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Total Average Employee (TAE) Counts Needed by Aetna

Jun 14, 2016

Aetna is collecting total average employee counts for California Dental customers in June 2016 

On June 7, 2016, Aetna is mailing letters to plan sponsors, and they'll need a response by August 12, 2016.

California plan sponsors with 200 or fewer employees enrolled with Aetna Dental®

Aetna will mail letters on June 7, 2016, to plan sponsors that had a fully insured Dental plan in 2015 with fewer than 200 employees.  Therefore, they need the total average employee count for 2014. 

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.

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