Coronavirus

COVID-19

COVID-19 Benefit Information

Vaccine Information

Nippon Life Benefits will be covering, without cost-sharing, a covered member’s and dependent’s COVID-19 vaccination(s) regardless of in or out of network provider or pharmacy.

To receive reimbursement for the vaccine, a completed claim form must be submitted along with proof of payment and a copy of the vaccination card. Medical claim forms can be found under the member service tab on our web portal or visit www.nipponlifebenefits.com/member-service

More information about the vaccines, please refer to the Center for Disease Control’s Vaccine Information page at https://www.cdc.gov/coronavirus/2019-ncov/vaccines

Testing

Nippon Life Benefits will waive in-network and out-of-network cost-sharing (including, but not limited to, co-pays, deductibles and co-insurance) for screen and testing for COVID-19, including the antibody test. This waiver of cost sharing also applies to FDA-approved home test kits, in-network and out-of-network hospital, emergency department, urgent care and provider office visits where the purpose of the visit is to be screened and/or tested for COVID-19.

Through July 31st, Nippon Life Benefits will be waiving cost sharing for surveillance testing, which is testing used for public health or social purposes such as employment (return to workplace), education, travel, or entertainment. This provision amendment will expire on July 31st, after which only medically necessary testing will be covered.

Treatment

For the treatment of those insureds that may not need a hospital stay, we will also cover the treatment of COVID-19 in accordance with and governed by the insured person’s Nippon Life Benefit’s booklet-certificate and applicable law - notably, if we do not have a health care provider in an insured person’s network with the appropriate training and experience to meet the particular health care needs of the insured, an insured may visit an out-of-network provider at the in-network cost-sharing level, in accordance with the insured person’s booklet-certificate.

Changes to FSA/HSA Eligible Expenses

The CARES act includes a permanent change that allows for purchase of over-the-counter medications and feminine hygiene products using your flexible spending account (FSA), health reimbursement arrangement (HRA), or health savings account (HSA). A prescription is no longer needed for reimbursement. This change is effective for expenses incurred on or after January 1, 2020. Please allow time for these changes to be reflected at local retailers. If you have difficulties at time of purchase, you can manually submit your claim(s) for reimbursement by using the www.nipponlifebenefits.com link, or mail to:

FSA/HRA claims,
Nippon Life Benefits
P.O. Box 2968
Clinton, IA 52733

Phone: 1-800-374-1835
Fax: 1-866-514-8287
Email: fsa-hra@nipponlifebenefits.com

Telemedicine

The provision allowing for no cost share of telemedicine visits has concluded on 3/31/2021 unless otherwise noted in state-specific mandates. For details regarding telemedicine and how it relates to your specific plan coverage including state-specific mandates, please contact the Customer Service number on your ID card.

Short Term Disability Eligibility

COVID-19 related illnesses are handled the same as any other illness and will be considered according to the applicable plan provisions. The Families First Coronavirus Response Act (FFCRA) requires certain employers to provide employees with paid sick leave or expanded family and medical leave for specified reasons related to COVID-19.

Nippon Life Benefits’ short term disability benefits will be coordinated accordingly, as long as the employee meets the disability requirements as designated by their plan coverage.

In order to prevent delays in claims processing, Nippon Life Benefits asks for a completed Disability Claim form which can be found at https://www.nipponlifebenefits.com/member-service

Premium Payment Leniency

Our current premium payment policy will remain in place and includes a 31-day grace period, but allows 60 days to make the payment prior to cancellation. We are in compliance with applicable law and regulatory mandates regarding COVID-19 and will continue to closely monitor updates that may be enacted related to this concern for premium payment extension. If you have specific needs or requests, please contact us directly with specific information so that we can clearly understand any business impact needs you may have.

For groups in New Jersey, please follow the link below in reference to Executive Order 123 and emergency grace period protections. https://www.nipponlifebenefits.com/new-jersey-emergency-grace-period/

Lay-offs Due to COVID-19

Nippon Life Benefits has waived the coverage requirement that employees must be actively working in order to receive benefits under the condition that the monthly premium payment is received. That provision has concluded on June 30, 2021.

Enrollment Changes Due to COVID-19

If your plan meets the requirements outlined and you are continuing to pay premium for employees that are impacted by layoffs, hour reduction, etc., there is no immediate reporting needed at this time.

If you have non-COVID-19 specific eligibility updates, please submit through our web portal at www.nipponlifebenefits.com or email to admin-info@nipponlifebenefits.com or fax directly to 913-387-5920.

Continuation of Coverage

Employees have options for continuation of coverage. Employees may elect to continue coverage under COBRA or any applicable State Continuation programs by following standard notice and election procedures as long as one person remains actively employed. Please refer to your contact/booklet for details on these requirements. However, if there is not a single active employee, the plan is terminated and COBRA and/or State Continuation programs are not an option.

Waiting Period

Nippon Life Benefits has waived the waiting period requirement for furloughed employees who were rehired through June 30, 2021. This provision will not be extended.

For furloughed employees, if the plan requires the person to complete a waiting period, furloughed days will contribute to the overall waiting period for medical coverage. However, for ancillary coverages, furloughed days will not contribute to the eligibility waiting period.

Short-Term Disability Claims

The Families First Coronavirus Response Act (FFCRA) requires certain employers to provide employees with paid sick leave or expanded family and medical leave for specified reasons related to COVID-19. Nippon Life Benefits’ short term disability benefits will be coordinated accordingly, as long as the employee meets the disability requirements as designated by their plan coverage.

In order to prevent delays in claims processing, Nippon Life Benefits asks for a completed Disability Claim form which can be found at:

https://www.nipponlifebenefits.com/member-service

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Disclaimer

Nippon Life Insurance Company of America is continuously monitoring, and implementing policy and procedures to comply with, applicable federal and state law and directives related to the COVID-19 pandemic. This information is subject to change, at any time and without notice, by Nippon Life Insurance Company of America. Further, the policies and procedures summarized herein may vary based upon your policy situs state and/or state of residence. Please contact Customer Service for additional details. This material and information is intended for informational purposes only – the material and information provided on this website does not, and is not intended to, constitute legal or medical advice.

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