UPDATE: AFA Requirements for Applications

To improve underwriting results and competitiveness, AFA is requiring medical applications on groups with less than 25 enrollees beginning May 1 claiming this can potentially save another 10 percent on quotes.

See the notice from Aetna here for more information.

Contact your Cornerstone representative with any questions.

AFA Submission Deadlines

Case submission deadlines for Small Group (5-50) Aetna Funding Advantage

Idaho, Kentucky, Louisiana, Michigan and Mississippi

Aetna’s February effective date deadline is approaching quickly.See below for their new business submission deadlines for February, March and April:

Effective date Signed Employer Application
(Springboard)
Completed Sold Case Documents (Adobe Sign) and Enrollment (Springboard)
February 1 1/28/2019 2/1/2019
March 1 2/26/2019 3/1/2019
April 1 3/27/2019 4/1/2019

Contact your Cornerstone representative with any questions.

New AFA Plans Available

New AFA Plans Available. Aetna released their “Essentials” plans which feature lower cost share on PCP, lab and generic drugs with higher cost share on ER visits, imaging and specialty drugs. These plans run about 10% less than the other plans. Remember, AFA doesn’t limit the number of plans an employer can offer. See more in their flyer and plan grid.

Aetna Funding Advantage 1095-B Tax Forms Are On Their Way

Aetna Funding Advantage groups with 5 to 50 employees will receive 1095-B 2018 tax forms starting the week of January 28. Members can access these forms electronically through the Aetna Navigator or by mail.

Reminder: Members do not need to file their 1095-B forms.

Questions? Contact your Cornerstone representative.

Updates to Aenta Funding Advantage Broker Bonus Program

Aetna has extended its new business bonus for brokers selling the Aetna Funding Advantage product through April 1, 2019, effective dates.

Click here to learn more!

SilverScript Completes Acquisition of Aetna

Silverscript is excited to share that CVS Health, the largest pharmacy health care provider in the U.S., has completed its acquisition of Aetna, one of the nation’s leading diversified health care benefits companies.

The combination of CVS Health and Aetna is a transformative moment for Silverscript and the industry. With the combined capabilities of two leading organizations, Silverscript’s goal is to help transform the consumer health experience through a new innovative health care model that is easier to use, less expensive, and puts consumers at the center of their care. In doing so, Silverscript will deliver on their purpose of helping people on their path to better health.

As they bring the two companies together, your clients will continue to work with Silverscript as they do today, and receive the same great products, support and service.

Please read the Silverscript & Aetna Acquisition FAQ document here for more information.

 

For more senior marketing news, visit the Cornerstone Senior Marketing website!

CVS Health Announces Completed Acquistion of Aetna

CVS Health completed its acquisition of Aetna on Wednesday. The combined company intends to provide consumers access to the information and resources needed for quality health care, as well as remove barriers to access to affordable care.

New products and services developed by the combined company will be broadly available to the health care marketplace, regardless of one’s insurer, pharmacy benefit manager (PBM), or pharmacy of choice. Additionally, CVS Health offerings, including retail pharmacy services, specialty pharmacy and long-term care, walk-in clinical services, and PBM services, will continue to be fully accessible to other health plans. Aetna members will also continue to have a broad network of pharmacies, including community-based independent pharmacies, available to fill their prescriptions. CVS Pharmacy will continue to participate within the pharmacy networks for other PBMs and health plans.

Contact your Cornerstone representative with any questions.

 

Click here to view the official release from Aetna.

Click here to view the official release from CVS Health.

Aetna Updates on January New Business Deadlines, Billing Timelines, and Reporting Notices

December and January Deadlines

The deadline for Aetna December sales notices is right around the corner. Make sure you get your notices in for December 1 effective dates by Tuesday, November 27th. Also, today is the last day to submit sales notices early and earn an administrative fee credit for your clients. You must also submit all required documents by Monday, November 26th in order for your clients to qualify for the credit. Click here for a flyer with more details on the administrative fee credit program and deadlines.

Below are the regular submission deadlines for December and January effective dates:

Effective Date Sales Notice Submitted All Required Documents Submitted
December 1 11/27/2018 11/30/2018
January 1 12/27/2018 12/31/2018

Billing

On the 25th of each month, Aenta posts monthly AFA invoices on Springboard Marketplace. Aenta emails invoices directly to those who do not use Springboard. The invoice is based on how many employees are enrolled for coverage on the 17th of that month. On the second business day of the following month, Aetna will pull funds from your account.

The first month’s bill may follow a different timeline if Aetna installs a group after the 19th of the month before their effective date. In this scenario, Aetna will pull eligibility on the first day of the month of their effective date and five days later post your invoice on Springboard. Aetna will pull funds by the 15th of the month. If they install a group after the effective date, they will not pull funds the first month. Instead, they will pull funds for two months of coverage on the second business day of the next month. For renewals, they will pull funds at their renewal and the next month’s invoice will include any changes that occurred after the 20th of the month.

*If group is not installed by the effective date, the customer will receive a bill for 2 months of coverage at once.

NY HCRA Notices

AFA customers may have recently received a communication from the New York State Office of Pool Administration regarding their NY HCRA filing eligibility. Please note, that there is no action needed. As the third party administrator, Aetna files NY HCRA forms on behalf of their Small Group AFA customers and determine whether that filing is annual or monthly.

5 Reasons Aetna is Your Choice in Northeast Ohio

 

Cornerstone Senior Marketing & Aetna MA/MAPD want to share some insightful benefit information on Aetna’s plans if you have clients in the Northeast Ohio region.

5 reasons Aetna is your BEST choice in Northeast Ohio:

  1. Access to National Network on PPO and HMO plans. Network includes ALL acute care hospitals in Ohio, with access to a national network which includes Cleveland Clinic, Akron Children’s and Aultman.
  2. Expanded service area into Wayne, Carroll and Tuscarawas counties.
  3. $0 premium HMO Value and $0 premium Value PPO plans.
  4. $0 PPO includes dental, OTC, hearing and meal benefit.
  5. Reduction in MOOP and copays including $0 Tier 1, and Tier 2 Prescription gap coverage.

 $0/MONTH

Two plan options including both medical and prescription drug coverage at $0/month

PROVIDER NETWORK

All acute-care hospitals in Ohio are in-network for Aetna members

(The Ohio State University is in-network for Aetna PPO members only)

NEW BENEFITS ADDED

Plans may include: OTC allowance, transportation, post-discharge meals, and dental, vision, & hearing benefits

If you have questions or want to get contracted with Aetna please contact your Cornerstone Senior Marketing representative.

Aetna Funding Advantage New Broker Bonus

Earn more for groups sold using IMQs with Aetna Funding Advantage’s new broker bonus. 

From 11/1 through 1/1 effective dates, you can earn more per subscriber for sold Aetna Funding Advantage (AFA) groups underwritten using Individual Medical Questionnaires (IMQs).

When you sell a Small Group (5-50*) AFA case underwritten using IMQs, you get:

  • Opportunity for group to save up to 15% on costs**
  • $100 per subscriber instead of the standard $50 per subscriber AFA bonus, paid quarterly
*10-50 in NV, 26-50 in NC
**Versus a group underwritten through GRx methodology. Based on AFA book of business analysis.

Click here to learn more.