Essential StaffCARE, in conjunction with Staffing Industry Analysts, recently had the opportunity to produce a webinar dealing with important topics facing the insurance field today. Delivered by Senior Analyst Marco Nunez, Essential StaffCARE chose to explore the importance of including voluntary benefits in a medical benefits landscape very constrained by the Affordable Care Act.

Follow the link below to view a replay of the webinar that defines real value for staffing employees, and how this value impacts an employer’s ability to recruit and retain top performing workers.

COVID-19 and ESC Benefits

Important Updates Regarding the Current Coronavirus Pandemic
and ESC Fixed Indemnity, MEC, and Bronze Major Medical Plans

COVID-19 has swiftly introduced enormous uncertainty into the day-to-day operations of staffing companies. The purpose of this webinar is to provide Tricom customers offering ESC benefits with the information needed to confidently answer any employee questions that may arise regarding ESC benefits and COVID-19. In this brief webinar we will discuss COVID-19 testing as it relates to our Bronze Major Medical, Fixed Indemnity, and MEC health plans, as well as the ESC Short-Term Disability benefit plan. We will also review the ESC “missed premium” feature and answer any questions you may have regarding your employee’s use of our benefits at this time.

Updates as of March 31st:
Why It’s Critical to Offer Essential StaffCARE Indemnity to All Job Applicants

The onset and continued spread of the Coronavirus (COVID-19) is causing employers to take a closer look at their insurance protocols. As a helpful and critical reminder to our clients and partners, Essential StaffCARE is urging employers to ensure that benefits are being offered to 100% of your temporary staff, new hires, re-hires and candidates

The Reasons are Two-Fold:

1. ESC Fixed Indemnity is Designed For Employees’ Day-to-Day Medical Expenses

During uncertain times, the ESC Fixed Indemnity plan provides a solid foundation of first-dollar healthcare coverage and our unique network arrangement pays claims directly to physicians and hospitals. Employees pay no deductible, no co-pay and do not have to file paperwork for reimbursement of in-network claims, which eases the strain of seeking medical attention during these stressful times.

2. Compliance to Avoid Potential Claims of Discrimination

The recommended ESC process is to offer benefits on-site at time of job application. Adherence to this process protects the employer by ensuring that every candidate and subsequent new hire receives an offer and either elects or declines coverage.

If a new hire had not been offered an opportunity to enroll in an insurance plan that others were offered, and later suffers a medical calamity, it could result in potential claims of discrimination against the employer.

Following ESC’s best practice of ESC managing employee eligibility by mandating all job applicants must elect or decline coverage at time of on-boarding protects the employer from eligibility errors and potential discrimination claims in this time of increased medical need.

Updates as of March 20, 2020 Include Essential StaffCARE Products and Benefits Related to COVID-19:

ESC Bronze Major Medical Plan Insurance Coverage for COVID-19
ESC Fixed Indemnity Plan Insurance Coverage for COVID-19
ESC Minimum Essential Coverage Plan Coverage for COVID-19
ESC Short-Term Disability Coverage for COVID-19
Business Continuity & Increased Call Volume Contingencies
Employee Lapse in Coverage Due to Non-Assignment


Frequently Asked Questions:


Is testing for COVID-19 covered under the ESC 5500 (Bronze) Major Medical Plan?
For employees who are insured under the ESC Bronze Major Medical plan, physician’s office visits and lab work related to the diagnosis of the COVID-19 virus will be covered at 100%. No co-pays / co-insurance or deductible will be required.

Is testing for COVID-19 covered under the Fixed Indemnity Medical Plan?
For employees who are enrolled in the Essential StaffCARE Fixed Indemnity Medical Plan, benefits will be paid for physician’s office visits, testing and lab work related to the diagnosis of the COVID-19 virus. A flat dollar amount will be paid per day based upon the ESC outpatient medical benefit schedule for your specific plan.

Is testing for COVID-19 covered under my self-funded Minimum Essential Coverage (MEC) Plan?
Yes: To comply with the requirements set forth by the Families First Coronavirus Response Act, signed into law March 18, 2020, MEC plans will cover diagnostic testing and related service visit(s) in regard to COVID-19. Treatment of the virus is not covered under Minimum Essential Coverage Wellness & Preventative Plans. If you have specific questions about coverage and your specific plan please contact ESC Customer Service at 1-866-798-0803.

Will Short-Term Disability cover work missed due to COVID-19?
Medically diagnosed illnesses including COVID-19 are covered under the ESC Short-Term Disability benefit. However, employees who self-diagnose or self-quarantine without a medical diagnosis, will not be covered by the ESC STD benefit.
Workers who are forced to quarantine because of employer, city, state or federal mandates, but have not tested positive for the COVID-19 virus themselves, will not qualify for the short-term disability benefit. The federal government is contemplating a number of different potential remedies to address the unprecedented financial impact of the COVID-19 pandemic, including expanded unemployment and welfare benefits.
Workers who are temporarily laid off should contact their state unemployment insurance department and monitor potential federal assistance programs that are in development.

Does your administrator have an appropriate business continuity plan? 
As a wholly-owned subsidiary of Blue Cross Blue Shield of South Carolina (BCBS), our administrator, Planned Administrators Inc. (PAI), has a comprehensive emergency response plan in place as well as a business continuity plan that includes a secure, HIPAA-compliant telework protocol to ensure the highest level of customer service and information security.
BCBS of SC provides PAI with the highest level of customer service training and data security oversight.

Is your administrator able to manage increased call volumes related to additional claims activity? 
The Essential StaffCARE Customer Service Call Center was designed with the scalability to quickly expand with highly-trained claims specialists to accommodate any anticipated increase in call volume.

Is my employee covered during an absence or time without an assignment?
The ESC Fixed Indemnity Medical Plan includes a missed premium accommodation of up to six weeks allowing enrolled employees to make up missed premiums directly with our administrator, Planned Administrators, Inc.
After six weeks without a premium payroll deduction, the employee’s Essential StaffCARE group coverage will terminate and the employee will receive a COBRA offer letter sent to their home address.
The employee will be able to continue ESC coverage under COBRA at no more than 2% above their Essential StaffCARE group policy premium. If the employee returns to work, they can then re-enroll in payroll deducted coverage.

What if an employee’s assignment is suspended or eliminated due to a business shutdown from COVID-19?
If an employee is off assignment and not receiving a paycheck, the missed premium protocol will remain in effect. Employees can make direct payments for up to six weeks of coverage and retain their policy. After six weeks they will be able to continue coverage through enrollment under COBRA if they so elect.

Who do I contact if I have coverage questions?
If you have additional questions about your coverage or require specific details about the steps we are taking to manage the impact of the COVID-19 virus, please contact: ESC Customer Service at 1-866-798-0803.

Where should I get the most up to date information regarding COVID-19?
For real time COVID-19 updates and news, Essential StaffCARE recommends the Journal of the American Medical Association (JAMA) Network. The JAMA Network provides a peer-reviewed analysis of the COVID-19 outbreak.   |  

Both of these sites provide preventative instructions and protocols that can be shared with your offices and employees to reduce the potential spread of this virus. Essential StaffCARE will share new information and instructions from these sources as they are updated. 
We also recommend the Centers for Disease Control and Prevention (CDC).

Guidance for Businesses and Employers to Plan and Respond to COVID-19 Disease

Click the link below for information regarding:
Recommended Strategies for Employers to Use Now
Planning for a Possible COVID-19 Outbreak in the US
Important Considerations for Creating an Infectious Disease Outbreak Response Plan
Recommendations for an Infectious Disease Outbreak Response Plan


Additional Links:
Preventing COVID-19 Spread in Communities, Schools, Church Organizations, etc.
Read More  

What to Do If You Are Sick with Coronavirus 2019 (COVID-19)
Download PDF  

What You Need to Know about Coronavirus 2019 (COVID-19)
Download PDF  

Coronavirus Update #1

Over the last several days and weeks, the daily news cycle has been dominated by breaking alerts surrounding COVID-19 or Coronavirus.
In times like these, it is incredibly important to keep a balanced perspective and to get your information from unbiased, non-politicized, agenda-free sources.

For real time COVID-19 updates and news, Essential StaffCARE recommends the Journal of the American Medical Association (JAMA) Network.

The JAMA Network provides a peer-reviewed analysis of the COVID-19 outbreak. We also recommend the Centers for Disease Control and Prevention (CDC).   |  

Both of these sites provide preventative instructions and protocols that can be shared with your offices and employees to reduce the potential spread of this virus. Essential StaffCARE will share new information and instructions from these sources as they are updated.

A common question many of our clients and prospects like to ask is how they can know if their healthcare and benefits program is truly providing value to their employees. It’s a great question. There are so many options when creating a benefits bundle, even the best HR managers may not be able to assemble the optimal mix without a little trial and error.

But there are four simple questions you can ask yourself when evaluating benefit components, to help gauge their effectiveness and value:

Question 1: Is the benefit easily accessed and used by employees?

Employer sponsored benefits should be easily accessible without hoops to jump through, waiting periods, applications, review committees and other red tape subtly designed to lower usage rates. Something as simple as a plan that pays for benefits directly, instead of reimbursing employees a few weeks later, can be the difference between a valuable or worthless perk. Low-wage workers in high turnover industries need benefits to help them with healthcare expenses and other insurance products that may make the difference in financial solvency or financial ruin.

Question 2: Is the benefit payroll deducted?

Employers also need to beware that many niche players in the voluntary benefits market offer products that cannot be payroll deducted. Some companies offering these types of benefits make the pitch to implement these plans with auto deductions from employees’ credit cards, and that makes it“portable,”another big“benefit”to the employee. This is just another distortion. Going around the payroll provider is typically a sign of razor thin margins and should be a red flag that other inadequacies lay beneath the surface.

Question 3: Is the benefit affordable?

Limited Indemnity(Voluntary)insurance is exempted from ACA mandates for major medical coverage. The things that make ACA compliant plans — no lifetime or annual claims caps, for example — do not apply. This means that voluntary insurance products can be provided at a lower cost and the lower cost can be passed on to the employee. Follow the money. If the benefit is expensive with no clear reason, or if the employee could likely afford the plan’s inclusions by saving the premium on their own, then the risk pooling equation is off-kilter and should be questioned.

Question 4: Is the benefit priced at a preferred group rate?

Employers bring group buying power to the table that employees cannot get on their own in the open marketplace. This gives the employer the ability to provide valuable benefits at even more affordable prices for their employees. Many ancillary products like pet insurance, home, auto, identity theft insurance and legal protection are readily available to the consumer online at the same price. Employees who want these coverages are welcome to get them on their own, but an employer adds no value in these cases.


Be sure to ask these hard questions when evaluating benefit options. By choosing flimsy, niche programs, employers are not only reducing value, but they can also seriously undermine HR operations and employee satisfaction.

By: Alan Gilbert

Learn more about the latest updates in health reform and how they affect you.

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