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What is the definition of “health plan” for purposes of complying with the requirement that COVID-19 related services be provided without cost sharing?

Posted by: Bonita Hatchett-Bodle    May 1, 2020 2:13:31 PM

Health plans include group health plans and health insurance issuers offering group or individual health insurance coverage (including grandfathered health plans). Group health plans means insured and self-insured group health plans, including private employer group health plans, non-federal governmental plans (such as plans sponsored by states and local governments), and church plans.

Individual health insurance coverage includes coverage offered in the individual market through or outside of an Exchange (Marketplace), as well as student health insurance coverage.

Health plans do not include short-term, limited-duration insurance, or excepted benefits. Health plans also do not include group health plans that do not cover at least two employees who are current employees (such as plans in which only retirees participate).

Topics: health plans, FFCRA, CARES Act, COVID-19 medical services

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