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Physicians Testing Positive for Coronavirus

Disability coverage for physician who test positive for coronavirus is available through our Association Group Long Term Disability insurance contract with MGIS/Sun Life.

We are acutely aware that all of our Wisconsin Physicians involved with direct patient care are at risk of testing positive for COVID-19. At a time when the coronavirus is causing concern for all of us, a physician’s ability to provide for their families if they could not practice because of testing positive should be the last of their worries.

So, this is to let you know that we have a special Group Long Term Disability contract for Physicians. It is the strongest in the nation with one of the strongest insurers in the market.

There is more good news for you: if you currently are not insured with Sun Life, consider switching. Because of our negotiated association contract, we may be able to provide you a lower insurance premium.

And, of course, unlike any other Agency, our profits go directly to the Wisconsin Medical Society and are put to work for you.

The following documents from insurance carriers provide greater detail about disability coverage eligibility.

To learn more, please contact Chris Noffke or Dave Serena.

Chris Noffke GBDS                                         Dave Serena
Director of Group Benefits                          Group Disability Specialist
WisMed Assure                                           WisMed Assure
(608) 442-3734                                            (414) 238-6105
chris.noffke@wismedassure.org                dave.serena@wismedassure.org

NOTE: We also work with the “Big 5” Personal Disability Insurers (Standard, Principal, Berkshire/Guardian, Ameritas, and Mass Mutual) and have asked them if their “personal” disability policies would pay benefits.  So far, we have heard different responses from “testing positive” by itself would not be covered to responses using terms like “may” and “probably”.

What’s Next for Physicians, Clinicians and Health Systems? the Coronavirus and Your Insurance.

Healthcare Insurance

Most if not all insurance companies are waving first-dollar (co-pay, deductibles, co-insurance) for diagnostic testing. Other costs will likely apply depending upon your plan and needs. We will update you if any significant changes occur.

Short-Term Disability

If you are sick and unable to work for more than the number of days specified in your policy (typical terms are 0,1,7,14 or 30 days), a Short-Term Disability claim will be approved and paid. But, if you are quarantined for more than the number of days stipulated in your policy – quarantine typically lasts two weeks – but do not contract the virus, your Short-Term Disability insurance would not pay.

Long-Term Disability

The important number here is, like Short-Term Disability, the number of days specified in your policy (the shortest is 30 days but it can be 60, 90 or more). If you contract the virus and are unable to work for longer than the number of days stipulated in your policy, you will most likely be eligible for compensation.

Workers Comp

Filing a workers compensation claim if you are unable to work because of Coronavirus quarantine or actual illness is tricky. You would have to be able to prove you actually contracted the virus at your place of work. Since it is similar to a flu, insurance companies are likely to treat it as such and your claim would most likely not be approved.

Business Interruption Insurance

Business interruption insurance is designed to replace income that is lost due to an event that causes business to be halted or interrupted due to damage to the business physical property, such as a fire or hurricane or other natural disaster.  Policies differ but most specify what kind of event would trigger coverage.  Additionally, most policies have coverage for when a civil order prevents access to the property.  Many policies “contingent business income coverage” if business cannot continue due to a loss experienced by a third party, such as a critical supplier.  None of these triggers or policy coverage language specifically address an event like we are experiencing now with COVID-19.  Ultimately, coverage will depend on how the facts are applied to the policy language.  

What’s Next?

What’s next indeed! We know physicians, clinicians and health systems are on the frontlines in this battle. That’s why we are doing everything we can to make sure we are here for you. We are actively monitoring our teams’ health and updating plans to provide best service possible if they can’t come into work.  All of our staff has the ability to work from home.

We are also actively monitoring coverage policies and watching for any changes from our insurance company partners.

Warm regards,

Shawna Bertalot, CIC, ACI,

President


To address any questions or concerns, please contact Christopher A. Noffke, GBDS

Director of Group Benefits.

608.442.3734 direct

Chris.Noffke@wismedassure.org

PS: The Johns Hopkins Coronavirus Resource Center hosts a website dynamically tracking cases around the world. Despite the increase in cases worldwide, a visit to the site shows how China was able to relatively quickly “flatten the curve” by enacting public health and safety measures. I think this is a very good indication of how quickly we will be able to eliminate this threat.

Networks and Carriers – Making a Move

By Chris Noffke, GBDS

If you’ve been renewing your insurance policy year after year without researching your options, it’s time to switch strategies because you may be missing new opportunities!

Insurance carriers and networks are changing significantly in Wisconsin, and we can help you find the best option.

WEA Trust – Health Traditions

WEA Trust is expanding its footprint in the state of Wisconsin. The Trust recently purchased the Health Traditions company and network and will now be able to sell a Mayo option in the La Crosse and Eau Claire areas as well as to private sector employers.

United Health Care

Another new option in this region is United Health Care (UHC), which has released a level-funded plan with up to 15 months rate guarantee. Prior to January 1, 2018, UHC had a non-compete with Medica, which made this area a near sales-free zone for one of the largest health insurance providers in Wisconsin.

Level-funded plans can work well for low utilizing or low health care cost groups with 10 or more people on their plan. Additionally, UHC returns up to two-thirds of unused claims dollars, so a group could potentially receive money back at the end of the contract period.

In addition, UHC’s dental and vision rates offer inexpensive options for group benefits portfolios.

Robin

Is it a bird or do we have another network in Wisconsin? At the end of 2017, ThedaCare, Bellin and HealthPartners announced that they would be joining to form a new network (along with some other systems), which has started providing insurance rates and quotes.

The Alliance

The Alliance – a local Wisconsin not-for-profit – is expanding its network statewide and plans to develop a national network option. The changes in The Alliance network include adding health systems like Agnesian, Affinity, Gunderson and many more, which will benefit Western Wisconsin, Marathon County and surrounding areas, Fox Valley and even the Milwaukee area.

This will make the Wisconsin Medical Society Association Health Plan an even more competitive product. Members of our Association Health Plan receive concierge-type networking negotiation from the Alliance.

Several of these changes may create a more competitive market with increased plan options. Wisconsin Medical Society Insurance works exclusively with health care professionals so we better understand your needs and can offer solutions specifically designed for you. And profits generated by Wisconsin Medical Society Insurance go back to the Society to support its mission of advancing the health of the people of Wisconsin.

Contact us today at insurance@wismedassure.org or call 866.442.3810 for more information.

The views and opinions expressed in this blog are solely those of the author and do not necessarily represent the views of the Wisconsin Medical Society, Wisconsin Medial Society Holdings Corporation or its subsidiaries. Nothing in this blog should be construed as legal, financial or clinical advice.Categories:Employee BenefitsHealth InsuranceInsurance Basics

Christopher Noffke, GBDS, Insurance Advisor

Christopher has over 10 years of experience in group insurance sales and retention, including six years on the health insurance carrier side. A graduate of the University of Nebraska, Chris has completed the National Association of Health Underwriters Voluntary/Worksite Certification and holds a Group Benefit Disability Specialist (GBDS) designation.