Aetna has announced the following updates to underwriting requirements effective immediately.

Quarterly Wage and Tax Statement for Groups with 6+ Enrolling

Aetna Small Group CA underwriting requires a copy of the current carrier bill for all groups that answer ‘yes’ to the question asking if they use the services of a payroll company.

Question on employer application: Do you use the services of a payroll company?
If yes, please provide the name of the payroll company and submit a copy of the current carrier bill.

In addition, if the group is currently with a PEO, a copy of the termination letter from the PEO for the group is required.

PEO (Professional Employer Organization) Guidelines

Guidelines for Professional Employer Organization (PEO) Sub–Groups: Payroll remaining under the tax ID of the PEO (not the Employer)

Groups enrolled with a PEO in any type of co-employer relationship (benefits, workers’ comp, etc.) are not eligible.

Groups filing a DE-9C and using ‘payroll only services’ are eligible subject to meeting the standard underwriting guidelines. Groups indicating they use payroll services must provide a copy of the DE-9C or prior carrier bill to validate they are not part of a PEO.

Groups leaving a PEO are eligible for coverage and must provide the below information in addition to the standard underwriting requirements

  • Copy of letter from PEO confirming termination of the PEO arrangement
  • Copy of two weeks of payroll