Service Employees Benefit Fund
Covid-19 (Coronavirus) Updates
In response to the ongoing Coronavirus Pandemic, the SEBF Board of Trustees have made the following changes in the SEBF Medical Plan.
Important Medical Plan Changes Due to COVID-19 (Coronavirus) Pandemic
Participants will not be responsible for copayments, coinsurance or deductibles for in-network inpatient hospital, in-network provider
office visits, in-network urgent care visits, and emergency room visits and medically necessary diagnostic tests (consistent with
CDC guidelines) related to the Coronavirus.
Participants will not be responsible for copayments, coinsurance or deductible for: (a) diagnostic tests (approved and authorized
by applicable law) for the Coronavirus: and (b) in-network or out-of-network health care provider office visits, urgent care visits,
or emergency room visits resulting in testing for the Coronavirus, to the extent such items and services relate to the furnishing
or administration of testing or to the evaluation of such individual for purposes of determining the need of such individual testing.
SEBF waives any preauthorization requirements for diagnostic tests and covered services that are medically necessary and consistent with CDC guidance for Participants diagnosed with the Coronavirus.
Temporary Deadline Extensions- SEBF will disregard the time period from March 1, 2020 until 60 days after the announced end date of the COVID-19 National Emergency, in determining whether you have met the following deadlines:
1. The 30-day deadline to request special enrollment in the Plan due to a loss of other coverage, your marriage, affirmed domestic partnership, or the birth, adoption, or placement for adoption, with you of a new dependent.
2. The 60-day deadline to request special enrollment due to the loss of Medicaid or CHIP coverage.
3. The 60-day period to elect COBRA continuation coverage, the initial 45-day COBRA premium payment deadline, and the subsequent 30-day deadlines for making COBRA premium payments for each month thereafter.
4. The deadline for individuals to notify the Plan of a qualifying event or determination of disability for purposes of COBRA.
5. The deadline to file an initial benefit claim under the SEBF's claims procedures.
6. The deadline to file an appeal of an adverse benefit determination under the Planís appeals procedures, the four-month deadline to file a request for an external review after receipt of an adverse benefit determination or final internal adverse benefit determination, and the deadline to file information to perfect a request for external review upon a finding that the request was not complete. A Plan must allow a claimant to perfect the request for external review within the four-month filing period or within the 48-hour period following the receipt of the notification of a deficient request for review, whichever is later.