A letter from Hawaii Mainland Administrators Chairman Paul Carter regarding COVID-19

The following is valuable information regarding the Novel Coronavirus called COVID-19.  This information and advice was provided in a letter to clients of Hawaii Mainland Administrators, a very valued partner of Apex Management Group.  Great information regarding prevention and testing for the virus.

Dear Valued Client,

There is an unprecedented amount of studies ongoing to understand this new viral strain Novel Coronavirus called COVID-19. They include different treatment attempts, observations of the life cycle of the disease, vaccine potentials, and pathologic studies. Out of this comes the understanding that the COVID-19 virus is about as contagious as a cold and about half as contagious as Chickenpox.

The easiest way to think about its virulence, is that out of 100 people who get sick, 80 will have mild disease, 15 will be bad enough they’ll seek help from their doctor, and 5 will be sick enough to be hospitalized. Out of the 5, 2 will succumb.

Vaccines will be available - but not until early 2021 or a little later. While multiple drugs are currently being tested against it, no clear treatment for COVID-19 has emerged yet.
The best things to prevent disease are the following: rest, stay hydrated, eat reasonably and healthy, get some exercise, adopt the new prevention measures of 20 second hand washing, not touching your face, and being aware of surfaces commonly touched by others. Also, for the near future, avoiding crowds of people if possible. An employee who has cold or influenza symptoms should stay at home and seek medical advice if symptoms are severe.

With the rapid spread of COVID-19 Hawaii-Mainland Administrator’s (HMA) is closely monitoring the outbreak to take precautionary measures as it unfolds. HMA’s standard default will be to cover COVID-19 testing at 100% under all self-funded insurance plans at no cost to the members. We strongly urge our members to utilize their Telemedicine benefit when necessary before seeing a physician in person. If seeing a physician in person is your only option, please remember to call your provider before seeking care.

Any diagnostic radiology performed in a hospital, inpatient hospital stay, or hospital quarantine will require a prior authorization per usual procedures and will be covered under the usual benefit per your plan design.

Per the IRS regulation, COVID-19 testing is not disqualifying coverage for HSA eligibility even when provided without cost to participants or subject to cost sharing below the deductible of the High Deductible Health Plan.

Hawaii Mainland Administrators, LLC
1600 West Broadway Road, Suite 300, Tempe, Arizona 85282
www.hmatpa.com 866-206-7920

To summarize,

  • Coverage For Testing: 100% covered benefit under the plan. Plan sponsor must opt out if they choose not to cover at 100%.

    Estimated cost to plan:
    Per CDC Test: $61.06
    Per Non-CDC Test: $87.26

  • Coverage For Immunizations: 100% covered benefit under the plan. Plan sponsor must opt out if they choose not to cover at 100%.

    Estimated cost: TBD

  • Coverage for Qaurantine, Diagnostic Scans, Inpatient Stays: Normal member and plan liabilities, prior authorization is required.

Stay healthy, be safe, and wash your hands!

Paul Carter Chairman