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Cost-Sharing Prohibited for COVID-19 Boosters

 

On September 27, 2021, Superintendent Toal issued Bulletin 2021-020. This bulletin reminds carriers who issue plans regulated by the state that state rules prohibit cost-sharing for the diagnosis and treatment of COVID-19. This prohibition extends to COVID-19 booster shots. In addition, the bulletin reminds payers that COVID-19 testing remains exempt from cost-sharing obligations when the testing is medically appropriate as determined by a provider.

These prohibitions apply to all group plans and plans providing individual coverage, including self-funded plans, all group and individual insurers (including grandfathered and transition plans) on and off a Health Insurance Exchange, and to state and local government health plans.

Employers with plans regulated by the state should be aware of this development.

Bulletin 2021-020 »

PPI Benefit Solutions does not provide legal or tax advice. Compliance, regulatory and related content is for general informational purposes and is not guaranteed to be accurate or complete. You should consult an attorney or tax professional regarding the application or potential implications of laws, regulations or policies to your specific circumstances.

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