All People, Carrier News, News

Aetna has released their January 1, 2018 rate and portfolio updates. Quoting is now available in HealthConnect.

Rate Updates

Statewide average shows a 2.5% increase for HMO plans and no increase for PPO plans. Keep in mind that rates vary with plan design changes, as well as the rating methodology for children. New ACA-dependent age bands changed from “20 & Under” to “14 & Under”, 15, 16, 17, 18, 19 and 20.

There are no changes to the rating area at this time.

New Plans and Portfolios

Aetna has 8 HMO base plans that will be available in one or more of the 5 HMO networks, and 9 MC/PPO/EPO base plans among 6 PPO networks. New for 2018 — EPO plans will also be available in the PrimeCare network.

Ninety-nine percent of the plans have name and benefits changes. View the plan mapping change for 2018 here. Keep in mind that the plan names may change, as Aetna is in the process of finalizing them. Aetna anticipates to complete this by the end of the year (if not sooner).

There are 5 new plans and 13 terminated plans. One of the terminated plans is the Silver Indemnity 1500 80 plan, which was intended for out-of-state employees who reside out of the Aetna MC/PPO service area. These employees will be considered ineligible and will not count against participation.

New Formulary

Aetna will be switching to a new formulary, called Small Group ACA Formulary, with no deductible (except for mirror plans) and lower cost share for generic prescription drugs. However, coinsurance for specialty prescription drugs increased and there will be a limited number of brand name drugs. The brochure on Small Group ACA Formulary will be released by November.

Underwriting Updates

Employers may have a benefit waiting period of exactly 90 days following the date of hire. Aetna does not prorate the premium, which means there will be no charge for the member if the coverage starts after the first of the month.

Materials

Enrollment forms, the toolkit brochure, formulary and SBCs are scheduled to be released on November 1, 2018.