Please contact your Geisinger Health Plan Account Executive or AE Service Specialist

Yes. Through May 11, 2023, Geisinger Health Plan is relaxing its requirement that employees be actively working to be eligible for coverage and will allow you to continue coverage for laid-off employees.

Please note this is subject to all monthly premiums being paid and coverage offered on a uniform, non-discriminatory basis. You may not choose only certain people for whom you continue coverage and pay premium.

If at least one person remains employed by the company and covered by the plan (e.g., the owner or a management employee), the company can continue to cover laid-off employees through May 11, 2023, if premium is paid.

Please note that you must offer this coverage on a uniform, non-discriminatory basis. In other words, you may not choose only certain people for whom you continue coverage and pay premium.

Coverage will terminate on the last day of the last month for which we received premium payment unless otherwise noted on the Geisinger Health Plan Change Form. The employer’s request should indicate the last day of coverage.

An employee returning from layoff or leave is eligible to enroll if they were covered by the Plan before their departure and they meet eligibility criteria. When the new application is submitted, write “recalled from layoff” across the top. The effective date will be the day they return to work.

If your group is subject to COBRA and one person remains actively employed, employees may elect to continue coverage under COBRA under the normal notice and election procedure. If the plan has no active employees, the plan is terminated and COBRA is not an option. In that case, employees losing coverage would have a special enrollment period to enroll in individual or other coverage (for example, through a spouse).

If your group is subject to COBRA and one person remains actively employed, employees may elect to continue coverage under COBRA under the normal notice and election procedure. If GHP is your stop loss carrier, GHP will not limit the number of COBRA participants under the stop loss policy through May 11, 2023.  

If GHP is not your stop loss carrier, check with your stop loss carrier about any rules it may have regarding minimum enrollment of active employees for stop loss coverage. If the plan has no active employees, the plan is terminated and COBRA is not an option. In that case, employees would have a special enrollment period to enroll in individual or other coverage (for example, through a spouse). 

Through May 11, 2023, if the loss of enrollment is a result of the COVID-19 pandemic, rates and premiums will not be adjusted due to enrollment change. 

QHDHPs will not lose that status merely because they cover the cost of testing for or treatment of COVID-19 before plan deductibles have been met. The IRS notice 2020-15 also noted that, as in the past, any vaccination costs continue to count as preventive care and can be paid for by a QHDHP.

Geisinger Health Plan can offer ACA-compliant Individual plans for those who have been laid off and lost employer-sponsored coverage, and those individuals may be able to benefit from premium subsidies (Advanced Premium Tax Credits). Those interested in an Individual plan should contact 800-918-5154 to speak with a Geisinger Health Plan Individual Sales Center Associate. Our associates can help consumers determine whether they qualify for premium subsidies to help reduce their monthly premium and, when applicable, can also refer individuals with qualifying income to be evaluated for Medicaid eligibility.

If you have furloughed employees/members that are 65 years of age or older, please have them call Geisinger Gold at 877-821-5056 to review their options into one of our Medicare Advantage plans. We offer all-in-one $0 deductible health plans that include prescription drugs, as well as optional supplemental benefits such as dental, vision, hearing, and even gym memberships all with monthly premiums as low as $0. We encourage them to call as soon as possible to review their eligibility.

For plans sold on the Federally Facilitated Marketplace (FFM), the FFM will determine the earliest allowable effective date, which may be the first day of the following month. For plans sold off the marketplace, accelerated effective dates may be available. Individuals interested in an individual plan should contact 800-918-5154 to speak with a Geisinger Health Plan Individual Sales Center Associate.

Please note that premium subsidies may be available for plans purchased on the FFM. Premium subsidies are not available for off-exchange plans. 

We are allowing early refills for 30 or 90-day prescriptions at retail pharmacies. Members are encouraged to ask about and use home delivery when available for their prescriptions.

We are also allowing early refills on 90-day prescriptions from our mail order pharmacy, which delivers directly to the member’s home at no extra cost. Early refills are available for controlled substances but will not apply for prescriptions that contain opioids outside of certain conditions.