The AFL Hotel and Restaurant Workers Health and Welfare Trust Fund (“Fund”) will begin to cover the cost of over-the-counter (“OTC”) COVID self-tests purchased on or after January 15, 2022 as required by law.
Based on recent guidance from the federal government, group health plans must begin to cover the cost of over-the-counter (“OTC”) COVID self-tests that are purchased on or after January 15, 2022, without a doctor’s note, individualized health assessment or prior authorization. The Fund is working with its network pharmacies in hopes to implement a process that will allow the Fund participants and dependents to obtain the OTC COVID self-tests at participating pharmacies at no up-front cost to the participant as soon as possible. However, until this process is set up, participants and dependents should keep both the UPC code on the packaging of the test purchased and accompanying purchase receipt for OTC COVID self-tests purchased on or after January 15, 2022 in order to submit for and receive reimbursement for up to 8 individual test (4 two-test kits) per participant per month. Which medical carrier you are enrolled in will determine where and what you will need to submit for reimbursement. You may experience a slight administrative delay in receiving reimbursements for tests purchased on or after January 15, 2022 until we can get our own internal new processes up and running.
Please note that as is the case with COVID tests ordered by a doctor, the new guidance does not require plans to cover the costs of OTC COVID self-tests purchased for employment/surveillance purposes. You will be requested to attest that the OTC COVID self-test submitted for reimbursement was not purchased for employment testing purposes.
Please look out for future communications from the Fund, as we will be providing you with more information on this topic as it becomes available.