Last week, after observing that the vast majority of large employers either offer or plan to offer telemedicine benefits for employees, we considered the logistics of how a company might choose to launch such a program. Three methods present viable options: adding telemedicine as a new feature of a group health plan, incorporating telemedicine as part of an Employee Assistance Program (EAP), or creating a stand-alone telemedicine benefit. In all three cases, compliance with legal and regulatory requirements is non-negotiable; who bears the brunt of the responsibility depends on the strategy selected. In last week’s blog post, we explored the pros and cons of appending telemedicine benefits to a group health plan. Today, we’ll consider the other two approaches.
This article is part two of a two-part series exploring how employers can offer telemedicine benefits for employees. Read part one here.
Add-on to Employee Assistance Program
Another method is to incorporate telemedicine benefits for employees into an existing Employee Assistance Program (EAP). Employers are increasingly offering mental health assistance-type benefits through digital technologies, and adding telemedicine as yet another perk would not be a hardship. The cautions with this technique are the exceptions under the Affordable Care Act (ACA) and federal requirements for EAPs, as well as the payment model. An EAP cannot solicit contributions or cost sharing to participate, so covering the costs of the telemedicine service may be a challenge for the employer. Unfortunately, as with the group health plan, since not all employees utilize the EAP, this strategy fails to offer telemedicine to all employees.
Perhaps the most inclusive way for employers to offer telemedicine is to structure the service as a stand-alone benefit that gives all employees access to the service regardless of whether or not they participate in other employer-sponsored programs. However, this strategy significantly increases the compliance burden on the employer because an independent benefit has to meet separate requirements under federal laws such as ERISA, HIPAA, COBRA, the ACA, and IRS rules governing Health Savings Accounts (HSAs). This translates to separate summary plan descriptions (SPDs), separate Form 5500 filings, separate COBRA notices, and so on. State laws must be adhered to, as well; regulations regarding issues such as licensing requirements, online prescribing, informed consent, and scope of services can change rapidly and impact employers’ telemedicine programs greatly.
To further simplify the process, many employers contract with telemedicine vendors to provide the telemedicine benefit rather than building their own programs from scratch. These vendors must ensure they are following all state and federal requirements, while the employer’s role is to monitor the service provider’s compliance.
As a strategy, providing and promoting telemedicine benefits for employees is bound to produce positive results including increased productivity, less time off work due to illness and traveling to/from the clinic, and more goodwill toward the employer for caring about the health of its workers. An employer that is contemplating adding or changing a telemedicine benefit should research the compliance issues thoroughly before committing to a particular policy; there is no “one-size-fits-all” solution, only the “what-best-suits-your-company” solution.