Here are the resources that were mentioned during our July 22, 2020 BenefitsChat.
The presentation can be accessed here:
The coronavirus pandemic has altered daily life for everyone across the globe, and caused tens of millions of job losses in the United States. Because losing your job often means losing your health insurance, this can be a double whammy for affected individuals.
Congress recognized this problem in 1985 by passing the Consolidated Omnibus Budget Reconciliation Act (COBRA), a law that protects employees by letting them continue the group health insurance coverage they enjoyed while employed for up to 18 months (and sometimes longer) after their termination. (As with any law, there are exceptions. Not every employer is governed by COBRA’s rules – for example, COBRA only applies to employers who have 20 or more employees.)
However, many people don’t know that they can continue their health insurance coverage, and often employers inadequately inform their employees of their rights under COBRA, or simply don’t inform them at all. This is illegal. COBRA requires employers to provide written notice to terminated employees of their coverage options.
The riots throughout the United States have been heartbreaking on a number of levels. While the social and political implications will be something our country grapples with for years into the future, the economic effects will be felt immediately.
Small businesses, already devastated by the pandemic and government-mandated shutdowns, are now having to deal with damage from riots and looting. How are businesses going to recover from this double assault on their bottom line?
Ideally, most businesses have insurance to provide security in the event of riots or looting. However, many insurance policies have exclusions of or limits on activities that could be viewed as “terrorism.” We do not yet know how insurers will categorize the riots.
Kantor & Kantor has established a regular, live, and interactive Zoom conversation to discuss generally and answer questions from the public about long-term disability, health insurance, pensions, life insurance, casualty (homeowners), and more. BenefitsChat will be live on Wednesday evenings from 5:00 pm – 6:30 pm Pacific Time.
Host Andrew Kantor, his fellow Kantor & Kantor attorneys, and select guests will explain and discuss everything from “big picture” concepts, such as the distinctions between different ways of obtaining insurance, to case-specific concepts designed to help individuals protect their rights.
While there is always a demand for legal information, current events have created an unparalleled need for as many real, live, helping hands as are available to be lent—even if the hand can only be safely lent via webcam. This forum will give people the chance not only to learn from our attorneys and each other; but to do so within the safety and comfort of a like-minded and supportive group of individuals and their families.
On April 14, 2020, California Insurance Commissioner Ricardo Lara and the California Department of Insurance (“CDI”) directed all agents, brokers, insurance companies, and other Department licensees to accept, forward, acknowledge, and fairly investigate all business interruption claims caused by the COVID-19 pandemic.
The agency said that, “despite the Department’s on-going guidance to businesses statewide during the COVID-19 pandemic, it has received numerous complaints from businesses, public officials, and other stakeholders asserting that certain insurers, agents, brokers, and insurance company representatives are attempting to dissuade policyholders from filing a notice of claim under its Business Interruption insurance coverage, or refusing to open and investigate these claims upon receipt of a notice of claim.”
The Regulations require all agents, brokers, insurance company representatives, and other Department licensees to accept any communication from the policyholder or its representative indicating that the policyholder desires to make a claim against a policy that reasonably suggests that a response is expected as a notice of claim. Upon receipt of a notice of claim, every Department licensee is required to transmit such notice of claim to the insurer immediately.
Even though most of us are still sheltering in place in an attempt to lessen the immediate spread and most severe health consequences of COVID-19, it is not too soon to start considering possible long-term health impacts that may arise in the wake of the coronavirus pandemic.
Because the virus affects many organs and systems within the body – from the lungs and cardiovascular system to the liver, kidneys and likely the brain – it now appears likely that at least some patients will suffer long-term physical symptoms. These long-term and even permanent problems may result from the virus itself, the body’s own immune response or even medical interventions, especially respirators, or a combination of all these factors. But whatever the cause, doctors are already seeing heart damage, kidney and liver damage and, unsurprisingly, lung scarring and damage in a number of COVID-19 patients who are no longer actively infected.
And these are still early days. Some patients present during the illness with serious neurologic problems such as strokes and encephalitis, as well as other more mild neurologic symptoms such as dizziness, headache and loss of smell. There have been reports of some patients suffering from Guillain-Barré Syndrome, an auto-immune disease where the immune system responds to an infection by mistakenly attacking the body’s own nerve cells. It seems possible that at least some of these patients may continue to suffer neurologic and autoimmune issues, and related pain, fatigue and cognitive difficulties for at least some time.
Millions of people are affected by mental illness each year. While 1 in 5 people will experience a mental illness during their lifetime, everyone faces challenges in life that can impact their mental health. As the increase in the number of COVID-19 cases affects our entire country, so too will the need for access to mental health treatment and awareness of mental health issues. So far, older adults, along with those who have underlying health conditions, have been hit the hardest by the COVID-19 outbreak, with many developing severe, life threatening illnesses. Another group that is expected to be acutely affected by the pandemic include those who have severe mental illness.
Mental illness is a real and treatable set of conditions that includes major depression, bipolar disorder, eating disorders, panic attacks, generalized anxiety disorder, attention deficit hyperactivity disorder, and schizophrenia, among dozens of others. These disorders are serious enough to significantly impact a person’s daily life functioning, whether at school, work or in their relationships with others.
Mental health issues often coincide with a unique set of challenges that make it difficult for people to access even the most necessities, such as food, medications, stable housing, and healthcare. Combined, all these factors put people with severe mental illness at a much higher risk for contracting and transmitting the new coronavirus and dealing with COVID-19.
As we might expect during this time of pandemic, state governments are not able to make progress on many pressing issues. In January, California governor Gavin Newsom unveiled a $47 billion proposal to expand health care coverage to all Californians. However, the coronavirus scourge has sidelined that proposal as California has scrambled to find funds to respond to it.
Due to these funding pressures, Governor Newsom has asked lawmakers to prioritize their legislative agendas and focus on the outbreak. One senator, however, is pushing ahead with a proposal to protect Californians suffering from mental illness.
As reported by Kaiser Health News, California State Senator Jim Beall, who is the chair of the Senate Select Committee on Mental Health, wants to toughen state parity laws to ensure that patients with mental illnesses are provided benefits on par with those received by patients with other medical conditions. California and the federal government already have mental health parity laws on the books, but Senator Beall argues that they are not stringent enough and are poorly enforced.
On April 28, 2020, the U.S. Department of Labor’s Employee Benefits Security Administration (EBSA) issued deadline relief and other guidance under Title I of the Employee Retirement Income Security Act of 1974 (ERISA) to help, among other groups, disability plan participants who are impacted by the COVID-19 pandemic, also referred to as the coronavirus outbreak.
The Department of Labor, Department of the Treasury, and the Internal Revenue Service issued a joint notice explaining the extension of time frames for healthcare coverage, portability, and continuation of group health plan coverage under COBRA, and time frames to file a benefit claim or appeal of denied claims. They also issued COVID-19 FAQs for Participants and Beneficiaries that address a number of common questions concerning health and retirement benefits.
The final rule published by EBSA and submitted to the Office of the Federal Register (OFR) for publication contains information of the extension of certain timeframes under ERISA and the Internal Revenue Code for group health plans, disability and other welfare plans, pension plans, and participants and beneficiaries of these plans during the COVID-19 National Emergency.
The past few months have heralded an unprecedented situation. Millions of Americans are being laid off as COVID-19 shuts down businesses throughout the nation. This is frightening for everyone. It is doubly difficult for workers who have physical or mental limitations. For those workers, the specter of finding a new job in this economy, one that can accommodate their often significant limitations, may be overwhelming.
Workers experiencing health issues — including cognitive issues or mental illnesses — who have been having difficulties performing their jobs because of those limitations but have been fighting through them, may well be among the first to be laid off as underperformers. While these workers are in fact impressive in their drive to keep working in the face of daunting health issues, that very refusal to admit defeat may result in unemployment and a lack of income for them.
If you are among these workers, now is the time to evaluate whether a disability claim makes sense for you. While you still have access to your job-related insurance, you can preserve some of your income and access to health insurance. If you have ongoing medical issues for which you have already been treating that significantly impact your ability to work, be it physical pain, chronic illness, depression, anxiety, or auto-immune issues, talk to your doctor about whether he or she would recommend disability for you.