Dental Practice FAQs During COVID-19

Updated March 30, 2020 – 5:30 PM

The Kansas Dental Association will update this document as new information becomes available. View the latest COVID-19 recommendations at the KDA COVID-19 Resource Center.

CARES Act

As the KDA and the ADA have reported, Congress passed the CARES Act, a COVID-19 relief bill containing several provisions important to dentistry including Small Business Administration loans, retirement account withdrawals, and student loan payment and interest deferral.

If you are considering applying for an interim loan, the ADA suggests the following:

1. Go to the Small Business Administration website (sba.gov) and apply for the Economic Injury Disaster Loan (EIDL) . This will guarantee you receive a $10K grant (whether or not you are approved) that you will not have to pay back.
2. Once approved, go to a SBA preferred lender and apply for a 7A Payroll Protection Loan.
3. Roll the EIDL balance into the 7A loan. If you disperse all the loan money to qualified expenses between May 1 and June 30, 2020, the loan will be forgiven.

Human Resources

For more information on workforce issues, please visit the KDOL web site.

Q1: If I close my office, do I have to pay my employees?

A: Hourly (non-exempt) employees you do not have to pay — if they don’t work, then they don’t get paid.

For exempt (salaried) employees, you will have to pay them if they are willing and able to come to work, but you closed the office. You may direct exempt staff to take vacation or debit their leave bank account during a disaster, whether for a full or partial day’s absence, provided the employees receive in payment an amount equal to their guaranteed salary.

Q2: If I close my office, does my staff qualify for Unemployment Insurance (UI) benefits?

A: A staff person is considered unemployed in any week that they do not work and any week for which wages are not paid to that staff person. So, if one of your employees is not working and not being paid, he/she is unemployed for purposes of the UI program.

Unemployment insurance benefits may be available to individuals who are involuntarily unemployed as a result of COVID-19. The amount of the benefit will vary based upon the amount of money that the individual has previously earned, but will be between $122 and $488 per week. At this time, individuals can receive up to a maximum of 16 weeks of benefits.

Q3: Do my employees need to exhaust their accrued sick, vacation, and/or personal time before they can draw unemployment benefits?

A: No, an employer can lay off employees without requiring them use their accrued time. That being said, where an employer offers a bona fide benefits plan or vacation time to its employees, there is no prohibition on an employer requiring that such accrued leave or vacation time be taken on a specific day(s).

However, if an employee is receiving paid leave, such as sick leave, vacation leave, or some other paid benefit while off work, it is considered paid wages and the employees will not be eligible for benefits for that time period. In other words, an individual cannot double-dip.

Q4: If the business owner draws a salary, can they be eligible for UI benefits?

A: If a business owner collects a salary and receives a W-2, the business owner may be eligible to file for UI benefits. Definitely file and the Kansas Department of Labor (KDOL) will let you know of any issues.

Q5: Is it better to do a Shared Work Plan, or lay off employees?

A: A Shared Work Plan can be used when an employer reduces the normal weekly work hours for an employee by at least 20 percent (but no more than 40 percent). In the case of the COVID-19 pandemic and the ADA and KDHE recommendation of dentists only treating emergency patients, a dentist’s workload would typically be cut by a far greater margin than the 40% maximum. Therefore, a Shared Work Plan would not apply and the employer should proceed with a temporary layoff of employees.

Q6: If I lay off employees, do they have to look for work in order to maintain their UI eligibility status?

A: If an individual is unemployed due to COVID-19 and have taken all necessary steps to return to work for their regular employer, the individual does not have to look for other work.

Q7: Do my staff members have to file for unemployment benefits themselves, or can I do it for them?

A: The Kansas Department of Labor (KDOL) provides employers the option to assist their employees with filing an application for Unemployment Benefits during a layoff. This process allows the employer the ability to submit the application for unemployment insurance benefits for employees that are impacted by a temporary or permanent layoff. The employer would just put the names and information of each employee affected into a spreadsheet downloaded from the KDOL website and then upload it once complete.

How this benefits the employer:

• Zero waiting. Employers will have the ability to communicate directly with the Employer Relations Administrator instead of waiting to speak with a representative at the Unemployment Contact Center. The Employer Relations Administrator will be able to answer any questions about unemployment such as when and how to file by spreadsheet.
• Helps reduce unemployment fraud. In the event of a temporary layoff, the employer will be able to enter an employee’s return to work date into the spreadsheet. This date is used to prevent payment from being released should the employee continue to claim benefits after returning to work.
• Reduced paper. Instead of receiving an Employer Notice for each employee that files, the employer will receive one listing of all claims filed off the spreadsheet.

Q8: If a staff member works a few hours answering phones or helping with an emergency procedure, would they still qualify for Unemployment Insurance (UI) benefits?

A: A staff person may also be considered unemployed if they work less than full time and their gross weekly wages are less than their determined weekly UI benefit amount. So, if the employee’s hours and wages have been reduced, they may also be considered unemployed.

Q9: Do I have to serve a waiting week?

A: The waiting week requirement for those unemployed due to COVID-19 is waived.

Q10: What is required of employers?

A: All employers must notify their employees of the availability of UI benefits at the time of separation from employment. While not required, employers may also consider filing claims by spreadsheet. For more information, visit the KDOL web site.

Q11: If I close my office, will my employees lose their health insurance coverage?

A: Many carriers have expressed their desire to offer flexibility for their clients and are in the process of drafting formal guidance. At this point, each carrier will develop their own guidelines and we will keep you informed as receive any updates.

Q12: What is the federal legislation “Families First Coronavirus Response Act”?

(Note: updated as of March 17, as this proposed legislation changes daily)

A: Congress is working on legislation in response to the coronavirus disease outbreak and the ADA is working to ensure that those bills include provisions that are beneficial to dentists—particularly dental practice owners—and their patients.

Congress is currently considering a legislative package—H.R. 6201, the Families First Coronavirus Response Act. That bill, which was developed between Speaker of the House Nancy Pelosi, D-Calif., and Treasury Sec. Mnuchin, focuses on short-term issues such as child and elderly nutrition programs, COVID-19 testing, unemployment benefits, and family medical and sick leave.

The bill is currently headed to the Senate floor for a vote after the House adopted technical corrections on March 16 that were needed to move the bill forward. These corrections, which the ADA is still evaluating, are important because the provisions regarding family medical leave/sick leave could cause a financial burden to dentist owners and other small businesses in America.

The ADA is concerned about the paid leave provision because while it could be beneficial to employees, it could also cause a financial burden for many small businesses in America. In response, the ADA, along with more than 80 organizations, asked Congress to reconsider the provision.

Finally, the ADA has learned that Congress is working on an additional legislative package related to COVID-19. That package is expected to provide at least $750 billion to alleviate the economic crisis facing millions of Americans. The new proposal, among other things, contains provisions to increase federal funding to provide immediate help to small businesses. The ADA will be working to ensure that those provisions will benefit our dentist owners.

Follow all of the ADA’s advocacy efforts at ADA.org/advocacy.

Q13: What do I do if an employee is exhibiting symptoms?

A: KDHE recommends that employees who appear to have acute respiratory illness symptoms (i.e. cough, shortness of breath) upon arrival to work or become sick during the day should be separated from other employees and be sent home immediately. Sick employees should cover their noses and mouths with a tissue when coughing or sneezing (or an elbow or shoulder if no tissue is available).

Do not require a healthcare provider’s note for employees who are sick with acute respiratory illness to validate their illness or to return to work, as healthcare provider offices and medical facilities may be extremely busy and not able to provide such documentation in a timely way. o

Employers should maintain flexible policies that permit employees to stay home to care for a sick family member. Employers should be aware that more employees may need to stay at home to care for sick children or other sick family members than is usual.

Q14: Would it be better to lay off my employees now or should I wait for the paid leave and tax credits available through H.R. 6201?

A: Whether or not a dentist should or should not lay off employees is an individual business decision and we cannot advise any business owner as to what is best in their situation. What we can say is H.R. 6201 is the Families First Coronavirus Response Act (FFCRA) signed by President Trump on March 18, 2020 and it goes into effect April 1. It essentially expands FMLA and requires certain employers to provide their employees with paid sick leave or expanded family and medical leave for specified reasons related to COVID-19. The lack of, or reduction of business due to COVID-19 is not a qualifying event for an employee to be eligible for paid sick time under this Act.

For more information on the Families First Coronavirus Response Act, please visit the US Department of Labor web site at dol.gov.

Q15: What is the Pandemic Unemployment Assistance plan and does it apply to me/my staff?

A: The Pandemic Unemployment Assistance plan is part of the recently signed CARES Act. Under the plan, weekly benefits for all unemployed workers will be increased by a set amount of $600 a week for up to four months. This applies to workers already in the unemployment system and eligible employees about to apply.

Q16: Is there a separate process to apply for the $600 UI benefit amount available through the CARES Act?

A: The additional $600 in benefits will be administered through the Kansas Department of Labor. States have the option of providing the entire amount in one payment or sending the extra portion separately. But it must all be done on the same weekly basis.

Q17: If my employee receives UI benefits equal or greater than their weekly pay due to the expanded UI benefits, what incentive do they have to return to work?

A: If you have asked your employee to come back to work and they refuse, you would report the refusal to the Kansas Department of Labor through a form on their website, and the employee would lose their UI benefits.

Insurance

Q1: Will my insurance company pay business income if I have to close my office?

A: Most likely, no, since business owner’s (BOP) policies require “direct physical loss” like a fire, flood, or tornado in order to trigger a business income claim. When in doubt, file a claim since only your insurance carrier can make a final determination.

Q2: If an employee contracts the coronavirus, does workers’ compensation provide coverage?

A: An employee who contracts the coronavirus while at work might have coverage under workers’ compensation, but the burden of proof would be on the employee to prove the triggering event of the illness arose out of employment and occurred in the course of employment. Your insurance carrier will evaluate each claim on its own individual set of circumstances.

Q3: If I contract the coronavirus, will my long-term disability income (LTD) policy provide benefits?

A: It’s doubtful, since typical LTD policies have a 90-day waiting period before benefits are compensable. Check with your carrier on your individual policy specifics.

Q4: Will my group short-term disability income (STD) policy provide benefits if one of my employees contracts the coronavirus?

A: It’s possible, since STD policies contain relatively short waiting periods. Check with your carrier on the policy specifics.

Financial Relief

Q1: Would my practice be eligible for federal loans offered by the Small Business Administration (SBA)?

A: SBA’s Economic Injury Disaster Loans offer up to $2 million in assistance for each affected small business. These loans can provide vital economic support to small businesses to help overcome the temporary loss of revenue they are experiencing.

On March 17, 2020, as part of the Trump Administration’s aggressive, whole-of-government efforts to combat the Coronavirus outbreak (COVID-19) and minimize economic disruption to the nation’s 30 million small businesses, U.S. SBA Administrator Jovita Carranza issued revised criteria for states or territories seeking an economic injury declaration related to Coronavirus (COVID-19).

The relaxed criteria will have two immediate impacts:

• Faster, Easier Qualification Process for States Seeking SBA Disaster Assistance
• Expanded, Statewide Access to SBA Disaster Assistance Loans for Small Businesses

At this time, Kansas is not an eligible state for the SBA Disaster Assistance Loans for Small Businesses Impacted by Coronavirus. We will continue to monitor this situation and provide updated information as it becomes available. To check if Kansas has been designated a state for SBA loans related to impacts of the coronavirus, visit the SBA’s website.

Q2: Would another option be to get a loan from my financial institution?

A: Yes, working with a banking partner with whom you already have an established relationship is an excellent option to consider. Often, this may be a more efficient option that allows relatively quick access to needed capital. Some financial institutions are waiving penalties and fees for things like emergency CD withdrawals, so it's best to reach out and inquire about what would be best for your situation.

Q3: Are there options if my practice needs to skip payments?

A: The best recommendation is for you to contact vendors and financial partners directly — and proactively — to make requests. Since skipping a payment without making prior arrangements can have a negative impact on your credit, it’s encouraged that you reach out in advance of missing any payments. You could potentially negotiate terms that include requesting a pause on payments, making interest-only payments or pausing automatic payments.