Self-insured employers across America are faced with a big decision on the heels of announcements from Aetna, Cigna, Humana, and now United HealthCare, that they will waive cost sharing for all COVID-19 care and treatment for insured plan members. While the CARES Act requires first-dollar coverage for testing and vaccines, the mandate does not apply to treatment. The insurers’ rationale for covering COVID-19 treatment at 100% is to remove financial barriers that might cause people to avoid or delay care that is needed both for their own safety and to potentially assure prompt identification and containment of the virus.
Self-insured employers are being asked to choose whether or not to waive cost-sharing, which includes deductibles, coinsurance and co-pays for COVID-19 treatment. This announcement, along with a short deadline for a decision, comes at a time when many companies are already struggling with the business impact of COVID-19 and facing the prospect of furloughs and layoffs. Any decision that is likely to result in additional cost will need to be weighed carefully.
In a Mercer poll of about 650 self-funded employers conducted on April 2, more than a third said they were very likely (24%) or likely (14%) to waive cost sharing, while just under a fourth said they were unlikely (17%) or very unlikely (7%) to do so. But 39% had not yet begun to consider the question. For organizations that haven’t yet decided how to respond, here are some considerations:
Some employers we’ve spoken with have raised the question of equity: How can they justify waiving cost sharing for COVID-19 and not for other serious and life-threatening conditions? While this question can be debated, one important difference is that COVID-19 is a mass contagion with enormous societal impact, and the steps we take to control it benefit all plan members, even those who don’t contract the virus or need to seek treatment. We are all in this together.