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Aetna's Small Group May 2010 Updates

Apr 02, 2010

Aetna Small Group
May 2010 Rate, Benefit & Portfolio Updates
Aetna Small Group will be implementing rate, benefit and portfolio changes for May 1, 2010 effective dates. Aetna has also revised their RAF Guarantee Program for May 1 through June 15, 2010 effective dates.

Read on for the details or click here for the Aetna Small Group flyer containing all updates.
 

RATE CHANGES EFFECTIVE MAY 1, 2010

Medical
  • Medical rates will increase May 1, 2010
  • Average statewide trend increase of 4% for both HMO and MC Plans
  • Book rates available on the beere&purves website
Dental - There will be no adjustment to dental rates.
 

DENTAL & LIFE PORTFOLIO CHANGES EFFECTIVE MAY 1, 2010

New Dental Plan
  • Freedom of Choice Coinsurance
    • Available in Standard & Voluntary offerings
    • Fee schedule plan with rates in the mid $30s
    • DMO Side:
      • 100/90/60
      • Endo/perio covered as Basic
      • Adult & Child ortho included
    • PPO Side:
      • 100/80/50
      • $2,000 calendar year maximum
Eliminated HMO Plan
  • Freedom of Choice Basic
 

PPO MEDICAL PORTFOLIO CHANGES EFFECTIVE MAY 1, 2010

New PPO Medical Plans
  • MC $3500 65/50
  • MC HSA $2000 80/50
  • MC HRA $5000 80/50
Plans Experiencing Benefit Changes
  • MC $2500 75/50: added $250 Rx deductible for brand and non-formulary drugs
  • EPO 80 renamed EPO $500 70: $500 deductible added and coinsurance changes to 70%
Eliminated Plans
  • MC Basic migrates to MC $2500 75/50

HMO MEDICAL PORTFOLIO CHANGES EFFECTIVE MAY 1, 2010

New HMO Medical Plans
  • HMO $50
  • Vitalidad Plus HMO $10/$5
  • Vitalidad Plus HMO $20/$5
  • Vitalidad Plus HMO $30/$10
  • Vitalidad Plus HMO $40/$10

HMO Plans Experiencing Benefit Changes
  • Aetna Value HMO plans now contain a separate Specialist visit copay
    • AVN $10 renamed AVN $10/$20
    • AVN $20 renamed AVN $20/$30
    • AVN $30 renamed AVN $30/$40
    • AVN $40 renamed AVN $40/$50
Eliminated HMO Plans
  • HMO HRA $750 migrates to HMO $30
  • HMO HRA $1500 migrates to HMO $30
  • HMO 15 migrates to HMO $20
 

RAF PROMOTION through MAY - JUNE 15, 2010
Aetna's revised RAF promotion is available for May 1 - June 15, 2010 effective dates.
  • .95 RAF: 10-14 CA medically enrolling employees
  • .92 RAF: 15-50 CA medically enrolling employees
  • Click here for Aetna's current RAF promotion
Guidelines:
  • Groups must submit a copy of their 'original' current and prior renewal or their issued RAF at new business.  (Revised renewals will not be accepted)
  • Groups applying for the guaranteed RAF must be AB1672 eligible and have a current RAF of 1.06 or less with their current carrier
  • Groups must apply for the RAF promotion prior to final underwriting approval
  • AB1672 eligible groups moving from a large group contract are eligible if the group provides a large group renewal of less than a 20% increase within 90 days of their requested effective date
  • Groups that received a 10-point RAF increase are ineligible
  • Groups with 30% or more COBRA/Cal-COBRA enrollees are ineligible
  • COBRA/Cal-COBRA enrollees do not count toward enrolled employee counts
  • Groups moving from CaliforniaChoice, Contractor's Choice, HSA California, Kaiser Permanente Choice Solution and/or groups that have withdrawn from Aetna within 12 months of the requested date are ineligible
  • Carve out groups (management/non-management, union/non-union) are ineligible
  • Groups self-funding a portion of the deductible outside of a federally qualified HRA or HSA are ineligible for the RAF promotion.
 

Please contact any member of your B&P Sales Team for assistance with quote requests and questions regarding the details above.
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