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51-125: Medical Product Updates; New Voluntary Health Plan
May 10, 2011
Aetna 51-125 announced updates to their medical portfolio for June 1, and July 1, 2011 effective dates. Updates to this portfolio are as follows:
- Specialty Rx enhancement for June 1, 2011 effective dates and later.
- 20% coinsurance up to a $150 per script maximum.
- Healthy Incentive Credit embedded in traditional plans (OAMC).
- Completion of HRA and one behavior modification program results in a $50 credit to the plan year deductible; unused amounts rollover from year-to-year.
- Changes to Out-of-Network reimbursements effective July 1, 2011.
- Fee Schedule for hospital and physician visits
In addition to the changes above, Aetna has also introduced the Aetna Volutary Hospital Plan (AVHP)
- Pays members cash for a qualifying hospital stay
- Members receive benefit check for:
- $1,000 to $2,000 for one hospital admission per year
- $100 to $500 per inpatient day up to 100 days per year
- Voluntary - No Employer Cost
- Makes sense with any "higher" deductible medical plan (not just HSA/HRA)
- Helps in the transition to a higher deductible plan strategy
- Provides security for members until HSA/HRA is funded
- Allows members to keep tax-advantaged savings in HSA
- No restrictions on how member uses payment
Additional features of the AVHP:
- No pre-ex, No Coordination of Benefits
- Must be offered alongside an Aetna OAMC plan
- Minimum participation of 25 employees (125 eligibles or < 125 with employer contributions)
- Hospital indemnity; not a wrap plan
- Composite book rates offering price stability
To discuss any of Aetna's portfolio updates, please contact your b&p Group Sales Representative or your dedicated Large Group Sales Assistant - 888.722.3373.