News & Updates
|Aetna Small Group has announced great news for January 1, 2009 effective dates. They will be offering an HSA Open Enrollment, a revised RAF Guarantee Program and more plans with combined deductibles. Read on for the details.|
PLAN CHANGES EFFECTIVE JANUARY 1, 2010
MC HSA $2300 80/50 Plan
The HSA $2300 plan will change to a $2500 deductible, combined for both in and out of network. The change in the deductible to $2500 is required to maintain compatibility under the HSA guidelines for 2010. There will be no rate change to the plan as a result of these changes.
More Plans With Combined Deductibles
Aetna Small Group has improved their plan designs to include more options in their portfolio with combined deductibles. Effective for January 1, 2010 effective dates, eight (8) small group plan designs will offer combined deductibles to maximize benefits for subscribers.
New Combined Deductible Plans Effective January 1, 20101
Plans Already With Combined Deductibles
1 - Combined deductible will be effective for new business as of January 1, 2010. All members enrolled in these plans as of December 31, 2009 will have a combined in and out-of-network benefit as of January 1, 2010 regardless of their effective date.
2 - Increased deductible for HSA $2300 80/50 plan to $2500 80/50 plan takes effect as of January 1, 2010 group renewals to ensure the HSA meets Federal guidelines. Members will move to the new plan on their renewal date after January 1, 2010.
HSA OPEN ENROLLMENT
Your clients may choose to offer employees currently enrolled in an Aetna Small Group plan, the option to enroll in an HSA-compatible plan for a January or February 2010 effective date. Change requests may be submitted as early as December 1 through January 31, 2010.
Requesting an Effective Date:
Submitting the Change Request:
RAF PROMOTION EFFECTIVE JANUARY 1, 2010
Aetna has revised their RAF promotion guidelines for effective dates January 1, 2010 - April 15, 2010.
Guidelines (changes from current RAF promotion in bold):
PRIOR CARRIER DEDUCTIBLE CREDIT
Clients and members often wonder how they go about receiving credit for money paid toward their prior carrier's plan deductible. Details are provided below.
These letters will provide details on how a member may submit the letter along with their most recent EOB from their prior carrier to obtain credit. The attached letter should be used to submit deductible credit for newly enrolled groups that did not submit during initial submission. Processing time for completion of these requests is five (5) business days. Members can follow up with Member Services at 888.802.3862.
Effective January 1, 2010, Aetna will have a Vitalidad Plus network that allows members to select providers for care in the United States or Mexico. This network and products will be rolled out in Small Group May 1, 2010. The network and plans will be effective in Mid-Market effective May 1, 2010.
UCSF Medical Group and Hills Physician Medical Group has formed a new affiliation to provide primary and specialty health services for HMO members in San Francisco area. This new affiliation is effective January 1, 2010. With this new affiliation UCSF's relationship with Brown & Toland ends. For Aetna HMO members, there is no change to their primary care physician or hospital access.
Monterey Peninsula Surgery Center has a new contract for Aetna's MC/PPO network in Monterey that was effective October 1, 2009.
CLOSED PANEL NOTICE: The Department of Managed Health Care (DMHC) has served a Cease & Desist Order that requires Aetna to immediately stop assigning or adding any additional enrollees to Lakeside Medical Group (Burbank/N. Hollywood, Central Valley, Glendale, North Valley & Santa Clarita Valley), effective October 1, 2009.
Affiliated Group also served this order to include Community Medical Group of the West Valley, Eastland Medical Group and West Covina Medical Clinic, effective October 15, 2009. Current Aetna membership in these medical groups may remain assigned to their PCPs. Aetna will provide any updates to the re-opening of the panel as they become available.