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Latest Updates

Employee Assistance Program (Updated 03/31/2020)

For our Member Groups with Deer Oaks Employee Assistance Program, additional information can be found at www.deeroakseap.com or by calling 1-866-327-2400.

Expanded member benefits during the coronavirus outbreak

ID Card and Debit Card Mail Distribution (Updated 03/26/2020)

In response to many “Shelter in Place” orders now being issued throughout Texas, TML Health will temporarily mail identification and debit cards directly to employees’ homes rather than to the employers for distribution. As a reminder, employees may also access an electronic copy of their Identification card online at www.tmlhealthbenefits.org.

Waiving member costs for COVID-19 testing (Updated 04/01/2020)

To help ensure our members get the testing and treatment they may need for the COVID-19 coronavirus, and to help prevent community transmission by increasing access to testing, we are waiving all out-of-pocket expenses for COVID-19 diagnostic testing at approved facilities for members of TML Health.

Treatment is covered (Updated 03/17/2020)

Reasonable, medically necessary treatment including hospitalization, supportive treatment, doctor’s office visits, and other services for patients who test positive for COVID-19 will be covered in accordance with the benefit plan. This coverage is subject to the usual patient share responsibilities for your individual plan, such as your deductible.

Early prescription refills and extended authorizations (Updated 03/17/2020)

In response to the COVID-19 pandemic and the need many members may face of avoiding public places, we are temporarily removing limits on early refills so that our members can get refills of their maintenance medications as needed.

This is similar to the temporary lifting of "refill too soon" restrictions you might request when you are going on an extended trip.

Physician authorizations on maintenance medications that would otherwise expire between March 17, 2020 – May 1, 2020 will automatically be extended 90 days. For example, a May 1 expiration date will be extended to August 1. During this time, you will be able to use your authorization that would have expired to fill or refill your prescription of these medications.

This extended authorization does not include opioid medications, which will be subject to their usual authorization requirements.

Teladoc (Updated 03/20/2020)

All Teladoc patient consults are now be screened for COVID‐19 symptoms and risk factors. Teladoc Health care providers are evaluating symptoms (e.g. fever, cough, shortness of breath) and contact history (e.g. known exposure to a person diagnosed with COVID‐19, recent travel or living in an area with an active outbreak, healthcare worker who may have increased risk of exposure) to assess COVID‐19 risk. Although your copay (if any) will be collected by Teladoc at the time you request an appointment, if the provider makes a COVID-19 diagnosis, TML Health will reimburse you for your copay.

If the doctor gathers information that supports testing for COVID‐19 in accordance with Texas guidelines, Teladoc will contact the appropriate public health department in accordance with local reporting requirements. Each public health department defines its own parameters regarding how they will contact patients to initiate diagnostic testing, conduct contact tracing, and/or implement at‐home self‐monitoring, at‐home supervised isolation, or quarantine requirements.

Many health departments and health systems are prioritizing testing for patients with the greatest risk of COVID‐19 complications or greatest risk of spreading to others. Teladoc advises individuals suspected to have been infected with COVID‐ 19 to call their local doctor or their state’s public health hotline to verify test availability and to notify the in‐person care facility in advance of their arrival, so that healthcare personnel on-site can direct them appropriately and minimize potential exposure for others.

Emotional support (Updated 03/31/2020)

Through our relationship with Optum, we are offering our members access to a free 24/7 emotional support line at 866-342-6892. This Help Line is staffed by professionally trained mental health experts.

Members can also get emotional support by downloading the Sanvello app. Sanvello is available 24 hours a day, 7 days a week, and is free. Specially trained mental health specialists can help deal with stress and anxiety, as well as provide referrals to community resources for specific concerns.

Texas Health and Human services has also launched a 24/7 statewide mental health support line to help Texans experiencing anxiety, stress, or emotional challenges due to COVID-19 pandemic. People can call the statewide COVID-19 mental health support line 24 hours a day, 7 days a week toll-free at: 833-986-1919.

First Responder Worker's Compensation (Updated 03/17/2020)

Members who are first responders and contract COVID-19 in the course of their work may be eligible for Workers’ Compensation benefits. Contact your employer to report the diagnosis and get the process started.

First responders, particularly 911 operators and Emergency Medical Services (EMS), should refer to the CDC Guidance for EMS for more information on personal and public safety concerning suspected cases of coronavirus.

Service to Member Groups

Renewal Extensions (Updated 03/25/2020)

We know renewal paperwork is the last thing on your mind right now, and you still need health coverage. To take at least one concern off your plate, we will automatically renew coverage for any Member Group that does not change their plan sponsor.

For our groups that scheduled open enrollment in March or April and would like to postpone, we are extending the renewal date to October 1 so that you can hold open enrollment later this year. Groups requesting this extension will have the same benefit plan and rates as they have today extended until October 1. This is how we live our core value of Public Service. Please contact your Account Executive to request an extension.

Waiver of Actively-at-Work Eligibility Requirements (Updated 03/24/2020)

TML Health’s stop loss carrier recently advised us that it is temporarily waiving its actively-at-work eligibility requirements until May 31, 2020 for employees whose hours are temporarily reduced due to the Coronavirus, provided that:

  • The employer’s contribution is paid for all eligible employees each month, including those with modified eligibility or actively-at-work provisions;
  • Employers must notify the Pool of any employee for whom modified eligibility or actively-at-work provisions have been applied; and
  • The employer continues to pay at least 50% of the employee’s health insurance contributions.

Therefore, for those employees whose hours have been temporarily reduced through May 31, 2020 due to the Coronavirus, employers are not required to terminate the affected employees from the benefit plan(s) just because of the reduction in hours. You can read more details on the available options here.

ID Card and Debit Card Mail Distribution (Updated 03/26/2020)

In response to many “Shelter in Place” orders now being issued throughout Texas, TML Health will temporarily mail identification and debit cards directly to employees’ homes rather than to the employers for distribution. As a reminder, employees may also access an electronic copy of their Identification card online at www.tmlhealthbenefits.org.

TML Intergovernmental Risk Pool Resource Page (Updated 03/23/2020)
Texas Municipal League (TML) COVID-19 Resource Page (Updated 03/23/2020)
CDC recommendations for businesses and employers (Updated 03/08/2020)

General Coronavirus Information

What if I May Have Been Exposed? (Updated 03/19/2020)

If you have been in a situation that may have exposed you to the COVID-19 coronavirus, for example as a first responder, an attendee at an event attended by an individual who tested positive, or sharing a household with or caring for someone with the virus, the CDC recommends the following:

  • Self-isolate for 14 days after your potential exposure.
  • Monitor your symptoms.
  • If you develop fever, cough, or shortness of breath, call (not visit) your doctor. They can evaluate and refer you for testing. Currently, you cannot be tested without a referral.

You can find more information at: https://www.cdc.gov/coronavirus/2019-ncov/if-you-are-sick/steps-when-sick.html

CDC coronavirus situation summary (Updated 03/21/2020)
CDC Guidance for EMS (Updated 03/08/2020)
COVID-19 información en español (Updated 03/24/2020)