The U.S. Department of Labor has issued a new series of Frequently Asked Questions for employers with group health plans that must now cover the cost of in-home COVID-19 test kits or reimburse employees, within certain limits, for these tests without requiring cost-sharing.
The most recent FAQ provides employers with greater flexibility if a supply shortage prevents the direct-to-consumer shipping of home-test kits. The FAQ also addresses concerns about “double-dipping” by employees using workplace health savings accounts (HSAs) or flexible spending accounts (FSAs) for COVID at-home tests already paid for by their employer.
A federal requirement, which took effect Jan. 15, requires insurers and group health plans to cover all types of COVID-19 testing, including in-home COVID-19 tests purchased without prescription. The plan or insurer can limit coverage to eight tests a month per person.
The latest FAQ, issued on Feb. 4, clarifies that health plans and insurers are not in violation of the law if they are unable to provide OTC tests by mail because of a supply shortage. In that event, the plan or insurer can still meet its coverage responsibility by reimbursing the cost of COVID-19 tests/kits purchased for up to $12 per test. At-home tests can be self-administered, without the involvement of a laboratory for processing or the involvement of a healthcare provider to read the results.
The FAQ also clarifies that the cost of a COVID-19 test covered under a group health plan is not eligible for reimbursement under a health flexible spending arrangement (FSA), health reimbursement arrangement (HRA), or a health savings account (HSA) for the same expense.
If an employee mistakenly receives reimbursement for the same COVID-19 test costs from a health FSA, HRA, or HSA arrangement separately covered and paid through an employer’s or insurer’s group health plan, the employee must contact their plan administrator for correction of the error or could be subject to income tax on the amounts overpaid.
When a health plan provides OTC COVID-19 tests through a direct-to-consumer shipping program, “plans and issuers must cover reasonable shipping costs related to covered OTC COVID-19 tests in a manner consistent with other items or products provided by the plan or issuer via mail order,” the guidance states.