Critical Health Alert; Last Updated: April 07, 2020 1:40 P.M. EST
Keeping You Informed - General FAQs
If I am diagnosed with COVID-19 and need to be admitted to a hospital, how will MetLife employee benefits help me?
If you or an eligible family member have Hospital Indemnity Insurance or Accident Insurance that includes Sickness Hospital Benefits, and you are admitted to the hospital for treatment of COVID-19, you will be able to file a claim under your coverage provided you meet the plan requirements.
Can I use my employee benefits to be tested for COVID-19?
If the Health Screening Benefit is included in a Critical Illness, Accident or Hospital Indemnity Insurance certificate, the Health Screening Benefit would be payable for a COVID-19 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. Please check with your employer or sign into MyBenefits for plan details.
What is MetLife doing to ensure questions can be answered and claims are filed quickly?
MetLife remains committed to ensuring employees get the service they expect and the timely handling of claims. At this time, we are confident in our abilities to service our employees.
If I have been diagnosed with COVID-19 and I am unable to work, will MetLife Disability Insurance pay benefits?
If you have MetLife Disability Insurance, are diagnosed with COVID-19 and are unable to perform your job due to the sickness, you may be entitled to MetLife Disability Insurance benefits. Disability Insurance will replace a portion of your income for a given time period, which depends on your policy.
If I am quarantined, but not diagnosed with COVID-19 or can still work, am I eligible for a Disability Insurance claim?
Being quarantined most likely does not meet the requirements for a disability and would not be covered by MetLife Disability Insurance. However, if you develop COVID-19, or another qualifying sickness while quarantined, and you meet the definition of disability within the policy, benefits would be reviewed for payment.
If I am quarantined because of exposure to COVID-19 but not diagnosed with the illness, will I qualify for disability benefits?
We will review each leave request on a case-by- case basis, however, in order to qualify for disability, quarantined employees would need to satisfy the definition of a “serious health condition.” If the employee is unsure if the claim will be approved, we encourage the claim to be submitted for review.
If I am quarantined because of exposure to COVID-19 but not diagnosed with the illness, will I qualify for FMLA?
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” or be caring for a child if the school or place of care has closed or childcare provider is unavailable due to a public emergency regarding COVID-19, 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.
Life Insurance FAQs
I submitted a life insurance application which requires medical evidence of insurability (MEOI), or Statement of Health (SOH). What happens to my life insurance application if I cannot complete the MEOI/SOH form immediately?
MetLife offers group life insurance policies through employers. If you select additional life insurance coverage, medical evidence of insurability (MEOI), or a Statement of Health (SOH), may be required based on your employer’s plan. Each individual applicant’s medical history must be reviewed before a coverage decision is made. If you are unable to go to the post office, or mail the paper form via the US Postal Service, there are two additional ways to submit your MEOI/SOH form for processing, including email and fax submission options. You can find the email and fax information in the Instructions section on your MEOI/SOH form.
In instances where additional medical evidence of insurability is required (for example, a paramedical exam) you will be given 6 months to complete this requirement. Once this additional information is received, MetLife will inform you of a coverage decision in writing.
I purchased a life insurance policy directly from an agent, not through my employer. How can I get help with my policy?
Self-service forms, answers to frequently asked questions, contact information, and performance information can be found on our website for those individuals who have purchased their policy through an agent (Life Insurance Policyholders site). You can also contact your financial professional for assistance.
Dental Insurance FAQs
Is MetLife seeing that dental offices are still providing emergency care for patients?
Earlier in the year we were seeing that dental offices were providing emergency dental care for patients. They were following the guidance from the American Dental Association, their state dental associations, and state regulators that they should offer emergency dental care as a response to the COVID-19 pandemic. MetLife recommended that plan members contact their dentist for direction on how to seek the appropriate care at that time. Plan members can contact MetLife at 1-800-942-0854 or visit mybenefits.metlife.com for assistance in finding a dentist in their area in the event they don’t have a dentist or their dentist is not available.
[updated April 07, 2020; 1:40pm EST] Does MetLife provide benefit coverage for dental services delivered through tele-dentistry?
MetLife dental plans provide coverage for dental services delivered through tele-dentistry. The coverage is handled the same as if the patient was receiving the dental services in a dental office. Dental services that can be delivered through tele-dentistry typically include problem focused exams and re-evaluations. The coverage is subject to the plan terms and conditions. Dentists can verify benefit coverage using MetLife’s web portal, www.MetDental.com as well as MetLife’s interactive voice response (IVR) capabilities. To the extent a state has enacted mandates regarding tele-dentistry due to the COVID-19 pandemic, MetLife will fully comply.
Are employees going to be charged for additional personal protective equipment (PPE) costs from dental providers?
Currently, members who have services performed by a network provider should not incur any additional costs for infection control, including PPE, per our network contracts with our providers. These costs are not considered a separate billable dental procedure and cannot be billed to a participant or to MetLife. If a member is surcharged by a network provider for PPE upfront, they should report this charge to MetLife by calling us at 1-800-GETMET8 (1-800-438-6388). MetLife has an established grievance process to fully resolve these charges and track these types of issues which allows us to educate providers accordingly.
If a member receives services from an out-of-network provider, they may be responsible for any additional PPE charges billed by the provider.
Legal Plan FAQs
Will there be any disruption of service due to the pandemic?
Our Client Service Center is open during its regular hours Monday through Friday, 8 am – 8pm ET, and we are operationally prepared to handle all calls and claims. You can reach out to us at 800-821-6400 with any questions or concerns.
Can I access attorneys during this time?
Our attorneys can provide consultations over the telephone, and many can consult via virtual meetings. While our attorneys will do their best to handle all inquiries in a timely manner, our e-panel attorneys are also available to answer general questions online. You can submit questions and a Network Attorney will respond to within 24 to 48 hours.
Information relating to Continuation of Coverage (Portability)
What are MetLife Legal Plans’ portability options for furloughed, temporarily laid-off or reduced hours/salary employees?
Beginning April 1, 2020 through July 31, 2020, we are offering employees that would like to keep their plan benefits due to a COVID-19 related leave of absence, unpaid leave, or termination the option to either port their plans for 3 months or choose our standard 12-month portability. You can call our Client Service Center at 800.821.6400, Monday-Friday (8am - 8pm ET) to enroll in the portable plan. You must enroll within the month of July. Enrollment is prepaid via remittance of a lump sum payment equal to the legal plan’s monthly rate times three months (or 12 months if you choose our standard portability plan).
Under portable enrollment, dependent definitions are the same as those for active employees. The covered services and exclusions are the same as those under the current plan. Members can visit members.legalplans.com or call 800.821.6400 for plan details.
How long will MetLife Legal Plans offer this three-month portability plan?
At the end of July, we will evaluate whether to continue the three-month portability option in June. For those who enroll in the three-month program, we will evaluate at the end of the period whether to extend for an additional three-month renewal option.
*Standard Exclusions apply. See a full list of our exclusions here:
No service provided, not even consultation for:
- Employment-related matters, including company or statutory benefits
- Matters involving the employer, Network Attorneys, MetLife and affiliates
- Matters in which there is a conflict of interest between the employee and spouse or dependents, in which case services are excluded for the spouse and dependents Appeals and class actions
- Farm and business matters, including rental issues when the plan member is the landlord
- Patent, trademark and copyright matters
- Costs and fines
- Frivolous or unethical matters
- Matters for which an attorney-client relationship exists prior to the participant becoming eligible for plan benefits