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Aetna Plan & Rate Updates Effective January 2022

Oct 01, 2021

Aetna announced ​plan and rate updates for January 1, 2022 effective dates. Rates are available for quoting!

 

Rates

Quarterly medical rate change (may vary by plan, region or network)

  • OAMC/PPO/EPO: 2.0%
  • HMO: 0.8%

 

Dental rates will be changing effective January 1, 2022. There are no changes for vision rates at this time.

 

2022 Network Updates

Sutter Health | Aetna performance network available to small group business in 2022

As of January 1, 2022, small groups in Northern California can offer the Sutter Health | Aetna performance network to their employees as part of their Aetna plan. It will give employees of small groups access to a local, connected network of providers.

 

The network includes those affiliated with: 

  • Sutter Health
  • Stanford Health Care
  • Brown & Toland Physicians

 

Employees can also access all Sutter Walk-In Care, MinuteClinic and CVS HealthHUB locations.

 

The Sutter Health | Aetna performance network aims to bring on going affordability and efficiency to small groups. Aetna wants to make costs transparent and predictable. Sutter Health OAMC network is available in rating areas 1-8 and 10. The network price is 6 to 12 percent less than OAMC based on rating area. Learn more at SutterHealthAetna.com.

 

HMO Deductible and OA EPO to be discontinued 

Beginning January 1, 2022, the HMO Deductible and OA Elect Choice EPO networks will no longer be available to California small groups. Membership will be moved as follows: 

  • HMO Deductible to Aetna Value Network HMO
    • HMO rates were reduced over the past two quarters to match HMO deductible rates in a majority of rating areas
    • Approximately 80 percent of IPAs in the HMO Deductible network are in AVN HMO. See Northern California and Southern California network flyers for details
  • Open Access Elect Choice (EPO) to Open Access Managed Choice

 

Members have the option to move to any Aetna plan at renewal. 

 

Savings Plus

In addition to rating areas 15 – 19, Savings Plus will be available in Fresno and Ventura.

 

Aetna Whole Health

In addition to Rating Areas 15 - 19, the Aetna Whole Health HMO network is available in Ventura County (RA 12) and Kern County (RA 14).

 

For a listing of all hospitals and providers, go to Aetna.com.

 

Portfolio Updates

Medical

2022 Plan Count: 12 HMO plans and 16 OAMC/PPO plans

  • All plans cover state mandated infertility preservation services.
  • Plans referencing "w/INF" in the plan name include additional infertility services. See plan booklet for details.
  • All plan cover acupuncture.
  • All non-mandated plans include chiropractic care.
  • “M” within the plan name indicates mandated plans.

 

Pharmacy 

2022 Formulary is the Aetna Small Group Affordable Care Act (ACA) Formulary – California

  • Maintenance Choice with opt-out is part of all HMO and OAMC plans. See flyer for details.

 

Small Group Dental

Aetna has the range of plans, ease of administration and competitive rates your employer groups are looking for.

 

Voluntary and nonvoluntary dental offerings:

  • Aetna Dental DMO – Quality dental coverage that fits everyone’s budget. An in-network primary care dentist (PCD) guides members’ care, with no deductibles, paperwork or hassles. It’s the simple way to care for smiles.
  • Aetna Dental PPO & Dental PPO MAX – If your members like freedom, they’ll love Aetna Dental PPO with more than 395,000 providers. They can pay a little more to visit any out-of-network dentist. Or stay in Aetna's broad network to budget and save. There are no referrals required either way.
  • Aetna Freedom-of-Choice DMO PPO – Members can switch between two plans, with two networks, to fit changing needs. For one price, they can choose Aetna DMO for the simplicity and savings of in-network, PCD-guided care. Or they can choose Aetna's PPO or indemnity plan for the freedom to visit any provider, anywhere. In fact, members can switch between two plans every month. It’s that easy.

 

Dental rating by group size:

  • 2–9 employees: Standard rating
  • Groups with 10–100 employees: Group rating

 

Aetna selected the most popular plans in your market and created a simple rate card. This can help you select the best plan option for their employer groups. Aetna offers rate cards for their most popular nonvoluntary plans in California for group sizes 2–50. The rate cards will be available in the Producer World platform.

  

Vision - Set your sights on lower rates – up to 18% less

Aetna is making it easy for your clients to look and feel good, all while giving extra discounts.

  • New business vision clients effective January 1, 2022, and after will qualify for these lower rates
  • These rates will be available to current vision clients at their next renewal on or after January 1, 2022

 

Also, beginning January 1, you may qualify for more bonus incentives when you add vision to other lines of coverage. See the updated Broker Excellence Program for more details.

 

Underwriting Updates

  • Relaxed participation promotion: Groups with 5–100 eligible employees can now meet a 25 percent participation when enrolling five or more lives. This promotion runs from October 2021 through March 2022.
    • Aetna requires a standard 60 percent participation for groups enrolling less than four lives.
  • DEC9C not required with 5 or more subscribers enrolling.
  • Pick 10: New and renewing groups can select up to 10 plans. No need to worry about which networks you can sell together. Aetna offers any combination of plans under Pick 10.

 

Attain by Aetna

The Attain app has empowered over 200,000 users to get healthier and 92 percent of users feel Attain is making them healthier.*

 

So, Aetna is taking things up a notch by expanding to Android in Q1 2022. Their secret sauce still remains the same: high engagement, proven behavior change and unique sensor analytics. Plus, the increased productivity and cost savings that go with them.

 

The Attain app is now available to all Commercial medical members with an iPhone, their covered spouses, and dependents at least 18 years old. Visit AttainbyAetna.com for more details.

 

Checkout Aetna's lookbook and share with your customers. It will help them take advantage of this great program.

 

*Stats based on Attain by Aetna analytics data. Current as of June 2021.

 

MinuteClinic and CVS HealthHUB services at no or low cost*

MinuteClinic locations make it easy for members to get the care they need, when and where they need it. MinuteClinic locations are open every day, including evenings. Aetna is also expanding their footprint with HealthHUB locations. See how they’re connecting members to more health services, one-on-one guidance, and total health resources here.

 

Find a MinuteClinic or HealthHUB location near you or download the sell sheet here.

  • Aetna HMO members pay PCP copay
  • Aetna OAMC member pay $0* copay 

 

*Includes select MinuteClinic services. Not all MinuteClinic services are covered. Please consult benefit documents to confirm which services are included. Members enrolled in qualified high-deductible health plans must meet their deductible before receiving covered non-preventive MinuteClinic services at no cost-share. However, such services are covered at negotiated contract rates. This benefit is not available in all states and on indemnity plans.

 

2022 Broker Bonus

Take advantage of Aetna's new rates to earn a bonus from Aetna. You can earn extra dollars for selling dental, vision and Aetna Whole Health products. The bonus is the same if you sell directly with Aetna or through a general agent.

 

Download Aetna's 2022 program flyer for details.

 

Book Rates

Book rates for Aetna will be provided on the B&P website when they are available.

 

For questions, please contact a member of your B&P Sales Team - 888.722.3373.

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