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1-100: Aetna's California Waiting Period

Sep 27, 2013

Starting January 1, 2014, for new group plans and at the first renewal for those group plans renewing after January 1, 2014, the waiting period may be no longer than 60 calendar days. A waiting period is the amount of time an eligible employee has to wait before coverage starts. This is for new or newly eligible employees and applies to all fully insured medical plans regardless of employer size.

The mandate also includes a special rule about individuals in a waiting period greater than 60 days and prior to the renewal date. If the employee is subject to a waiting period that exceeds 60 days, and is within 60 days of the customer's renewal date, it will no longer be valid. The employee must then be given the opportunity to elect coverage no later than the customer's renewal date.

This mandate is extraterritorial, which means it applies to all insurance policies issued in the state of California and to all California residents regardless of the state in which their insurance contract is issued.

What this means for your clients

Aetna is updating their systems internally to implement the new law. Any existing Small Group plan with a waiting period longer than 60 calendar days will be changed to conform with the new California mandate upon renewal in 2014.

Small Group 1-100
Impacted plans will be updated automatically to a waiting period of first of the month following 30 days from the date of hire, as part of the renewal process.

Middle Market
Plan sponsors will need to submit a waiting period that complies with the new law as part of the renewal process. An Aetna Account Manager will be available to help these plan sponsors select a compliant wait period.

Please note:

For questions regarding Aetna plans or California's waiting period, please contact your b&p Sales Team - 888.722.3373.

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