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Aetna Announces Exciting Changes for Plan Underwriting

Aetna has announced relaxed participation and medical questionnaire requirements for some groups.

2025 Aetna Prescription Drug Data (RxDC) Collection Requirement

Aetna will reach out to groups via email, starting on Friday, January 31, 2025. Groups must respond with the requested information by March 31.

Aetna Posts 1095-B Forms for Level Funded (AFA) 2-50 Clients

Aetna handles 1095-B forms for your Aetna Funding Advantage clients with 2-50 eligible employees.

Aetna 2024 Gag Clause Compliance Approach

Aetna will file on behalf of all self-funded (including AFA), insured and split-funded plan sponsors that had active coverage in 2024.

Aetna 2023 MLR Experience Year Rebate Pools

Aetna, Innovation Health, Banner|Aetna, and Texas Health|Aetna plans are scheduled to receive rebates under the Health Care Reform Minimum Medical Loss Ratio (MLR) requirements. Rebates will be mailed...

Aetna AFA Portfolio Updates, September 2024

Aetna will be hosting meeting soon to go over these changes.

Aetna Prescription Drug Data (RxDC) Collection Requirement

Aetna will reach out to groups via email, starting on Friday, March 15th. Groups must response with the requested information by April 12.

Aetna Formulary Update: Humira To Be Replaced By Biosimilar Products

This change impacts all Small Group AFA and Fully Insured 51-100 plans using the Advanced Control Plan formulary.

Aetna Gag Clause Prohibition Compliance Attestation Completed and Filed

They were submitted to CMS by the December 31, 2023, due date.

Aetna Shares CAA Gag Clause Compliance Approach

Aetna will submit the Gag Clause Prohibition Compliance Attestation on behalf of all fully-insured and small group AFA plan sponsors.

Aetna 2022 MLR Experience Year Rebate Pools

Aetna, Innovation Health, Banner | Aetna, and Texas Health | Aetna plans are scheduled to receive rebates under the Health Care Reform Minimum Medical Loss Ratio (MLR) requirements. Rebates will be ma...

Aetna Adds New AFA Credit as of July 2023

Starting with 7/1/2023 effective dates, the new $200 per subscriber credit will apply to 2-50 employee groups on pre-Affordable Care Act grandfathered plans. These