Important Information About Coronavirus-Related Benefits

Below is information about and links to important information about your benefits coverage related to the coronavirus.

Find out more about COVID home-testing coverage.

Read the Announcement

COVID-19 Over-the-Counter (OTC) Home Test Kits

Effective January 15, the Plan will cover up to eight OTC COVID-19 tests for each covered member of your family if the test is not ordered by a health care provider. This latest announcement explains the details and eligibility requirements

Coverage at a Pharmacy

Once COVID-19 vaccines are available from local retail pharmacies, the Plan will cover the vaccine under its Prescription Drug benefit. The Plan will cover 100% of the administrative costs for all COVID-19 vaccines administered at local retail pharmacies.

Coverage at a Doctor’s Office, Medical Facility, or Clinic

The Plan covers vaccines administered at a doctor’s office, medical facility, or clinic at 100% of administrative costs when received from in-network providers and 100% of reasonable administrative costs when received from out-of-network providers. The Plan’s payment of these administrative costs is covered under the Plan’s Wellness Benefit and is not subject to the Plan’s annual deductible.

COVID-19-Related SMMs and Forms

COVID-19 Home Test Kits 2/2022
7/2021 Summary of Material Modifications: Special 14 Day Weekly Income Benefit COVID 19 Quarantine Extended through 9/2021 and Virta Health Diabetes Management Program
Special 14 Day Weekly Income Benefit COVID-19 Quarantine Application Form
12/2020 Summary of Material Modifications: Special 14 Day Weekly Income Benefit COVID 19 Quarantine Extended through 5/2021
5/2020 Summary of Material Modifications: Special 14 Day Weekly Income Benefit COVID 19 Quarantine/Update on Diagnostic COVID 19
3/2020 Summary of Material Modifications: Diagnostic COVID 19 Testing/Telehealth Benefits