FAQ about Guardian’s Response to COVID-19

Our business continuity plans are active, and our workforce is working remotely to support our customers during this time of uncertainty. Claims can be submitted electronically, as we expect mail restrictions could cause delays.

As an AA+ rated* insurance company, our financial strength is solid. We were founded on and are managed to withstand times like these.

Our website and emails will keep you informed. Messaging is being reviewed and updated daily in response to evolving circumstances. The self-service capabilities of our website are being increased to offer even more support to you and your employees.

We recognize that small businesses have been especially impacted by the coronavirus crisis. To help support our small business customers, we are extending our comprehensive WorkLifeMatters Employee Assistance Program (EAP) to all our Guardian planholders with 500 employees or less, at no cost through July 31, 2020. Learn more here.

This response was updated 5/14/20:

As the impact of coronavirus disease 2019 (COVID-19) continues to unfold, large numbers of employees’ hours are being reduced. In response, Guardian has made changes to eligibility requirements in order to provide coverage under its group insurance products.

Layoff / Furlough

• For Group Dental, Vision, Life/AD&D, and/or Supplementary Health coverages – employees whose furlough or layoff began at any point between March 1, 2020 and June 30, 2020 will be considered benefit eligible for up to 12 months from the start of the furlough or layoff.
• For Short Term Disability – employees whose furlough or layoff began at any point between March 1, 2020 and March 31, 2020 will be considered benefit eligible until July 31, 2020.  Employees whose Furlough or layoff began between April 1, 2020 and June 30, 2020 will be considered benefit eligible for up to 90 days from the start of the furlough or layoff.
• For Long Term Disability – Guardian will follow any layoff / furlough provisions within the existing contract.

Reduction in Hours

• For Group Dental, Vision, Life/AD&D, and/or Supplementary Health coverages – employees whose reduction in hours began at any point between March 1, 2020 and June 30, 2020 will be considered benefit eligible for up to 12 months from the start of the reduced hour period.
• For Short and Long Term Disability – employees whose reduction in hours began at any point between March 1, 2020 and March 31, 2020 will be considered benefit eligible until July 31, 2020.  Employees whose reduction in hours began between April 1, 2020 and June 30, 2020 will be considered benefit eligible for up to 90 days from the start of the reduced hour period.

Please see the question regarding specific guidelines for more details.

These temporary accommodations apply as follows:

Layoff / Furlough - applies to Dental, Vision, Accident and Cancer, Critical Illness, Hospital Indemnity, Life, Short Term Disability, Accidental Death and Dismemberment, Optional Life, and Optional Accidental Death and Dismemberment products.

Reduction in hours - applies to Dental, Vision, Accident and Cancer, Critical Illness, Hospital Indemnity, Life, Short Term Disability, Long Term Disability, Accidental Death and Dismemberment, Optional Life, and Optional Accidental Death and Dismemberment products.

• The temporary accommodations can be selected at the product level for the company or at the employee contractual class level.
• Both fully insured and Administrative Services Only (ASO) arrangements are eligible for the extension.
• During the extension, premiums must be paid according to your regular billing cycle and extended grace periods, if any. In the event that a premium is not paid during the grace period, coverage will terminate retroactively to the last date of paid coverage, and no future dates of loss or dates of service will be covered or reimbursable.
• Life and Short Term Disability compensation-based volumes and premium amounts will be based on the pre-furlough and/or pre-reduced hour period for the applicable coverage.
• Long Term Disability premiums and benefits due will be at the reduced hour amounts for the period over which those lower hours are maintained.
• The accommodations will end on the earlier of a return to normal work hours and the period stated in our temporary accommodations.
• Normal underwriting rules, contractual provisions, and any applicable regulations will continue to apply.

If you choose to accept the temporary accommodation:

• Do not change an employee’s eligibility if they experience a reduction in hours, leave of absence, layoff, or furlough that would normally make them benefit ineligible.
• Communicate your intentions to your benefit administrator.
• Contact your Guardian Representative to address changes in employee hours worked for LTD.

If you don’t change the benefit eligibility status of your employees, we will assume that your plan has accepted Guardian’s temporary accommodation. 

If you choose not to accept the temporary accommodation:

• Follow the termination process you normally follow to change the eligibility of an employee who no longer meets the full-time hourly work requirement for eligibility on your group plan. We will remove the employee from coverage as of the effective date you provide. 
• Send portability, conversion, and COBRA notices as normally required when an employee loses coverage.

Click here to view our How-to video series for submitting employee eligibility updates in Guardian Anytime.

Premium amounts paid for each covered employee should remain the same during the extension unless changes outside the accommodation were made. All premiums (employer and employee paid) must be remitted by the employer according to your regular billing cycle and extended grace periods, if any. However, in the event premium is not paid during the grace period, coverage will terminate retroactively to the last date of paid coverage and no future dates of loss or dates of service will be covered or reimbursable.

For premium amounts related to reduction in hours for LTD, contact your Guardian Representative to ensure that premiums remain commensurate with LTD coverage.

For plans without specific contract language about rehire or reinstatement situations, Guardian will resume your prior coverage as of the date your business reopens and/or employee rehire date if:

• For Dental, Vision and Supplemental Health coverages:
  • The benefit plans, their underlying provisions and the rates remained the same for both the pre- and post-furlough periods.
• For Life and Disability coverages:
  • The benefit plans, their underlying provisions, the rates, and definitions for benefit eligibility (benefits classes and hours worked) remained the same for both the pre- and post-furlough periods.
    AND
  • The employee count, demographics (ages, genders, salaries), and participation are similar.

In addition:

• These employees will be grandfathered at their prior level of coverage (including dependent coverage) as of their rehire date if:
  • The parameters for coverages are met as listed above.
  • They’re furloughed anytime between March 1, 2020 and June 30, 2020 and are rehired within 6 months of their furlough date.
• These employees will not be subject to Evidence of Insurability for those coverage amounts.
• The original coverage effective date will be used to determine if a Pre-Existing Condition Limitation review is warranted, and for determining if eligibility and/or benefit waiting periods apply.
• Annual satisfaction of items such as deductibles and benefit limits will continue from the beginning of the calendar year as if coverage had not stopped.
• Guardian’s normal underwriting rules and contractual terms will continue to apply.

New employees who are hired after your business reopens will be subject to all regular new hire rules and limitations.

Click here to view our How-to video series for submitting employee eligibility updates in Guardian Anytime.

Employees will be grandfathered at their prior level of coverage (including dependent coverage) as of their rehire assuming:

• The employees experienced a drop in benefit eligible status due to a reduction in hours during the period of March 1, 2020 through June 30, 2020.
• The employees are returned to active, full-time, benefit eligible work status within 6 months of their loss of benefit eligibility.
• The plan has been in effect during this time.
• Premiums have been paid on remaining benefit eligible employees.
• Changes have not been made to the plan.

In addition:

• These employees will not be subject to Evidence of Insurability for those coverage amounts.
• The original coverage effective date will be used to determine if a Pre-Existing Condition Limitation review is warranted, and for determining if eligibility and/or benefit waiting periods apply.
• Annual satisfaction of items such as deductibles and benefit limits will continue from the beginning of the calendar year as if coverage had not stopped.
• Guardian’s normal underwriting rules and contractual terms will continue to apply.

The IRS recently released new guidance (IRS Notice 2020-29) permitting employers to allow their employees to make mid-year pre-tax election changes under a Section 125 Cafeteria Plan at any time for the remainder of 2020. These elections are limited to “qualified benefits”, which may include Guardian Dental and Vision products. We have also received a limited number of requests from clients to offer an off-cycle open enrollment period. These requests are reviewed by Underwriting on a case-by-case basis.

No.  The state has indicated that employees who have been furloughed or laid off should apply for unemployment benefits. Individuals cannot receive both unemployment benefits and DBL/PFL benefits at the same time. However, if an eligible employee becomes disabled within 4 weeks of the date of separation of employment, the employee remains eligible for DBL benefits under the employer’s NY DBL policy.

The Outbreak Period is the period from March 1, 2020 until 60 days after the end of the national emergency or another date announced by DOL in a future notice.  

To the extent there are different outbreak period end dates for different parts of the country, DOL and Treasury will issue additional guidance.

Unknown at the present time. The end of the national emergency will be announced by DOL and Treasury in a future notice.

During the Outbreak Period, COBRA beneficiaries have extended time frames in which to make elections and to pay premium. So long as notice or premium payment is received as discussed below, COBRA coverage is retroactive to the date of the initial qualifying event or the date of the last paid premium.

COBRA provides a qualified beneficiary at least 60 days to elect COBRA continuation coverage.

Due to COVID-19, a qualified beneficiary experiencing a qualifying event during this time now has 60 days plus the Outbreak Period to make an initial COBRA election.

EXAMPLE 1:  Assume that the National Emergency ends on April 30, 2020, with the Outbreak Period ending on June 29, 2020.

Since the Outbreak Period is disregarded for purposes of determining the Individual’s COBRA election period, the last day of Individual ‘s COBRA election period is 60 days after June 29, 2020, which is August 28, 2020.  Premium is due 45 days from August 28, 2020 for the period from April 1^st through September 1^st.

The temporary extension serves as a stoppage of time for the standard requirements to make an election (60 days) or pay initial premium (45 days) following a qualifying event. So for qualified beneficiaries who have experienced a qualifying event prior to the Outbreak Period (or before March 1, 2020), those days leading up to the Outbreak Period will be counted towards the standard 60 days (election)/45 days (initial premium payment) allowable window of time when tolling commences again after the Outbreak Period ends.

EXAMPLE 2: Qualified beneficiary experiences qualifying event on February 19, 2020, 10 days before the Outbreak Period. Assume that the National Emergency ends on April 30, 2020, with the Outbreak Period ending on June 29, 2020.

Since the Outbreak Period is disregarded for purposes of determining the Individual’s COBRA election period, the last day of Individual ‘s COBRA election period is now 50 days after June 29, 2020, which is August 18, 2020, because 10 days have already accrued between the qualifying event and the Outbreak Period.  Premium is due 45 days from August 18, 2020.

Qualified beneficiaries must give notice within 60 days after certain secondary qualifying events such as divorce or a dependent ceasing to qualify as a dependent, to trigger COBRA. 

A qualified beneficiary who is determined to be disabled can qualify for a COBRA extension up to 29 months if notice of the disability is given within 60 days of the date of a social security determination of disability and before the end of the original 18 months of COBRA.

Due to COVID-19, a qualified beneficiary now has 60 days plus the Outbreak Period to provide notice of a secondary qualifying event or disability. See EXAMPLE 1 above.

Qualified beneficiaries experiencing a qualifying event prior to the Outbreak Period (March 1, 2020) will have the 60 days less the amount of days already tolled between the qualifying event date and the beginning of the Outbreak Period. See EXAMPLE 2 above.  

The initial COBRA premium is due 45 days after the date of the initial COBRA election. 

Due to COVID-19, a qualified beneficiary now has 60 days plus the Outbreak Period to make their initial COBRA election, therefore has 45 days after that election to submit their initial premium payment. If the COBRA election occurred before the Outbreak Period, the qualified beneficiary has the amount of days remaining of the 45 days less the days already tolled between the election date and the Outbreak Period (March 1, 2020).

All COBRA qualifying events that occur on or after March 1, 2020 are subject to the Outbreak Period extended time frames.

Qualified beneficiaries are responsible for COBRA premium payments. Payments must be made to the employer or to the employer’s COBRA administrator.

COVID-19 rules and guidance do not change how or where premiums are paid.

Yes.  Standard procedure is employers must allow COBRA premium to be paid in monthly installments.  Future premium is due monthly.

Due to COVID-19, COBRA beneficiaries may delay premium payment until the end of the Outbreak Period, plus a 30-day grace period. COBRA coverage cannot be terminated during this extended period. 

This premium delay applies to any COBRA beneficiary currently paying premium irrespective of the date of the COBRA election.

EXAMPLE 3:   Assume that the National Emergency ends on April 30, 2020, with the Outbreak Period ending on June 29, 2020.

A COBRA beneficiary made a timely February payment, but did not make a March payment or any subsequent payments during the Outbreak Period.  As of July 1, the beneficiary made no premium payments for March, April, May, or June. Does the beneficiary lose COBRA, and if so for which month(s)?

Since the Outbreak Period is disregarded for purposes of determining timely COBRA monthly premium payments, any payments made by 30 days after June 29, 2020 (which is July 29, 2020 – the end of the grace period), for March, April, May, and June 2020, are timely, and the beneficiary is entitled to COBRA.  

Note, the COBRA beneficiary is covered under the group plan during the Outbreak Period, even though some or all the premium payments may not be received until July 29, 2020.    The group plan must make retroactive payments for the period premium was eventually paid. 

Example 4:  Using the same facts as Example 3, by July 29, 2020, the COBRA beneficiary made a payment equal to two months’ premiums. For how long does the beneficiary have COBRA coverage?

The COBRA beneficiary is entitled to COBRA for March and April of 2020, the two months for which timely premium payments were made. The beneficiary is not entitled to COBRA coverage for any month after April 30, 2020.  

Benefits provided by the group plan that occurred on or before April 30, 2020 are covered under the terms of the plan. Benefits are not payable if incurred after April 30, 2020.

If a qualified beneficiary was terminated in error during the Outbreak Period, coverage will be reinstated.

Yes. If premium payment is not made, COBRA coverage terminates retroactive to the date of the last full premium payment, if any.

The employer bill will be reconciled for any premium credits due.

No. To date there is no parallel guidance from any of the states with respect to state continuation provisions.

The duration of the Outbreak Period.

Section 125 and HIPAA special enrollment periods apply to Guardian group dental and vision fully insured and self-insured products.

HIPAA requires a special enrollment period in certain circumstances.  These include:

• when an employee or dependent loses eligibility for coverage in which the employee or the employee’s dependents were previously enrolled. This includes like benefits provided by Medicaid and the Children’s Health Insurance Program (“CHIP”).
• when a person becomes a dependent of an eligible employee by birth, marriage, adoption, or placement for adoption.

In these circumstances, individuals must be allowed to enroll in the group plan if they are otherwise eligible and if enrollment is requested within 30 days of the occurrence of the event (or within 60 days, in the case of the special enrollment rights added under CHIP).

Under the HIPAA special enrollment period, coverage is made effective no later than the first day of the month following the special enrollment request.

In light of COVID-19, Guardian must disregard the 30- or 60- day time limit for the duration of the Outbreak Period and accept any special enrollment request.

Section 125 plans now allow employees to make the following mid-year elections during calendar year 2020:

• make a new election, if the employee initially declined to elect employer-sponsored dental or vision coverage.
• revoke an existing election and make a new election to enroll in different dental or vision coverage sponsored by the same employer on a prospective basis.
• revoke an existing election.

The employer may but is not required to allow these changes. Plan changes may be retroactive to January 1, 2020, but mid-year election changes are prospective only starting on or after May 12, 2020.

Until further notice, Guardian underwriting will evaluate employer group requests for prospective mid-year changes without a qualifying event and determine eligibility on a case by case only.

Until further notice, Guardian underwriting must review each employer request and determine eligibility on a case by case basis.

No. If an employer’s request to open a mid-year election is approved by Guardian underwriting, under HIPAA special enrollment provisions, these penalties are waived if the special enrollment election is made with the 30-day election period, as extended by the Outbreak Period.

Deadline to Make an Initial Claim. Group plans may impose a 12- or 24- month deadline for claimant to file a claim. Due to COVID-19, these deadlines are extended by the Outbreak Period.

Example 5:  On March 1, 2020, a member received treatment for a condition covered under the plan, but the claim was not submitted until April 1, 2021. The plan provisions require that claims be submitted within 365 days from the date the Individual received treatment.  Was the claim submitted timely?

Normally this claim must be submitted by February 28, 2021. Due to COVID-19, however, these deadlines are extended by the Outbreak Period. Therefore, the last day to submit the claim is 365 days after June 29, 2020, which is June 29, 2021.

Claims Appeals. Claimants normally have 180 days to appeal a denied claim.  Due to COVID-19, a claimant now has 60 days plus the Outbreak Period to appeal the denied claim.

Example 6: A claimant received a notice of a denied claim on January 28, 2020. The notice advised the claimant that there are 180 days in which to file an appeal. 

Normally this claim must be submitted by February 28, 2021. Due to COVID-19, however, these deadlines are extended by the Outbreak Period.  Therefore, the last day to submit an appeal is 148 days (180 – 32 days following January 28 to March 1) after June 29, 2020, which is November 24, 2020.

External Review. Guardian group dental and visions plans are not subject to federal external review

Group Claims areas have included these notices on dental and vision member EOBs as well as member adverse benefit determination and appeals notices.

Guardian offers many products and services to help protect employees’ health and financial well-being, as well as manage their absences. At a high level the benefits that could apply include:

• Hospital Indemnity – If a covered member is admitted to the hospital for COVID-19, a Hospital Indemnity benefit, if applicable, may be paid according to the terms of the contract.
• Short Term Disability (STD) – Employees covered by a Guardian Short Term Disability plan may be eligible for benefits if they are diagnosed with COVID-19 and are sick and unable to perform the major duties of their job. Eligibility may be determined based on medical documentation and additional information received by Guardian. Some Guardian contracts include a rider, which can provide benefits in a quarantine situation as ordered by a doctor. This rider is explained in more detail in this FAQ.
• Absence Management Services – Under the Families First Coronavirus Response Act (FFCRA), a new leave is available to employees of certain public employers and employees of private employers with fewer than 500 employees. The leave is for employees unable to work or telework due to a school or childcare closure for a minor child as a result of COVID-19. Guardian is able to administer this new, expanded leave reason available under the FFCRA for our current Guardian AbsenceEssentials® and Guardian AbsenceAdvantage® customers. Employees may also be eligible for leave under the Family Medical Leave Act (FMLA) which entitles the employee to unpaid leave when individuals or family members are ill as a result of COVID-19.
• NY and NJ Paid Family Leave and State Mandated Disability – NY and NJ recently released clarification that quarantined individuals are eligible for coverage. If an employer has a current NJ state-mandated temporary disability (TDB) or NY state-mandated disability benefits and paid family leave policy (DBL/PFL) with Guardian, Guardian is able to manage these claims in compliance with updated guidance from the states.
• Employee Assistance Program (EAP) Services – To help support our small business customers, we are extending our comprehensive WorkLifeMatters EAP through Integrated Behavioral Health (IBH) to all our Guardian planholders with 500 employees or less, at no cost through July 31, 2020. Learn more here. If you already have EAP services through Guardian, please check your email from IBH for helpful information and the latest program updates.

Employees quarantined due to COVID-19 may be eligible for benefits under one of Guardian’s Short Term Disability (STD) riders. After the quarantine period, if the employee is determined to be disabled due to COVID-19, benefits could be paid for the disability until the maximum period under the plan (excluding any weeks paid for the quarantine period).

Under the STD plan, employees may be eligible for benefits if they are diagnosed with COVID-19 and, as a result, are unable to perform the major duties of their job. Eligibility will be determined based on medical documentation.

The Quarantine Rider covers employees if they are placed under a doctor ordered quarantine and are unable to perform the major duties of their job. The employee must be suspected of carrying or having been exposed to an infectious and contagious disease as determined by the doctor who would then order the quarantine. The nature of quarantine and the definition to support it is determined by the Centers for Disease Control (CDC) or the U.S. Secretary of Health and Human Services.

The rider was included on all 2016 contract (DI 16) series for STD and is not available in Washington or New York.   

In order to be eligible for FML, an employee or family member the employee is caring for needs to have medical documentation that certifies the individual’s condition meets the definition of a serious health condition.

Under the Families First Coronavirus Response Act, a new paid leave is available for employees who are unable to work or telework due to a school or place of care closure for a minor child as a result of COVID-19 precautions.

Guardian will cover active virus testing under our Accident Wellness benefit as a routine exam for COVID-19 tests performed on or after 3/1/20. This benefit is not payable under the Wellness Benefit included with Critical Illness, Hospital Indemnity, and Cancer products.

In most cases, the Accident product doesn’t provide benefits for a sickness like COVID-19. However, benefits may be payable if the plan includes a hospital confinement sickness rider or a short-term disability rider that covers injuries and sickness benefits. The disability rider does not cover quarantine situations. Please read the details of policy/contract to determine if this benefit rider is included.

In most cases, the Critical Illness product doesn’t provide benefits for a sickness like COVID-19. However, benefits may be payable if the plan includes a hospital admission benefit rider. Please read the details of the policy/contract to determine if this benefit rider is included.

Yes. If a covered member is admitted to the hospital for any reason, a benefit may be paid, according to the terms of the contract. All plans pay for an initial hospital admission benefit, and many plans pay for a daily hospital confinement benefit (including Intensive Care Unit).  

Some plans may include benefits related to doctor office visits, diagnostic tests, prescription drug benefit, and urgent care and emergency room benefit. Please read the details of the policy/contract to determine if these benefit options are applicable.

In most cases, the Cancer product doesn’t provide benefits for a sickness like COVID-19. However, benefits may be payable if the plan includes an Intensive Care Unit rider. Please read the details of the policy/contract to determine if this benefit rider is included.

Yes. Guardian will administer FFCRA-eligible leaves for our current Guardian AbsenceEssentials® and Guardian AbsenceAdvantage® programs. This new leave applies to employees of certain public employers and employees of private employers with fewer than 500 employees who are unable to work or telework due to a school or childcare closure for a minor child as a result of COVID-19.

Guardian will review eligibility and proof provided to make the leave decision and will track the leave through both the paid and unpaid periods for the full 12-week timeframe. The employer is responsible for handling all aspects of benefit payments, including benefit calculations, during this time.

Yes. If an employer has a current NY Disability Benefit (DBL) and Paid Family Leave (PFL) policy with Guardian, all claims will be determined in compliance with updated guidance from the State.

For more information on the NY COVID Paid Leave Benefits, see New York Paid Family Leave COVID-19: Frequently Asked Questions.  

If an employer has a current NJ Temporary Disability Benefit (TDB) policy with Guardian, all claims will be determined in compliance with updated guidance from the State.

Guardian does not currently administer NJ Family Leave Insurance (FLI) benefits.

For more information on the NJ COVID Paid Leave Benefits, see NJDOL Benefits and the Coronavirus (COVID-19): What Employees Should Know.

The interplay between the federal and state legislation can be complicated and the resulting combination of leave and benefits available to any particular employee depends on a variety of factors including employer size, employee salary, employee work hours, and eligibility for and prior use of New York DBL and PFL benefits.

After the Federal Act (FFCRA) went into effect on 4/1/20, employees are only eligible for the NY COVID-19 Paid Sick Leave and DBL/PFL to the extent that their benefit entitlement under the NY COVID-19 Paid Sick Leave law  exceeded the benefits that were paid under FCCRA. 

The following situations would be examples of this:

• If the employee works for an employer who has over 500 employees, the employee would not be eligible for the Federal benefits.
• If the employee has worked for the employer for less than 30 days, the employee would not be eligible for the Federal benefits.
• The employee earns more than $2,555 per week (or $132,860 annually). This is due to the $511 per day maximum under the FFCRA. For example, an individual who earns $145,600 per year (or $2,800 per week), would receive full pay from their employer from both programs as follows:
  • $2,555 under FFCRA Sick leave
  • $245 under NY Sick leave

The NY COVID-19 Paid Sick Leave would only be applicable to NY covered employees under the employer’s existing NY DBL/PFL policy. Out of State employees would not be recognized as being in NY covered employment by the NY Workers’ Compensation Board (WCB); and thereby, would not be eligible to the benefit entitlements under NY Worker’s Compensation law.

While we cannot waive the need for medical certification, we recognize the current and anticipated strains on providers and are adapting our processes to collect information verbally and electronically wherever possible.

To help ensure quick processing of claims, we highly recommend employees submit claims online at guardiananytime.com. 

For disability claims, employees can enroll in our direct pay program when they submit their claims online. By submitting claims online, an employee can set up their bank account to have disability payments deposited directly.

In addition, we’re leveraging our Medical Specialist to gather medical documentation over the phone to assist with the disability claim management process. We continue to evaluate the evolving environment to adapt as needed.

Davis, Guardian, and VSP Vision claims have protocols in place to prevent any disruption in service, including alternate work locations and remote work for their employees. Since most claims are completed electronically, we can continue supporting you and your employees as usual.

Telemedicine services are health care services delivered through the use of electronic technology or media, including interactive audio or video, for the purpose of diagnosing or treating a patient, providing remote patient monitoring services, or consulting with other health care providers regarding a patient's diagnosis or treatment.

To help our customers move toward more electronic interactions in response to COVID-19, we’ve made temporary changes to our telemedicine claim practices.

For our Accident product, we’re making temporary changes to our telemedicine claim practices. In response to COVID-19, we will approve telemedicine services associated with our Accident product through December 31, 2020 when used by our members for initial doctor visits or follow up visits. We’ll reassess the current situation and determine future direction on December 31. Members will need to provide documentation of the visit which can include a copy of their medical EOB, bill or treatment notes from that date.

For our Dental product, we offer a Guardian teledentistry service for our PPO members. They can access it at www.virtudent.com/guardianteledentistry

For our Disability products, we will evaluate the medical documentation that is available, whether through telemedicine or another provider.  Each claim and medical information provided is evaluated on its own merits to ensure there is sufficient documentation to assess the disability. We will work with our customers and/or their treating providers as needed and appropriate to clarify medical information and ensure we are positioned to make accurate decisions aligned with the policy.

There are several options to pay your company’s premium electronically:

• Pay online at guardiananytime.com.
• Set up or change a recurring draft from your bank account.
• Pay with a wire transfer.

If a group has concern with an upcoming draft, contact us to request a stop on the draft. A stop can be processed if the payment has not been released to the bank.

Guardian understands the challenges that employers are experiencing since the start of COVID. We have revised our policies where we can, to make it easier on our customers.

As the coronavirus evolves, grace period extensions are beginning to expire. Please review and submit any premium due. If you are still experiencing hardships caused by the pandemic and need more time to pay, please let us know. Our systems will continue to send payment notices. These will reflect the original grace period of your contract and any outstanding balances. The due date and grace period date on payment notices do not reflect extensions due to the pandemic. Please follow https://www.guardianlife.com/coronavirus for up-to-the-minute details.

Unless otherwise mandated by your state, if premium is not paid by the end of the grace period, coverage will terminate retroactively to the last date of paid coverage and no future claims will be covered or reimbursable.

We will retain rates (no rate change) on all renewals for May 1, 2020 through August 31, 2020 plan anniversary dates. The next renewal rate review will be set to the plan anniversary month/day in 2021.

For example, if the original renewal anniversary date was August 1, 2020, you will continue your current rates as of that date, and your next renewal anniversary will be August 1, 2021.

We will defer planned anniversary renewals scheduled between May 1, 2020 and August 31, 2020 for three months from the original renewal anniversary date. For example, a renewal planned to be effective May 1, 2020 will now be deferred to be effective on August 1, 2020.

After this period of deferrals, your original renewal anniversary date will apply for any 2021 and forward renewals.

If your renewal for a May 1, 2020 through August 31, 2020 anniversary date has already been released/discussed, we will apply the policy mentioned above to those renewals as well for both the <500 and 500+ employer segments.

Yes, planholders are encouraged to contact us with any questions or to discuss these changes and proper business planning. For our 500+ cases, the discussions will reflect the same focus on your company’s needs and the underlying benefit performance to assure your benefit programs are built for the long term.

Yes, normal underwriting rules, contractual provisions and applicable regulations will continue to apply.

There is no change in coverage provided, however, dental and vision providers and vision retailers are beginning to reschedule appointments and/or limiting hours. The Centers for Disease Control (CDC) is recommending that routine dental and eyecare visits be postponed for a few weeks. It is recommended that those who can defer their eyecare visits do so at this time.

The American Dental Association has recommended postponing elective procedures that are not emergency related. Some states have passed regulations mandating the postponement of those services, so we encourage you to connect with your provider for additional information.

We provide a teledentistry option for our PPO members who need urgent dental care. They can simply visit www.virtudent.com/guardianteledentistry to schedule an appointment. Standard plan limitations and exclusions apply

Providers and retailers are still fulfilling orders, but their hours should be checked before visiting since many have revised schedules at this time.

If you have VSP and Davis coverages, your employees have in-network online eyewear options available: 

• VSP:
  • Eyeconic.com
• Davis:
  • 1800contacts.com
  • Glasses.com
  • Visionworks.com
  • Befitting.com