Please read below for information relative to the NCAA Board of Governors’ announcement and how it affects institutions’ accident insurance policies.
NCAA Board of Governors Announcement relative to COVID-19 Testing & Treatment Costs
Today’s announcement from the NCAA Board of Governors (BOG) may be read here: http://www.ncaa.org/about/resources/media-center/news/board-directs-each-division-safeguard-student-athlete-well-being-scholarships-and-eligibility. In their announcement, the BOG mandates that member institutions, in conjunction with existing insurance standards, must cover COVID-19 related medical expenses for student-athletes to prevent out-of-pocket expenses for collegiate student-athletes and their families.
Existing Insurance Standards
So, what are the “existing insurance standards” relative to COVID-19 Testing and treatment costs?
The Families First Coronavirus Response Act (FFCRA) passed on a federal level on March 18th, 2020. One of the mandates of the FFCRA is that beginning on March 18th and for the duration of the public health emergency, all forms of public and private insurance must now cover FDA-approved COVID-19 testing with NO COST SHARING as long as the test is deemed medically appropriate by an attending health care provider. This does not apply to Short-Term Medical plans. Further, “As outlined by the Centers for Medicare & Medicaid Services (CMS) in a series of FAQs, there is no limit on the number of COVID-19 tests that an insurer or plan is required to cover for an individual, as long as each test is deemed medically appropriate and the individual has signs or symptoms of COVID-19 or has had known or suspected recent exposure to SARS-CoV-2. Federal guidance does not require coverage of routine tests that employers or other institutions may require for screening purposes as workplaces reopen.” (Reference: Kaiser Family Foundation: https://www.kff.org/coronavirus-covid-19/issue-brief/five-things-to-know-about-the-cost-of-covid-19-testing-and-treatment/).
The coverage of COVID-19-related expenses is a sickness benefit. As such, state Departments of Insurance (DOI) do not currently permit accident insurance carriers to cover this cost in an accident insurance plan. Just as student-athlete influenza (flu) vaccines and infection have not traditionally been permitted to be covered by each state’s DOI, COVID-19 testing and treatment is not at this time permitted to be covered under accident policies.
While the FFCRA and subsequent Coronavirus Aid, Relief, and Economic Security (CARES) Act have mandated no cost sharing for testing, neither addressed cost sharing for treatment. The current recognized treatment protocols for COVID-19 are considered Essential Health Benefits (EHBs) under the Affordable Care Act (ACA). As such, individual and small-group insurance plans must cover these treatments; however, these rules do not apply to all employer-based plans, particularly some large group and self-insured plans. The bottom line in this is two-fold: (1) the treatment of COVID-19 is not currently permitted to be covered under an accident policy, and (2) Institutions must be very careful in evaluating what out-of-pocket expenses may result from the treatment of COVID-19; in particular, reliance on student-athlete primary health insurance to cover these costs with minimal costs to NCAA institutions may not be accurate. Institutions must carefully assess the potential out-of-pocket expenses for the testing and treatment of COVID-19.
NCAA Guidelines & Best Practices related to COVID Testing
The NCAA released a series of “guidelines and best practices” through their NCAA COVID-19 Advisory Panel. These are core principles and guidelines on COVID-19 policies, procedures, and best practices. The principles and guidelines may be found here: http://www.ncaa.org/sport-science-institute/coronavirus-covid-19.