EPIC Risk Advisory Bulletin
Volume 1, Issue 8
The global COVID-19 (coronavirus) pandemic remains both dynamic and fluid. We continue to see unprecedented disruptions at home and abroad. In this issue, we take a focused look at:
- General Information on Coronavirus
- Supply Chain and Business Risks
- Repurposing Campuses for Hospital Overflows
- Insurance Products and Coverage Information
- Liability Immunity for Healthcare Workers
- Proposed Ban on Surprise Medical Bills
- Legislation and Litigation Roundup
- Human Resources and Employee Benefits
- Newly Released FAQs on FFCRA and CARES Act
- FFCRA Navigation Flowchart
- CDC Safety Guidelines for Critical Infrastructure Workers
- DOL Guidance on Recording Coronavirus Cases
- Requirements for Written Social Distancing Protocols
- Complimentary Identity Theft Offering
- Employee Benefits Insights
The information presented here is intended to provide a high level overview of critical areas of concern for businesses around coronavirus. Consult your EPIC insurance broker for more in-depth guidance.
General Information on Coronavirus
While the best source for timely information on the coronavirus pandemic remains the Centers for Disease Control (CDC) and the World Health Organization (WHO), EPIC has compiled resources to aid in understanding the impact of the pandemic on employers, their workforces and managing risk.
In addition to the map below, there is an interesting study and interactive model from the Institute for Health Metrics and Evaluation. The study is a state-by-state forecast of health service utilization and deaths due to coronavirus. It projects the day resource use will peak in each U.S. state, and includes hospital bed use, need for intensive care beds, and ventilator use. The model was built using observed death rates from coronavirus and incorporates preventative measures taken by each state.
According to the model, America will reach its peak day on April 15. Hospital beds needed are anticipated to be 140,823, which is a shortage of 36,654 beds. ICU beds needed are expected to be 29,210, which reflects a shortage of 16,323. Additionally, 24,828 invasive ventilators are needed. The site also projects deaths and information is searchable by state. Information is dynamic, so please visit the following link for up to date results. View the study here: https://covid19.healthdata.org/projections
Source: John Hopkins
Supply Chain and Business Risks
Universities and Colleges Repurposing Campuses for Hospital Overflows
Across America, risk managers at many colleges and universities have suddenly found their campuses empty. Some of them may find themselves busy again, but not necessarily from student activity.
The government and hospitals are contacting some colleges and universities, advising that they plan to repurpose some of their buildings for use as overflow hospitals. While this is necessary and helpful, it does raise risk management issues and concerns. Liability protection is an important consideration for both sides. An entity facing a repurposing proposition should have the health care facility complete a Facility Use Agreement, to include a Certificate of Insurance naming the college as an Additional Insured via endorsement, a Hold Harmless agreement and more. Any professionals onsite must have current Professional Liability coverage, to support the need for the assurance of exemption from liability. The school should also require a clear plan for logistics and security, as well as details related to the specific responsibilities of the hospital versus those of the school.
Staff that is familiar with the property will be required to support the modified operation, to include security and maintenance personnel available around the clock. Additional costs will be incurred in relation to lease agreements, security, electricity, water, heat, air conditioning and more. The larger the operation becomes, the more that costs will rise.
Additional risk concerns, which merely scratch the surface of unplanned and uncovered risks, include:
- Dining and supplies
- Sanitation and management of biohazardous waste
- Management of visitors
- Emergency power
- Medication controls
- Emergency logistics, such as ambulance access
The sad reality is that when things go wrong, everyone becomes a candidate for a lawsuit. It is an unfortunate necessity for colleges and universities to consider the real risks involved with the repurposing of spaces, and to act prudently to obtain proper assurances and protections should worst case scenarios occur.
If you are facing this risk, or any risk related to the coronavirus pandemic, contact your EPIC broker for assistance.
Insurance Products & Coverage
Liability Immunity for Healthcare Workers Issued by States
Across America, state governors are issuing executive orders to protect healthcare workers from lawsuits related to the delivery of healthcare services during the coronavirus pandemic.
States argue that it is in the public’s best interest to afford healthcare workers protection against liability for their good faith efforts to provide assistance in response to states’ need to supplement existing healthcare workforces. Arizona, Massachusetts, New Jersey and Vermont are among the latest to protect healthcare workers.
While many states already provide some protections for healthcare professionals and volunteers, it has become increasingly necessary to provide specific protections related to the current coronavirus response. Such protections provide assurance to those working on the frontlines of the crisis. Entities protected by such executive orders have included:
- Licensed and volunteer health professionals
- Emergency medical care technicians
- Healthcare institutions
- Licensed healthcare and un-licensed entities operating modular field treatment facilities and other sites as designated by state departments of health and human services
The orders do not provide immunity from civil liability to healthcare professionals, volunteers, institutions and others for gross negligence or reckless or willful misconduct. These orders also do not remove or negate other defenses against liability provided under law.
The orders come as new research finds that more than 350 hospitals in rural settings across 40 states are vulnerable to closures. In these extreme situations, these orders provide needed relief to doctors, nurses and others making difficult choices that can, at times, involve deciding who receives access to increasingly limited resources and hospital beds.
Proposed Ban on Surprise Medical Bills
Senator Lamar Alexander of Tennessee made news recently when he tweeted that he signed on to a letter encouraging congressional leadership to protect patients from all surprise medical bills. The letter asks for protections to be included for patients in future coronavirus legislation that “ensure during this time of uncertainty, patients and their families have peace of mind knowing they will not receive unexpected medical bills when seeking treatment for COVID-19 or other medical conditions.”
Specifically, the letter, which is supported by the American Heart Association and other leading medical organizations, asks congress to enact legislation that would:
- Hold patients harmless
- Apply protections to all insurance plans
- Apply protections to all surprise bills for all covered services
- Apply protection to all care settings
- Require greater transparency from plans and providers about in-network and out-of-network services
- Conduct additional research on the impact of provider networks on surprise medical bills
- Strengthen state protections against surprise medical bills
- Protect patients who use emergency transportation
It remains to be seen whether any or all of such requests will become part of future legislation passed by congress in response to the coronavirus crisis.
Legislation and Litigation Roundup
The passage of another week has brought forth more legislation from city, county and state governmental bodies, as well as litigation. As business owners and policy holders threaten to sue for coverage, more states are trying to press insurance policies into covering coronavirus-related claims. President Trump weighed in last week, telling insurers to pay virus claims if pandemics were not excluded in contracts. Here is a rundown of recent news on both the legislation and litigation fronts.
Legislation News of Note
- Insurance companies ordered to give refunds to Californians due to coronavirus, LA Times, April 13
- States attempt to shift economic burden to insurance industry with new legislation on business interruption coverage, National Law Review, April 10
Litigation News of Note
- Grubhub, DoorDash, Postmaters, Uber Eats are sued over restaurant prices amid pandemic, Reuters, April 13
- GOP senators urge Trump to protect insurers from state legislation, The Hill, April 11
Other Coverage News of Note
- The governors of seven eastern states will cooperate on reopening, New York Times, April 14
- California, Oregon and Washington announce western states pact on reopening based on health outcomes, Office of Governor Gavin Newsome, April 13
- Wimbledon coronavirus insurance policy to pay out $141M after cancellation, Fox Business, April 8
HR & Employee Benefits Insights
FAQs Address Health Plan Obligations Under FFCRA and CARES Act
The Families First Coronavirus Response Act (FFCRA) and the Coronavirus Aid, Relief, and Economic Security (CARES) Act contain provisions addressing coronavirus testing (and vaccination) costs as well as the expansion of telehealth services.
Since both laws passed, the U.S. Department of Labor (DOL), Health and Human Services (HHS) and the Treasury (collectively, the Departments) have released FAQs and other guidance with explanations on interpretation and enforcement. Most recently, a new set of FAQs was released on April 11, addressing required costs of plan sponsors.
Read our Compliance Alert, which includes a link to the FAQs, here.
Navigating the FFCRA
Understanding the qualifications for leave within the provisions of the FFCRA can be confusing. We have simplified it with a flowchart that guides the decision-making process, mapping out the path to follow for Emergency Family Medical Leave (EFML) versus Emergency Paid Sick Leave (EPSL). It also clearly highlights when neither provision apply to an employee’s situation.
CDC Issues Safety Guidelines for Critical Infrastructure Workers
In order to ensure the continuity of operations of essential functions during the coronavirus pandemic, the CDC has issued guidance for implementing safety practices for critical infrastructure workers. The guidance pertains to personnel in 16 different sectors including federal, state and local law enforcement; 911 call center employees; fusion center employees; hazardous material responders from the government and private sectors; janitorial and custodial staff; and more. The document issues advice for workers who may have been exposed to coronavirus, but remain asymptomatic.
DOL Releases Guidance on Recording Coronavirus Cases
OSHA released interim guidance on how to enforce its recordkeeping requirements as they relate to recording cases of coronavirus, which is considered a recordable illness. Employers are responsible for recording cases if the case is confirmed as a COVID-19 illness; is work-related as defined by 29 CFR 1904.5; and if it involves one or more of the general recording criteria in 29 CFR 1904.7, such as medical treatment beyond first aid or days away from work.
Read the full statement on OSHA’s website
Requirements for Written Social Distancing Protocols
Municipalities and counties across America are beginning to require essential businesses to create and display written social distancing protocols at their facilities. Late last week, three counties in southern California became the latest to do so. Some businesses will have a more challenging time than others in enforcing requirements, such as keeping employee workstations six feet apart.
Amazon, for example, says it has made 150+ process updates to protect its employees and has distributed protective gear and instituted temperature checks, among other things, at its facilities.
The goal of social distancing is to limit exposure to infectious bacteria and viruses during a communicable disease outbreak. Social distancing protocols may include:
- Adhering to public health hygiene recommendations
- Displaying and following proper hand washing routines
- Avoiding touching the face, nose, mouth and eyes
- Practicing proper coughing and sneezing etiquette
- Maintaining a distance of six feet from other individuals while working
EPIC’s Training & Awareness Practice has created posters and handouts that may be useful in addressing some of these issues. They can be displayed or distributed in workplaces to encourage employees to continue to exhibit safe and healthy behaviors. Links to access those materials were included in Volume 1, Issue 7 of EPIC’s Risk Advisory Bulletin
During the crisis and while social distancing guidelines remain in effect this protocol document, released by the San Diego County Government, provides a helpful template for thinking through social distancing measures.
Complimentary Identity Theft
During times of stress and crisis, we are all more vulnerable to fraud. The FBI has reported a steep rise in coronavirus-related scams designed to trick victims into giving up money, and personal or financial information. Cyber criminals are exploiting people at alarming rates through activities that include phishing attacks via text, stealing IRS refund and stimulus checks, and hacking unsecured home WiFi networks. These criminal activities are putting work-at-home and furloughed employees at risk for cyberattacks that may lead to catastrophic outcomes.
EPIC’s National Voluntary Benefits Practice has teamed up with industry-leading identity theft partners to offer complimentary identity theft protection. The service is available to an organization’s employees through December, and could be added beyond 2020 as a coverage election offered through a nominal payroll deduction.
For more information, contact EPIC’s National Voluntary Benefits Practice Leader:
Employee Benefits Insights
EPIC’s employee benefits leaders have written numerous articles on matters related to coronavirus and employee benefits, all of which are available on EPIC’s website. These articles include:
- Coronavirus and Workplace Well-being: Pushing for Physical Health (Apr 13)
- Health Plan Obligations Under FFCRA and CARES Act (Apr 13)
- What Will COVID-19 do to Healthcare as we Know It? (Apr 10)
- COVID-19: Workers Compensation FAQs (Apr 9)
- SBA Payment Protection Program Considerations (April 7)
- Insurance Companies Don’t Give it Away for Free (Apr 6)
- EPIC’s Workers’ Compensation Claims Advocacy (Apr 6)
- DOL Releases Additional FFCRA FAQ (Apr 3)
- Benefits Plans are Changing to Help Consumers (Apr 2)
- IRS Provides Guidance on FFCRA Tax Credits (Apr 1)
- IRS Provides Guidance on CARES Act Employee Retention Tax Credits (Apr 1)
- San Francisco Health Care Security Ordinance 2019 Annual Report Form Cancelled (Mar 31)
- COVID-19 Special Enrollment Period Raises Compliance Questions (Mar 31)
- CARES Act Addresses COVID-19 Economic Crisis (Mar 27)
Conclusion
Our understanding of coronavirus and its impact around the world continues to evolve at a rapid pace. This newsletter briefly touches on issues that businesses may want to consider as they approach their response to novel coronavirus. More topics will be considered in future issues as our understanding of the virus and its impact continues to evolve. Please reach out to your EPIC broker for more information.
For all of EPIC’s coronavirus coverage, visit epicbrokers.com/coronavirus
Disclaimer: This has been provided as an informational resource for EPIC clients and business partners. It is intended to provide general guidance on potential exposures and is not intended to provide medical advice or address medical concerns or specific risk circumstances. Due to the dynamic nature of infectious diseases, EPIC cannot be held liable for the guidance provided. We strongly encourage readers to seek additional safety, medical and epidemiological information from credible sources such as the Centers for Disease Control and Prevention and the World Health Organization. Regarding insurance coverage questions, whether coverage applies or a policy will respond to any risk or circumstance is subject to the specific terms and conditions of the policies and contracts at issue and underwriter determinations. </small class>
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