News & Updates
Aetna will mail letters on June 7, 2016, to plan sponsors that had a fully insured Dental plan in 2015
Information to determine 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, they’ll send two more.
New law for California dental carriers
You are probably already aware that the Affordable Care Act 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. This rule does not apply to Dental plans. The 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 plans' 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.
For questions, please contact a member of your b&p Sales Team - 888.722.3373.