CARES Act

THE CARES ACT REVIEW PART V: Health Provisions

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One of the objectives of the Coronavirus Aid, Relief and Economic Security Act (CARES) is to help people get the care they need with fewer obstacles and less-in-person contact. It adds to the health provisions in a bill passed in March – the Families First Coronavirus Response Act (FFCRA).

The CARES ACT health provisions will be most beneficial to families with High Deductible Health Insurance plans (HDHPs) and health savings accounts (HSAs) or flexible spending accounts (FSAs), which are pre-tax savings accounts for healthcare expenses. However, Medicare Part D participants and anyone who gets a test for COVID-19 will benefit too.

EXPANDED USE OF HSAs
Temporary provision:
-Telehealth services used to be subject a deductible, now they are covered before a patient has met the plan deductible. Usual cost-sharing, such a co-pay, is still allowed. This provision will sunset in December 2020.

Permanent and retroactive to January 1, 2020 provisions:
-It’s now ok to buy over-the-counter medical products, such as OTC drugs and surgical masks, without a prescription and get reimbursed by an HSA. With the prior rules, effective since January 2011, a prescription was necessary for reimbursement.
-Certain menstrual care products such as tampons and pads are now reimbursable medical expenses.

PLANNING TIP: For individuals and families experiencing cash flow issues some of the existing HSA rules can help. For example, there are no time restrictions or deadlines for when you can reimburse yourself from your HSA. You can claim reimbursement for eligible items if you have proof of purchase as far back as when you first opened the account.

PLANNING TIP: While HSA can’t be used to cover your share of employer-provided medical insurance, they can be used by unemployed people to pay premiums on an independent policy or coverage through COBRA.

COVID-19 TESTING WITHOUT COST SHARING
The FFCRA mandates that private insurance companies and Medicare cover COVID-19 testing and a vaccine for free. The CARES Act extends free testing to any services or items provided during a medical visit that results in coronavirus testing. Medical visits can be in-person, a telehealth visit, an urgent care or emergency room visit. This benefit remains in effect only while there is a declared public health emergency. It’s not certain if self-administered tests (if and when available) will be covered.

The CARES ACT also clarifies that Medicaid must cover such tests regardless of whether they are authorized for emergency use by the FDA.


PRESCRIPTION SUPPLY BENEFIT

Medicare PART D recipients can order up to a 90 day supply of medications. Prior to the CARES Act passing, a PART D insurance plan had the option to relax their “refill too soon” restrictions but now they are required to do so. The change is designed so that all Part D enrollees can get an extended supply of medications during the COVID-19 public health emergency.

PLANNING TIP: Place orders of your medications for 90-day supplies to save trips to the pharmacy and the hassle of having to reorder in less time.

SOME OTHER HEALTH PROVISIONS
-Reauthorization of programs to strengthen rural community health, the Healthy Start program, Temporary Assistance for Needy Families
-Dollars to support domestic food assistance programs (breakfast and school lunch, SNAP, emergency food assistance.
-Funding for the Defense Production Act, Pandemic Response Accountability Committee, Disaster Relief Fund, FEMA, Indian Health Service, CDC, Substance Abuse and Mental Health Services Administration, CMS, Public Health and Social Social Services Emergency Fund and others.

If you missed Part IV: Review of the Paycheck Protection Program (PPP) go here.
And, for a comprehensive article about HSAs, go here.

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The CARES Act Review Part IV- The Paycheck Protection Program

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Included in the CARES Act is $350 billion for a small business loan program called the Paycheck Protection Program.

This program intends to get money into the hands of small business owners quickly so that they can continue operations and pay their employees. The SBA is working with 1,800 approved lenders and plans to add more of them.

Not all the details about eligibility are available yet, but the SBA plans to publish specific regulations soon. Small businesses and nonprofits can apply first (as soon as April 3!), followed by independent contractors and self-employed.

These are essential details of the program:

  • Small businesses, nonprofits, tribal business concerns, and veterans organizations with fewer than 500 employees are eligible for loans under the program. If the business is in foodservice, the 500 employee cap is on a per-location basis.
  • Self-employed individuals, independent contractors, and sole proprietors are eligible.
  • Borrowers must certify that their business has been affected by the coronavirus slowdown.
  • Lenders will not require collateral or a personal guarantee. The loans are guaranteed by the Federal government.
  • The company must have been in business since February 15, 2020.
  • The loans can be up to $10 million to cover payroll and other expenses, or 2.5 times total payroll expenses for the loan period. The payroll expenses covered are broad including salaries, retirement, healthcare, parental leave parents and bonuses.
  • The loan applies to costs incurred from February 15 to June 30.

        GREAT FEATURE  LOW LOAN RATE

  • The Treasury Department set the loan rate at 1%, but the cap is 4%, so it could change.
  • The first payment will be due after six months, and the full loan will be due in two years. 
  • A business that has other SBA disaster loans such as a Disaster Relief Loan can still apply for the Paycheck Protection Loan but the loan must be used for different things.

    GREAT FEATURE: LOAN FORGIVENESS

  • The loan includes loan forgiveness covering costs for the first eight weeks for companies able to keep employees on payroll and continue paying bills through the crisis.
  • The loan forgiveness will include payroll costs for individuals below $100,000 in annual income, mortgage/rent, including interest and utilities. 
  • If a business reduces the workforce or wages, then the total amount of loan forgiveness will be mitigated unless employees are hired back.
  • Eligibility for loan forgiveness starts eight weeks after the loan origination date. 
  • It’s not clear yet whether salaries (up to $100,000) of sole proprietors, independent contractor, LLC’s or other businesses will count towards loan forgiveness; guidelines will be issued soon.

IT’S ALL IN THE DETAILS

To read more details and to get updates, its best to go to the Treasury Department Website where you can also find the loan application.

And a more detailed summary from the Treasury Department here and from the SBA here.

There will be a huge demand for these loans, so if applying it’s best to find out what information you need to gather soon and find an approved lender to work with you to get your needed funds.

If you missed CARES Act Review Part 3 Unemployment Benefits go here.

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