualify for low-cost or no-cost coverage through Medi-Cal. Check out the following info provided by Covered California:

TABLE: Estimated Number of Uninsured Eligible for Financial Help Through Covered California or Medi-Cal (by Metro Region)

Metro Region

Uninsured Californians Eligible for Financial Help

Northern California and Sacramento Valley

139,000

Greater Bay Area

122,000

Central Coast

60,000

San Joaquin, Central Valley, Eastern, Kern

163,000

Los Angeles

338,000

Inland Empire

192,000

Orange

88,000

San Diego

100,000

Total

1,202,000

Of those eligible for subsidies, more than half — 650,000 — are believed to be Latino. Please consider spreading the word to your clients, family and friends.

UNUM Revamps Hospital Insurance

Employers can now get Unum hospital insurance with more funding options and greater flexibility in how the coverage is offered. The new hospital insurance is available for quotes with coverage starting in 2021. The revamped hospital product better complements health insurance with fewer coverage gaps and less duplication for employees. Other features include more options in coverage level with varying price points, compatibility with health savings accounts, a well-child benefit for newborns who get routine check-ups, and coverage for mental health hospital confinement. Hospital insurance pays a lump-sum benefit for qualifying hospital visits, such as trips to the emergency room, in-patient surgeries, or childbirth. Employers can offer the coverage to employees on an employer-paid or employee-paid basis — or a mixture of both. It’s offered on the same administrative platform as Unum’s other group benefits — like disability and life insurance — for streamlined onboarding, billing, and management for plan administrators. Companies with 100 or more employees can purchase the coverage, and at least 10 employees must be enrolled. Hospitalizations due to COVID-19 may be covered under Unum’s hospital insurance depending on the terms of the policy.

CA Department of Insurance Issues Letter Protecting Youth Gender Dysphoria Treatment

California Insurance Commissioner Ricardo Lara directed the Department of Insurance this week to issue a General Counsel Opinion Letter clarifying that under existing California law, health insurance companies may not deny coverage for male chest reconstruction surgery for female-to-male patients undergoing care for gender dysphoria based solely on a patient’s age. Lara says that people diagnosed with gender dysphoria have had to battle a host of challenges to access gender-affirming care. “Social stigma, misconceptions about gender dysphoria and its treatment, and outdated medical criteria create barriers to necessary medical care that can lead to tragic results for individuals with gender dysphoria, especially for our transgender youth,” says Lara. California law already provides protections meant to reduce these barriers to gender-affirming care for gender dysphoria. However, due to complaints from young Californians and their parents, some health insurance companies may still use coverage criteria and processes that wrongfully deny coverage, and place the burden on consumers to pursue their legal rights to transgender health services through time-consuming appeals and independent medical reviews. To be proactive, health insurance companies should evaluate their coverage criteria for gender dysphoria treatment and eliminate any noncompliant practices to avoid needlessly delaying and interfering with medical care recommended by a patient’s doctor. The Department’s General Counsel Opinion Letter, issued pursuant to Insurance Code section 12921.9, was prepared in response to an inquiry from San Diego’s TransFamily Support Services regarding several denials of coverage for male chest surgery for patients under 18 years old who are transitioning from female to male. The Department determined that denying coverage for mastectomy and reconstruction of a male chest based solely on age is impermissible under state laws requiring coverage of reconstructive surgery. Health insurance companies must consider a patient’s specific clinical situation in determining medical necessity.

2021

Transamerica Thinks We Could Have A Very Good 2021

Transamerica recently issued the Transamerica 2021 Market Outlook: Where We Stand written by Tom Wald, Chief Investment Officer for Transamerica Asset Management, Inc. This is just one of the takeaways:

While U.S. economic growth could be challenged in 1Q 2021 as COVID-19 cases continue to rise, we look for the economy to accelerate meaningfully in 2H 2021 as vaccine accessibility dovetails with an accommodative interest rate environment and eventual fiscal stimulus, driving pent-up demand by consumers and businesses. This could result in annual gross domestic product (GDP) growth of 4% in 2021 helping the economy return to pre-virus levels of real aggregate GDP by year end.

Download the whole report here.

MDRT

MDRT Launches Association for Field and Home Office Leaders

Million Dollar Round Table (MDRT) announced it is expanding its family of brands with the introduction of MDRT Global Services, an individual membership association created exclusively for field and home office leaders. MDRT Global Services will introduce its initial offerings and build an inaugural member base with a pilot program in select countries beginning on January 1, 2021. Membership benefits include diverse opportunities for innovative leadership development, enhanced agency productivity and deeper engagement within the MDRT community. The new association will offer access to tools that allow field and home office leaders to inspire a culture of excellence within their organizations while also supporting their advisors and influencing their advisors’ success.

EMPLOYEE BENEFITS

LIMRA: COVID-19 Spurs Employer Interest in Providing Emergency Savings Account

According to LIMRA research, 14% of consumers say they have lost their job due to COVID-19 and 32% are earning less because their hours or pay were reduced. Almost half (45%) of workers indicate the pandemic’s economic downturn has negatively affected their retirement savings and 56% are worried about the long-term impact the pandemic will have on their financial security. The pandemic, however, is just exacerbating a problem that already existed. Almost 1 in 4 Americans have no money set aside for emergencies and another 26% have less than three months of emergency savings. But, according to LIMRA, more employers are interested in offering emergency saving vehicles. Nearly two-thirds of employers are somewhat or very interested in offering employees access to an emergency savings account. Also, 3 in 10 defined contribution (DC) plan advisors would like to see recordkeepers offer workplace emergency savings alongside retirement plan recordkeeping.

There are a few different approaches to the emergency savings gap:

  • Use an in-plan option. This approach supplements an existing workplace retirement plan, and it is intended to prevent employees from dipping into their actual retirement savings. Employees designate a percentage of their paycheck towards an emergency savings account within their DC plan.
  • Add a “sidecar” solution. Employers offer a program separate from their DC plan to enable their workers to save for emergencies.
  • Take it online. There are apps —like Twine, Acorns and Qaptial — specifically built to help consumers improve their savings habits.
  • Turn to insurance. One less formal (and also likely not well-known) option is to tap into a whole life policy. For people who own this product and have a cash balance, they are able to access those funds during difficult financial circumstances.

The good news is LIMRA research finds more than 6 in 10 workers are interested in a workplace emergency savings account. Innovation in this area can help create more stability today and a more certain tomorrow for employers, their employees, and families across America.

Could Employers Mandate COVID Vaccinations?

Employers may already be asking benefits folks if they can mandate that their employees get the COVID vaccination. Below, veteran labor attorney Elaine Turner, shareholder/partner at the national law firm Hall Estill, weighs in.

The Equal Employment Opportunity Commission (EEOC) has not yet spoken to whether employers may mandate that all employees take a COVID-19 vaccine when one becomes available. However, during the H1N1 public health crisis, the EEOC determined that, during an influenza pandemic, employers could not mandate that all employees take a flu vaccine regardless of employee medical conditions and religious observances. Courts have reviewed similar issues related to mandatory vaccine policies for the flu and for other diseases as well. Under federal law, courts have found that employees were not exempt from mandatory vaccine policies when their medical condition did not rise to the level of a disability under the ADA or their anti-vaccine philosophy was not a sincerely held religious belief. Courts determining federal law claims have also not exempted employees from mandatory vaccine policies when to do so would impose an undue hardship on employers such as healthcare providers whose patients would be placed at risk if exposed to employees with a contagious disease.

While we wait for the EEOC and other government entities to speak to the issue, employers should begin evaluating whether their business is legitimately in need of a mandatory COVID-19 vaccine policy or should merely encourage employees to take the vaccine. Under federal law, employers must have a reasonable belief that a mandatory vaccine policy is required because an employee’s ability to perform essential job functions will be impaired by COVID-19 or an employee will pose a direct threat due to COVID-19. This is likely an easy determination for healthcare providers, but not so easy for other kinds of employers who are outside the healthcare industry. Employers should also closely examine applicable state law requirements. Many states have laws relating to vaccine requirements. In the context of other vaccines, a small number of states have allowed individuals, such as school age children, to be exempt from mandatory vaccines based solely on their parents’ personal beliefs or the belief of the child.

EVENTS

  • LAAHU’s Zoom Happy Hour is the first Wednesday of the month from 4-5p.m. Members and nonmembers welcome. Register here.
  • NAHU Power Hour, 4th Wednesday of the month from 4-5p.m. Pacific. Members and nonmembers welcome. Register here.
  • NAIFA-Los Angeles 68th Annual Will G. Farrell Award & Leadership Recognition Event, Virtual, Feb. 18, 2021. More info here.
  • CAHU Women’s Leadership Summit, April 7-9, 2021!The latest news from CAHU’s WLS committee is that the CAHU Women’s Leadership Summit will now take place April 7 –9, 2021, at Green Valley Ranch in Las Vegas. Questions should be emailed to info@cahu.org.