Updated Delaware, Pennsylvania and West Virginia ACA Small Group new case submission dates and termination policy
To help members use their benefits effectively and get the care they need, we must make sure that they’re enrolled by their effective dates.
As you know, there’s a delicate balance between high year-end small group ACA new sales volumes and late or incomplete ACA case submissions. And our goal is to provide access to medical and pharmacy benefits for new members on their effective dates. So we’re implementing the following new business submission dates for September and 4th quarter.
||Monday, September 12
||Monday, September 26
||Monday, October 10
||Tuesday, October 25
||Thursday, November 10
||Thursday, November 24
The following must be submitted to receive the requested effective date:
- Master/Employer application (fully completed)
- Check copy or ACH form
- Enrollment and waivers (fully completed)
Remember, we cannot process cases that are missing vital information. Incomplete cases will be moved to the next effective date.
States included in the updated ACA new sales submission dates are: California, Colorado, Connecticut, Delaware, Georgia, Illinois, Maryland, Oklahoma, Pennsylvania, Utah, Virginia, West Virginia and Wisconsin.
We will publish our 2017 submission date schedule by November 1st. This will reflect different timelines to account for quarterly volumes.
New Small Group ACA termination policy effective October 1
As an important small group partner, we want to keep you informed of upcoming policy changes. Starting October 1, we must receive written confirmation of customer renewal acceptance in advance of the customer renewal date for all Aetna small groups.
This means that beginning with all October 1 renewal dates, we must receive written confirmation in advance of the policy renewal date. Written confirmation may include signed renewal acceptance from the customer delivered by mail, fax or email. Note: premium payment received in advance of the renewal date will also be considered renewal acceptance.
If we haven’t received written acceptance of the renewal, or renewal alternates, from the customer in this time frame, we will initiate termination of the policy on the renewal date.
This change allows us to provide new and renewing members with access to correct medical and pharmacy benefits in a timely manner. And it helps us prevent paying claims incurred after the termination date.
Please help us avoid member disruption by sending your group’s renewal intentions before the renewal date.
If you have questions or would like additional information, please contact your Aetna representative.