Returning to the Workplace

While it’s important to be aware of common concerns like depression, stress and anxiety all the time, Blue Cross and Blue Shield of Louisiana reminds everyone to be especially mindful of how they feel during the COVID-19 pandemic.

“It’s completely understandable that we are all feeling more fearful or sad than usual right now,” said Blue Cross medical director Dr. Jeremy Wigginton. “The key is to keep yourself from letting these feelings overwhelm you.”

• Focus on the things you can control
• Be mindful of how much you’re watching the news, and set healthy limits
• Use tactics for boosting your mental health that you know work for you
• working out regularly
• doing a creative activity like painting or journaling
• unplugging to focus on family time

“Our mental health affects our physical health and overall well-being, and it’s a common concern among people who are struggling with serious health issues, either directly or with a loved one,” Wigginton said. “Be aware of how you feel, and ask for help if you need it. If you are struggling to get through the day, let your healthcare provider know that and ask about treatment recommendations.”

There are a number of resources available to your employees as they navigate both remote work and the potential stress of returning to the workplace.

Be Stronger Than Ever
Blue Cross has an in-house clinical team that includes nurses, dietitians, pharmacists and social workers. The care team works with members who are dealing with long-term health needs, serious illnesses or acute injuries. The team’s job is to help the members be STRONGER THAN any disease or diagnosis. They offer health coaching, personalized education and assistance in setting and reaching wellness goals.

Blue Cross social workers and other health coaches give members support and encouragement and help them find healthcare providers in their network or develop skills to cope with a diagnosis. They also connect members with local support groups and community resources to assist them.

To learn more about Care Management programs and services or to sign up for health coaching, visit www.bcbsla.com/Stronger. There is no cost for members to work with a health coach.

Blue Cross social workers also share tips for managing depression and stress on the STRONGER THAN EVER: Care Team Programs playlist, part of the Blue Cross YouTube channel.

Blue Cross social workers and other care team members regularly host live events on Blue Cross’ Facebook page. They offer tips and take questions about various health issues, including mental health concerns.

Behavioral Health Providers Available on BlueCare
Members can use BlueCare, Blue Cross’ telehealth platform, to have online visits with behavioral health providers. 

BlueCare behavioral health appointments can be a good service if your employees are feeling stress, anxiety or depression because of COVID-19, or if your team is practicing social distancing and looking for ways of getting care without going somewhere for treatment.

Log in to BlueCare to schedule appointments with available psychology or psychiatry providers who are trained and certified in telehealth care. Behavioral health providers available through BlueCare can help with anxiety, depression, stress, grief, substance abuse, coping with life transitions, couples counseling and more.

BlueCare can also be used 24/7 to treat routine, non-emergency medical conditions like colds, bladder infections, allergies, pink eye, mild stomach bugs or rashes. BlueCare is available in all 50 states and works on any device with internet and a camera, like a smartphone, laptop, tablet or computer.

Members can create a BlueCare account at www.BlueCareLA.com or with the BlueCare (one word) mobile app for Apple and Android devices. Then, simply log in and have a medical visit anytime or schedule a behavioral health appointment.

If a member regularly sees a behavioral health provider for care, they should ask if telehealth visits are an option.

Blue Cross has a YouTube channel with videos from our clinical team on a variety of topics. Watch videos at YouTube.com/BlueCrossLA.

Connect with Blue Cross on social media for regular updates.

New Directions
New Directions has opened up a crisis line to anyone who may need to discuss behavioral health issues related to COVID-19. Call 1-833-848-1764 to reach the New Directions Emotional Support Hotline. This is a free and confidential 24/7 helpline staffed by trained and caring professionals.

Other Resources
HealthWise:
The HealthWise Coronavirus Resource Center is offered as part of Blue Cross’ wellness services and content available to members. This specific resource center includes additional articles, videos and infographics that employers may post at their worksites or send by email to share messaging about COVID-19.

Healthfinder.gov:
A good resource to help employees Manage Stress.

National Alliance on Mental Illness (NAMI):
NAMI HELPLINE - 1-800-950-NAMI or TEXT "NAMI" to "741741."

National Suicide Prevention Lifeline:
1-800-273-8255

Disaster Distress Hotline:
During the COVID-19 outbreak the national Disaster Distress Helpline remains open to offer crisis counseling and emotional support related to the current COVID-19 outbreak from trained counselors across the country. The 24/7/365 helpline can be accessed by calling 1-800-985-5990, (para Español, oprima 2) or text TalkWithUs to 66746.

Substance Abuse and Mental Health Services Administration:
Coping During Infectious Disease Outbreaks is a publication available for download at samhsa.gov.

How do I keep my workplace safe?
The Centers for Disease Control and Prevention (CDC) has issued interim guidance for employers based on what is currently known about COVID-19. The guidance includes strategies and recommendations to employers responding to COVID-19, including those seeking to resume normal or phased business operations.

Below are some decisions Blue Cross made to keep our workplace safe. We are sharing these decisions to help walk you through the steps you may want to consider.

When should employees report exposure?

• When they:
• Test positive for COVID-19
• Are told by their healthcare providers to self-quarantine
• Are told by their healthcare providers to be tested for COVID-19
• Are showing respiratory illness symptoms
• In addition, employees who work at hospitals, clinics and other healthcare facilities and may be exposed to patients with COVID-19 should self-quarantine for 14 days and report this to their supervisors.
• Supervisors with an employee who self-reports these issues are required to share this information as soon as possible with our Human Resources department.
• For employees who have been exposed or are sick, we follow these quarantine guidelines from the Blue Cross medical directors based on guidance from the CDC.

Are there guidelines for employees diagnosed with COVID-19?

• Employees who test positive for COVID-19, who are told to self-quarantine, are told by their healthcare providers to be tested for COVID-19 and/or are showing respiratory illness symptoms must report this to their supervisors immediately, and supervisors must inform Human Recourses as soon as possible. This includes when an employee self-reports an issue and goes home OR when a supervisor sends an employee home because of these issues.
• Refer to the protocol from our medical directors about employees who are diagnosed with and/or exposed to COVID-19.

What should management tell employees to do if they think they’re sick?

• Call ahead before visiting your doctor. If you have a medical appointment, call the healthcare provider and tell them that you have or may have COVID-19. This will help the healthcare provider’s office take steps to keep other people from getting infected or exposed. Inform your immediate supervisor.

Should we require employees to wear masks?

• Blue Cross recommends employees wear masks when not at their desks or individual workspaces with physical distancing.
• The U.S. Centers for Disease Control and Prevention (CDC) continues to study the spread and effects of the novel coronavirus across the United States. Based on recent studies, it appears that a significant portion of individuals who have coronavirus lack symptoms and can transmit the virus to others before appearing ill. This means that the virus can spread between people interacting in close proximity—for example, speaking, coughing or sneezing—even if those people are not exhibiting symptoms. In light of this new evidence, CDC now recommends wearing cloth face coverings in public settings where other social distancing measures are difficult to maintain (e.g., grocery stores and pharmacies), especially in areas of significant community-based transmission, like Louisiana.
• Social distancing (staying home except to run essential errands and remaining at least six feet apart from others when outside the home) is still the best way to prevent spreading the virus, but cloth face coverings fashioned from household items like bandannas or T-shirts, or made at home from common materials at low cost, can be used as an additional, voluntary public health measure. Click here for a video tutorial on how to make a simple mask at home.
• Note: The cloth face coverings recommended are not surgical masks or N-95 respirators. Those are critical supplies that must continue to be reserved for healthcare workers and other medical first responders, as recommended by current CDC guidance.

Should we require employees to have antibody tests?

• Antibody tests are used to see if an antibody formed from a previous infection or a level of immunity is present. Blue Cross recommends that members talk to their healthcare providers before going to get a test.
• Blue Cross clinicians strongly believe that the current scientific evidence does not in any way support the use of antibody testing as part of a return-to-work strategy.
• Purchasing antibody tests can be very costly and may not be effective in informing a reasonable and safe return-to-work strategy. In order to protect the safety of employees and businesses from further financial harm, employers must consider the risks involved in making antibody testing part of their return-to-work strategy.
• Employers can find detailed information about COVID-19 tests at employers.bcbsla.com/covid19 or by calling their Blue Cross representatives.

How should employees work together back in the workplace?

• Employees should remain at least six feet apart from other employees while in the office, per U.S. Centers for Disease Control & Prevention (CDC) guidelines for social distancing. This may involve relocating some employees to new workspaces to create more distance among employees who come in to work. Take the recommended steps to make sure your workspace is properly sanitized.
• We recommend employees wear masks when not at their desks.

What if my employees need assistance with childcare while at work?

• The Louisiana Department of Education has started a statewide Child Care Assistance Program so that essential workers can apply for state financial support to pay for childcare at a childcare facility during the COVID-19 situation. If you have employees who are still coming into the office and are considered essential, they may be eligible for this program. Employees can refer to the Louisiana Department of Education website to see information about how to apply. 

What supplies do my employees need?

• Blue Cross recommends you provide some level of protective equipment such as masks, gloves and hand sanitizer.
• If you encounter a hand sanitizer shortage, you can make your own using CDC guidance of three parts isopropyl alcohol and one part aloe vera gel. While this would be equally effective as commercial products, it should remain on your property because it would not be labeled for distribution.

How can my employees find out about changes to our health insurance?

• Information about changes or additions to Blue Cross programs, services and/or benefits to help members during this time is being regularly updated at bcbsla.com/covid19. Check this site regularly to see the latest information.

How can I find out about health insurance changes as an employer?

• Employers can check the Employer page at bcbsla.com, or go to employers.bcbsla.com/covid19, for COVID-19-specific information for group leaders.
• Employers may also call their Regional Office representative for more information.

How can I apply for help through the CARES Act relief for small businesses?

• The CARES Act authorizes the Small Business Administration (SBA) to loan qualified businesses money to help endure the economic strain caused by COVID‐19. The CARES Act includes $376 billion for these SBA loans. Any small business with 500 employees or fewer, and also sole proprietors and independent contractors, can apply for the loans. The amount of the loan is 250% of the employer’s average monthly payroll with a maximum amount of $10 million for any one loan. If the money loaned is used to pay employee salaries, benefits, insurance premiums, rent, utilities or mortgages, the money spent on those expenses is eligible for forgiveness by the SBA. The CARES Act waives all borrower and lender fees and does not require collateral or personal guarantees from borrowers. Learn more at sba.gov.
• We encourage eligible groups to take advantage of the SBA loans to continue administrating their business operations.
• You can get a report of the premiums you’ve paid to date and copies of your invoices for your small business loan application through your eBilling account. If you do not have access to eBilling, please create an account through AccessBlue. You can find instructions on how to download your payment history, print an invoice and more on our Employer page at bcbsla.com.

How can I maintain health insurance coverage for my employees?

• Keep employees active if you have closed temporarily. If you consider an employee active, your health insurance company should too. This includes variable hour and shift work employees who may not be currently getting paid but are still considered active by the group. If the group considers employees terminated, rehire provisions may apply. For more details, go to employers.bcbsla.com/covid19.

Will there be a coverage waiting period for returning employees after layoffs?

• In general, groups determine eligibility waiting periods. Your health plan should put that process in place across the board as you direct. Please note that Affordable Care Act (ACA) rehire provisions (most cases 13 weeks and in some cases 26 weeks) will apply in the normal course of business. For more details, go to employers.bcbsla.com/covid19.

How should I plan for a potential spike in cases?

• Taking proactive steps now and planning for the possibility of later spikes of COVID-19 can lead to less business disruption in the future. Use this time to assess what worked and what did not work for your business during the stay-at-home order.
• The Emergency Paid Sick Leave Act and the Emergency Family and Medical Leave Expansion Act are in effect through December 31, 2020. 

Available Resources

• The Louisiana Department of Health is the public health agency of record for the state, and they have posted a COVID-19 webpage that is being updated at least once a day to show case counts, reported deaths, number of tests completed and the parishes that are reporting cases, among other information. Please refer to this page for official information about the spread of COVID-19 in our state. Also, please make your employees aware of this resource so they can see officially reported information about cases and deaths.
• There is a tremendous amount of coronavirus disinformation circulating, so for accurate and timely information it’s important we rely on trusted sources like the U.S. Centers for Disease Control and Prevention (CDC), the World Health Organization and other official federal and state sources. The CDC has created a repository of guidelines, tools and resources at https://www.cdc.gov/coronavirus/2019-ncov/community/organizations/businesses-employers.html.

Questions about health insurance coverage:

• If you have general questions about your coverage during this public health emergency, please call your Regional Office or visit our Employer page at bcbsla.com.

These are the guidelines put in place at Blue Cross and Blue Shield of Louisiana. This is an example you may use when discussing your own guidelines with your legal or human resources representative.

What Does It Mean to Self-quarantine?
While we should all be practicing social distancing, additional self-quarantine measures are needed if you have COVID-19 or have been exposed to COVID-19. If you need to self-quarantine, we strongly suggest you follow these guidelines, which Blue Cross and Blue Shield of Louisiana medical directors developed based on CDC guidance: 

• Do not physically come to work or have personal contact with another employee during your quarantine period.
• Avoid leaving your home other than to obtain medical care. Remember, you are in self-quarantine to avoid potentially infecting others in the community. Thus, we recommend you not go shopping, eat out, go to the movies or other public places where you may come in close personal contact with someone. It is best to have someone else bring you groceries and other essentials or have them delivered.
• Avoid close personal contact with people living in your household. They are at risk. Close personal contact is coming within six feet of them.
• While household members likely will remain in your home, avoid having any guests to your house.
• Avoid sharing utensils, dishes, glassware or other items that you use personally with anyone else.
• You may go outside but be sure to avoid any casual personal contact with neighbors or other individuals. 

In addition, there are some other good steps to follow while in self-quarantine:

• Follow good hygiene by washing your hands frequently with soap and warm water.
• Frequently clean your environment with standard household cleaners. The COVID-19 virus may survive on surfaces up to nine days.
• Avoid touching your face, nose and eyes. You can become infected when the COVID-19 virus is transferred from surfaces to these areas of your body.

Ideally you should monitor your temperature twice a day to see if you have a fever of 100.4 degrees or more. If you do, contact your physician.

For Employees Who Are Diagnosed with or Exposed to COVID-19
Blue Cross and Blue Shield of Louisiana medical directors have established a protocol to help you know what to do if a member of your team is diagnosed with or exposed to COVID-19. Our medical directors developed this protocol in accordance with U.S. Centers for Disease Control and Prevention (CDC) guidelines.

This is the protocol put in place at Blue Cross and Blue Shield of Louisiana. This is an example you may use when discussing your own protocol with your legal or human resources representative.

Here are the different scenarios you may be facing, and what to do for each one:

Your employee is working at your facility and is diagnosed with COVID-19:

• Employee will be on mandatory quarantine from all engagement with the facility or staff, meaning they may not come to the facility or interact face-to-face with any other employee.
• Quarantine lasts until one of the following strategies is met:
  • Symptom-based strategy:
• At least 3 days (72 hours) have passed since the person has had no fever without the use of medication that lowers body temperature (e.g. aspirin, Tylenol, ibuprofen, etc.), and
• At least 14 days have passed since the person’s symptoms first appeared.
• Test-based strategy:
• At least 3 days (72 hours) have passed since the person has had no fever without the use of medication that lowers body temperature (e.g. aspirin, Tylenol, ibuprofen, etc.), and
• Improvement in respiratory symptoms such as cough and shortness of breath, and
• Negative results of an FDA Emergency Use Authorized molecular assay for COVID-19 from at least two consecutive sets of paired nasopharyngeal and throat swab specimens that were collected at least 24 hours apart, for a total of four negative specimens—two nasopharyngeal and two throat

• Employee will be on mandatory quarantine from all engagement with the facility or staff for 14 calendar days and may not come to the facility or meet face-to-face with other employees.

• Employee will be onmandatory quarantine from all engagement with the facility or staff and may not come to the facility or meet face-to-face with other employees.
• If the infected person leaves the same household as the employee, the quarantine lasts until 14 calendar days after the employee last had contact with the infected person.
• If the infected person remains in the same household as the employee, the quarantine lasts until 14 calendar days after the person who was ill with COVID-19 has met either the symptom-based or test-based strategy noted above.

• Employee may come to work, but should self-monitor for symptoms of COVID-19, including taking his or her temperature for 14 days.

• Employee will be on mandatory quarantine from all engagement with the facility or staff for three calendar days and may not come to the facility or meet face-to-face with other employees until three calendar days (72 hours) have passed since the person has had no fever without the use of medication that lowers body temperature (e.g. aspirin, Tylenol, ibuprofen, etc.).