COVID-19 U.S. Customer Update

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Critical Health Alert

COVID-19 U.S. Customer Update

March 17, 2020
COVID-19 U.S. Customer Update

You’re focused on health and well-being – for your customers, your employees and yourselves. So are we. We want you to know that we’re here for you and operationally prepared to handle all customer questions and service all claims in a timely manner.

What MetLife is doing for our customers

MetLife has launched a comprehensive approach to assess business readiness across all critical functions and markets through the lens of a global pandemic. This includes a review of a number of areas including operational readiness, employee mobility, infrastructure resiliency and information security.

MetLife remains committed to ensuring our customers get the service they expect and the timely handling of claims. To achieve this, we are:

  • Activating our business continuity planning to assess readiness throughout the enterprise
  • Conducting a review of end to end plans and interdependencies
  • Stress testing critical processes and systems including information technology and security
  • Determining alternate solutions for all critical processes, including resources and technology
  • Testing employee mobility and connectivity by enacting elements of our business continuity plan in a controlled environment
  • Scenario planning for a high number of resources being out due to illness and counter-measures and supplemental staffing should this situation arise

Additionally, MetLife is prepared to handle a shift to a remote workforce with the majority of our team already equipped to work remotely and securely.

COVID-19 Preparedness for MetLife Customers

MetLife takes the health and well-being of our customers and their employees, our associates and our business partners seriously. During this time, we are here for you and your workforce.

Federal Leave Legislation

How does the Federal Leave Legislation in Response to the Coronavirus impact my business?

DocumentsFor employers of more than 500 Employees


How does the Federal Leave Legislation in Response to the Coronavirus impact my business?

Documents For employers of less than 500 Employees

Leave Legislation – New Jersey

[March 30, 2020; 11:00 am EST]  Newly Enacted Leave Legislation in New Jersey in Response to COVID-19

DocumentsDownload NJ Leave Legislative Update

Leave Legislation – New York

[March 20, 2020; 6:15pm EST]  Newly Enacted Leave Legislation in New York in Response to COVID-19

DocumentsDownload NY Leave Legislation Letter


[March 27, 2020; 12:45am EST] NY Leave Legislative Update Presentation

DocumentsDownload NY Leave Legislative Update

 

Impacts on your business and how we can help:

Furlough and Reduced Hours:

[updated March 27, 2020; 12:37am EST]  Are employees who were actively at work prior to a furlough, temporarily lay-off or reduce hours/salary and enrolled for coverage, eligible for benefits while on furlough, temporarily lay-off or reduce hours/salary?

We understand that the COVID-19 pandemic may require customers to unexpectedly furlough, temporarily lay-off or reduce hours/salary for employees.

As a response to these unique events, and assuming premium continues to be remitted to MetLife:

For group life, dental, AD&D,  vision, accident & health and legal coverage, MetLife is willing to allow employees who are furloughed, temporarily laid-off or have reduced hours/salary to continue their coverage for 12 months from the date of the furlough, temporary lay-off or reduced hours/salary (collectively, “temporary salary reductions”). Premiums need to be remitted for coverage to remain active.

For purposes of group life, the coverage amounts will not be reduced as a result of temporary salary reductions and will remain in effect just as they were prior to the furlough, temporary lay-off or reduced hours/salary.  Accordingly, premium needs to be remitted based on the volume for the   regular (non-reduced) coverage amounts.

For group disability, MetLife is willing to allow employees who experience a furlough, temporary lay-off or have reduced hours/salary between March 1, 2020 and May 31, 2020, to continue their coverage for 60 days from the date of the furlough, temporary lay-off, or reduced hours/salary. Coverage amounts will not be reduced as a result of temporary salary reductions and will remain in effect just as they were prior to the furlough, temporary lay-off or reduced hours/salary. Accordingly, premium needs to be remitted based on the volume for the regular (non-reduced) coverage amounts.  

In all instances, if your group policy allows for longer periods of continued coverage under any of the circumstances outlined above, we will honor the longer period of time.

In addition, if your coverage is self-insured, and you are not comfortable with the timelines outlined above, please contact your Account Executive for alternatives.

FAQs

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What are the steps MetLife is taking?

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MetLife is leveraging its existing Business Continuity Plans and revising these plans through the lens of a global pandemic. This includes reviewing several potential scenarios including employee and location outages as well as various work-from-home solutions and stress testing our plans.

How is MetLife meeting its customer needs during this time?

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We are focused on ensuring business operation continuity during this time. This includes responding to inquiries and processing and paying claims. To achieve this, we are conducting mock pandemic exercises, stress testing critical processes and systems, and determining alternative solutions for all critical processes, including resources and technology. Our planning also includes testing for a high number of employees being out due to illness and counter-measures and supplemental staffing should this situation arise.

MetLife remains committed to ensuring our customers get the service they expect, maintain the coverages they need and that we process all claims for all products in a timely manner. We are working with our customers in affected markets to promptly address their questions on coverage, claims, and treatment. This is being done on a local level to observe all regulations, adhere to insurance policy terms, and ensure our customers can easily and quickly engage with us as necessary.

Is MetLife prepared to handle a large shift to remote workers or an increase in claims volume?

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Yes, MetLife is prepared to handle a shift to a remote workforce, if needed. Our employees are equipped to work remotely and securely. The MetLife claims teams are cross-trained and can be deployed in areas of the business with the greatest need. So, if a pandemic event results in increased claims activity across some of our benefit products, we can adjust accordingly and handle any spikes in volume.

What is MetLife doing for its employees?

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The health and well-being of our employees is a top priority. MetLife is closely monitoring the COVID-19 situation around the world. We are taking several proactive steps to protect the well-being of our employees. These include:

  • A ban on all non-essential air travel, both internationally and domestically.
  • Postponement of all large meetings, defined as 50 or more people, for the next 45 days
  • 14-day self-quarantines for those who have traveled to impacted areas or might otherwise have come into contact with infected persons
  • Deep cleaning of facilities where our people work, and
  • Regular consultations with medical professionals to ensure our policies remain robust

Are there any plan or policy limitations that would impact a COVID-19 related claim?

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Please know that each claim received will be reviewed consistent with policy terms and applicable insurance law.

Life Insurance: For Group Life Insurance (Basic, Optional, Dependent, GUL and GVUL), there are no policy limitations that would limit a claim payment resulting from COVID-19, provided the individual met all other certificate requirements.

Accidental Death and Dismemberment (AD&D): AD&D policies do not cover diseases. Therefore, death due to COVID-19 is excluded, as are all deaths caused by disease.

Hospital Indemnity: Because COVID-19 is a viral infection it would be considered a sickness and the Sickness Hospital benefits (admission and confinement) would be payable provided the individual met all other certificate requirements.

Accident Insurance: The definition of an “accident” includes that it is not a sickness so this condition would not be covered under our standard accident plan for COVID-19. However, it would be covered if the accident plan included Sickness Hospital benefits (admission and confinement) and would be payable provided the individual met all other certificate requirements.

Critical Illness/Cancer Insurance: Because COVID-19 is not a listed “covered condition” it would not be covered under any of our Critical Illness product versions.

Disability Insurance: There are no policy limitations that would apply for COVID-19. MetLife will evaluate each claim in accordance with the terms of the policy and use claim processes already in place for disability claims.

[updated March 23, 2020; 4:30pm EST] How is MetLife handling claims relating to COVID-19?

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For disability claims reported for disabling flu-like symptoms reported to be due to, or potentially due to, COVID-19, MetLife will conditionally approve 14 calendar days from the date disability commenced pending supporting medical evidence, except where prohibited by law.  We will apply any contractual eligibility provisions and are not waiving the EP.  MetLife will implement this process beginning on Thursday, March 19, 2020 for both our fully insured and self-insured customers to any pending claim with these circumstances.  We anticipate maintaining this process for an initial 30-day period, then reassessing based on how this crisis unfolds.

For FMLA claims, MetLife will use the same claim processes to evaluate a COVID-19 claim as it does for any other sickness or injury (whether the employee’s or a family member).  Each claim will be reviewed consistent with federal law.  

If the Health Screening Benefit is included in a Critical Illness, Accident or Hospital Indemnity Insurance certificate, would the Health Screening Benefit be payable if someone received a laboratory screening test for the Coronavirus?

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The Health Screening Benefit would be payable for a Coronavirus laboratory screening test (regardless of the test result), subject to the requirements for payment of that benefit and the other terms and conditions of the certificate.

An employee was exposed to COVID-19 while on an airplane and is now under quarantine. Under the Life Insurance policy, is the employee considered Totally Disabled and eligible for Waiver of Premiums?

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Claimants would not satisfy the definition of disability in the applicable plan solely due to being quarantined. If the claimant develops COVID-19 or some other qualifying sickness while quarantined, the claim would be reviewed per the requirements of the plan.

For claimants who are quarantined because of exposure to COVID-19 but are not themselves afflicted with the disease, will these claimants be considered disabled?

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Claimants are unlikely to satisfy the definition of disability in the applicable plan solely due to being quarantined. If the claimant develops COVID-19 or even some other qualifying sickness while quarantined, and it meets the definition of disability within the policy, benefits would be reviewed for payment.

[updated March 30, 2020; 11:10am EST]  For claimants who are quarantined because of exposure to COVID-19 but are not themselves afflicted with the disease, will these claimants qualify for FMLA?

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We will review each leave request on a case-by- case basis.  However, in order to qualify for FMLA, quarantined employees would need to satisfy the definition of a “serious health condition” among the other FMLA eligibility requirements. If the employee is unsure if the claim will be approved, we encourage the claim to be submitted for review.  For additional guidance on FML compliance related to COVID-19, please refer to the DOL guidelines at https://www.dol.gov/agencies/whd/pandemic/ffcra-questions.

[updated March 30, 2020; 11:10am EST]  Will MetLife be making any changes or having leniency for payments?

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During this period of uncertainty, MetLife will make an exception to extend the Grace Period for premium payment to 60 days after the Premium Due Date, for customers with a policy Grace Period less favorable than 60 days. Customers with Grace Periods greater than 60 days will retain the Grace Period in their policy.  This policy will be applied for all premiums due 3/1/2020 and forward, until this crisis is deemed over, as well as apply to any premium within the current 30-day grace period. MetLife will continue to monitor the situation and will provide additional guidance as it becomes available.  We are also monitoring state specific mandates and will comply with those mandates, if required.

[updated March 27, 2020; 6:30pm EST] What are the steps MetLife is taking to support inforce Individual Disability Insurance (IDI) policies?

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There are no policy limitations that would apply for COVID-19. MetLife will evaluate each claim in accordance with the terms of the policy and use claim processes already in place for disability claims 

  • We will follow the policy provisions and treat each claim on its own merits.  IDI policies have elimination periods of 90 or 180 days, which must be satisfied before benefits become payable.  The policies provide benefits only for disabilities that result from a sickness or injury.
  • Claimants are unlikely to satisfy the definition of total disability in the applicable policy solely due to testing positive or being quarantined.  If a claimant develops COVID-19 or some other qualifying sickness while quarantined, and it meets the definition of disability within the policy, benefits would be reviewed for payment.
  • MetLife will temporarily extend the Grace Period for premium payment to 60 days after the Premium Due Date.  This temporary extension will be applied to all policies with premiums due 3/1/2020 and after, until such time as this crisis is deemed over.  MetLife will continue to monitor the situation and will provide additional guidance as it becomes available. We are also monitoring state specific mandates and will comply with those mandates as required.

For all other questions regarding inforce IDI policies, please contact your Account Manager, Account Executive or MetLife representative.

Would any additional fees be imposed if a significant number of claims were submitted as a result of a pandemic event?

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For insured business, rates in effect during the current policy period would not be affected. For self-funded business or for absence administration, the terms of the applicable Administrative Service Agreement will apply.

What resources are available for employees with Travel Assistance coverage?

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MetLife AXA Travel Assistance1 program provides medical evacuation/repatriation if an employee was exposed to COVID-19 or is in a high-risk area or country. The employee would be eligible for evacuation/ repatriation services, and AXA would coordinate the employee’s return.

Proof must be established that the employee does not have COVID-19 even if the evacuation is for another reason. In addition, destination countries are implementing more stringent screening practices at points of entry. Access to and clearances for air and ground ambulance providers, as well as other transportation options, are becoming more challenging to secure as action is taken to contain the spread of the virus.

What resources are available for customers with MetLife’s Employee Assistance Program?

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MetLife offers an Employee Assistance Program (EAP)2 that provides 24/7 confidential access to professional support to help employees manage stress, anxiety, grief, financial concerns, and much more. Employees can connect to support by phone, video, or chat anytime, anywhere, and they have access to a vast library of online resources for coping with trauma, building resiliency, self-care, and managing change.

Our EAP program also offers manager consultations and webinars to support leaders in dealing with sensitive workplace situations.

Are there any additional benefits available for customers and their employees?

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MetLife is committed to helping employees get maximum value from their benefits. Once we receive a MetLife Group Disability claim, we automatically look at whether the employee has hospital indemnity coverage. If they do, we will inform and guide the employee so they can understand and use the benefits available to them.

For our Optional Life customers, employees have access to Will Preparation3 services including telephone or in-person consultations with an attorney in the MetLife Legal Plan attorney network. Covered services include preparing important planning documents like a power of attorney, which is a document that allows someone to conduct transactions on another person’s behalf, and a health care proxy, where someone can appoint another person to make medical decisions on their behalf.

For customers with PlanSmart Financial Wellness4, the financial education and advice available may be helpful in managing finances during times of increased market volatility such as we’ve seen in recent weeks.

For our Life Insurance policy customers, licensed Grief Counselors are available from Lifeworks5 for insured employees and their dependents if they experience a loss, regardless of cause of death, or are diagnosed with a potentially life-threatening disease such as COVID-19. Whether it’s help coping with a loss or a major life change, confidential counseling sessions can be tailored to meet the individual needs.

MetLife Worldwide Benefits (Expatriate Coverage) FAQs

[March 16, 2020, 5pm EST] MetLife Worldwide Benefits coverages include Medical, Dental, Vision, Life, AD&D, LTD and short-term traveler products. For clients, brokers, and members who have policies with MetLife Worldwide Benefits, below are some frequently asked questions and answers as they may relate to your policy with us. For specific questions or questions not answered here, brokers and clients should contact their MetLife Worldwide Benefits Account Manager; members should contact Customer Service using the information on their ID card.

Expat Medical FAQs

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Do we cover tests to diagnose COVID-19?

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There are no policy limitations that would apply to a pandemic event. MetLife is required to evaluate each claim in accordance with the terms of the policy and to use the same claim processes as it does for any other sickness or injury claim. Each claim will be reviewed consistent with policy terms and applicable insurance law.

MetLife Worldwide Benefits is waiving patient responsibility (including deductibles, coinsurance, and copays) related to the testing of the coronavirus, when medically necessary. However, please note that costs related to mandatory or voluntary quarantine are not covered – only costs related to testing.

Do we cover evacuation for members who have been diagnosed with COVID-19?

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A member may be eligible for emergency medical evacuation due to COVID-19 if the insured member suffers an Emergency Sickness that warrants Emergency Medical Evacuation while outside his or her country of primary residence.

MetLife will use any and all available resources to ensure a safe and timely evacuation, however, we will not be liable for failure to render services or for delays in service due to circumstances beyond our control.

Please reference your certificate for plan specific definitions.

Do we cover evacuation for members who have not been diagnosed with COVID-19, but are in an area where there are quarantines? 

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No. A member must meet the definition of Emergency Sickness to qualify for an Emergency Medical Evacuation.

Please reference your certificate for plan specific definitions.

We are happy to make referrals for providers that are appropriately staffed and capable of testing and treating the condition. As a result of the fluid situation, we advise members to contact their Regional Service Centers when assistance is needed locating a provider.

For health and travel advisory members should be directed to: World Health Organization and US Department of State.

Are there any limitations or exclusions with what would be covered if someone needs testing or treatment?

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There are no policy limitations that would apply to a pandemic event. Each claim will be reviewed consistent with policy terms and applicable insurance law.

What should I do if I get diagnosed with COVID-19?

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We urge you to consult with and follow the advice of your treating physician in circumstances where you have been diagnosed with COVID-19

[updated March 24, 2020; 8:30pm EST] What additional services does MetLife Worldwide Benefits offer to help me during the COVID-19 outbreak?

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Your plan may have access to an International Employee Assistance program, which provides counseling from highly qualified, licensed professionals.

Please reference the Schedule of Benefits in the certificate for benefit definitions and to determine if members have access to the above benefits.

Will members still be covered under the plan if they work remotely during the COVID-19 outbreak?

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If members are actively working while quarantined or working virtually from their jurisdiction country, we will continue to cover them under the plan. If members are actively working and returned to their home country, we will continue to cover them within 90 day establishing residency statement under the “Date your Insurance Ends” section of the certificate.

What is MetLife Worldwide Benefits doing to prepare for a pandemic?

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In order to address pandemic concerns, we have incorporated a loss of personnel scenario into our Global Resiliency program. This scenario provides a combination of solutions for employee and work area recovery. Testing is performed throughout the year. All plans and scenarios in our Global Resiliency program are reviewed annually.

What up-to-date educational resources are available to learn more about novel coronavirus, how it spreads, regions impacted, travel alerts, and how to avoid exposure and stay healthy?

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For health and travel advisory: World Health Organization and US Department of State.

[updated March 24, 2020; 8:30pm EST] Can you include benefit language for COVID-19 on a certificate of coverage (COC)?

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No. MetLife is not able to add plan specific benefit language on a certificate of coverage. This document is used to provide verification of insurance and contains the group name, participant name, certificate number, and covered dependents. It also validates coverage for each product (i.e. medical, dental, prescription, emergency evacuation, etc.) but does not detail specific plan benefits. To review benefits for your plan please refer to your certificate of insurance which includes covered medical services as well as exclusions and general limitations.

There are no policy limitations that would apply to a pandemic event. MetLife is required to evaluate each claim in accordance with the terms of the policy and to use the same claim processes as it does for any other sickness or injury claim. Each claim will be reviewed consistent with policy terms and applicable insurance law.

[updated March 30, 2020; 11:00am EST] Do we cover telemedicine services?

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You have access to telemedicine services through our preferred vendor AXA Assistance that you may leverage to avoid travel to a provider or hospital. With our telemedicine service, employees and their families can connect directly to U.S. licensed medical providers by smartphone, tablet or computer. There is no member cost sharing for these services, and they will be covered in full.

Get started by going to: www.AXATeleconsultation.com/MetLifeWorldwide

Our Voyageur Global Benefits members do not have access to our preferred telemedicine services through AXA Assistance, however you still have coverage for medically necessary telemedicine services through a licensed provider of your choice. Since COVID-19 is a communicable disease you may choose to seek medical advice through these services instead of in person health care. Patient responsibility (including deductibles, coinsurance, and copays) will be waived when medically necessary telemedicine services are utilized for a coronavirus-related consultation.

There are no policy limitations that would apply to a pandemic event. MetLife is required to evaluate each claim in accordance with the terms of the policy and to use the same claim processes as it does for any other sickness or injury claim. Each claim will be reviewed consistent with policy terms and applicable insurance law.

[updated March 25, 2020; 9:45pm EST] Would MetLife’s ability to perform a medical evacuation be impacted by a country’s travel restrictions?

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The terms and conditions of the policy and certificate will apply. If a medical evacuation is warranted in accordance with the terms of the policy, the evacuation will be performed, subject to any restrictions imposed by the country in question. We are required to comply with all applicable laws, rules, and regulations in every jurisdiction in which we do business.

[updated March 25, 2020; 9:45pm EST] Would the travel restrictions being imposed by many countries impact coverage?

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The travel restrictions placed by countries have no effect on insurance coverage. The terms and conditions of the policies are applicable.

Expat Life FAQs

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Are there plan or policy limitations that would prevent a Life claim from being paid due to a disease, including coronavirus?

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For Group Life Insurance, there are no Policy limitations that would limit a claim payment resulting from coronavirus, provided the individual met all other certificate requirements. Each claim will be reviewed consistent with policy terms and applicable insurance law.

An employee was exposed to coronavirus while on a plane and is now under quarantine. Is the employee considered Totally Disabled and eligible for Waiver of Premiums?

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The employee must meet the other certificate requirements which include: The Waiting Period, the definition of Total Disability, and that the Disability must continue through the end of the Waiting Period. Being exposed to the virus, in and of itself, is not necessarily considered a Total Disability.

If an employee dies after contracting coronavirus, would an AD&D claim be payable?

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AD&D policies do not cover diseases. Therefore, death due to coronavirus is excluded, as are all other diseases.

What special handling, if any, will MetLife put in place to facilitate claim review?

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We do not anticipate special handling will be necessary. However, if such a situation should arise, MetLife will assess and make appropriate adjustments to ensure claimants are assisted in a caring and timely manner.

Expat LTD FAQs

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Are there plan or policy limitations that would be imposed if there were a significant number of claims submitted as a result of a pandemic event?

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There are no policy limitations that would apply to a pandemic event. Each claim will be reviewed consistent with policy terms and applicable insurance law.

What special handling, if any, will MetLife Worldwide Benefits put in place to facilitate claim review/payment?

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We do not anticipate that special handling will be necessary, if such a situation should arise, MetLife will make appropriate adjustments. Claims submitted with a diagnosis of coronavirus will be administered the same as any other disability claim. MetLife’s current claim processing standards and procedures apply.

For claimants who are quarantined because of exposure to coronavirus but are not themselves afflicted with the disease, will these claimants be considered disabled?

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No. Claimants are unlikely to satisfy the definition of disability in the applicable plan solely due to being quarantined. If the claimant develops coronavirus or even some other qualifying sickness while quarantined, the claim would be reviewed for payment.

1 Travel Assistance services are offered and administered by AXA Assistance USA, Inc. Certain benefits provided under the Travel Assistance program are underwritten by Certain Underwriters at Lloyd’s London (not incorporated) through Lloyd’s Illinois, Inc. Neither AXA Assistance USA Inc. nor the Lloyd’s entities are affiliated with MetLife, and the services and benefits they provide are separate and apart from the insurance provided by MetLife.

2 EAP services provided through an agreement with LifeWorks US Inc. (LifeWorks by Morneau Shepell). LifeWorks is not a subsidiary or affiliate of MetLife.

Will Preparation is offered by MetLife Legal Plans, Inc., a MetLife company. In certain states, legal services benefits are provided through insurance coverage underwritten by Metropolitan Property and Casualty Insurance Company and Affiliates, Warwick, Rhode Island. For New York sitused cases, the Will Preparation service is an expanded offering that includes office consultations and telephone advice for certain other legal matters beyond Will Preparation. Tax Planning and preparation of Living Trusts are not covered by the Will Preparation Service.

4 MetLife administers the PlanSmart program, but has arranged for Massachusetts Mutual Life Insurance Company (MassMutual) to have specially-trained financial professionals offer financial education and, upon request, provide personal guidance to employees and former employees of companies providing PlanSmart through MetLife.

5 Grief Counseling services are provided through an agreement with LifeWorks. LifeWorks is not an affiliate of MetLife, and the services LifeWorks provides are separate and apart from the insurance provided by MetLife. LifeWorks has a nationwide network of over 30,000 counselors. Counselors have master’s or doctoral degrees and are licensed professionals. The Grief Counseling program does not provide support for issues such as: domestic issues, parenting issues, or marital/relationship issues (other than a finalized divorce). For such issues, members should inquire with their human resources department about available company resources. This program is available to insureds, their dependents and beneficiaries who have received a serious medical diagnosis or suffered a loss. Events that may result in a loss are not covered under this program unless and until such loss has occurred. Services are not available in all jurisdictions and are subject to regulatory approval. Not available on all policy forms.