Although the fate of the Occupational Safety and Health Administration’s (OSHA) rules remains in limbo, many employers are moving ahead with efforts to comply with the OSHA emergency temporary standard (ETS) that requires employers with 100 or more employees to ensure that all are fully vaccinated or subject to COVID-19 testing at least weekly.
Those efforts are raising a range of employee benefits questions and below we answer some of the questions employers often ask.
Question 1. Does a medical plan have to cover all testing for unvaccinated employees enrolled in coverage?
Answer 1. No. The Coronavirus Aid, Relief, and Economic Security (CARES) Act requires medical plans to pay for COVID-19 testing when a medical professional has made an individualized determination that testing is medically appropriate. That determination might be based on an individual’s symptoms or potential exposure. However, the CARES Act does not require medical plans to pay for testing that is not based on a clinical determination that testing is appropriate. Specifically, coverage is not required when testing is done for employment-related reasons. Nearly all plans are currently written so that they do not cover testing when it has not been ordered by a medical professional making an individualized determination that testing is medically appropriate. Employers may want to review their medical plan documents to determine what kinds of testing are covered.
Q2. If a plan does not currently cover...
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