On behalf of Aetna, your agent at Kelly Insurance would like to notify you that effective immediately, the carrier has made important changes to some of the health benefits plans for existing business.
Calendar Year vs. Plan Year
Aetna has changed its health benefits plan designs from Calendar Year to Plan Year deductibles in Virginia and DC to better align with the Maryland market. This change impacts all existing HMO/POS groups and PPO groups with anniversary dates from October 1, 2010 through September 15, 2011.
Impact to plan sponsors and employees
When a group has a plan change from a calendar year to a plan year, it is necessary within Aetna's systems to terminate the old group number and assign a new group number.
This process will not cause a lapse in coverage and employees will remain active under their new plan. However, because the employee has been terminated under the old group number, the following will occur:
- All affected groups will receive a new group number.
- All members on an HMO/POS plan will receive a new member identification number.
- PPO member ID numbers will not be affected by this change.
- Employees will receive new ID cards in the mail.
- Employees who recently had enrollment changes may need to complete a new Aetna Navigator® registration.
- When the termination of the old group number occurs, Aetna is required under HIPAA legislation to issue Certificates of Prior Health Coverage. Please be advised that these employees are active in the carrier's system under the new group number and if they receive a notice, should disregard it.
Aetna is making every effort to take into account the impact of the change, however, additional challenges may occur with regards to absence of deductible credit on plan year plans or the need to transfer medical precertification from an older member ID to new member ID on HMO/POS plans.
If the group has decided not to move to the Aetna recommended plan design(s), the carrier will need to receive a new plan selection no later than 25 days prior to the effective date. If changes are received after that time, the group's installation may be delayed.
For additional information, call upon your agent at Kelly Insurance Agency.
