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Aetna Collecting TAE for CA Dental Customers

Jun 06, 2017

Total average employee (TAE) counts for California dental customers

Collecting TAE for CA dental customers in May 2017

Aetna mailed letters to plan sponsors on May 29, 2017. Aetna needs a response by August 11, 2017. 

California plan sponsors with 200 or fewer employees enrolled with Aetna Dental® 

On May 29, 2017, Aetna mailed letters to plan sponsors with 200 or fewer enrolled employees that had an Aetna fully insured dental plan in 2016. Aetna needs the total average employee count for 2015. 

This information is used to determine the group size 

California law states that dental plans in the state have to report the loss ratio. The reporting is different for Small Group and Large Group. The group size is determined by how many employees the plan sponsor had in the year before the loss ratio experience year. Aetna needs to include the plans in the correct size group when they report information to the state. If plan sponsors don’t respond to the first letter, Aetna will send two more. This is a new law for California dental carriers You are probably already aware that the Affordable Care Act (ACA) sets rules on the minimum percentage of premium that medical plans must spend on medical costs and activities that improve quality. This is known as the minimum medical loss ratio (MLR). This rule does not apply to dental plans. The new California laws (section 1367.004 of the Health & Safety Code and section 10112.26 of the Insurance Code) do not set a minimum dental loss ratio and only require the eligible employee information be reported by dental carriers. 

You can find more information about dental plan reporting of medical loss ratio from the California Department of Insurance and the California Department of Managed Health Care in the AB 1962 Guidance document.

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