Small Group

Important Business Updates

Important sold case reminders and dates
 

Did you know that a key date* in every month ensures that your clients’ claim and member ID cards are ready by their plan’s effective date? 

The best way to ensure your clients have all they need by their effective date is to submit all sold cases and their final paperwork by the 15th of most every month. The two exceptions every year are December and January:

• December 1, 2025 effective dates=11/13/2025
• January 1, 2026 effective dates=12/12/2025

This timeline provides an overview of what you and your clients should expect:

• Sales notice submitted: be sure your sales notice is completed and filled out to avoid any delays.
• Paperwork and forms are sent to you and your client within 24 hours.
• Once all paperwork is received, underwriting will finalize the group, and you’ll receive an approval letter.
• Our case installation process begins and once completed, you and your client will receive a welcome letter. 
• Finally, a Sales Implementation Manager is assigned, who will send you member IDs via email, 2-3 days after you’ve received the welcome letter.

*The above dates are to ensure groups are claims and ID card ready, final sold cases may still be submitted up till:

Heads up: Multifactor Authentication (MFA) is coming to Producer World 

We began collecting MFA contact information from all users in early August at first login to Producer World. If you have already supplied your MFA contact information, we will begin to roll out the MFA requirement in a phased approach starting October 3, 2025. If you have not yet supplied your MFA contact information, upon your next login to Producer World you’ll be prompted for an email address and cell phone number. To keep your account secure and avoid log-in issues, be sure to complete this set up on Producer World.

For support with your MFA contact information and any questions about the program, contact the Producer World Help Desk at 866-714-9301, option 6.

Gag Clause Prohibition Compliance Attestation – filing on behalf of all plan sponsors
 

Group health plans are to comply with the Gag Clause Prohibition Compliance Attestations (GCPCA), established by the Consolidated Appropriations Act, 2021. Employer-sponsored group health plans (both self-funded and fully insured) are prohibited from entering into agreements with a health care provider, network or association of providers, Third Party Administrator, or other service provider where the plan is restricted from accessing and sharing certain information.

As part of this clause, plan sponsors are required to submit an annual attestation that the plan is in compliance with these requirements. Aetna will file the Gag Clause Prohibition Compliance Attestation on behalf of all plan sponsors by December 31, 2025. There is no action for plan sponsors or brokers to take for this filing. If the plan sponsor needs an attestation of compliance, please contact your account team and they can request a certificate.

MA Minimum Creditable Coverage attestation form deadline – 10/31/25
 

In the state of Massachusetts (MA), residents must file 1099-HC tax forms by January 2026. This is due to a Massachusetts health care law requirement that mandates their residents to have health insurance that meets Minimum Creditable Coverage (MCC). While Aetna manages this process for our Small Group fully insured plan sponsors, our Small Group Aetna Funding Advantage℠ plan sponsors are responsible for taking steps to comply with this requirement if they have any Massachusetts-based members during the calendar year.

Aetna can help Small Group AFA plan sponsors with this process if they complete and return the attestation form to us by October 31, 2025 (Aetna emailed a form to all Small Group AFA plan sponsors who had Massachusetts-based members during 2025). If Aetna receives the completed attestation form by the deadline, we’ll send the tax forms to members with a MA address*. We do copy the broker on our email outreach and appreciate your help in explaining this requirement to the customer. For more information on MA Minimum Creditable Coverage, click here.

*This applies to any SG AFA groups with members in Massachusetts at any time during calendar year 2025.

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Aetna Funding Advantage^SM plans are self-insured by the employer and administered by Aetna Life Insurance Company.

This message is for informational purposes only, is not medical advice and is not intended to be a substitute for proper medical care provided by a physician. Information is believed to be accurate as of the production date; however, it is subject to change. Refer to Aetna.com for more information about Aetna^® plans and for a full list of participating providers.

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