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1-100: Aetna Plan & Rate Updates Effective January 2017
Oct 28, 2016
Aetna has announced rate adjustments for January 1, 2017 effective dates with benefit and underwriting changes. All rates are available for quoting!
4th Quarter 2016 Rates
- HMO: 11.9% average statewide annual increase
- Reduced rates in Bay Area Regions 5, 6 & 8
- HMO: 1.6% average INCREASE
- PPO: 2.8% average INCREASE
Dental: rate INCREASE
Vision: RATE PASS
Life: RATE PASS
PLANS & BENEFITS
- New Medical Plans:
- Gold EPO 750 80
- Silver EPO 2000 Copay
- Bronze EPO 4000 Copay
- Silver MC 2000 80/50 HDHP Plan
- Bronze MC 6500 Copay
- Bronze MC 4800/60% HSA
- Bronze MC 6550/100% HSA
- Bronze MC 6850 100/50 offers first-dollar benefits: •
- Office Visits
- Lab & X-ray
- Existing Plans: Most Aetna small group plans will experience benefit changes with many plans being discontinued for specific network pairings. Contact your b&p Sales Rep for specifics.
- For new and renewing groups in 2017, Aetna will be changing from Aetna Value Plus Formulary (four tier) to Aetna Value Formulary (four tier).
- Transitioning members are allowed a one-time fill, up to a 30-day supply, of a medication that requires precertification, step-therapy, or other utilization management.
- Specialty drugs must be filled through Aetna Specialty Pharmacy.
- Vitalidad network will be discontinued for all groups effective January 1, 2017.
- Employers may choose up to five (5) plans across all networks and metallic levels.
- Aetna Whole Health network has expanded to include:
- Providence - Los Angeles (pending regulatory approval)
- MemorialCare - Los Angeles/Orange counties
- New business must be submitted by the effective date; no exceptions.
- 60 days notice required to change effective dates.
- No DE-9C or payroll required for groups with 6+ enrolled; increases to 20+ enrolled effective January 2017.
- Statement of Understanding is not required.
- Individual coverage, on and off the Exchange, is considered a valid waiver; policy changes effective January 2017.
Alongside Another HMO
- 40% AND minimum 5 enrolled with Aetna required alongside Kaiser.
- Aetna must be the sole carrier for groups enrolling during the Special Open Window; alongside Kaiser is not allowed.
JANUARY BOOK RATES
Book rates for January 2017 effective dates are provided below and on the b&p website.
For questions, please contact a member of your b&p Sales Team - 888.722.3373.