CMS Releases Guidance to Group Health Plans Regarding COVID-19 Vaccination and Testing

Thursday, March 4, 2021
Michael Bivona
workplace safety

The Centers for Medicare and Medicaid Services has released new guidance for group health plans regarding COVID-19 testing and vaccinations. Key pieces of guidance include:


- Plans and issuers MUST cover all COVID-19 vaccinations (including the vaccination administration fee), so long as that vaccination has received approval from the Advisory Committee on Immunization Practices (ACIP). Plans may not impose cost-sharing on plan participants for COVID-19 vaccinations.


- Plans and issuers must cover qualifying COVID-19 preventative services without cost-sharing. In the event of a new preventative service approved by the ACIP or the United States Preventative Services Task Force (USPSTF), the plans/issuers have 15 days to remove cost-sharing restrictions around those services.


- Plans and issuers may not exclude coverage (or impose cost-sharing) for any COVID-19 preventative services.


- Plans and issuers may not deny coverage of vaccinations to plan participants even if that participant is not qualified for early vaccination.



Plan administrators should ensure that they are familiar with this new guidance as soon as possible. You can read the entire guidance HERE.



Heather Reynolds, ESQ
CCO - Administrative Officer
FNA Insurance Services, Inc.
516-348-7199 |[email protected]

Michael Bivona
Compliance Paralegal
FNA Insurance Services, Inc.
516-348-7135 |[email protected]