News & Updates
Announcing upcoming plan changes for new and renewing groups with 2 - 50 eligible employees effective as of October 1, 2010.
Overview of Upcoming Changes
Aetna is changing health benefits plan designs to comply with new federal laws.
Aetna is making it easier for your clients to choose plan designs by simplifying the plan designs available.
Aetna is making other changes to better manage rising health care costs.
Health Care Reform Plan Changes
Dependent children can now enroll in an Aetna medical or dental plan up to age 26. If state law requires coverage of dependents age 26 and older, the plan will continue to cover those dependents.
Coverage for enrollees up to age 19 will include services needed to treat pre-existing conditions.
Plan designs will have no overall dollar limit on how much Aetna will pay over a member’s lifetime.
Aetna members won’t pay anything for certain preventive care delivered from network providers.
Competitive Product Solutions for California
As of October 1, 2010, Aetna will be launching a refreshed product portfolio allowing Aetna to serve your California Small Group clients’ more efficiently and simplify their plan choices. Their new streamlined portfolio of products will give your customers the ability to select from different plan designs at a variety of price points.
These changes are part of Aetna's continuing effort to provide your clients access to high-quality, affordable health coverage.Changes in plan designs may result in reduced coverage for some services. Aetna recommends you and your clients carefully review their plan documentation to understand which of these changes may apply to their plans.
Plans with Benefit Changes
MC $10,000 100/50
MC HSA* $2000 80/50
MC HSA* $3000 90/50
MC HSA* $3500 80/50
* As of 10/1/10, all of the HSA Plans in the Small Group portfolio will be True Integrated Family (TIF) deductible and coinsurance plans. With a TIF plan the Individual Deductible or Out-of-Pocket maximum can only be met when a member is enrolled for self only coverage with no dependent coverage. The Family Deductible or Out-of-Pocket maximum can be met by a combination of family members or by any single individual within the family. Once the Family Deductible or Out-of-Pocket maximum is met, all family members will be considered as having met their deductible or Out-of-Pocket maximum for the remainder of the calendar year.
Vitalidad HMO $5
Vitalidad Plus HMO $20/$5
Vitalidad Plus HMO $40/$10
HSA $3300 80/50
EPO $500 80
Please click here to access all of Aetna's current plan designs.
What to expect
In-force customer plan design(s) will stay in effect until current policy periods end. At that time, the plan design will be updated for health care reform or provided an alternate plan design to renew into that best meets the needs of their employees.
Aetna will send a renewal packet before the current plan period ends. At that time, if your clients currently offer one or more of the benefits plan designs Aetna will no longer be offering, they will provide information on the alternative plan design that most closely resembles the in-force plan design as well as other Aetna plan designs that are available.
If Aetna does not hear from existing plan sponsors prior to their renewal date, they will automatically switch them to the Aetna plan design that we believe most closely matches their existing plan.
You should also be aware that the Federal government recently released regulations related to grandfathering of health plans in existence on March 23, 2010. Changes in benefit design and contribution strategy may affect grandfathering. Renewal offerings may not preserve grandfathering.
Contact us with questions
If you have questions regarding Aetna's October 2010 plan changes, please contact your b&p Group Sales Representative at 888.722.3373.