Q4 Rate changes:

Annual trend is less than 8%!

The below is a summary of rate changes for the 4th quarter. Annual trend is less than 8%. And, rate reductions in Rating Area 15 (Los Angeles).

HMO Quarterly Annual
Bronze 3.2% 1%
Sliver 3.2% -.4%
Gold 3.2% 7.9%
Platinum 3.2% 3%

 

PPO Quarterly Annual
Bronze 2.2% -2.6%
Sliver 2.5% 1.2%
Gold -.8% 5.9%
Platinum .6% -2.9%

 

PPO RA 15
only
Q4
Bronze -14.5%
Sliver -10.1%
Gold -12.7%
Platinum -11.5%

Rates changes may vary by plan and rating area.

Network update

Looking for cost savings for your Employer Groups? Aetna has 5 HMO networks and 3 OAMC Networks. Network savings can add up to 25% less than Full Networks. Contact your RBG Representative to get more information about Aetna’s Narrow Network Options.

Effective 7/1/2020, the Savings Plus network will no longer be available for new business in Northern California, which includes Fresno County. All renewing groups currently with Savings Plus will continue to have the network available to them. There are no changes to the Savings Plus network for Southern California.

See the linked updated Savings Plus flyer that shows the hospitals included in the Savings
Plus network.

For a complete listing of hospitals/providers, go to aetna.com/docfind.

Expanded walk-in clinic access for Aetna CA HMO members

Treating minor injuries and illnesses doesn’t have to mean hours or even days of lost time for your clients’ employees.

Walk-in clinics can simplify and speed up care. No referrals are needed, and the only cost is the PCP copay.

For more coordinated care, most in-network walk-in clinics will share clinical data from a visit with the member’s primary care doctor.

The in-network walk-in clinics can help with:

  • Minor illnesses (flu, infections and body aches)
  • Minor injuries (blisters, burns, wounds and minor sprains)
  • Screening and monitoring (asthma, diabetes and high blood pressure)
  • Skin conditions (minor infections, rashes, sunburn and poison ivy)
  • Wellness and physicals (pregnancy testing, weight evaluations)*

Find out more about additional, in-network walk-in clinics at aetna.com.

*Most wellness and physicals are no cost to member.

Underwriting reminders

Participation

    • Relaxed participation promotion through December 31, 2020 effective dates:
      • 25% participation for groups of five or more enrolled subscribers.
      • 65% participation required for four or less subscribers enrolled.
    • Aetna will allow one other Carrier HMO and/or PPO alongside (excludes EPO plans)
    • Participation with another carrier is not considered a valid waiver

New Business Submission Deadlines

  • 1st of the month effective dates – complete submission due by the 5th of the month of the effective date
  • 15th of the month effective dates – complete submission due by the 20th of the month of the effective date

2020 Broker bonus

It’s simple. Just sell Aetna new business plans to groups in California with 1-100 eligible employees. Bonus is based on the total number of enrolled employees for all the groups you sell with Aetna.

1 – 74 subscribers – $50 per enrolled employee

75+ subscribers – $100 per enrolled employee

See the linked Broker Bonus flyer for more information.

Introducing the Attain by AetnaSM app

The Attain by Aetna program is now available to all medically enrolled members with a CA ACA compliant plan.

The Attain app is a first-of-its-kind health experience designed in collaboration with Apple®, that offers personalized goals, achievable actions and big rewards. Attain members can order an Apple Watch in Attain and earn it with points over 24 months and earn up to $80 in gift cards. All they’ll pay is a one-time activation fee of $7 plus sales tax. Or bring their own Apple Watch & earn up to $280 in gift cards to popular retailers like Amazon, CVS and Best Buy.

Attain is available to medically enrolled employees, their spouses and 18+ dependents.

See the linked Attain FAQ flyer for Frequently Asked Questions (FAQs) and the Attain flyer more information.

Other information

  • Aetna HealthSM App for both IOS and Android Users – download from app store
    • Find doctors, get a copy of ID card, pay claims, etc.
  • Teladoc – included with all Small Group plans
  • Pharmacy Formulary – 2020 SG CA ACA formulary (https://www.aetna.com/individuals-families/find-a-medication.html)
  • Chiropractic coverage is included on all HMO, EPO and OAMC plans, except for State Mandated plans

Renewals

  • Confirmation of renewal
    • Confirmation by the employer via letter, fax or email to the client management team and receive prior to their renewal date
      • Premium payment in advance of the renewal date will also act as confirmation
  • Groups submitting renewal plan changes must be received 10 days prior to their renewal (5 days prior if submitting changes on the eList tool)