2-50: Aetna Extends RAF Guarantee through September 2013

To qualify for the guaranteed RAF, groups must meet the below criteria:

• AB1672 eligible.
• Current RAF of 1.06 or less.
• Less than 10-point increase in their RAF at last renewal.
• Less than 31% COBRA/CalCOBRA enrollees.  COBRA/CalCOBRA enrollees do not count toward the enrolled employee counts
• Groups must submit a copy of both their current and last year’s renewal or their issued RAF at new business.  The current renewal must be the original renewal, not a revised renewal (RAF).
• Groups must apply for the RAF promotion prior to final underwriting approval.

Other eligible groups:

• PEO - Groups with 10+ enrolling coming from a PEO (excluding groups coming from an Aetna PEO) if they meet all other guidelines.
• No Prior Coverage - Groups with 10+ enrolling with no prior coverage and meet all other guidelines.
• CalChoice - Groups 10+ enrolling coming from CalChoice if they meet all other guidelines.
• Large Groups - Groups coming from a large group contract if they can provide a large group renewal of less than a 20% increase and qualify per AB1672.  Contact Aetna for groups that did not receive a large group renewal due to group size or groups moving from an Aetna large group contract.
• Groups funding a portion of the employee’s deductible, copayment/coinsurance are eligible for a .95 RAF if their renewal RAF is 1.0 or lower and they meet the program rules and eligibility criteria. (Please note:  HSA plans are eligible for RAF promo when funding is through a federally qualified HSA).

Ineligible groups:

• Groups coming from Contractor’s Choice, HSA California, Kaiser Permanente Choice Solution, Associations, or groups that have withdrawn from Aetna within 12 months of the requested date are not eligible.
• Carve out groups (management/non-management, union/non-union) are not eligible.

*Groups with 6 or more enrolling are eligible for lower RAF upon review of medical information on the application.