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Aetna's MLR Filing Continues to Demonstrate Appropriate Pricing

Aug 28, 2019

Aetna (including Innovation Health and Coventry, subsidiaries, and affiliates) is paying rebates in some markets. The rebates Aetna is paying are modest, and most policyholders/employers won't receive a rebate at all.

 

What's Next

By September 30, Aetna will send notices to subscribers and policyholders/employers of plans due a rebate for Aetna, Innovation Health and Coventry Health Plans. The amount of the check will depend on the total premiums paid by the customer in 2018.

 

The government has issued rules on how group policyholders/employers may use the rebates. Aetna has provided an overview at www.aetna.com. Look at the bottom of the page for the Health Care Reform link or search “MLR”. Then click the link for “Affordable Care Act (ACA) & Health Care Reform – Employer | Aetna.” Aetna is not providing legal advice and suggest that plan sponsors work with their legal counsel to decide how to use the rebate.

 

In most cases, for group plans, policyholders (plan sponsors/employers) will receive the plan's rebate. In certain circumstances, the government has directed that the rebate go directly to subscribers of the group policyholders. This happens if:

  • The policyholder/employer has terminated and Aetna is not able to locate them, or
  • A non-ERISA/non-government policyholder failed to provide the required written assurance that they would use the rebate payment according to the government rules.

 

Impacted Pools

A list of MLR pools where rebates are being issued for Aetna, Innovation Health and Coventry Health Plans is available on www.aetna.com. Look at the bottom of the page for the Health Care Reform link.

 

Aetna will mail rebates to impacted plan sponsors or subscribers by 9/30/19.

 

List of Employees/Roster Request Process

You can request a list of employees/roster on behalf of your impacted plan sponsor by calling Aetna's MLR service center at 1-855-697-7509 between 10:00 am and 6:30 pm EST, Monday through Friday.

 

If you already indicated your plan sponsor would like an employee roster, you do not need to request another one. Only request an employee roster if your plan sponsor requests one. If an email roster was requested, it will be sent securely from the [email protected] mailbox and will include instructions on how to open the message for viewing. The roster will be sent at the same time as the rebate check. 

 

 

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

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