Aetna's CA Small Group Q4 Insights: Bonuses, Dental Deals, and More


In the latest 2023 Q4 update from Aetna California Small Group, brokers are incentivized through a bonus structure based on the total number of enrolled employees for all groups in 2023. For current bonus standings, brokers are advised to reach out to their Aetna sales executive.

Rate changes for Q4 include a 2.5% increase for HMO and a 4.1% increase for PPO. These rates might differ based on the network and rating area. Additionally, Aetna introduces an appealing offer for new and renewing groups by offering a premium credit for adding dental services to their packages. This credit, exclusive to CA-based groups, is influenced by the number of subscribers and is applied once on the third invoice from the effective date.

Aetna emphasizes the advantages of bundling services. Benefits include higher member engagement, more effective identification of at-risk members, increased care participation, and simplified administration.

Producer World serves as an all-encompassing platform for brokers, providing essential underwriting guidelines, forms, and more. In the realm of pharmacy, Aetna made pivotal drug changes as of July 1, 2023, and divided the Small Group formulary into California HMO and California OAMC/PPO.

Teladoc remains a valuable service for short-term health needs, enabling members to quickly consult doctors via phone or video. New provisions state that Aetna Small Group HMO and OAMC/PPO members will now have a $0 Teladoc copay for General Medicine and Dermatology.

MinuteClinic continues to serve members with easy access to necessary care. Remarkably, new provisions mean that Aetna HMO and certain Aetna OAMC members can now access MinuteClinic services at a $0 copay.

Finally, the company emphasizes the importance of members having access to immunizations under the pharmacy benefit. With the Public Health Emergency ending on May 11th, 2023, Aetna is taking steps to ensure members can conveniently get immunized at pharmacies, including receiving the COVID-19 vaccine. To this end, starting September 1st, 2023, seasonal vaccine coverage will be added to members' pharmacy plans.