Aetna Small Group 2023

2023 Broker Bonus for both ACA and AFA

It’s simple. Just sell Aetna new business plans to groups in California with 1-100 eligible employees. The bonus payout is the same if you sell direct with Aetna or through a General Agent. Bonus is based on the total number of enrolled employees for all the groups you sell with Aetna.

Download the 2023 program flyer

Network updates

In addition to Aetna’s current 4 HMO networks and 3 Open Access Managed Choice networks, Aetna will be adding in Northern California an Aetna Whole HealthSM Northern California network

Effective January 1, 2023, small group businesses in Northern California can offer the Aetna Whole Health Northern California to their employees as part of their Aetna plan offering. This new network offering will provide small group customers’ employees access to over 1,700 PCPs, 5,200 specialists and more with an expected savings up to 6%.

Portfolio Updates

Medical

12 HMO plans, 18 OAMC/4 PPO plans

  • Plans referencing ‘w/INF’ in the plan name include additional infertility services. See plan booklet for details.
    • Acupuncture included on all plans.
    • Chiropractic included on all Aetna plans.
      • Mandated “M” plans and matching “wINF” plans excluded
    • “M” within the plan name indicates mandated plans.

New

  • $0 Teladoc copay for General Medicine and Dermatology for HMO and OAMC/PPO
    • Teladoc Behavioral Health to remain at in-person Mental Health Office Visit copay
    • State mandated “M” plans and matching “wINF” plans excluded

Pharmacy

2023 Formulary is the Aetna Health Exchange Plan – Small Group

Aetna Small Group Dental

Bundle up and save more with Small Group

New and renewing groups get a premium credit when you offer dental to your medical plan.

**Only available in state of California. Credit is only applied once and will appear on the third invoice from the group’s effective date.

Why bundle

  • Increased member engagement
  • More identification of at-risk members
  • Increased participation in care
  • Simplified administration – consolidated invoice and one contact for health, dental and vision products

Download the dental flyer here.

Underwriting

Underwriting promotions extended through March 15, 2023, effective dates

  • DE9C not required with five or more subscribers enrolling for groups with current coverage.
  • Groups with 5-100 eligible employees can meet a 25 percent participation when enrolling five or more.

Pick 10

New and renewing groups can select up to 10 plans!

No need to worry about which network can be sold together –
any combination of plans can be offered under Pick 10.

In addition to the above changes, review Aetna’s underwriting guidelines to see how they have streamlined the process for common ownership and newly formed groups.

Elist

All new business case submissions will be required to submit enrollment with the elist template.

Aetna Solutions that drive value

Attain by Aetna®

Attain by Aetna is available to all Aetna® members aged 18 or older. It’s already included in your health plans for no extra cost. Members can earn an Apple® Watch or gift cards.

By encouraging members to stay active, take healthy actions, and incentivizing them with rewards, Attain by Aetna has successfully empowered over 200,000 users to get healthier in its first two years since launch.

Share this program with your employer/member groups.

MinuteClinic® and CVS® HealthHUBTM services at no cost/low cost*

MinuteClinic locations make it easy for members to get the care they need, when and where they need it. MinuteClinic locations are open every day, including evenings. See how Aetna is connecting members to more health services, one-on-one guidance, and total health resources.

  • New – Aetna HMO members pay $0 copay
  • Aetna OAMC member pay $0* copay

Includes Virtual MinuteClinic at No Cost across all plans

Find a MinuteClinic location near you

*Aetna OAMC members on HSA plans receive $0 copay after deductible is met.