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Frequently Asked Questions

Below are a list of Frequently Asked Questions regarding premiums, eligibility, and more during the COVID-19 pandemic. Check this list often for updates.

Please note the information below applies to full-insured commercial groups. Self-funded employer questions should be discussed with your CDPHP account representative.

Will CDPHP consider offering a premium holiday across any of our products?

No, not at this time. A premium holiday suggests that premium would be waived for a specified period of time with no requirement to pay. We are continuing to monitor guidance from state regulators on this topic.

NYSOH has created a Special Enrollment Period (SEP) for COVID-19 for Marketplace plans. Is CDPHP creating a SEP for employer group plans?

No, we are not creating a specific SEP for COVID-19 for employer group plans. Qualifying events such as loss of coverage on another plan – for example, if your spouse carried insurance through his/her employer for you and then lost coverage – this could trigger an opportunity to join an existing plan offered through your employer group.

Actively at work. Is there a minimum number of hours an employee needs to work to be eligible for CDPHP group benefits during this time?

No, due to this unprecedented situation, both active and furloughed employees can remain on the plan as long as the employer and employee continue to provide the same premium contribution level as they do for active employees, and all employees are treated equitably.
NOTE: A furloughed employee is an employee who is let go on a temporary basis where the employer intends to bring that employee back.

What happens if an employee is permanently laid off?

A laid off employee is defined as an employee who is being let go on a permanent basis with no intent to bring that employee back. Laid off employees are no longer eligible for health care coverage and must enroll in either COBRA, a qualified health plan via the New York State of Health Marketplace, or any other plan that the employee is eligible for. If an employer goes out of business, the employee will not be able to get COBRA or continuation coverage. He or she would need individual coverage. CDPHP is here to help. For help navigating this process, please call us at 1-844-237-4773.

Will CDPHP consider changing/waiving waiting periods upon rehire?

Yes, as long as an employee is reinstated to the same plan and on the same Member ID, within the same plan year, waiting periods can be waived. Additionally, we will not reset deductibles and accumulators for the employee and they will be able to continue coverage with current balances available on their current plan. Members will not be allowed to change plans upon rehire.

Can a group “buy down” and change plans at this time?

Yes, through standard process, a group is allowed to buy-down and change plans. This will trigger a new plan effective date for the group and all benefits will reset.

Can employers contribute toward COBRA premium if they want to during this time?

We cannot provide legal advice to our groups, and decisions that employers make in this regard could have broader tax implications, group-size qualification implications, workers’ compensation insurance implications, etc.

CDPHP does not offer administrative or direct billing services for COBRA at this time. Premiums for active furloughed and COBRA enrollees will continue on the group invoice with payment due from the group.