USAble Life is ready to provide assistance during the COVID-19 outbreak
At USAble Life, we always strive to make a meaningful difference in the lives of our customers. Even more so now, during the spread of COVID-19. USAble Life remains firmly committed to providing a high-level of service to our customers while ensuring the safety of our employees. Even with our best planning and our team members’ focus, our disability and hospital indemnity products could see a considerable increase in claim volumes and related calls because of COVID-19. An increase would allow us to demonstrate fulfilling the promise of our products, but the volume of claims and related calls may impact our response times. We plan to keep pace with our current service levels, but given the unknown impacts, please know we will work quickly through any delays. We will keep our promise to you.
USAble Life maintains business continuity and disaster recovery plans for a variety of possible business interruptions. Plans were in place and are now activated to allow USAble Life to navigate the outbreak with minimum disruption to partners and customers.
The following steps have been taken:
- Increased workplace sanitation and educate employees on health and safety best practices
- Enhanced our remote-work capacity to handle a higher volume of people working from home, and encourage employees who can do so to work remotely; presently well over 90% of our employees are working from home
- Tested technology to confirm we can shift critical tasks to other worksites and our remote workforce
- Identified critical system needs and ensured they will remain operational
- Worked with our vendors to ensure data transmission remains secure and information is protected as they temporarily shift their workforce to remote working
- Validated that our vendors and business partners are well prepared for the current business interruptions
Below are answers to frequently asked questions related to USAble Life policies and the impact COVID-19. We will continue to update this list as approaches and questions evolve.
Frequently asked questions
Are there alternative ways to get my paper bill?
If your products are available on AccessAbleSM, you may retrieve your invoices. Additionally, you can adjust your membership roster real-time and regenerate the bill. Finally, you can also pay your invoice online. Click here for more information on AccessAble.
For other products, please email firstname.lastname@example.org, and we will forward an electronic copy of your invoice.
Are payment grace periods going to be extended?
We are currently holding on delinquency processing, awaiting state-specific insurance department guidelines. We will implement the grace period mandates of each state. If you anticipate having payment issues due to COVID-19, please contact us at email@example.com.
Is USAble Life considering offering alternative, less expensive products to help in-force groups to bridge some coverages as we respond to the impacts of COVID-19?
We are working through alternatives that we can offer our policyholders during these unprecedented times.
Note: Benefits and claims determination are made based on a customers’ specific contract, subject to the temporary expanded definitions in this document.
If our company falls below minimum lives requirements in our contract, will that terminate our coverage?
For the foreseeable future, we will waive minimum lives requirements for existing coverage but will still require accurate membership and paid premiums.
If we have employees that fall below minimum-hour requirements to be considered actively at work, what impact does that have on their eligibility?
Effective March 1, 2020, and through July 31, 2020, we will treat those employees as if they are on an approved leave of absence and will retain their coverage eligibility provided premiums continue to be paid for the original amount of coverage prior to the reduction in hours. For purposes of disability and salary-based life insurance, USAble Life will use the higher of the employee’s wages on their last day of work before the disability began or death occurred or the employee’s most recent wages before the reduction in hours.
Are employees enrolled in USAble Life products eligible for benefits while on temporary furlough, leave of absence or temporary layoff?
Current policies generally do not address temporary furloughs as an approved leave of absence. As an accommodation for temporary furloughs between March 1, 2020, and July 31, 2020, the policyholder may elect to continue to remit premium for the furloughed employees. Should an employee on temporary furlough, leave of absence or temporary layoff for whom premium is paid become disabled or die on or before 7/31/2020, the claim will be determined as being actively at work. For purposes of disability and salary-based life insurance, USAble Life will use the higher of the employee’s wages on their last day of work before the disability began or death occurred or the employee’s most recent wages before the reduction in hours. We will continue to review the situation and provide additional guidance as situations evolve.
If employees are permanently laid off or terminated, does USAble Life allow for the coverage to remain in place? USAble Life policies generally include continuation of coverage provisions for employees who do not meet the actively at work requirement. Portability or conversion options may be available for coverage that is not continued. Please refer to the policy for specific details about durations and qualifications.
How will USAble Life handle Actively-at-Work requirements for new businesses if employers have employees on a temporary furlough, leave of absence, or temporary layoff?
For new policies with effective dates through July 1, we may extend Actively-at-Work status for anyone that is continuing to pay premiums under their current plans. In addition, we may provide extended reinstatement during this time for terminated employees. We will review these dates on an ongoing basis, and additional documentation may be required.
COVID-19 Related Coverage questions
How will COVID-19 related illnesses impact Short Term Disability (STD), Temporary Disability Insurance (TDI in HI), and Hospital Indemnity claim determination?
- For sickness that prevents someone from working, the employee may be considered Totally or Partially Disabled.
- For employees who are hospital confined as a result of sickness caused by COVID-19, that confinement is covered under our Hospital policies.
- Applicable waiting periods and elimination periods still apply.
How quarantines associated with COVID-19 impact claims determinations?
- If someone is quarantined and unable to work due to their symptoms, then the employee may be considered Totally or Partially disabled during a period of medically required or directed confinement.
- If someone is quarantined, but their symptoms would allow them to perform their work duties, then generally they would not be considered Totally or Partially disabled and would be considered actively-at-work.
- If someone is quarantined, they can be considered actively-at-work to maintain their benefit eligibility provided the premiums are paid, and this leave is employer approved.
- Quarantined employees who are capable of and/or required to telework would not be typically considered disabled. In general, an employee would not be considered disabled until the symptoms prevent the employee from telework.
- Symptomatic employees engaged in limited telework may be considered partially or residually disabled under the terms of many of our contracts.
The CDC has created a list that outlines segments of the population that are at risk for contracting COVID-19. The CDC list continues to be updated most recently, adding pregnant women. If a doctor takes an at-risk individual out of work as a precaution, does this make them disabled?
Being on the CDC at-risk list does not in and of itself qualify for a disability claim. We would review symptoms, established restrictions, and the duties of their occupation to potentially expose the claimant to the virus. Each claim will be reviewed to determine if the claimant meets the policy definition of disability.
General Product questions
How will USAble Life handle COVID-19 related claims?
Some of our products will cover coronavirus-related claims as determined in the provisions of the contracts, just as we do for all diagnoses and conditions.
Below are descriptions of how product lines generally will treat COVID-19 related claims, provided all other provisions are met.
Short Term Disability (STD) and Temporary Disability Insurance (Hawaii)
A coronavirus diagnosis or illness as a result of the vaccine would likely be payable if all other requirements are met, including elimination period and disability definitions. Quarantined individuals without a diagnosis and without symptoms would not generally be covered as a disability.
Long Term Disability (LTD)
A COVID-19 diagnosis or illness as a result of the vaccine may be payable under LTD if all other requirements are met, including elimination period and disability definitions. Quarantined individuals without a diagnosis and without symptoms would not generally be covered as a disability. Waiver of premium may apply to life and disability products while on long term disability.
COVID-19 or illness as a result of the vaccine is covered for our group and voluntary life insurance products. Benefits would be paid according to provisions in the policy.
Accidental Death & Dismemberment
Accidental Death & Dismemberment coverage does not apply with a COVID-19 diagnosis or loss as a result of the vaccine.
COVID-19 is not considered a covered condition under our Critical Illness products. If someone is diagnosed with a covered illness as a result of the vaccine, this may be covered.
COVID-19 or illness as a result of the vaccine is not a covered diagnosis or treatment.
Hospital admission and confinement benefits are available for a diagnosis of COVID-19 or illness as a result of the vaccine, once all other policy provisions are met.
Are there other benefits that can help policyholders?
Integrated Claims Determination: If a policyholder has multiple USAble Products, our claims team will always cross-reference claims with other related products. For instance, if we receive a life insurance claim, we will check for related insurance products for eligible claims, such as Hospital Indemnity or Critical Illness, to ensure beneficiaries receive all applicable benefits.
Employee Assistance Programs (EAP): Many of our disability insurance products have an EAP service included to help employees with services and anxiety. In addition to the regular resources, EAP offers counseling, work/life referrals, legal/financial consultations, etc. EAP also provides COVID-19 specific information for employees that is regularly updated.
Travel Assistance: AXA Travel Assistance provides transport benefits if a member is sick, injured, or passes away while traveling more than 100 miles away from home. If a member contracts COVID-19, AXA will use best efforts to assist with this person’s case as for any other medical situation. AXA will coordinate based on the local country’s requirements for COVID-19 since each county has different restrictions due to the pandemic. If the infected individual can receive appropriate local treatment, then it would not warrant a medical evacuation. If there is a medical necessity to move a patient as they are not receiving appropriate care, AXA will arrange a means of transport. AXA will handle situations on a case by case basis since localities and travel companies have enacted various travel and transport restrictions. If a member passes away due to COVID-19, repatriation of remains is covered under the policy, and AXA will be able to assist with the return of the remains. There may be some additional requirements depending on the country to ensure that the remains are free from infection. It may take longer, but AXA certainly will be able to assist.
Does COBRA apply to Life, Disability, Accident, Hospital Indemnity and/or Critical Illness Products?
COBRA applies to medical and dental continuance. Many of our Life, STD, and supplemental products contain continuation of coverage provisions that allow employees to continue coverage. The amount eligible to be continued is determined by the terms of the policy. The continued coverage is an individual contract; this is billed directly to the employee.
Will the COVID-19 stimulus checks affect any benefits I receive from my USAble Life policies?
No. USAble Life benefit payments will not be affected by any stimulus checks that you receive.
Impacts of Federal and State Regulatory changes
We intend to adhere to all Federal and State regulations that provide direction regarding how we manage claim follow up for additional information and/or proof of loss, addressing policy cancellations associated with premium delinquency, etc. We will share these updates accordingly to our impacted customers.
For more information on state-specific mandates/guidelines, please visit: https://www.usablelife.com/state-guidelines/
How does the Family First Act impact eligibility and or payments for disability claims?
The leave provisions of the Act apply to employers with less than 500 lives. If this Act applies and USAble Life has your Short Term Disability, our benefits will coincide with the payments of the sick leave provided the leave is deemed a disability under our contract. During this period of payments, we will offset the federal benefits subject to the provisions in the contract.
COVID-19 Claims Extensions
For more information related to claims extensions, please visit: usablelife.com/uploads/claims-extensions.pdf