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.