Aetna's Jekyll & Hyde Underwriting

Aetna expanded and changed their underwriting criteria in May in hopes of writing more business. The old formula was 25%, 50%, decline. Now they use 10% increments up to 100%.

At a roll out meeting they said the new formula, combined with the automated underwriting (robo-underwriter) would allow them to write cases that would have previously been declined. Some cases that would have had a 50% rate up in the past might now be 30%, making them more competitive.

Well . . .

Since implementation I have experienced more declines and HIGHER rate loads than before.

Just submitted a pre-screen on a 24 yr old with anxiety. He takes paroxetine HCL (generic Paxil) daily. This is a $4 generic drug, no counseling, no serious issues.

Aetna wanted a 40% increase. Humana says it is a standard risk.

I have had similar situations on other condtions where Aetna wants 100% increase while others are in the 50% range or less. Aetna has declined cases where other carriers were willing to take them on.

I have been wanting to find reasons to place business elsewhere. Aetna is giving me that reason.


Tell the truth peach pit?
Doesn't it aggrivate when you know this putz can do with out that medication?
Oh well, there's $18 a month you won't be seeing I guess?

P.S.

Aetna blows.
Strickly paper apps. from now on, unless they overhaul it, or unless threatened at gun point by the client for a link ...
Last three; all got annoyed with their lousy online system ... switched to paper midstream.
I've never had a client insist on it.

- - - - - - - - - - - - - - - - - -
If that is the only restriction in the plan, I would take that deal and recommend that anyone (especially a 20 something) as healthy as I am and who has no medical issues take that deal. I have NEVER (in 61 years) gone to the doctor 5 times in one year!

In CA when you see the word "Value" or "Smart" or "Saver" in a plan name it usually means no brand-name or non-formulary drug coverage... sometimes not even generic!

Al


No poop putz.

Whever you see those words anywhere it is a "nice sounding" way of saying you pay for it on your own ...?
 
Last edited:
Back
Top