NEW Broker Bonus, NEW Plans, EASIER Underwriting and More!

Q3 Rate Action:

Northern California Quarterly Average

  • HMO: 1.0% decrease
  • PPO/EPO: 6.6% increase

Northern California Renewal Average

  • HMO: 1.0% decrease
  • PPO/EPO: 1.9% increase

Southern California Quarterly Average

  • HMO: 3.0% decrease
  • PPO/EPO: 3.0% increase

Southern California Renewal Average

  • HMO: 1.8% decrease
  • PPO/EPO: 1.2% increase

NEW Broker Bonus Program – July 2019 through December 2019

Earn up to $100 per enrolled employee on new small group medical sales with July – December 2019 effective dates.

  • Earn $50 per enrolled employee with 1-74 enrolled employees.
  • Earn $100 per enrolled employees with 75 or more enrolled employees.
  • New business small group medical sales only.
  • Business submitted through RBG qualifies for the bonus!

See the Aetna Broker Rewards Program Flyer for complete details.

NEW Bronze PPO Plans Added for Q3

A new Bronze plan design is available with both the MC and the Savings Plus networks starting with July 2019 effective dates.

This plan design is a non-HSA plan with first dollar outpatient benefits for the following services:

  • Primary Care Office Visit
  • Lab Services
  • Walk-In Clinics
  • Urgent Care
  • Generic Drugs

OA Managed Choice POS Bronze CA 50/50 6800 Ded:

Benefit Summary

Savings Plus OA Managed Choice POS Bronze Ca 50/50 6800 Ded:

Benefit Summary

Renewing Business Reminder

  • Employer plan change requests for renewals must be submitted 10 days prior to the renewal date.
  • Employee plan changes can be submitted through the month of the renewal.

Aetna Announces Several Underwriting Updates Effective July 1, 2019

  • Relaxed DE9c Requirement
    • No DE9c required for groups with 6 or more enrolling employees with prior group coverage.
    • DE9c is required for the following groups:
      • 1-5 enrolling employees
      • 6-100 enrolling employees with:
        • No current health coverage.
        • More than 10% of the employees located out-of-state
        • More than 20% COBRA/CalCOBRA enrollees
        • Associated, Affiliated, Multiple Companies
  • Revised Participation Guidelines
    • The greater of 25% or a minimum of 5 enrolled employees enrolling with Aetna when the group offers another carrier’s HMO
    • 60% participation if Aetna is the sole carrier
  • NEW Valid Waiver
    • Individual coverage on or off the exchange is now considered a valid waiver.
  • More Time to Submit New Business
    • 1st of the month effective dates: submitted by the 1st of the month (previously the 20th calendar day of the prior month)
    • 15th of the month effective dates: 5th of the month after the effective date (previously the 5th calendar day of the effective month)
    • Groups received after the submission deadline will be moved to the next effective date
  • Relaxed Re-Applying Requirements
    • Small groups can re-apply for coverage with Aetna without waiting the previously required 12-month period
      • Group must be replacing other group coverage
      • Group must be in good standing with Aetna and pay any premium balance due

For more information refer to Aetna Small Group Product & Services Update for Q3 2019

RBG is Your Resource for Everything Aetna – Contact Us Today!