A vaccine for the H1N1 flu is in production and could be ready in the fall, the Centers for Disease Control and Prevention (CDC) reported. The new vaccine will supplement, not replace, the seasonal flu vaccine already on the market. The CDC recommends the vaccine for pregnant women, anyone living with or caring for a child younger than 6 months old, health care personnel, people 6 months to 24 years old, and people ages 25 to 64 with health conditions that could be complicated by the flu.
The CDC also reported that the number of new cases of H1N1 in Mexico and the United States is declining. As of September 19, there have been more than 19,100 hospitalized cases of H1N1 flu and 1,500 deaths in the U.S. and territories.
TDI surveyed more than 300 insurers, health maintenance organizations, guaranty associations, special deputy receivers, workers' compensation networks, and surplus lines carriers regarding their pandemic preparedness. Insurance industry responses reflected the CDC's guidance for businesses and industry best practices. Their pandemic preparedness plans include:
teleworking; working remotely
business continuity efforts to reroute functions to assist policyholders
cross training to cover for absent employees
social distancing; suspend group meetings and gatherings
enhanced information on website
contracts with out-of-area vendors
expanded use of cell phones and smart phones to conduct business
24-hour nurse hot line that plan members can access
emergency notification system to provide critical information to employees at home and work
assuring that staff have taken flu vaccines and offering on-site flu vaccine programs where feasible
generous sick pay program that provides financial support for flu-stricken employees to stay home
cancel or postpone travel; limited travel of employees to geographic areas where an enhanced exposure to the flu exists
increased facility sanitation protocols
increased employee education and health awareness programs
disaster drills to prepare for an event
Health Coverage
It's always important to understand your health care coverage. Take a few minutes and answer these questions:
Does your health plan have a preauthorization requirement for hospital admission or other services?
What is your copayment for the most common H1N1 treatments? The two drugs doctors can prescribe to treat H1N1 flu are Tamiflu and Relenza. Also find out if there are any coverage limitations that apply to the distribution of the medication. Some plans will restrict coverage on the number of doses per prescription or per year.
What is your out-of-network copayment? If you travel, you may not be able to see your regular physician in a timely manner. If you have to go out-of-network, be aware you may have higher out-of-pocket costs for your office visit and possibly any medical tests performed during the visit. If you need emergency treatment, your plan's emergency benefits should apply. Make sure you know how your plans defines an emergency.
Get prepared for any eventuality with the following checklist:
Have your health coverage I.D. card handy.
Review your health plan's provisions. Know which doctors and hospitals are in your network.
Make note of your copayments. Know how much a doctor's office visit will cost. Check to see if your co-payments go up if you go out-of-network.
Find the list of pharmacies covered by your health plan.
If you are going to travel, make sure you check to see if there are any doctors or medical facilities in-network where you will be visiting.
Make sure you have contact information for your health insurance company or health maintenance organization available in case you have questions.
The CDC recommends that people at high risk of complications from any type of flu talk with their doctor before traveling. Healthy people should make travel plans as normal and take common-sense precautions to protect their health.
The following people are considered at high risk of complications from the flu:
Children younger than 5 years of age
Persons aged 65 years or older
Children and adolescents (younger than 18 years) who are receiving long-term aspirin therapy and who might be at risk for experiencing Reye's syndrome after influenza virus infection
Pregnant women
Adults and children who have chronic pulmonary, cardiovascular, hepatic, hematologic, neurologic, neuromuscular, or metabolic disorders
Adults and children who have immunosuppression (including immunosuppression caused by medications or by HIV).
Travel insurance policy language is typically specific and may not cover epidemic or pandemic situations. Review your policy and check with the insurance company that issued the policy to see if you are covered.
Policies that allow “cancellation for any reason” offer the most flexibility when cancelling or changing plans. “Cancel for any reason” coverage provides a full refund as long as reservations are cancelled before the scheduled time of departure.
If you were planning a cruise, be aware that cruise and tour operators might offer “cancellation waivers.” Read the restrictions of the cancellation waiver carefully to know your options.
Major types of travel insurance are:
Trip cancellation. Reimburses you for pre-paid travel expenses if you are not able to take your trip because you become ill or because a family member becomes ill or dies.
Travel delay. Reimburses you for pre-paid expenses if you are not able to take your trip because of a travel delay, such as a flight delay or cancellation.
Trip Interruption. Reimburses you for pre-paid expenses if your trip is cut short because you become ill, because a family member becomes ill or dies, or because of any other misfortune listed in your policy. Covered reasons might include bad weather, airline strikes, terrorism, bankruptcy, jury duty, or damage to your home from a fire or flood.
If you are planning to travel outside the United States and are worried about getting sick while away from home, be aware that American health insurance is generally not accepted outside of the United States. To find out more about the extent of your coverage, speak with your insurance agent or company before leaving home. Texas residents may call TDI's Consumer Help Line at 1-800-252-3439. Residents of other states should contact their state's department of insurance. A link to state insurance department web site and contact details can be found at www.naic.org/state_web_map.htm.
Business Interruption Insurance
Business owners might be concerned about having to shut down their operations because of an outbreak or absenteeism. Check your business interruption policy to see what events will trigger coverage. Coverage generally requires the interruption to be caused by physical damage or loss (such as fire or weather).
Business interruption policies generally will not be triggered by epidemic or pandemic warnings or alerts from public officials. Business owners will need to rely on existing risk management and business continuity plans to mitigate losses due to emerging public health crises.
Also read TDI's Business Interruption Coverage publication (PDF).
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