As part of their goal to provide greater access to medical and pharmacy benefits, beginning in October Aetna will accept submissions on the 1st of the month for coverage during that month. They will also accept submissions on the 15th of the month for coverage on the 15th of the month.
Cases must be submitted with the following to receive the requested effective date:
- Fully completed Master/Employer application
- Copy of check or ACH form
- Completed eList* or fully completed enrollment and waiver forms
- Tax/payroll for group with an enrollment of five and under
*New business should be submitted using the Aetna eList tool. Information about the eList tool can be found on the Producer World website under Small Group Quotes.
Aetna cannot process cases that are missing vital information. Incomplete cases will be moved to the next available effective date.
Renewal Changes Effective October 1, 2016
Aetna must receive written confirmation of a group’s planned renewal in advance of the renewal date for all groups of one to 100. Confirmation may include a signed renewal acceptance from the customer delivered by mail, fax, or email to Aetna. Premium received in advance of the renewal date will also be considered renewal acceptance.
If no written acceptance of the renewal or renewal alternates are received, Aetna will initiate termination of the group’s policy for nonpayment.
This change allows Aetna to provide new and renewing members with access to the correct medical and pharmacy benefits in a timely manner. It also helps prevent paying claims incurred after a group’s termination date.
If you have any questions about any of Aetna’s new business rules or renewal guidelines, contact your Word & Brown representative.
