Employee Assistance Programs in Times of Need

The COVID-19 pandemic has brought mental health to the forefront for many people, as they tried to cope with abrupt changes to their work and social lives, isolation, fear of getting sick and losing loved ones to the disease.

Even now, as the pandemic ebbs, the mental health crisis has not. A recent National Safety Council survey of 1,600 employers and 7,000-plus workers found that half of large employers saw an increase in mental health or impairment-related absences and incidents. Meanwhile, mental health has become American’s biggest health concern, overtaking COVID-19, according to a study by Ipsos.

The number of Americans who said COVID was one of the biggest health concerns in the U.S. dropped from 68% in 2021 to 43% in 2022. Meanwhile, more Americans rated mental health as one of their top health concerns, rising from 35% in 2021 to 51% over the same time frame.

Fortunately, employers can step up their efforts to help employees dealing with mental health issues by offering an employee assistance program (EAP). Many employers already have. According to the NSC study, 25% of organizations with an employee assistance program implemented that program during the pandemic, while 66% expanded their offerings.

If you do not already have an EAP, you may want to learn more about them as it can be crucial to helping struggling workers.

What’s an EAP?

An EAP is an intervention program designed to help employees resolve personal problems that might be affecting their work performance. Many employers make EAP services available to employees’ family members, as well.

These programs can help cover the costs of counseling services that employees seek out. An EAP provides outside counselors, resources, and referrals to assist employees and their family members. Any EAP benefit received by employees or family members remain confidential. Employers do not get to know who is utilizing the service, what the reasons are for, or how often employees call.

Typical services include:

A study by the University of Warwick in the U.K. found that satisfied workers are 12% more productive and provide better customer service than their less happy peers. The study found that employers who implement EAPs experience:

EAPs also help managers to become more effective. They can help them develop skills in consulting with employees, managing workplace stress, maintaining drug-free workplaces, responding to crises, and helping employees achieve an appropriate work-life balance.

EAP options

Employers have several options for establishing EAPs.

They can run them with their own staff or outsource them to third party providers. Providers can be hired on a fee-for-service basis or for a fixed fee.

They can be arranged by single employers, groups of small employers banding together, or by unions. Some employers or unions even train employees to provide peer counseling to their fellow workers.

EAP providers should meet the standards set by the Employee Assistance Professionals Association. These include standards for program design; management and administration; confidentiality; direct services; drug-free workplace and substance-abuse professional services; partnerships; and evaluation of the program.

The takeaway

Besides COVID-19, employees are subject to the stresses of day-to-day living, sudden illnesses or deaths of loved ones, natural catastrophes and work. Family members can develop substance-abuse problems, parents grow old and need care; unexpected financial shocks occur; and marriages often deteriorate.

By implementing an EAP, an employer can help make these problems, and the shock of a natural disaster, a little easier for their employees to manage.

EAPs can help retain good employees, make them more productive, and make their lives a little better. In turn, this can make a business more profitable and a better place to work.

How Your Employees Can Get Free COVID Test Kits

While COVID-19 cases start rising again, more people are once again likely to contract the coronavirus — and that usually involves getting tested. But for employees in your group health plan, they have many options for obtaining a test with no out-of-pocket costs.

Under an executive order issued by President Biden, employees in a group health plan are eligible to receive COVID-19 at-home test kits with no cost-sharing, copay, coinsurance or deductible. Additionally, most health plans are also covering tests performed at hospitals, clinics and pharmacies.

While we told you about these new rules a few months ago, it’s likely that a good many of your employees don’t know about it. With that in mind, you may want to disseminate information to them about how they can be reimbursed by their insurer for COVID-19 tests they purchase.

Here’s what your employees need to know:

Steps for reimbursement

Procedures will vary from insurer to insurer, but the order requires that health insurance carriers reimburse members for up to eight tests a month and no doctor’s order, prior authorization or prescription is required. This applies to any tests they purchased on or after Jan. 15, 2022.

Most health plans have preferred pharmacies that they urge their enrollees to go to for their take-home COVID-19 tests. In these instances, the plans will typically cover the cost at the point of sale so that the health plan member doesn’t have to pay out of pocket.

Covering costs upfront eliminates the need for members to submit reimbursement forms.

However, if they go to a non-network pharmacy or drugstore or purchase a kit online, the health insurer is still required to reimburse them for a test up to $12 (or the cost of the test if it’s less than that).

In these cases, the employee will have to pay for the test upfront and then seek reimbursement from their health insurer.

You can contact your health insurer for information and resources for how your staff can receive reimbursement. Most insurers have published materials to make it easier for your workers to access COVID-19 tests with no cost to them.

Typically, to be reimbursed for at-home test kits, members must submit the reimbursement form and a receipt that shows proof of purchase, which should include the name of the retailer, including the street address, or, if bought online, the website address; date of purchase; UPC code for the at-home test kit; and the cost of the kit.

The order that health plans cover these tests with no out-of-pocket costs for their enrollees will sunset when the federal public health emergency is declared over.

On-site tests

Health plans are also covering the cost of tests that are administered at pharmacies or in hospital settings after either a doctor ordered a test or if the person was exposed to someone who had COVID-19.

Like at-home tests, insurers will cover the costs of these tests regardless of if they are received in-network or from an out-of-network provider or pharmacy.

The types of COVID-19 tests health insurers currently cover are:

Individual testing with or without symptoms,
Testing ordered by a health care provider,
Testing for contact tracing, known or suspected exposure, and
Testing before or after travel (COVID-19 screening tests for domestic travel are usually covered by most plans, but enrollees should not expect their plan to cover any testing they do abroad).

After the public health emergency ends, however, it’s likely most insurers will stop covering tests obtained out of network.

What You Need to Know About COVID Test Kit Rules for Group Health Plans

Starting Jan. 15, the nation’s health insurers have been required to cover the cost of up to eight at-home rapid COVID-19 tests per month for their health plan enrollees.

Insurers are taking different approaches to the mandate and, as an employer, you should communicate with your covered staff about this new benefit, how it works and other advice.

According to frequently asked questions posted by the Department of Labor, coverage for over-the-counter test kits must be covered by insurers without cost-sharing and without a doctor’s order or prescription. It laid out a series of rules insurers and health plans must follow. They:

May require enrollees to submit reimbursement claims for OTC COVID-19 tests (the agency, however, “strongly encourages” plans to reimburse pharmacies directly instead).
Must reimburse plan enrollees for tests they purchase outside of their preferred network up to $12 per test if they also offer coverage for OTC tests through a pharmacy network. Health plans are authorized to provide a more generous reimbursement from tests purchased through a non-preferred provider.
Can limit the number of OTC tests covered without cost-sharing, as long as they cover eight per month per enrollee with no cost-sharing. That means a family of three on a family plan can be reimbursed for up to 24 tests per month.
Cannot limit the number of covered tests if they are ordered by a doctor after a clinical assessment.
Can require enrollees to attest that OTC tests they are reimbursed for are for personal use and not for work, that they are not being reimbursed for the tests by other sources and that they won’t resell the tests.
Can require that enrollees provide receipts as proof of purchase.

Action items

Check that it has pharmacy and retailer networks in place where covered individuals can obtain the OTC tests.
Check if it has a direct-to-consumer shipping program for kits.
Check if it has systems in place to handle claims and for reimbursing either participants or participating pharmacies that have point-of-sale test kits available.
Ask the insurer whether it has any purchase or reimbursement limits if tests are purchased at a non-network pharmacy or retailer.

Once you have those details in hand, hold a meeting with your staff covering the following:

An explanation of the new benefit and how their insurer will reimburse or pay for the kits.
Go over the claims and reimbursement process if they pay out of pocket at a non-participating pharmacy.
Provide a list of network pharmacies and retailers that will offer point-of-sale test kits that the insurer pays for direct. Also provide information on any direct-to-consumer purchase options.
Tell them about any reimbursement limits if they purchase from non-preferred pharmacies, or other limits (like the eight tests per month limit).
Advise your staff to keep receipts for any at-home test kits they have purchased since Jan. 15. They should also save the boxes the test kits come in as some plans may require them as proof of purchase.

Long-Haul COVID Can Be Covered Under ADA

The Equal Employment Opportunity Commission has issued guidance stating that employees suffering from “long COVID-19” may be protected under workplace disability discrimination statutes.

The guidance states that someone suffering from impairments resulting from long-haul COVID-19 symptoms can be considered “disabled” under the Americans with Disabilities Act and entitled to the same treatment as other disabled workers. But not in every case.

The EEOC emphasized that long-haul COVID symptoms can vary greatly from person to person and that eligibility would have to be determined on a case-by-case basis.

Employers should read the guidance, posted on the EEOC’s website on Dec. 14, to ensure they stay on the right side of the law if they are confronted with a worker who is battling COVID-19 symptoms for more than a few weeks and they ask for special accommodation under the ADA.

According to the guidance, a person infected with COVID-19 who is asymptomatic “or who has mild symptoms similar to those of the common cold or flu that resolve in a matter of weeks — with no other consequences — will not have an actual disability within the meaning of the ADA.”

But for those who have COVID-19 symptoms lasting more than a few weeks, and depending on their specific symptoms, a worker may have a “disability” if the illness is affecting them in any of the following ways:

Physical or mental impairment — The EEOC states that COVID-19 is a physiological condition affecting one or more body systems, which would be considered a disability under the ADA.

Substantially limiting a major life activity — “Major life activities” include both major bodily functions, such as respiratory, lung or heart function, and major activities, such as walking or concentrating. COVID-19 has been known to cause these issues. An impairment need only substantially limit one major bodily function or other major life activity to be substantially limiting.

Examples of COVID-19 cases that may be considered a disability under the ADA include:

An employee who experiences ongoing but intermittent multiple-day headaches, dizziness, brain fog and difficulty remembering or concentrating, which their doctor attributes to the coronavirus.
Someone who received supplemental oxygen for breathing difficulties during initial stages of treatment and continues to have shortness of breath, associated fatigue and other virus-related effects that last for several months.
Someone with heart palpitations, chest pain, shortness of breath and related effects due to the virus that last for several months.

What to do

As a result of this guidance, an employee experiencing long-haul COVID with symptoms that could be considered a disability may ask for reasonable accommodation for work. To determine if the employee is eligible, the employer and the employee must enter into an interactive process.

The employer can ask the worker to provide backup documentation about their disability or need for reasonable accommodation, such as notes from doctors outlining restrictions. The employer can also request that the employee sign a limited release allowing the employer to contact the employee’s health care provider directly.

If the worker doesn’t cooperate in providing the information, the employer can deny the accommodation request.

Pandemic Fallout: Employers Boost Mental Health, Substance Abuse Benefits

The COVID-19 pandemic has had profound effects on health insurance in the U.S., with many employers improving mental health and other benefits to help their workers during this trying period, according to a new report by the Kaiser Family Foundation.

Despite the disruptions caused by the pandemic, the proportion of employers that offer their staff health coverage has remained steady, while health insurance premiums and out-of-pocket expense increases have remained moderate, according to KFF’s “2021 Employer Health Benefits Survey.”

With the stress of the pandemic weighing on workers in all industries, as well as the effects on their families and society from lockdowns and other changes brought on by COVID-19, many Americans have been struggling with mental health as well as substance abuse.

Provisional data from the Centers for Disease Control’s National Center for Health Statistics indicate that there were an estimated 100,306 drug overdose deaths in the United States during the 12-month period ending in April 2021, an increase of 28.5% from the 78,056 deaths during the same period the year before.

Besides drugs, alcohol abuse has also skyrocketed during the pandemic, according to the CDC.

Another report by the CDC found that 40% of U.S. adults had reported struggling with mental health or substance abuse:

31% reported symptoms of anxiety and/or depression.
26% reported symptoms of trauma/stressor-related disorder.
13% started or increased substance abuse.
11% reported seriously considering suicide.

It’s no surprise then that since the pandemic started, 39% of employers surveyed said they’d boosted their benefits covering these issues.

Of those that made changes:

31% increased the ways employees can access mental health services, such as telemedicine.
58% of employers with 200 or more employees and 38% of those with 50 to 199 employees expanded online counseling services.
16% started offering employee assistance programs or other new resources for mental health.
6% expanded access to in-network mental health providers.
4% reduced cost-sharing for such visits.
3% increased coverage for out-of-network services.

How did employers act? For example, after the pandemic hit, Rhode Island-based Thundermist Health Center’s employee health plan reduced the copayments for behavioral health visits to zero from $30.

As to employees, they responded by taking advantage of the new and expanded services:

38% of large companies (1,000 or more workers) said their workers had used more mental health services in 2021 than the year before.
12% of companies with at least 50 employees said their workers had increased their use of mental health services.

What you can do

With so many people suffering from mental health and substance abuse issues that may have been exacerbated by or are a direct result of the pandemic, it’s certain that most employers have staff who are struggling.

Talk to us about what your current plan choices offer in terms of substance abuse and mental health counseling benefits. Many insurers, in response to rising demand, have been increasing access to these treatments.

If you do not have one, you may also consider an employee assistance program, which will provide a set amount of counseling appointments as well as substance abuse treatment to complement your health plan.

Dealing with COVID Vaccination Status Friction Points with Employees

The controversy over COVID-19 vaccine mandates in the workplace continues growing and human resources are sounding the alarm on how employers should approach the matter.

While the Equal Employment Opportunity Commission and impending OSHA regulations will provide some cover to employers who want their employees to get vaccinated, they need to make sure that they follow certain steps in dealing with those who refuse to have a jab, won’t say if they are vaccinated or are claiming a religious or medical exemption from getting inoculated.

The California employment law firm of Shaw Law Group LLC. recently held a webinar on a number of friction points that could get employers in hot water. Here are some tips to avoid getting sued:

If you require your staff to disclose their vaccination status, treat those who refuse to divulge their status as unvaccinated. There is no point in continuing to hound someone about giving the information if they don’t want to. Just assume they are unvaccinated for the purposes of your office rules.
If you have set rules requiring your workers to be vaccinated, do not automatically put someone who won’t get vaccinated on a leave of absence if that is your policy. Instead, treat it like an Americans with Disabilities Act request and enter into a meaningful discussion if they request accommodation.
During this time, you have to consider alternative accommodations, such as requiring them to always wear a mask at work and submit to weekly testing.
If you are going to accommodate workers who don’t get vaccinated, you as the employer are obligated to cover the costs of such accommodations (like those in the above bullet point). That also applies to employees who refused to get vaccinated on religious or medical grounds.
Have a process in place for handling requests for accommodations. A request for religious accommodation can put the employer in a quandary since they don’t want to require proof of what part of the person’s religion requires them not to get vaccinated. Shaw Law Group warns: “And, do not question the sincerity of an employee’s stated religious belief, unless you have an ‘objective’ reason to do so.”
There are no laws or regulations requiring employers to provide a “reasonable accommodation” for political, social or secular personal beliefs that may affect why an employee refuses to get vaccinated.
If you have an employee who refuses to participate in the accommodation process and provide documentation backing up their religious or medical exemption request, deny the request.

HIPAA Privacy Rule considerations

Meanwhile, the Department of Health and Human Services’ Office for Civil Rights has issued guidance regarding how the HIPAA Privacy Rule affects employees’ disclosures of their COVID-19 vaccination status.

Employers can require employees to disclose whether they have received the COVID-19 vaccine, according to the guidance. That includes requiring them to disclose their status to a client or another third party like a vendor.

Why is this? HIPAA’s Privacy Rule does not regulate the health information an employer can request from its employees as part of the terms and conditions of employment.

Employers who require staff to provide proof of vaccination status are required to keep all documentation or confirmation of vaccination status confidential, under this rule. Any such documentation must not be stored in the employees’ personnel files and must be kept separately.

Finally, your employees are free to disclose their vaccination status to other employees, customers, vendors or trade partners, as the Privacy Rule does not apply to such circumstances.

The takeaway

As more Americans get vaccinated, there is also a significant portion of them that will continue refusing to get inoculated for a number of reasons.

To avoid being sued for overstepping your authority as an employer, if you are requiring vaccinations, make sure you put in place procedures for handling requests for religious or medical accommodation.

You’ll also need to decide how to handle employees who won’t divulge their vaccination status or are refusing vaccination on grounds other than religious or medical reasons.

Finally, if you decide not to require staff to get vaccinated, decide how you will accommodate unvaccinated workers in the workplace, such as requiring full-time masking and weekly COVID-19 testing.

COVID-19 Home Test Kits Reimbursable under FSAs, HSAs

Under new guidance issued by the IRS, at-home COVID-19 testing kits will be considered a reimbursable medical expense under the three main health care savings vehicles offered to employees.

This new guidance adds to the list of personal COVID-19-related expenses for which employees can seek reimbursement under:

Health savings accounts
Health reimbursement arrangements, and
Flexible spending accounts.

This is good news as these home tests become more common during this stretch of the pandemic.

The IRS earlier announced that personal protective equipment for use in preventing infection and spread of COVID-19 is also reimbursable by HSAs, FSAs and HRAs. That includes:

Masks,
Sanitary wipes, and
Hand sanitizers.

What to do

If you offer one of the above savings vehicles, you may need to amend your group health plan’s language, unless the plan is drafted to reimburse all IRS-permitted expenses. In that case, you can leave it as is.

If, however, the plan lists all permitted expenses, you’ll need to amend it. If you plan to set the effective date for 2021, say Sept. 15, you should make the amendment no later than Dec. 31, 2021 for it to be effective.

Regardless of whether you have to change the plan or not, you should notify all participating staff of the change so they can take advantage of their plan if they need to.

Coverage for Virtual Substance Abuse Treatment Grows

Thousands of American families have been affected by the tragedy of someone with a substance abuse problem.

For many, especially during the COVID-19 pandemic, finding available and affordable treatment has been difficult or impossible. Recently, however, virtual treatment options have become available, and some insurance companies are beginning to pay for them.

This is an important development for both the group health insurance arena as well as the individual health insurance market. For employers, this is another lifeline that they can highlight for their staff as so many people have been affected by the stresses of the pandemic. For individual policyholders, they could have access to convenient and timely treatment.

Start-up companies across the country are offering virtual substance abuse treatment, including:

Boulder Care, which provides digital opioid-addiction treatment.
Pear Therapeutics, which provides software-based disease treatments; its lead product is a treatment for substance abuse disorders approved by the U.S. Food and Drug Administration.
Ria Health, which employs 45 clinicians who can prescribe treatments online for alcohol-addicted patients.

These start-ups have attracted the attention of group health insurance companies, some of which are starting to cover their treatments for people insured under their health plans. For example:

Ria Health has contracts with at least four insurers covering millions of people.
Boulder Care has a partnership with Anthem.
Pear Therapeutics has contracts with regional health plans in three states.
An opioid-addiction treatment provider in Massachusetts has partnerships with UnitedHealth Group and Kaiser Permanente.

Virtual treatments for addiction are becoming popular for several reasons. Patients may feel a social stigma from receiving in-patient treatment at rehabilitation centers.

Instead, virtual treatment in their homes permits them to keep their conditions private. It also provides flexibility. Ria Health offers its services on demand while enabling patients to customize their goals.

Receiving treatment faster

Demand for substance abuse treatment has grown during the pandemic.

Studies show that a quarter of American adults reported drinking more alcohol during the health emergency, including more than half of parents of elementary school children. As a result, space has been at a premium at in-patient rehabilitation facilities. Some have had lengthy waiting lists.

Virtual treatment gives new options to patients who cannot get admitted to rehab centers.

Because of the pandemic:

Some states made new rules for prescribing medicine via telehealth visits less restrictive.
The federal government started requiring payment parity for physician visits done via video.

Both of these factors have encouraged the growth of these start-ups.

These solutions are attractive to insurers because they reduce costs. Substance abuse patients who cannot get into rehab centers may overdose and end up in emergency rooms.

ERs are often the most expensive places to obtain care. Planned treatments over periods of time reduce the need for ER visits.

Multiply the savings over hundreds of thousands of patients, and it should be no surprise that insurers are signing seven-figure contracts with these providers.

Employers see these new plan features as an additional way to retain valuable employees. In any large group of employees, there will be some who are suffering from addiction or have family members who are, and they will value this benefit.

If you are an employer who offers these plans, you may want to check with your health insurers to see if they’ve changed coverage terms for this type of treatment. If so, you may want to consider spreading the word among your staff.

For some of your employees or their family members, life-saving help may be just a video chat away.

Employers Mull Higher Health Plan Cost-Sharing for Unvaccinated Staff

Some employers are considering a new incentive for their workers to get vaccinated against COVID-19: Charging them higher health insurance premiums if they don’t.

A recent brief from consulting firm Mercer reported that employers are looking at surcharging the health insurance premiums for employees who refuse vaccination for reasons other than disability or sincere religious belief. Many employers apply similar surcharges for employees who use tobacco.

The news comes as the Delta variant of the coronavirus that causes COVID-19 has sent infection rates soaring, with reports indicating that most new cases are occurring in people who have not been inoculated.

Employers may choose this option for a simple reason: The large costs of hospital stays and treatments for COVID-19 patients. When health plans incur large claim costs, they must either accept lower profits or make up the difference by spreading the costs among plan participants. Charging higher premiums penalizes vaccinated and unvaccinated employees alike.

The U.S. Equal Employment Opportunity Commission has said that it is permissible for employers to require workers to be vaccinated. However, many employers have been hesitant to take that step, fearing negative employee reactions, waves of resignations and bad publicity.

Freedom of choice

Surcharging insurance premiums for unvaccinated workers may be an appealing alternative for some employers. Rather than ordering employees to get vaccinated, they would leave them free to choose.

Those who would rather bear higher costs as a consequence of refusing a vaccine would be free to make that choice. In turn, vaccinated employees would not have to subsidize the health care costs of colleagues who make riskier decisions.

A Mercer spokesperson has estimated that any surcharges would be in the range of $500 to $1,300 per year.

Extra costs like that might induce reluctant workers to get the shots. If unvaccinated employees decide to get vaccinated in order to avoid a surcharge, the workplace should be safer and more productive. Absenteeism due to illness can negatively impact productivity.

The takeaway

Employers need to consider the following before implementing surcharges:

The EEOC has provided guidelines for employers wishing to offer vaccine incentives. Employers should stay within those guidelines.
Are the incentives necessary? They might not be in areas or workplaces where vaccination rates are already high.
The line between “encouraging” and “coercing” employees to get vaccinated is not well-defined. Employers should avoid imposing surcharges that could be viewed as coercive.
Some employees have pre-existing health conditions that make the vaccinations unsafe. Others seriously practice religions that forbid their use. Federal law requires employers to accommodate these workers.

Group Health Insurers Not Factoring In COVID-19 Effects in 2022 Pricing: Study

In a glimpse of what we may expect in terms of premiums, a new study by the Kaiser Family Foundation has found that most insurers are not factoring in added costs or savings related to COVID-19 for their 2022 health coverage rates for personal health plans in 13 states and the District of Columbia.

The insurers expect health care utilization to return to pre-pandemic levels by 2022, according to the analysis by KFF.

While the analysis focused on the individual market, KFF found that insurers were making similar assumptions about how COVID-19 would affect their group market costs and pricing.

Despite them not expecting significant effects from COVID-19, there are other issues that are on health insurers’ radars that are likely to increase rates, including the costs of treatment that was delayed in 2020, the continued use of telehealth services and new federal regulations in response to the pandemic. A recent survey by PricewaterhouseCoopers found that employers are expecting an average rate increase of 6.5% for group health coverage.

It’s clear that most insurers are viewing the COVID-19 pandemic as a one-time event, with limited, if any, impact on their 2022 claims costs. KFF referred to the pandemic’s effect on rates as “negligible.”

The foundation looked at rate filings of 75 insurers and only 13 of them stated that the pandemic would increase their costs in 2022, but even then, most of them predicted an effect of 1%. The reasons those 13 insurers cited for the expected higher costs include:

Costs related to ongoing COVID-19 testing, treatment and vaccinations.
Anticipated vaccination boosters.

Delayed treatment, policy changes

While most insurers don’t expect to be paying out excessive amounts for treatments and medications related to COVID-19 infections, they are concerned about the increased flow of patients seeking treatment for procedures they postponed last year.

Those postponements have led to pent-up demand, driving higher utilization in 2021, which some health plans expect will spill over into 2022.

As a result, some insurance companies have filed rates that include a “COVID-19 rebound adjustment” to account for the services that were deferred in 2020.

Other carriers have filed for rate increases based on predictions that those delayed services will lead to an exacerbation of chronic conditions. Some are also predicting that COVID-19 “long-haulers” could push claims costs higher.

On top of all that, insurers this year have had to make decisions about benefits, network design and premium pricing in the face of the pandemic and federal policy changes that could dramatically expand coverage under the Affordable Care Act.

Other concerns

Some insurers are concerned about the costs associated with the explosive growth of telehealth services during the pandemic. These tele-visits boomed as people were avoiding doctors’ offices due to stay-at-home and social distancing orders and to reduce the chances of COVID-19 transmission.

Kaiser Permanente in one of its filings wrote: “We anticipate the high utilization of telehealth services to persist beyond the lifespan of the outbreak into the foreseeable future.”

Another insurer, MVP in Vermont, said that while it has seen costs associated with in-person ambulatory services increase this year and a return to in-person visits, it has not seen a reduction in use of telehealth services.

Finally, Blue Cross Blue Shield of Vermont in its filing predicted that the increased expenditures for mental health services (demand for which spiked in 2020 as people wrestled with isolation and depression aggravated by the pandemic) would continue in 2022 and beyond.

The insurer predicted that claims for mental health and substance abuse treatment would climb 20% from 2020 to 2022.

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