Broker Broadcast
New Plans on the Horizon
Aetna has uniformly revitalized their 51-99 medical plan structure to help facilitate the
changes that will accompany the Health Care Reform Law. The new plans will comply with new
federal regulations, will keep the rising cost of health care to a minimum, and will also
become more simplified, making it easier for clients to make an informed decision about their
coverage.
How Aetna’s plans will change
- Dependent children can now enroll in an Aetna plan up to age 26. If state law requires coverage of dependents age 26 and older, the plan will continue to cover those dependents.
- Coverage for enrollees up to age 19 will include services needed to treat pre-existing conditions
- Plan designs will have no overall dollar limit on how much will be paid over a member’s lifetime
- Aetna members won’t pay anything for certain preventive care delivered from network providers
- In some states, plans will require members to pay more if they choose to get care outside of Aetna’s network. Members can choose from Aetna’s broad network and avoid extra costs by visiting their online directory, DocFind (www.aetna.com/docfind)
A stream-lined portfolio of plans
Beginning October 1, 2010, Aetna will offer a stream-lined portfolio of plan designs
allowing you to serve your clients more efficiently and simplify their plan choices.
Customers will now able to choose a variety of simplified plans at competitive price
points. Aetna also promises improvements in timeliness and the accuracy of the
administrative process.
What to expect
- In-force customer plan designs will stay in effect until current policy periods end. At that time, they will renew into the new portfolio of products in the plan design that best meets the needs of their employees.
- A renewal packet will be mailed directly to your group before the current plan ends. At that time, if your clients currently offer one or more of the benefits plan designs that are no longer offered through Aetna, information on the alternative plan design that most closely resembles the in-force plan design will be provided.
- If there is no communication from the existing plan sponsor 30 days prior to the renewal date, Aetna will automatically switch the client to the plan design that most closely resembles their existing plan.
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