The Coronavirus (COVID-19) pandemic has introduced the need to take immediate action to ensure the health and well-beings of ourselves, and our families. As insurance industry professionals, this outbreak has also raised a host of questions that continue to evolve daily.
As your dedicated partner, we understand that you need access to information quickly. That’s why we’ve prepared this resource to ensure you have the resources and support you need during this time. We are monitoring this situation vigilantly and we encourage you to bookmark this page and check back often for updates.
In an effort to ensure employees have access to care, carriers have opened limited time special enrollment opportunities (SEO) for small and large employers. The SEO is designed to allow employees, who previously declined coverage during renewal or original enrollment, to enroll on the group plan off-anniversary. Some take it a step further by allowing employees currently enrolled to change their plan - like downgrading to a more affordable option!
CARRIER
SEO ALLOWED FOR THOSE WHO WAIVED/DECLINED
ENROLLMENT CHANGES ALLOWED FOR EXISTING MEMBERS
APPLICATION WINDOW
& OTHER DETAILS
Aetna
Yes, for employees and dependents.
Members currently enrolled in another carrier offered by the employer are not eligible to transfer to Aetna under this option.
Yes, employers may make a one-time "mid-plan year" change to downgrade their plan offerings.
Employer Plan Changes
Submit through July 31, 2020. All changes must be received are effective 1st of the month after the application received date.
Employee SEO
Submit through April 17, 2020. Request coverage for an April 1 or May 1 effective date.
Anthem Blue Cross
Yes, for employees and dependents.
Members currently enrolled in another carrier offered by the employer are eligible.
No.
Submit through April 3, 2020.
Blue Shield of California
Yes, for employees and dependents.
Members currently enrolled in another carrier offered by the employer are eligible.
Yes, employers may make a one-time "mid-plan year" change to downgrade their plan offerings.
Members may request a change to a lower benefit option.
April Effective Date
Submit through April 15, 2020.
May - July Effective Dates
Submit through June 30, 2020. All changes must be received are effective 1st of the month after the application received date.
Yes, but members may or may not receive deductible credit.
Submit through June 30, 2020. All changes are effective 1st of the month after the application received date.
Health Net
Yes, for employees and dependents.
No.
Submit through June 30, 2020. All changes are effective 1st of the month after the application received date.
Kaiser Permanente®
Yes, for employees and dependents.
Members currently enrolled in another carrier offered by the employer are not eligible to transfer to Kaiser under this option.
Yes, employers may make a one-time "mid-plan year" change to downgrade their plan or add a low option plan to their existing offerings; members may then request a change to a lower benefit option.
Deductible/OOP credit may or may not apply, see FAQ for details.
Employer Plan Changes
Submit before May 1, 2020.
Employee SOE
Submit through April 3, 2020 for an April 1, 2020 effective date.
Submit between April 4 and April 15, 2020 for a May 1, 2020 effective date.
Enhanced Benefits & Telemedicine: Medical Carriers
Updated 4/3/2020 at 9:45 am
Health insurers are responding to the Coronavirus threat by offering members no-cost screening and diagnostic testing. In addition, many are offering $0 telemedicine benefits.
CARRIER
ENHANCED BENEFITS1
RESOURCES
TELEMEDICINE
Aetna
Screening/diagnostic testing provided at no cost
$0 copay telemedicine through June 4, 2020
Members diagnosed with COVID-19 will receive a care package with over-the-counter medications and cleaning supplies
Early refill limits are waived on maintenance medications for all members with pharmacy benefits administered through CVS Caremark
CVS Pharmacy will waive charges for home delivery of prescriptions
CVS Health will help Aetna members that may be experiencing anxiety related to COVID-19 by:
opening Crisis Response Lines
providing plan sponsors with a Resources for Living toolkit
expanding 24/7 access to the Aetna Nurse Medical Line
Access to Resources for Living (RFL), Aetna's employee assistance program, for all Aetna members - even if RFL is not part of the employer's current benefits program.
No out-of-pocket costs for members who receive care for COVID-19 from doctors, hospitals and other health care professionals, in the plans network, from April 1 through May 31, 2020.
Relaxed early prescription refill limits for members who wish to refill most maintenance medications, where permissible.
$0 copay telemedicine through June 14, 2020, including mental health, for fully insured plans, individual plans, Medicare and Medicaid, where permissible - includes LiveHealth Online and other telehealth providers delivering virtual care
Coronavirus assessment available through the Sydney Care Mobile App
Prior authorization for lab work will be waived for screening and testing
Cost-sharing is waived for doctor office, urgent care and outpatient hospital (including emergency dept) visits for medically necessary COVID-19 related services
Waived prescription refill limits for medically necessary COVID-19 related services, and relaxed restrictions on home and mail delivery of prescriptions
Screening/diagnostic testing provided at no cost - this includes hospital (including emergency dept), urgent care, provider office visits, and telehealth appointments for the purpose of screening and/or testing for coronavirus
1 Screening/diagnostic testing when ordered by the physician. “Kaiser,” “Kaiser Permanente,” “Kaiser Foundation Health Plan” and the Kaiser Permanente Logo are registered trademarks or service marks of Kaiser Foundation Health Plan, Inc., in the United States.
Broker Resources
Get Answers
Check out LISI Compliance Alerts on current popular topics:
Are Payment Deferrals or Extended Grace Period Options Available?
Updated 4/3/2020 at 9:40 am
Insurance Commissioner Ricardo Lara issued a Notice requesting that all insurance companies provide their policyholders with at least a 60-day grace period to pay insurance premiums. The Commissioner's requests was to ensure policies are not cancelled for nonpayment of premium due to the Coronavirus (COVID-19) public health emergency. The Commissioner's request is being reviewed and evaluated by our carriers; it was recommended they comply but not a requirement. The chart below shows the current standard grace periods as well as any options the carriers have made available.
Group are required to submit payment by the due date shown on their bill. If a group misses their due date, they have up until the standard grace period to make a payment before coverage is cancelled. The standard grace period begins the day after the missed due date. Carriers are reviewing their policies to determine if/how they can assist their employer groups with making payments during this difficult time.
CARRIER
STANDARD
GRACE PERIOD
OPTIONS
Aetna
31 days
Per the Insurance Commission notice, will support a 60-day grace period for small groups.
Anthem Blue Cross
31 days
Requests will be reviewed on a case-by-case basis. Contact the Billing Department or Group's Account Manager for assistance.
Blue Shield of California
30 days
A general policy has not been put into place but requests will be reviewed on a case-by-case basis. If a group has determined they will not be able to pay on time they should contact the Billing Team (800-325-5166).
CaliforniaChoice
30 days
Requests will be reviewed on a case-by-case basis. Contact the group Account Manager or Customer Service for assistance.
Choice Builder
30 days
Per the Insurance Commission notice, will support a 60-day grace period.
CoPower
30 days
Payment deferral or grace period extensions are not available at this time.
CCSB
30 days
Payment deferral or grace period extensions are not available at this time.
Health Net
31 days
Payment deferral or grace period extensions are not available at this time.
Kaiser Permanente®
30 days
For large and small groups, Kaiser Permanente is following the California Insurance Commissioner's recommendation of allowing a 60-day grace period before suspending coverage. This applies all business regulated by the California Insurance Commissioner, including large group and small group. While the guidance does not apply to the majority of Kaiser Permanente's business because they are regulated by the Department of Managed Health Care, they are still complying with the grace period for all groups.
MediExcel Health Plan
60 days
Payment deferral or grace period extensions are not available at this time.
MetLife
30 days
Per the Insurance Commission notice, MetLife will support a 60 day grace period beginning 3/1/20 through when COVID-19 is deemed to be over.
Oscar Health
30 days
Payment deferral or grace period extensions are not available at this time.
Premier Access / Avesis
30 days
Per the Insurance Commission notice, will support a 60-day grace period.
Principal
30 days
Per the Insurance Commission notice, will support a 60-day grace period.
Sharp Health Plan
30 days
Payment deferral or grace period extensions are not available at this time.
Sutter Health Plus
30 days
Payment deferral or grace period extensions are not available at this time.
UnitedHealthcare
30 days
Payment deferral or grace period extensions are not available at this time.
Unum
30 days
If an employer anticipates having any issues with being able to remit premiums due to the circumstances surrounding COVID-19, please contact AskUnum at askunum@unum.com or connect with the groups Billing Coordinator.
Western Health Advantage
30 days
A general policy has not been put into place but requests will be reviewed on a case-by-case basis. If a group has determined they will not be able to pay on time they should contact the Premium Billing department.
Can Employers Cover Furloughed Employees or Those With Reduced Hours?
Updated 4/3/2020 at 4:54 pm
Carriers are easing guidelines so employers can keep their employees covered, even if the employees no longer meet eligibility due to reduced hours. For carriers who have made this option available, review the chart to find out how long these employees may be covered. Unless otherwise indicated, these rules apply to small and large group fully-insured plans.
Keep in mind that employees who are permanently terminated are no longer eligible and should be offered COBRA/Cal-COBRA as usual.
CARRIER
COVID-19 GUIDELINE
REFERENCE
Aetna
Members can remain on the plan, through July 31, 2020, as long as premiums are paid.
Members can remain on the plan, at the employers discretion, as long as premiums are paid.
-
CCSB
Members can remain on the plan, at the employers discretion, as long as premiums are paid.
-
Delta Dental
pending
-
Health Net
pending
-
Kaiser Permanente®
Members can remain on the plan as long as premiums are paid.
-
MediExcel Health Plan
Members can remain on the plan, at the employers discretion, as long as premiums are paid.
Approved groups will be allowed to remain active for a 6 month period, even if their last member terminates, keep their contract honored. Groups renewing during this period will be required to accept their renewal with new rates.
Members can remain on the plan as long as premiums are paid. Employers also have the option of paying premium for terminated employees who elect to enroll in COBRA/Cal-COBRA; with this option employers can set a specific amount of time they are committing to pay the premium (e.g. 1, 2, or 3 months).
-
Can an Employer Self-Adjust their Bill and Pay Only True Premiums?
Updated 3/27/2020 at 2:20 pm
Employers may want to adjust their own billing statement to pay only for employees still covered, taking into account any recent terminations. This is referred to as paying true premium. Avoid cancellation by understanding each carriers position on true premium.
CARRIER
GUIDELINE
Aetna
Employers may pay true premium. Employers should indicate terminated employees on the billing statement and review the next months bill to ensure members are removed.
Anthem Blue Cross
Employers should pay billed premium to avoid cancellation.
Blue Shield of California
Employers may be able to pay true premium. Employers should contact the Billing Team (800-325-5166) to request support.
CaliforniaChoice
pending
CCSB
Employers should pay billed premium to avoid cancellation.
Health Net
pending
Kaiser Permanente®
pending
MediExcel Health Plan
Employers may be able to pay true premium. Employers should contact their account manager first to discuss.
Principal
pending
Oscar Health
pending
Sharp Health Plan
pending
Sutter Health Plus
Employers should pay billed premium to avoid cancellation.
UnitedHealthcare
Employers should pay billed premium to avoid cancellation.
Western Health Advantage
Employers should pay billed premium to avoid cancellation.
Do Carriers Have Special Rules for Renewals and Re-certifications?
Updated 4/3/2020 at 9:50 am
Some carriers will not be re-certifying groups during this difficult time. Carrier systems may still auto generate letters to employer groups so it's important to know what you can expect.
CARRIER
GUIDELINE
Aetna
Will continue to re-certify 1 and 2 life groups at renewal.
Anthem Blue Cross
Groups will NOT be re-certified, they will auto renew.
Blue Shield of California
Groups will NOT be re-certified, they will auto renew. If a group receives a decline notice, this should be disregarded.
CaliforniaChoice
Business as usual.
CCSB
Business as usual, groups are not re-certified under normal procedures.
Health Net
Business as usual.
Kaiser Permanente®
Groups will NOT be re-certified, they will auto renew. If a group receives a re-certification letter, this should be disregarded (it is auto generated).
In addition, Kaiser will allow a delayed open enrollment window when it was not offered prior to the contract effective date, so long as it's offered to all eligible employees and all carriers offered.
MediExcel Health Plan
Groups will NOT be re-certified, they will auto renew.
Principal
All renewals for May through August, with under 500 lives, will auto renew with no increase.
Oscar Health
pending
Sharp Health Plan
Business as usual.
Sutter Health Plus
Groups will NOT be re-certified, they will auto renew.
UnitedHealthcare
Will continue to re-certify at renewal, however UHC is allowing employers more time to submit their information.
Western Health Advantage
Will continue to re-certify at renewal, however groups will still be renewed even if they are unable to turn in their re-certification documents.
Can Employers Make Off-Anniversary Eligibility Changes?
Updated 4/3/2020 at 2:30 pm
With the unique circumstances facing employer today, some may be looking to change their contract. This could mean changes like adjusting eligibility to include part-time employees as eligible or shortening the waiting periods so new hires can join the plan sooner. Most carriers require these changes be made only at the anniversary date. Read below to see which carriers may be loosening their guidelines.
Related: To see what carriers have opened a special enrollment opportunity allowing employers to make a plan downgrade, view the Member Access to Care tab above.
CARRIER
GUIDELINE
Aetna
Not allowed, changes may only be requested at open enrollment.
Anthem Blue Cross
Not allowed, changes may only be requested at open enrollment.
Blue Shield of California
Underwriting will review as an exception request. Employer must submit a completed Request for Contract Change Form along with the groups most recent reconciled DE-9C. If part-time employee must submit an application. All items can be send to SGUW@blueshieldca.com.
CaliforniaChoice
Employers may make a one-time "mid-plan year" change to adjust contribution.
CCSB
Not allowed, changes may only be requested at open enrollment. However, when it comes to FT/PT eligibility, CCSB does not monitor this and relies on the employer to determine when employees are added to the plan.
Health Net
pending
Kaiser Permanente®
Members can remain on the plan as long as premiums are paid.
MediExcel Health Plan
Not allowed, changes may only be requested at open enrollment. However, when it comes to FT/PT eligibility, MediExcel does not monitor this and relies on the employer to determine when employees are added to the plan.
Principal
pending
Oscar Health
pending
Sharp Health Plan
Not allowed, changes may only be requested at open enrollment.
Sutter Health Plus
pending
UnitedHealthcare
Not allowed, changes may only be requested at open enrollment.
Western Health Advantage
pending
Can Employers Waive the Waiting Period for Re-Hires?
Updated 4/2/2020 at 3:10 pm
Many employees who have been laid off will be re-hired once the pandemic is over. Read below to learn how each carrier handles this and whether your employer group will be able to waive the group waiting period for these individuals.
CARRIER
GUIDELINE
Aetna
The waiting period is waived for employees rehired within 1 year.
Anthem Blue Cross
If employee is rehired within 31 days
Coverage will resume with no lapse upon Anthem's receipt of a written request from the employer group.
If employee is rehired more than 31 days but not more than 91 days after the termination date
Coverage shall restart effective on the rehire date. The rehired employee will not be subject to any applicable group-imposed waiting period and must complete a new Employee Enrollment Application.
If employee is rehired more than 91 days (13 weeks) after the termination date
The employee is considered a new employee, subject to any applicable group-imposed waiting period and must complete a new Employee Enrollment Application.
Blue Shield of California
The waiting period is waived for employees rehired within 6 months.
CaliforniaChoice
Will allow the employer to define the waiting period when the employee returns to work.
CCSB
Does not monitor and will allow the employer to make the determination.
Health Net
The waiting period is waived for employees rehired within 30 days.
Kaiser Permanente®
Large Group: will allow the group to define the waiting period, as long as the waiting period and employer contribution are consistent for all employees.
Small Group: will allow the group to define the waiting period when the employee returns to work, with no minimum, but no greater than 90 days.
MediExcel Health Plan
Does not monitor and will allow the employer to make the determination.
Oscar Health
pending
Sharp Health Plan
Does not monitor and will allow the employer to make the determination.
Sutter Health Plus
Does not monitor and will allow the employer to make the determination.
UnitedHealthcare
All waiting periods are waived for re-hires employees who were terminated due to COVID-19.
Western Health Advantage
WHA will rely on employer instruction to notify them of employee eligibility, even if the time differs from their waiting period, so long as it does not exceed first of the month following 60 days.
How Do We Submit Employee Applications If We Can't Obtain Signatures?
Updated 4/3/2020 at 10:50 am
For new business submissions, some employees may not have access to printers/scanners/smart phones or may not have internet at home. This poses a concern for carriers that require employees sign applications. Read below to identify which carriers are more flexible on this requirement, and those that require a signature due to legal requirements.
CARRIER
SIGNATURE GUIDELINE
ELECTRONIC SIGNATURES ACCEPTED
Aetna
Signatures will not be required when submitting enrollment via the eTool spreadsheet.
Yes, must link to a reputable eSignature company.
Anthem Blue Cross
Signatures will not be required when submitting enrollment via the census spreadsheet.
Yes, must link to a reputable eSignature company.
Blue Shield of California
Signatures are required. Electronic signatures are accepted so long as they are time and date stamped by the service being used.
Yes, must link to a reputable eSignature company and have date/time stamp.
CaliforniaChoice
pending
Yes, must link to a reputable eSignature company.
CCSB
Signatures are required. Electronic signatures are accepted.
Yes, must link to a reputable eSignature company and have date/time stamp.
Health Net
pending
Yes, may sign with digital ID or link to a reputable eSignature company.
Kaiser Permanente®
Any type of signature will be accepted, including font/brush scripts.
Yes, must link to a reputable eSignature company.
MediExcel Health Plan
Signatures required if submitting applications. If signatures can't be obtained, submit census enrollment instead.
Not allowed.
Oscar Health
All enrollment is done online.
Yes.
Sharp Health Plan
Signatures are required.
Yes, must link to a reputable eSignature company.
Sutter Health Plus
Until further notice, will process the enrollment application with/without Subscriber/Employee signature as long as form is being submitted directly to SHP Enrollment/Sales by an authorized representative of the employer group such as an HR, Benefits Admin, COBRA TPA or Broker contact.
Yes, fillable forms allow for electronic signature.
UnitedHealthcare
Signatures not required, all enrollment processed through SAM.
Yes, must link to a reputable eSignature company.
Western Health Advantage
Signatures are required. If unable to obtain a hard copy, members can submit a photo of their signed form to their employer.
pending.
Contact your LISI Regional Sales Manager for help navigating this challenging time for you and your clients.
Employer Resources
Webinars
ThinkHR hosted a webinar on March 31, 2020, to address employer questions around current guidelines from the CDC, illness & quarantine questions, the Families First Coronavirus Response Act, and reducing hours or closing:
ThinkHR hosted a webinar on March 19, 2020, to address employer questions around employment, work from home policies, and to explain the Families First Coronavirus Response Act:
The Economic Development Collaborative (EDC) has provided some helpful information through their COVID-19 Business Resource Guide:
As the spread and impact of COVID-19 is still an unknown, the EDC recommends employers and self- employed individuals to take the following action steps:
Contact your insurance provider - Do you have business interruption insurance? If so, you may have coverage that supplements any income or sales loss during this time.
Track Losses - During moments of disruption it is important to track any loss your business may have incurred as programs designed to assist cash flow needs and access to capital depend on accurate counts of economic injury or production loss.
Do you have performance-based contracts with your suppliers or customers? - reviewing your current contracts and obligations will clarify limitations of liability and force majure.
Has your business experienced disruption or concern in the following areas?
Supply chain disruption and liability
Questions or concerns about the implications of tariffs
Technology plans for setting up remote work stations for employees
Concerns about cash flow during disruption
Concerns about credit and finance issues
Concerns about force majure
Assistance for Employers
The EDC had gathered recommendations for programs that can assist employers and employees affected by the Coronavirus:
PROGRAM
WHAT IS IT
MORE INFO
Work Sharing Program
Employers experiencing a slowdown in their businesses or services as a result of the Coronavirus impact on the economy may apply for the UI Work Sharing Program through the EDD.
This program allows employers to seek an alternative to layoffs. Retaining their trained employees by reducing their hours and wages that can be partially offset with UI benefits. Workers of employers who are approved to participate in the Work Sharing Program receive the percentage of their weekly Unemployment Insurance benefit amount based on the percentage of hours and wages reduced, not to exceed 60 percent.
Employers statewide directly affected by the new coronavirus (COVID-19) may request up to a 60-day extension of time from the EDD to file their state payroll reports and/or deposit payroll taxes without penalty or interest.
This extension may be granted under Section 1111.5 of the California Unemployment Insurance Code (CUIC). A written request for extension must be received within 60 days from the original delinquent date of the payment or return.
The Franchise Tax Board announced special tax relief for all California taxpayers affected by the COVID-19 pandemic. FTB is postponing until July 15, 2020 the filing and payment deadlines for all individual and business entities for 2019 tax returns, 2019 tax return payments, 2020 1st and 2nd quarter estimate payments, 2020 LLC taxes and fees, and 2020 Non-wage withholding payments.
The SBA will work directly with state Governors to provide targeted, low-interest loans to small businesses and non-profits that have been severely impacted by the Coronavirus (COVID-19). The SBA’s Economic Injury Disaster Loan program provides small businesses with working capital loans of up to $2 million that can provide vital economic support to small businesses to help overcome the temporary loss of revenue they are experiencing. Find more information on the SBA’s Economic Injury Disaster Loans at SBA.gov/Disaster.
The Labor & Workforce Development Agency has created the below chart to help employers understand what benefits their employees may be entitled to. This information does not yet reflect options now available as a result of the new Family First Coronavirus Response Act.
PROGRAM
WHY
WHAT
BENEFITS
MORE INFO
HOW TO FILE
Disability Insurance
If you're unable to work due to medical quarantine or illness related to COVID-19 (certified by a medical professional)
Short-term benefit payments to eligible workers who have a full or partial loss of wages due to a non-work-related illness, injury, or pregnancy.
Approximately 60-70 percent of wages (depending on income); ranges from $50-$1,300 a week for up to 52 weeks.
If you're unable to work because you are caring for an ill or quarantined family member with COVID-19 (certified by a medical professional)
Up to six weeks of benefit payments to eligible workers who have a full or partial loss of wages because they need time off work to care for a seriously ill family member.
Approximately 60-70 percent of wages (depending on income); ranges from $50-$1,300 a week for up to 6 weeks.
If you have lost your job or have had your hours reduced for reasons related to COVID-19
Partial wage replacement benefit payments to workers who lose their job or have their hours reduced, through no fault of their own.
Range from $40-$450 per week for up to 26 weeks.
Governor’s Emergency Proclamations waive the non-payable one-week waiting period for regular UI benefit payments to eligible individuals affected by current disasters. This means individuals can be paid benefits for the first week they are unemployed due to the disaster.
If you are unable to do your usual job because you were exposed to and contracted COVID-19 during the regular course of your work, you may be eligible for workers’ compensation benefits.
Benefits include temporary disability (TD) payments, which begin when your doctor says you can't do your usual work for more than three days or you are hospitalized overnight. You may be entitled to TD for up to 104 weeks. TD stops when either you return to work, your doctor releases you for work, or your doctor says your illness has improved as much as it's going to.
TD generally pays two-thirds of the gross wages you lose while you are recovering from a work-related illness or injury, up to a maximum weekly amount set by law. In addition, eligible employees are entitled to medical treatment and additional payments if a doctor determines you suffered a permanent disability because of the illness.
Summary
For certain circumstances related to COVID-19, employees will be eligible for:
Up to 2 weeks of paid sick leave (EPSL) for illness, quarantine, or school closures (full pay for self, 2/3 pay for family care)
Up to 12 weeks of Family and Medical Leave Act (FMLA) leave for school closures (10 days unpaid and then up to 10 weeks at 2/3 pay)
Effective Date of Law
The FMLA and Paid Sick Leave sections discussed below went into effect on April 1, 2020 and expire December 31, 2020. Leave benefits and payroll credits will not be retroactive.
Emergency Family and Medical Leave Act (EFMLA)
Covered Employers
Employers with fewer than 500 employees are covered.
Covered Employees
Any employee who has been employed for at least 30 calendar days, though employers may be able to exclude employees who are health care providers or emergency responders. See the ThinkHR COVID-19 FAQ for details on how the FFCRA defines health care providers and emergency responders.
Covered Leave Purpose
To care for a child under 18 of an employee if the child’s school or place of care has been closed, or the childcare provider is unavailable, due to a public health emergency, defined as an emergency with respect to the coronavirus declared by a federal, state, or local authority.
Duration
Up to 12 weeks of job-protected leave.
Compensation
No pay for first 10 days of leave (other paid time off, and emergency sick leave under the FFCRA, may be applied).
After 10 days, employers must pay two thirds of the employee’s regular rate of pay for the number of hours they would normally be scheduled to work, capped at $200/day and $10,000 total.
Reinstatement to Position after Leave
The same reinstatement provisions apply as under traditional FMLA. However, restoration to position does not apply to employers with fewer than 25 employees if certain conditions are met:
The job no longer exists because of changes affecting employment caused by an economic downturn or other operating conditions that affect employment caused by a public health emergency;
The employer makes reasonable efforts to return the employee to an equivalent position; and
The employer makes efforts to contact a displaced employee if anything comes up within a year of when they would have returned to work.
Emergency Paid Sick Leave (EPSL)
Covered Employers
Employers with fewer than 500 employees.
Covered Employees
All employees (no matter how long they have been employed), though employers may be able to exclude employees who are health care providers or emergency responders. See the ThinkHR COVID-19 FAQ for details on how the FFCRA defines health care providers and emergency responders.
Covered Leave Purposes
When quarantined or isolated subject to federal, state, or local quarantine/isolation order;
When advised by a health care provider to self-quarantine (due to concerns related to COVID-19);
When experiencing symptoms of COVID-19 and seeking a medical diagnosis;
When caring for an individual doing #1 or #2 (2/3 pay);
When caring for a child whose school or place of care is closed due to COVID-19 (2/3 pay); or
When the employee is experiencing any other substantially similar condition (2/3 pay).
Duration of Leave
Full time employees are entitled to 80 hours of paid sick leave.
Part time employees are entitled to sick leave equal to the number of hours worked on average over a typical two-week period.
Rate of Pay
Sick leave must be paid at the employee’s regular rate of pay for leave used for the employee’s own illness, quarantine, or care.
Sick leave must be paid at two-thirds of the employee’s regular rate if taken to care for a family member or to care for a child whose school has closed, or if the employee’s childcare provider is unavailable due to the coronavirus.
Pay is capped at $511/day and $5,110 total for reasons 1, 2, and 3 described above.
Pay is capped at $200/day and $2,000 total for reasons 4, 5, and 6 described above.
Small Business Exemption
Employers with fewer than 50 employees may be eligible for an exemption from the childcare leave provisions if at least one of the three statements below are true:
Providing leave would result in the small business’s expenses and financial obligations exceeding available business revenues and cause it to cease operating at a minimal capacity;
The absence of the employee or employees requesting leave would entail a substantial risk to the financial health or operational capabilities of the small business because of their specialized skills, knowledge of the business, or responsibilities; or
There are not sufficient workers who are able, willing, and qualified, and who will be available at the time and place needed, and these labor or services are needed for the small business to operate at a minimal capacity.
Payroll Tax Credit
The IRS has released DRAFT instructions on how to access and administer payroll tax credits. The draft document is available here. Employers should regularly check back at this link for the final instructions.
Get Answers to the Top FFCRA Questions
Our partner ThinkHR has provided a great resource with questions they've received during recent webinars. Below are highlights taken from the ThinkHR COVID-19 FAQ.
Do we need to provide the required sick leave under the FFCRA in addition to the sick leave we already offer?
Yes. The Department of Labor makes it clear in an FAQ regarding the FFCRA that leaves under the FFCRA are intended to be in addition to any pre-existing leave entitlements that an employee may have.
Do we still have to provide EPSL or EFMLA if we lay off or furlough employees?
No. Employers who are closed — either due to lack of business or a state or local order — do not have to provide these leaves. Employees who are furloughed (temporarily not working but still on the payroll) are also not entitled to these benefits. In either of these cases, employees would be eligible for unemployment insurance instead. However, employers should ensure that they are not making furlough or layoff decisions based on an employee’s request or potential need for leave, as this would likely be considered interference or retaliation (and grounds for a lawsuit).
How are we supposed to pay for the sick leave and FMLA leave mandated by the Families First Coronavirus Response Act?
To take immediate advantage of the paid leave credits, businesses can retain and access funds that they would otherwise pay to the IRS in payroll taxes. If those amounts are not sufficient to cover the cost of paid leave, employers can seek an expedited advance from the IRS by submitting a streamlined claim form that will be released soon.
For many, business slowdowns related to the spread of COVID-19 have made it hard to imagine how employers could bear any additional expenses. We encourage anyone with these concerns to read the linked announcement carefully.
The full announcement can be found here: Treasury, IRS, and Labor Announcement on FFCRA Implementation. Including the information in the link, this is all we currently know about the payroll tax credit under the FFCRA and how to access or administer it.
If I am a nonprofit or a public employer, do tax credits and reimbursement apply to me?
Most public employers (e.g., cities, municipalities, public school districts) will not be eligible for the tax credits or reimbursements provided in the act. Private nonprofit entities, however, are eligible
What are our EPSL and EFMLA obligations to different employee situations, such as remote employees?
All employees are entitled to emergency paid sick leave (EPSL) and emergency expansion of the FMLA (EFMLA) benefits unless a specific exemption applies to your business or the individual.
Is the FFCRA retroactive or applicable before its effective date?
No. The Families First Coronavirus Response Act (FFCRA) goes into effect on April 1, 2020 and is not applicable before that time.
How do EFMLA and EPSL relate to each other, especially in regard to caring for children?
The emergency FMLA (EFMLA) and emergency paid sick leave (EPSL) both cover caring for children whose school or place of care is closed due to COVID-19 precautions, though EFMLA has the broader restriction that the child be under 18 years old. The leaves can run concurrently with the first 10 days of EFMLA being unpaid, which will, in many cases, coincide with the 80 hours of pay (at 2/3 the regular rate) under EPSL for full-time employees.
Enforcement of FFCRA
The DOL will not bring enforcement actions against employers for violations of the FFCRA prior to April 17, 2020, provided that the employer has made reasonable, good faith efforts to comply with the Act. Read more about the brief non-enforcement period.
Documentation Required to Substantiate Leave Payments
(From the IRS) An Eligible Employer will substantiate eligibility for the sick leave or family leave credits if the employer receives a written request for such leave from the employee in which the employee provides:
The employee’s name;
The date or dates for which leave is requested;
A statement of the COVID-19 related reason the employee is requesting leave and written support for such reason; and
A statement that the employee is unable to work, including by means of telework, for such reason.
In the case of a leave request based on a quarantine order or self-quarantine advice, the statement from the employee should include the name of the governmental entity ordering quarantine or the name of the health care professional advising self-quarantine, and, if the person subject to quarantine or advised to self-quarantine is not the employee, that person’s name and relation to the employee.
In the case of a leave request based on a school closing or child care provider unavailability, the statement from the employee should include the name and age of the child (or children) to be cared for, the name of the school that has closed or place of care that is unavailable, and a representation that no other person will be providing care for the child during the period for which the employee is receiving family medical leave and, with respect to the employee’s inability to work or telework because of a need to provide care for a child older than fourteen during daylight hours, a statement that special circumstances exist requiring the employee to provide care.
Guidance from the DOL on Administering FFCRA Leaves
We strongly suggest that employers read through the entire Questions and Answers document, so they have an understanding of how the leaves work. The following are some highlights from the updated guidance:
These leaves are not available to employees with reduced hours, furloughed employees, or employees whose workplaces are closed. See questions 23-28.
These leaves are not available to employees whose workplaces are closed due to a federal, state, or local shelter-in-place or stay-at-home orders, or due to business slowdowns. See question 23.
These leaves (and payroll tax credit) are not retroactive. Employees are not entitled to pay under these leaves if they were absent or out of work (for any reasons) prior to April 1. See question 13.
Both emergency paid sick leave (EPSL) and emergency Family and Medical Leave (EFMLA) can be taken on an intermittent basis in certain situations. See Questions 20-22 for explanations about when intermittent leave is allowed.
Employees may not be required to use other forms of paid leave prior to or concurrently with EPSL or EFMLA. See questions 32 and 33.
Employers should keep documentation to show that employees who received leave were actually in need of leave. The documentation requirements are outlined in IRS guidance as discussed above. See Questions 15 and 16.
Coronavirus Aid, Relief, and Economic Security Act (CARES Act)
Updated 4/3/2020 at 8:50 am
On Friday, March 27, the President signed the Coronavirus Aid, Relief, and Economic Security Act (CARES Act). The new law is a $2 trillion economic stimulus package designed to repair the economic damage caused by COVID-19 and provide additional protection to individuals and businesses who may lose income due to the pandemic. While most of the act pertains to direct payments and loans, there are some sections that affect employers.
Providing Alternatives to Closure and Layoffs
The CARES Act gives employers the following options and benefits, which may allow them stay open and keep more people employed:
Small businesses may be eligible for emergency grants of up to $10,000 to cover immediate operating costs.
The Small Business Administration (SBA) may provide loans of up to $10 million per business; any portion of that spent to pay employees, keep workers on payroll, or pay for rent, mortgages, or existing debt could be forgiven, provided workers remain employed through the end of June.
Small businesses with existing SBA loans may have up to six months of payments waived.
Businesses that have experienced a decline in gross receipts of 50% as compared to the same quarter of 2019 or that have been fully or partially shutdown by order may be eligible to receive a refundable tax credit for 50% of qualified employee wages up to $10,000 per employee. This is unrelated to the dollar-for-dollar payroll tax credit that can be taken for FFCRA leaves.
Businesses may defer payment of employer payroll taxes imposed between the enactment of this law and December 31, 2020 with half of the deferred taxes due by December 31, 2021 and the rest due by December 31, 2022. This is unrelated to the dollar-for-dollar payroll tax credit that can be taken for FFCRA leaves.
We are unable to advise on these topics as they are outside the scope of our expertise. We encourage you to follow the IRS Coronavirus Tax Relief page and the SBA Coronavirus Loan Resources page, as well as consult with your tax professional or financial advisor. Detailed guidance on how to access these financial resources should be coming soon from those sources.
Impact on Unemployment Insurance
The act increases the length of time someone can be on unemployment benefits to a maximum of 39 weeks. In many states, this will be an increase of 13 weeks of benefits. The act also adds $600 to the weekly amount an individual would usually receive. Independent contractors may be eligible for benefits under this expansion. While these unemployment benefits are generous, employers should still consider their options and incentives under the CARES Act mentioned above before making decisions about reduced hours, furloughs, or layoffs.
Employees who experience reduced hours, furloughs, or layoffs should be encouraged to file for unemployment insurance as soon as possible. We recommend that both employers and employees visit their state’s unemployment insurance department website and track local and state news, as departments across the country are updating their rules to facilitate displaced workers during this time.
Paycheck Protection Program (PPP)
The Paycheck Protection Program (“PPP”) authorizes up to $349 billion in forgivable loans to small businesses to pay their employees during the COVID-19 crisis. All loan terms will be the same for everyone. The loan amounts will be forgiven as long as:
The loan proceeds are used to cover payroll costs, and most mortgage interest, rent, and utility costs over the 8 week period after the loan is made; and
Employee and compensation levels are maintained.
Payroll costs are capped at $100,000 on an annualized basis for each employee. Due to likely high subscription, it is anticipated that not more than 25% of the forgiven amount may be for non-payroll costs. Loan payments will be deferred for 6 months.
Eligible Employers
Small businesses with 500 or fewer employees—including nonprofits, veterans organizations, tribal concerns, self-employed individuals, sole proprietorships, and independent contractors— are eligible. Businesses with more than 500 employees are eligible in certain industries.
When to Apply
Starting April 3, 2020, small businesses and sole proprietorships can apply. Starting April 10, 2020, independent contractors and self-employed individuals can apply. We encourage you to apply as quickly as you can because there is a funding cap.
How to Apply
You can apply through any existing SBA 7(a) lender or through any federally insured depository institution, federally insured credit union, and Farm Credit System institution that is participating. Other regulated lenders will be available to make these loans once they are approved and enrolled in the program. You should consult with your local lender as to whether it is participating. All loans will have the same terms regardless of lender or borrower. A list of participating lenders as well as additional information and full terms can be found at www.sba.gov.
Economic Injury Disaster Loan Program (EIDL)
The SBA will work directly with state Governors to provide targeted, low-interest loans to small businesses and non-profits that have been severely impacted by the Coronavirus (COVID-19). The SBA’s Economic Injury Disaster Loan program provides small businesses with working capital loans of up to $2 million that can provide vital economic support to small businesses to help overcome the temporary loss of revenue they are experiencing. Find more information on the SBA’s Economic Injury Disaster Loans at SBA.gov/Disaster.
Benefits.gov offers an online questionnaire to assist employers in determining eligibility. Employers can apply online through the SBA website.
Program Description
The Small Business Administration's (SBA) disaster loans are the primary form of Federal assistance for the repair and rebuilding of non-farm, private sector disaster losses. The disaster loan program is the only form of SBA assistance not limited to small businesses.
The Economic Injury Disaster Loan Program (EIDL) can provide up to $2 million of financial assistance (actual loan amounts are based on amount of economic injury) to small businesses or private, non-profit organizations that suffer substantial economic injury as a result of the declared disaster, regardless of whether the applicant sustained physical damage.
An EIDL can help you meet necessary financial obligations that your business or private, non-profit organization could have met had the disaster not occurred. It provides relief from economic injury caused directly by the disaster and permits you to maintain a reasonable working capital position during the period affected by the disaster. EIDLs do not replace lost sales or revenue.
Program Requirements
To be eligible for EIDL assistance, small businesses or private non-profit organizations must have sustained economic injury and be located in a disaster declared county or contiguous county.
Loan Terms
The SBA can provide up to $2 million in disaster assistance to a business. The $2 million loan cap includes both physical disaster loans and EIDLs. There are no upfront fees or early payment penalties charged by SBA. The repayment term will be determined by your ability to repay the loan.
Application Process
Apply online for disaster loan assistance at your own convenience through SBA's secure Disaster Loan Assistance website. For application information, please call 1-800-659-2955 or email DisasterCustomerService@sba.gov.
FAQs from the California Employment Development Department can help answer questions on Disability or Paid Family Leave Benefits, Unemployment Insurance Benefits, and other employer information.
California’s network of small business support centers help businesses figure out which loans are best for them, develop resiliency strategies, and find other resources. Learn more.
The Office of the Small Business Advocate has also provided answers to a list of frequently asked questions to help support California’s small businesses. Learn more.
If you need to talk to a specialist in GO-Biz’s Office of the Small Business Advocate directly, please contact the team.
U.S. Small Business Administration Economic Injury Disaster Loan Program
SBA loans are available to the entire state of California.
For more Information about SBA disaster assistance programs, and to apply directly online, go to the SBA Website.
CA Infrastructure and Economic Development Bank (IBank) Finance Programs (1-750 employees)
Disaster Relief Loan Guarantee Program: This disaster program provides loan guarantees of up to $1 million for small business borrowers in declared disaster areas.
Jump Start Loan Program: This program offers loans from $500 to $10,000 to low-wealth entrepreneurs in declared disaster and emergency areas.
California Capital Access Program (CalCAP) (1-500 employees)
CalCAP is a loan loss reserve program which may provide up to 100% coverage on losses as a result of certain loan defaults. Individual borrowers are limited to a maximum of $2.5 million enrolled over a 3-year period.
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