Aetna Updates, Individual Market Broker Compensation, Updates, News & More

DICKERSON WEEKLY UPDATE

Aetna No Longer Offering OAMC Plans With Sutter Health

Aetna will no longer offer the Aetna OAMC plans which utilize the Sutter Health Aetna provider network. They stopped quoting small group Sutter Health Aetna network plans and will not be enrolling new customers into these plans after 7/1/22. Existing customers will be moved off of the Sutter OAMC plans upon renewal.

Sutter Health continues to be a participating provider in our OAMC and PPO networks.

Contact your Dickerson Sales Rep for more information!

INDIVIDUAL UPDATES

CMS Releases FAQs on Individual-Market Broker Compensation

CMS released a new FAQ document that clarifies that a health insurance issuer cannot treat commissions on enrollments during a Special Enrollment Period (SEP) differently than commissions on enrollments during the Open Enrollment Period (OEP).

As brokers who help enroll consumers in the individual market are aware, carriers can currently choose to offer lower commissions or choose not to offer commissions at all for enrollments made during an SEP during the same benefit year as the OEP.

Click here to read the FAQ document.

DICKERSON INDUSTRY NEWS

Private Insurers Expect to Pay $1 Billion in Rebates to Consumers This Year

Private insurers expect to pay $1 billion in rebates this year for setting premiums too high relative to medical costs.  This year’s total is roughly half the size of last year’s $2 billion, in part because 2021 was a less profitable year. Click here to read the full story.

 

Non-Quantitative Treatment Limits (NQTL) Annual Analysis Required

All group health plan sponsors of both fully-insured and self-funded plans must consider the requirements of the Mental Health Parity (MHP) and Addiction Equity Act and the Patient Protection and Affordable Care Act (ACA). All employers who sponsor group health plans should be aware of the requirement to have an annual analysis done of the plan’s non-quantitative treatment limits (NQTLs) as it relates to rules under mental health parity (MHP). Click here to read the whitepaper.