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COVID-19

During the COVID-19 Public Health Emergency (PHE), Wellmark enhanced benefit coverage to ensure your employees had access to COVID-related services. The Biden administration announced the end of the COVID-19 national emergency on April 10, 2023, and ended the HHS-declared COVID-19 Public Health Emergency (PHE) on May 11, 2023.

We've put together questions and answers to address how employer group benefits will be impacted by the end of the PHE.

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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