May 26, 2022
As part of Aetna's continued effort to streamline how they do business in small group 2-100, they’re excited to discuss more changes that make it easier for you to sell Aetna Funding Advantage (AFA).
Individual medical questionnaires
Current level funded incumbent cases quoting AFA: IMQ guideline changes
You no longer need IMQs to get a quote for your clients already on a non-Aetna level-funded plan with five or more enrolled employees.
This change only applies to employers headquartered in AZ, KS, NJ, FL, UT, CO, CT, DE, GA, IL, MD, ME, Memphis/Nashville, MI, NE, OH, PA, Raleigh/ Charlotte, TX, VA, WV.
The table below illustrates which employers will need to get a quote with IMQ.
| INCUMBENT FUNDING TYPE | COMPANY SIZE | IMQ REQUIRED |
|---|---|---|
| Level funded | 2-4 enrolled | Yes |
| Level funded | 5+ enrolled | No |
Helping you sell cases with IMQ – IMQ Elite team and broker sell-sheet
IMQ Elite team: Aetna takes the work off your plate. All you need to do is send a request with a completed quote cover sheet and either a member level census or the email address for your client’s HR administrator.
IMQ Broker sell sheet: Learn why selling cases with IMQ is a smart move, including proof points for you and your clients.
Underwritten quoting guidelines – consolidated quote cover sheet
Quoting AFA is easier than ever. You now only need to keep track of one quote cover sheet for your clients with 2-100 employees. Just complete the required fields and send it to our team.
Participation guidelines – now only 30% enrollment required
With new participation guidelines, your clients with 10-100 eligible employees only need to have 30% of total eligible employees enroll in the plan. For employers with 2-9 eligible employees, 50% of total eligible employees still need to enroll.
Refer to segment definition grid in the Aetna Funding Advantage underwriting guidelines for specific state information.
You can still get the “savings now, surplus later” promotion
Your new-business clients with 10-100 employees can continue to get an admin fee credit, guaranteed surplus and 7% cost increase cap* through September 1, 2022 effective dates where available. Check the table below to see state availability details:
| STATE AVAILABIILTY | IMQ REQUIRED | ADMIN FEE CREDIT | GUARANTEED SURPLUS | 7% COST CAP AVAILABILITY |
|---|---|---|---|---|
| CA | No | Contact rep | Yes | No |
| CT | Mixed | $300 per sub | Yes | Yes |
| AZ, PA , TX, UT | Yes | $125 per sub | Yes | No |
| FL, GA, N. IL, MI | No | $125 per sub | Yes | Yes |
| CO, IA, KS, MO, NC, NE, NJ, SC, S. IL, TN, and WI | No | $125 per sub | Yes | No |
| DE, ID, KY, LA, MA, MD, ME, MN, MS, OH, OK, RI, VA, WV, WY | Yes | $125 per sub | Yes | No |
| NV | Mixed | $125 per sub | Yes | No |
*Discount programs are subject to various eligibility requirements, terms, and conditions. Eligibility is limited to new groups and may vary depending on group size. Discounts may be subject to renewal and apply to the succeeding plan year. The Aetna offer is provided at the sole discretion of Aetna® and can be terminated or modified by Aetna at any time and without notice. Any subsequent program is at the discretion of Aetna.
