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If you have a business with less than 500 employees emergency assistance is available.

If COVID-19 is causing financial difficulties for your business, financial relief loans are currently being offered to assist you in maintaining employees and keeping your business operating.

In some cases, you may need to provide your current payroll expenses. Use our eBilling tool to access your payment history.

The cost of the test and treatment is fully covered for our members

We understand that our members may be concerned about their access to care during this time. Be assured, we will cover the full cost of COVID-19 diagnostic tests as prescribed by doctors. We will also cover the full cost of COVID-19 treatment regardless of where the care is provided in the United States. We are not requiring prior authorizations for testing, and all costs for participating doctors, telemedicine, urgent care, and emergency room visits for diagnostic testing related to COVID-19 have been waived.

Managing Premium Invoices and Payments

BlueCross BlueShield offers a quick and easy way to manage your health plan and pay your premiums. By logging into your employer account, you can manage invoices, schedule convenient automatic payments, and track payment history.

Set Up An Online Account

Complete the HIPAA Employer Authorization Form. The completion of this form is required to access the online portal. Once HIPAA Authorization form is received, you can log in to your account to handle tasks such as, pay an invoice, complete an enrollment or termination request.

Stress Management

myStrength by Livongo®

During this stressful time, myStrength by our partner Livongo is here for you. Learn ways to manage extreme stress, get tips for parenting during challenging times, and find support to help you take care of your emotional health. Available through the end of June.

Frequently Asked Questions (FAQs)

BlueCross BlueShield of Western New York is closely monitoring the COVID-19 (Coronavirus) situation. The health and well-being of our members is our top priority, and we remain committed to ensuring our employers and members have access to the care and information they need.

Cost Shares and Claim Processing

Is COVID-19 antibody testing covered for my employees?

  • Yes. In accordance with guidelines issued by the New York State Department of Health (NYSDOH), antibody testing will be covered at a $0 cost-share for in- and out-of-network services rendered.
    • Applies to claims dated April 10 through the expiration of the current state of emergency
    • Coverage pertains to medically-appropriate testing only with a prescribed doctor's order
  • Employees should consult with their doctor to determine if they meet medically-appropriate testing guidelines
  • This coverage applies to all fully-insured and self-funded Commercial members
  • Employees should follow the recommendation of their doctor regarding the appropriateness and/or location of testing
    • A telehealth consultation with their primary care doctor is encouraged
  • Employees have the option to conduct a telehealth visit with Doctor on Demand as well
    • Quest Diagnostics remains our preferred network laboratory
    • Urgent care facilities and hospitals are offering access to antibody testing, but employees should defer to their doctor’s recommendation

If I require COVID-19 antibody testing for my employees to return to work or continue working, would health insurance cover the cost?

  • No. Occupational testing for COVID-19 antibodies is not a covered health care benefit

Do my employees have to go to a specific lab to get antibody testing?

  • After consulting first with their primary care provider, if the doctor feels it’s appropriate, they will determine where they can go for testing
    • Quest Diagnostics remains our preferred network laboratory

Is COVID-19 diagnostic testing covered for my employees?

  • Yes. Employees that meet the New York State Department of Health (NYSDOH) guidelines AND have a prescription from their doctor will have the cost-share for COVID-19 diagnostic testing waived
  • Any testing done without a doctor’s prescription, and that does not meet the NYS Department of Health guidelines is not covered
  • Broad public health testing to identify individuals who may have been exposed, or surveillance testing for employment purposes are also excluded from coverage
  • This includes any Commercial, Individual, and Medicare Advantage members

If I require COVID-19 diagnostic testing for my employees to return to work or continue working, would health insurance cover the cost?

  • No. Occupational testing for COVID-19 is not a covered health care benefit

When did the $0 member cost share mandate go into effect?

  • For COVID-19 testing and office visit, urgent care, ER and telehealth visit for the purpose of testing, the  New York State mandate went into effect on March 13 and the Federal mandate went into effect on March 18

What is the claim processing start date for COVID-19 testing?

  • Claims will be processed for services dating back to February 4, 2020
  • This is date that CMS approved the initial two codes; A third code was approved on March 13
  • We would not expect to see many claims up to this point, as the majority of testing has been through governmental labs at no cost to members, employer groups or health plans

What is the claim processing start date for $0 member cost share for COVID-19 office visit, urgent care, ER or telehealth visits for the purpose of testing?

  • Office, urgent care and ER visit claims will be processed for services dating back to March 1
  • We will apply the $0 member cost-share for treatment with the designated diagnosis codes

What is the claim processing start date for $0 member cost share for COVID-19 treatment?

  • Claims will be processed for services dated from April 1, 2020 – May 31, 2020
  • The member cost-share waiver applies to medically necessary inpatient, outpatient or office visit costs with a COVID-19 diagnosis during April and May
    • We will apply the $0 member cost-share for treatment with the designated diagnosis codes
  • This coverage applies to all fully insured Commercial and Medicare Advantage members
    • Self-funded employers have the option to expand this coverage for their plans

What is the claim processing start date for $0 member cost share for all Telehealth services?

  • New York State Mandate to provide all telehealth at $0 member cost-share was effective March 17
  • Telehealth claims will be processed for services dating back to March 17

Premiums and Invoicing

How can I receive and pay my premium invoices if I can’t access my mail?

  • You can pay online by logging into our secure employer portal
    • You can pay any amount toward your balance until further notice
  • Premium invoices are available for viewing, download, and payment
    • If you do not already have access to our online tools, you will need to download HIPAA Form 2(I) from our website and return the completed form to your account executive via email
    • Your account executive will contact you with your login information
  • If you do not have the ability to pay online, you can mail your payment – with your group number listed on the check
    • Payment Processing Center
      PO Box 644366
      Pittsburgh, PA 15264-4362 

Will there be premium invoice payment due date flexibility during this state of emergency?

  • Yes, NYS Executive Order issued April 7 affords individuals and small businesses (1-100 employees) adversely impacted by COVID-19, the option to defer payment of premiums to the later of their contractual grace period or 11:59 PM June 1, 2020
  • Large employers (101+ employees) adversely impacted by COVID-19 who are unable to make premium payments on time should contact their Account Executive to discuss potential solutions

If I have to lay off some of my employees will pre-paid premiums be refunded?

  • If you maintain group coverage, your overpayment will be applied to your next month’s premium invoice
  • If you are terminating all employee coverage, you will receive a refund of any overpayment once the termination is processed

Are premium invoices still being mailed?

  • Yes, there is no disruption in mailing of invoices  
  • Additionally, all invoices are located within our secure employer portal 

Enrollment and Eligibility

Will there be enrollment and eligibility flexibility during this state of emergency?

  • Yes, BlueCross BlueShield will extend the 30-day enrollment guideline until further notice.
  • Eligibility transactions can be updated in a timely and automated manner via BlueConnect, our online enrollment tool.

Does the enrollment flexibility allow for special enrollments during this state of emergency?

  • Special enrollment is associated with a qualifying event, as outlined in our Group Benefit Administrator Manual

    • Examples of qualifying events would include newborns, loss of spousal coverage, etc. 

    • These qualifying events allow for changes in coverage in eligibility

    • Employees who waived coverage during the open enrollment period without a qualifying event cannot be added to the plan

      • We can connect these employees with our consumer market account executives to explore alternative coverage options

      • Members can call us directly at 1-800-888-5407

Will you accept emails for eligibility transactions?

  • No, we cannot accept emails to request eligibility transactions
  • We encourage you to use our BlueConnect tool or complete an application.
  • Applications can be downloaded from our website, and employee signature is not required.
    • Until further notice, we will not be requiring back up paperwork for items like domestic partner enrollment, adoption or disabled dependents
    • We will conduct an audit of transactions to obtain this information once the state of emergency is lifted

Plan and Coverage Options

Can I add a less expensive plan option?

  • Small groups can hold a one-time special open enrollment provided it’s available to all employees. 

    • NOTE:  If employees make a plan change mid-year, accumulators (such as deductibles and out of pocket maximums) would reset with their new plan 

      • Accumulators would also reset at their regular open enrollment period as well

  • Should you wish to hold such a special open enrollment please contact your Account Executive and/or broker

  • Large groups are subject to underwriting guidelines and review, and as such should contact their Account Executive and/or broker with questions 

What other options are available for coverage for members no longer on my group plan?

  •  We will support your employees, by connecting them with our consumer market benefit consultants to explore alternative coverage options

Can I maintain group coverage if my business has closed permanently?

  • No. Employees will receive a termination notice listing enrollment options which include state-subsidized plans (e.g. Medicaid, Essential Health Plan) or direct pay plans
  • We will support your employees, by connecting them with our consumer market account benefit consultants to explore alternative coverage options
  • Employees are not eligible for COBRA coverage if the business has closed permanently

Employee Coverage Considerations

If my business has reduced hours or is temporarily shut down, resulting in temporary layoffs, can I keep my employees on my health plan?

  • It’s the employer’s responsibility to determine employee coverage status
  • If an employer continues to offer health plan coverage and the account is in good standing, employees will continue to have coverage under the period for which premium has been paid 
  • It is the responsibility of the employer to notify us of a termination of coverage

If I choose to subsidize COBRA coverage for my employees, whether at the current cost share arrangement or an alternative arrangement, how will that be handled?

  • We will continue to cover these individuals so long as full payment of the associated COBRA premium is received

Can I amend my new hire policies to allow for coverage immediately upon employees returning to work or on day 1 for new employees?

  • Employers can amend new hire policies at their discretion 

Self-Funded Plans Regarding Stop Loss

What impact will a reduction in employee hours due to COVID-19 restrictions on business operations have on a stop loss policy?

  • If you modify your plan’s eligibility rules to extend coverage in connection with the COVID-19 pandemic, stop-loss policy claims incurred during the extended coverage period will apply provided that the following conditions are met:

  1. The extended coverage is offered only to those individuals who were covered under the plan and whose hours of employment were impacted by the pandemic
  2.  You provide us promptly with a clear written description on your Company letterhead of your extended plan eligibility terms
  3. The extended coverage period does not extend beyond [x date], [x months after the person would have lost coverage under the plan without the eligibility extension], [the date that the public health emergency caused by the pandemic ends], etc.  Any additional conditions could be added (e.g. employee having to pay a share)

An Important Message from our Chief Medical Officer, Thomas Schenk, M.D.

Prescription Drug Coverage: What You Need to Know

Number 1 Icon

Use your 90-day mail order benefit

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Sign-up for mail order delivery

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Refill or renew current prescriptions at retail pharmacies when 25% remains

Stay Informed

We encourage all employers to login to their secure accounts to access information about billing, enrollment, termination and forms.  

Keep Your Employees Informed

The health and well-being of our members is our top priority. Stay up to date with information regarding COVID-19.

Need More Information?

Coronavirus (COVID-19) Assessment Tool