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Frequently Asked Questions for Employer Groups

Impacts to benefits resulting from the end of the PHE are:

  • For fully-insured groups, standard benefits returned and were effective May 12, 2023, for COVID-19 vaccines, over-the-counter tests, and COVID-19 testing and testing-related services. Cost-share waiver for COVID-19 testing and testing-related services stops May 12, 2023.
  • For self-funded groups, Wellmark communicated options beyond standard benefits on April 12, 2023. Plans defaulted to standard benefits unless an option was elected and communicated.

If the vaccine is administered in a physician's office, the cost will fall under medical. If administered in a pharmacy, it will fall under your pharmacy plan.

  • For fully-insured groups, standard benefits were effective May 12, 2023 for COVID-19 over-the-counter tests. Under standard benefits, COVID-19 over-the-counter tests are not covered by the health plan, and employees are responsible for paying for out-of-pocket for these tests.
  • For self-funded groups, Wellmark communicated options beyond standard benefits on April 12, 2023. Plans defaulted to standard benefits unless an option was elected and communicated. Under standard benefits, COVID-19 over-the-counter tests are not covered by the health plan, and employees are responsible for paying for out-of-pocket for these tests.

Various employee benefit plan deadlines – such as claim filings or appeals – had been extended through an “outbreak period” from March 1, 2020, until 60 days after the announced end of the national emergency. The outbreak period ends on July 11, 2023.

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