COVID-19 insurance refunds, credits and reductions

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The Department of Insurance (DOI) has orders insurers to make premium refunds for March and April, 2020 because of COVID-19 because of curtailed activities of policyholders.  These refunds are for private auto insurance, commercial auto insurance, workers’ compensation insurance, commercial multiple peril insurance, commercial liability insurance, medical malpractice insurance, and any other line of coverage where measures of risk have become substantially overstated because of COVID-19.

Insurers can reclassify exposure or reduce the exposure base (miles driven, payroll receipt etc) without prior approval of rates or rules by DOI if done consistent with the insurer’s existing rate plan.

Insurers may refund premium without prior DOI approval if they apply a uniform premium reduction for all policyholders in an individual line of insurance.  The amount of the refund can be an average percentage based on estimated change in risk and/or reduction in exposure base.

Alternatively, insurers can reassess the classification and exposure bases of affected risks on a case-by-case basis. For example, an insurer could reclassify a personal automobile exposure from commute use to pleasure use and reduce estimated miles driven accordingly for the duration of COVID-19.

Insurers must provide each affected policyholder a notice of the amount of the refund, and a check, premium credit, reduction, return of premium or other adjustment within 120 days.  Insurers must report to DOI actions taken and planned to refund premiums within 60 days. (Bulletin 2020-3, April 13, 2020.)

COVID-19 IHSS initial assessments

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The California Department of Social Services (CDSS) is now allowing initial In Home Supportive Services (IHSS) assessment to be done by video call.  Counties must continue to do initial face-to-face assessments when appropriate.

Quality Assurance/Program Integrity home visits can be done in person or by video call during the COVID-19 emergency.  (ACL 20-42, April 16, 2020.)

COVID-19 overpayment and overissuance collection

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The California Department of Social Services (CDSS) has issued guidance regarding temporary changes to Franchise Tax Board (FTB) and Treasury Offset Program (TOP) collection of CalWORKs overpayments and CalFresh overissuances.

On March 25, 2020, FTB suspended all non-tax collection, including CalWORKS and CalFresh debts, until July 15, 2020 because of COVID-19.  FTB pre-offset letters will be suspended.

California was granted permission by the Food and Nutrition service to suspend TOP offsets for CalFresh debt between April 6, 2020 and July 6, 2020. TOP pre-offset letters will continue to be generated for debts that are 120 days delinquent.

Counties may approve refund requests for circumstances related to COVID-19 for TOP and FTB collections that occurred on or after March 1.  This is discretionary with the county.  These debts will remain outstanding to be collected starting in July, 2020.  Any refunds must also include administrative fees.

Counties may continue to accept payments and enter into new repayment agreements.  Counties can modify agreements or defer payments on request to mitigate the effects of COVID-19.

All other collection activities should continue.  (ACWDL, April 16, 2020.)

COVID-19 treatment of individual stimulus for CalWORKs and CalFresh

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The California Department of Social Services (CDSS) has issued guidance about how the individual stimulus payment is to be treated for purposes of CalWORKs, CalFresh and TCVAP.

Individual stimulus payments are excluded from being considered income in the month received and will not be considered as asset for 12 month following receipt.  (ACWDL, April 15, 2020.)

COVID-19 guidance on various Medi-Cal issues

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The Department of Health Care Services (DHCS) has issued guidance on various Medi-Cal issues affected by COVID-19.

The county computer systems were successfully programmed to delay processing of annual renewals and reported changes, and delay discontinuances and negative actions as a result of annual renewals or reported changes while Executive Order N-29-20 is in effect.

Individual case workers can discontinue cases.  This should happen when people have died, people are no longer living in California, people request voluntary discontinuance of Medi-Cal and when non-MAGI Medi-Cal individuals move to a Long Term Care aid code.

The requirement to maintain continuous coverage applies to people who might otherwise have coverage terminated or reduced because of a change in circumstances, including people who age out of a Medi-Cal eligibility group, people who lose other benefits that would affect their Medi-Cal eligibility, people whose whereabouts become unknown, children in the Optional Targeted Low Income Children Program who would otherwise move to a premium aid code, people who would have a new or increased share of cost, and people who would otherwise move from full scope to restricted scope coverage.

Some cases may have been discontinued as early as February 20 for failure to provide information or respond effective April 1. Counties must prioritize requests for reimstatement from these individuals.

Individuals discontinued prior to March 17, 2020 who are in their 90 day cure period must work with the county to resolve outstanding eligibility issues before the county can restore eligibility.

The time to request a hearing regarding Medi-Cal eligibility or fee for service issues is extended by 120 days to a total of 210 days.  Persons who are receiving aid paid pending during the Executive Order period are enrolled for benefits and must remain eligible.  Counties must delay processing negative actions because of a hearing decision through the duration of the Executive Order.

Counties shall conduct telephone interviews or appointments when applicants are usually required to visit the office.  Counties shall accept written affidavits by telephonic signature.

Counties must process transactions for individuals released from incarceration by reporting the release date because it is a positive action that addresses a barrier to care.

Persons who are in Managed Care Plan hold status need to obtain services through Fee for Service.  (MEDIL I 20-08, April 10, 2020.)

COVID-19 guidance for child care R&Rs and LPCs

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The California Department of Education (CDE) has issued guidance for child care Resource and Referral (R&R) programs and Local Planning Councils about requirements because of COVID-19.  R&Rs and LPCs must remain open and operate virtually.  They must be available to assist in county development of emergency child care for essential workers and to help coordinate early learning and care programs, providers and families searching for care.

R&Rs are the lead coordinator of emergency supply, demand and referral and response for each county unless the county appoints another agency.  By April 30, 2020, R&Rs and LPCs must update their emergency response plans for staffing and continuity of services to include COVID-19 guidelines.

All R&R programs must work with their licensed providers to collect or update information on each provider’s status, capacity and vacancy at least twice per week and submit that data to the the state.  That data will be made public here.

With CDE’s approval, R&Rs can support purchases of essential commodities and supplies for local child care providers.  (MB 20-07, April 15, 2020.)