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New Federal Guidance Regarding COVID-19 Home Tests May Impact Employers

Jan 18, 2022

mployers continue to feel the effects of the pandemic as both employees and customers contract COVID-19 and its variants. As the country has adapted, the Food and Drug Administration (“FDA”) has approved COVID-19 home testing kits. Although helpful in stopping the spread of COVID-19 and its variants, a new question has emerged: is the cost of a home test kit covered by health insurance? 

The United States Departments of Labor, Health and Human Services, and Treasury (collectively, “The Departments”), have just published FAQs, which expand upon existing requirements, and state that group health plans must cover the cost, with or without the involvement of a healthcare provider, so long as the test is taken for “diagnostic purposes.” This mandate imposes a major financial burden on self-insured employers and other providers of group health insurance.

Here is what self-insured employers, and other providers of group health insurance, should know:


  • A group health plan must cover the costs of at home COVID-19 tests for participants either directly (i.e. “direct coverage”) or by requiring participants to pay for the tests upfront and then submit a claim for reimbursement.

  • If the group health plan provides direct coverage at home COVID-19 tests, both through its pharmacy network and a direct-to-consumer shipping program, it may limit reimbursement for these tests from non-preferred pharmacies or other retailers to the lesser of $12 per test or the actual cost of the test.

  • The group health plan must ensure that participants have access to at home COVID-19 tests through an adequate number of retail locations (in-person and online).

  • A group health plan may limit the number of at home COVID-19 tests covered for each participant to no less than eight tests per 30-day period (this limit applies only to tests purchased without a health care provider order or clinical assessment; no limit if the health care provider orders or administers the test following a clinical assessment).

  • A group health plan may require reasonable documentation of proof of purchase with a claim for reimbursement for the cost of an OTC COVID-19 test.

We will keep you updated as the COVID-19 pandemic continues to evolve.

If you have questions about employer healthcare coverage, or any other general employment issues, please do not hesitate to contact the attorneys at The Royal Law Firm at 413-586-2288.

ALERT: EEOC Releases Workplace Guidance to Prevent Harassment

01 May, 2024
On April 29 th , 2024, the U.S. Equal Opportunity Commission (EEOC) finalized their guidance in harassment in the workplace after receiving and responding to nearly 38,000 public comments on the proposed guidance released on October 2, 2023. The renewed guidance provides numerous clarifying hypotheticals, and addresses more recent issues including protections for LGBTIQA+ employees and remote work. Of note, the EEOC clarified the scope of sex discrimination and harassment, stating that federal protections under Title VII extend to LGBTIQA+ employees. Specifically, the EEOC made clear that the scope of harassment extends to repeatedly and intentionally misgendering employees or denying access to bathroom facilities that align with their gender identity. Further, this guidance reminds employers that discrimination and harassment based on “sex” includes harassment based on pregnancy, childbirth and related medical conditions, which include employees’ decisions related to contraception and abortion. Several public comments suggested that these guidelines infringed on free speech and religious rights. The EEOC did not directly address these concerns, instead stating that free speech and religious rights issues are fact-specific and would be addressed on a case-by-case basis. Further, the EEOC updated guidance related to the remote work environment. The EEOC clarified that conduct in a virtual work environment, including electronic communications using private phones, computers, or social media accounts can contribute to a hostile work environment if they impact the workplace. The EEOC also clarified that conduct occurring outside of the workplace, including on social media, which does not target the employer or its employees and is not brought into the workplace generally will not contribute to a hostile work environment. Finally, the EEOC updated its Anti-Harassment Policy Requirements, stating that an anti-harassment and discrimination policy should be widely disseminated to employees, in a manner that is understandable by all employees and includes i) a definition of prohibited conduct, ii) a requirement that supervisors report harassment, iii) multiple avenues for reporting harassment, iv) a statement that clearly identifies accessible points of contact for reporting purposes, and v) an explanation of the complaint process, including adequate anti-retaliation and confidentiality protections, and prompt and effective investigation and corrective action. You can read more about the EEOC's ruling on their website by clicking here . If your business has any questions on this topic or any other matters, please do not hesitate to contact the attorneys at The Royal Law Firm at 413-586-2288.

Non-Compete Agreements Are in Jeopardy

26 Apr, 2024
On April 23, 2024, the Federal Trade Commission (“FTC”) issued a final rule banning non-competition agreements for all employees except for very narrow exceptions. The FTC’s Final Rule banning all non-competition agreements is effective 120 days after its publication in the Federal Register, which is expected in the next few days.  As of the effective date, all non-competition agreements are banned, except for franchisor/franchisee relationships and for sales of a business between buyer and seller. The FTC’s Rule is retroactive, prohibiting certain non-competition agreements before the effective date of the Rule as well. Existing non-competition agreements can remain in effect as to senior executives, which are defined in the Rule as employees in “policy-making positions” making at least $151,164 annually. The FTC’s Final Rule is already being challenged through the court system and a challenge from the Chamber of Commerce will most likely follow suit. Therefore, if an employer has existing non-competition agreements, the employer may not need to rescind them just yet. Stay tuned for updates as these challenges take their due course.
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