Employer Q&A Specific to COVID-19 Vaccines

Yes, we’ll cover the COVID-19 vaccine*. However, initially, the federal government will be purchasing vaccine doses. Providers are not allowed to charge an individual or a plan for the vaccine when it’s provided by the federal government. Once the government stops supplying the vaccine, plans will be required to cover the cost as they do any other preventive service.

The CARES Act requires that group health plans (and individual health insurance plans) include coronavirus preventive services, including COVID-19 immunizations, as preventive services to be covered without member cost-share.

*Those under self-funded grandfathered plans that don’t have the Affordable Care Act 100% preventive coverage can speak to their account executive about how their plan will cover the vaccine and vaccine administration.

Yes. Plans must cover both the vaccine and the administration charge at 100%, just as they do other ACA preventive services*. While the vaccine cost will be covered by the federal government initially, plans will cover the administration cost.

*Those under self-funded grandfathered plans that don’t have the Affordable Care Act 100% preventive coverage can speak to their account executive about how their plan will cover the vaccine and vaccine administration.

As of April 19, all U.S. residents age 16 and older are eligible for the vaccine. Your employees can check with their local health department or visit VaccineFinder.org to find vaccine locations. As of May 12, 2021, the Pfizer vaccine has been authorized by the FDA for children age 12 and up. It’s currently the only vaccine that can be administered to children at this time.

You can also find answers to many of your vaccine questions through the CDC.

More information can be found here.

As an employer, you play a key role in preventing and slowing the spread of COVID-19 within your workplace. The CDC has many resources to help you, including guidance on:

• Implementing virtual health checks
• Office quarantine policies
• Mask requirements
• Testing and vaccines in the workplace

Check out their Guidance for Businesses and Employers to learn about these topics and many more.