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 »
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