Underwriting

New Hire Rating Guide

Aetna New Hire rates will be based on the member’s age at the member’s enrollment date   Anthem BlueCross New Hire rates will be based on the member’s age at...

New Participation Guide for Dental

As part of our continuing commitment to help you write more Dental business, we’ve developed a new California Dental Participation Guide. It summaries carrier and third party administrator (TPA) guidelines...

No DE 9C Promotion Promotions/Guidelines

Quarterly Wage Report/DE 9C not required for:   Aetna Guideline: Groups of 6+ enrolled with prior coverage   Anthem Blue Cross Promotion: Groups of 6+ enrolled through 9/15/2020 effective dates...

PEO Guidelines

In addition to meeting standard Underwriting Guidelines, groups must provide the following: Aetna Guideline for staying with a PEO (1) 1-5 enrolling: • Letter from the PEO confirming that they...

Start-up Groups

Aetna Requirements Groups with 1-19 enrolled employees and groups with no existing health coverage must submit a copy of the most recently filed DE9C. If not available, two consecutive weeks...

Participation and Alongside Guidelines

Aetna Standalone 1-4 enrolled employees: 65% through 12/31/2020 5+ enrolled employees: 25% through 12/31/2020 Alongside Another Carrier 25% participation and a minimum of 5 employees enrolling required for groups offering...

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