Health Net for Large Group, Aetna Q4, PCORI, News & More

LARGE GROUP NEWS

Health Net Enhanced Choice Solutions has Only 10% Participation Required when Paired Alongside Another Carrier!

The Health Net large group Enhanced Choice underwriting program runs through 3/1/2022 and it gives you more opportunities to write large group business with Health Net and Dickerson. This program is for employer groups with 101-500 eligible employees that have difficulty meeting a carrier’s standard participation guidelines.
The Enhanced Choice Solutions features:
  • Multi-carrier: Participation requirements of a minimum of 10% of the eligible population, or 25 active, enrolled employees, whichever is greater
  • Total Replacement: Participation requirements of a minimum of 33% of the total eligible population, or 33 active, enrolled employees, whichever is greater
  • Flexible participation requirements
  • Best-selling Enhanced Choice portfolio
  • A choice of up to three selected Enhanced Choice Plans
  • Minimum employer contribution requirements are 50% of the lowest cost Health Net Plan
  • Effective dates between now and 3/1/2022

Dickerson is an official GA for Health Net Large Group. That means you will earn 100% of your commissions and our sales team will take care of the entire RFP and enrollment process for you!

For more information on Health Net Enhanced Choice Solutions underwriting, click here

DICKERSON WEEKLY NEWS

Aetna Small Group Q4 Update

Aetna shared some great information for Q4. Here are the highlights.
  • Q4 medical rate action
    • HUGE rate reductions, 25% participation requirement, and a broker bonus for October – December effective dates!
Northern California
Rating Area Quarterly Change Annual Change
PPO, OAMC, Savings Plus Full HMO HMO, Ded, AVN, Basic, AWH HMO PPO/OAMC Full HMO HMO, Ded, AVN, Basic, AWH HMO
1 -3.4% -7.1% -2.2% -4.2% 16.0% -6.7%
2 -3.4% -7.1% -2.2% -3.6% -15.6% -6.4%
3 -3.4% -7.1% -2.2% -2.9% -15.6% -6.4%
4 -8.2% -7.1% -2.2% -10.4% -15.6% -6.4%
5 -6.3% -7.1% -2.2% -6.3% -15.6% -6.4%
6 -9.2% -7.1% -2.2% -9.1% -15.6% -6.4%
7 -17.9% -11.5% -7.1% -21.9% -19.8% -11.1%
8 -8.2% -7.1% -2.2% -7.9% -15.6% -6.4%
9 -3.4% -7.1% -2.2% -4.0% -15.6% -6.4%
10 -3.4% -7.1% -2.2% -3.6% -15.6% -6.4%
11 -3.4% -7.1% -2.2% -3.6% -15.6% -6.4%
Southern California
Rating Area Quarterly Change Annual Change
PPO, OAMC, Savings Plus Full HMO HMO, Ded, AVN, Basic, AWH HMO PPO/OAMC Full HMO HMO, Ded, AVN, Basic, AWH HMO
12 -3.4% -7.1% -2.2% -3.1% -15.6% -6.4%
13 -3.4% -7.1% -2.2% -2.9% 16.0% -6.7%
14 -3.4% -7.1% -2.2% -3.1% 16.0% -6.7%
15 -5.2% -8.7% -4.0% -5.0% -17.1% -8.1%
16 -5.2% -8.7% -4.0% -9.2% -17.1% -8.1%
17 -19.4% -8.7% -4.0% -23.2% -17.1% -8.1%
18 -5.2% -8.7% -4.0% -5.1% -17.1% -8.1%
19 -3.4% -8.7% -4.0% -3.4% -17.1% -8.1%
  • CVS Health and Aetna have a unique set of combined capabilities. Examples include: Local access to care, No cost/low-cost MinuteClinic benefit, Care concierge at CVS HealthHUB, and more!
  • Underwriting Update
    • Relaxed participation promotion for groups 5-100 eligible employees can now meet a 25% participation when enrolling five or more subscribers. This promotion runs from July 2021 through March 2022.
  • Pick 5 is now Pick 10
    • Pick any 10 plans!
  • 2021 Broker Bonus
    • It’s not too late to earn up to $150 per enrolled employee: Take advantage of the new rates and earn a bonus from Aetna!
  • Aetna Small Group Dental
    • View the range of plans and competitive rates Aetna offers for your employer groups.

For more information on Aetna’s Q4 updates, click here .

Reminder:  PCORI Fees are due by July 31, 2021

Employers with a self-funded medical plan, or a fully insured plan with a health reimbursement arrangement (HRA) are required to submit their PCORI filing. The only employers who do not need to worry about the PCORI fee are employers with fully insured plans and no HRAs. Employers that sponsor self-insured group health plans, including health reimbursement arrangements (HRAs), should keep in mind of the upcoming July 31, 2021 deadline for paying fees that fund the Patient-Centered Outcomes Research Institute (PCORI).

The amount of PCORI fees due by employer sponsors and insurers is based upon the number of covered lives under each “applicable self-insured health plan” and “specified health insurance policy” (as defined by regulations) and the plan or policy year-end date. This year, employers will pay the fee for plan years ending in 2020.

For more information on PCORI click here.

DICKERSON INDUSTRY NEWS

States Push to Regulate Pharmacy Drug Brokers

In an ongoing effort to control prescription drug costs, states are targeting the companies that mediate deals among drug manufacturers, health insurers and pharmacies. To read the full story, click here.

Doctors Worry Memory Problems After Covid-19 Set The Stage For Alzheimer’s

Scientists have taken PET scans before and after a person develops COVID-19 and they noticed that the infection can cause changes that overlap those seen in Alzheimer’s. To read the full story, click here.

Start Your Day With Breathing Exercises For Stress Relief

Having a moment of mindfulness with breathwork at the beginning of the day can help add consistency and structure to your routine. To read the full story, click here.

How Can the U.S. Reduce Drug Overdose Deaths?

The government, academic researchers, criminal justice experts and health-care workers try to help the nation’s more than 8.1 million people with substance use disorders. Solutions range from completely decriminalizing the consumption of drugs, to overturning the way the health-care system treats users. To read the full story, click here.