Has Aetna individual health dumped out of your state yet....

[Crabcake Johnny]

John... Split the family up b4 issuse, submit onlne as one, get letter from client requesting split policies... do the same for rated conditions. This not only helps for the cost of the policy, but gives you more app count

Just a thought, but I have been doing it like that for a year and had NO problems... the key is to get the letter to seperate B4 the policy is issued

That won't do the trick. Take a case I just had - $512 premium and a rating of 25% on the wife - family of 4. In this case the premium, if all left on the same plan, would have been $640.

Now, split the case. It's STILL the same family rate of $512 even though there's three members. Now the wife has her own premium of $186 + 25% = $232. So add the $232 to $512 and they're actually worse off by splitting.

The only way a split would work if it were a family of three. Then seperate the wife and you have "male/child" rates" plus the wife instead of still having a family rate.

 

[somarco]

Aetna rates the entire policy even if only one person get rated. Take that family above; family of 4 for $512 a month. If just the husband gets a B rating the entire plan goes up 25%.

Where did you get that?

One of the questions I asked the RSD (someone I have known for several years) when contracting is does Aetna apply the rate up to the individual or the entire family? He indicated the rate up was only on the individual.

I only have singles with Aetna, no families so I can't prove this one way or the other. I have asked them to pre-screen 2 or more individuals in a family and they have come back with "B" ratings for some family members & "C" for others.

If they are in fact applying the load to all family members, then submit the individual with a rate up as a single and put the other family members on a different contract, and possibly with a different carrier. I have done that where the family rate was not competitive with Aetna and the one with a pre-ex got a better deal from Aetna than other carriers. The pre-ex goes with Aetna, rest of the family goes with another carrier.

Aetna is not competitive in GA, only in a limited number of counties and only has one plan that is worthy of consideration (PPO Value). Even though they have the $$$ to do anything they wish, they are moving very slowly here and I do not think they will ever be a major force in the individual market.

 

[Crabcake Johnny]

I think your RSD better contact underwriting. The rate applies to the entire family even if one person is increase. Here's one case - note that only the son was rated a "B" rating yet the entire policy was increased. I sold dental on this deal so the rating didn't effect dental which is why the $25% load on the initial $389 premium is off a bit.

"A" primary means A rating. "B" dependent means only the son got rated.

$389 initial premium finalized at $475 and only the son was rated. You do the math. The child alone would have been $78 per month of the $389 premium. That means the final rate should have been only $19 more if just the child was rated. Instead, as you can see below, a $86 rating was applied which, not including dental, is 25% of the entire premium.

(I obviouly blocked out the client name for HIPAA)


Application Status
***347 Approved with Rate Up
Key Dates
Requested Effective Date Actual Effective Date Signature Date App. Received Date
12/01/2006 12/01/2006 11/21/2006 11/21/2006
Plan Information
Primary Medical Product 1 Dental Optional Coverage 1 Quoted Rate Final Rate
PPO 30 Included $475.00
Applicant Information
Total Members Approved Members Declined Members
3 3 0
Applicant Name Rating Level Relationship Gender Date of Birth
******** A Primary F 9/14/1963
******** B Dependent M 7/9/1994
******** A Dependent F 11/11/1996


Policy Information

Policy Issued
Multiple Policies No.of Policies Monthly Premium
No 1 $475.00
Policy No. Applicant Name Relationship Risk
Category Premium Additional
Premium % Additional
Premium Amount Final
Premium
********* Primary A $389.00 25% $86.00 $475.00
********* Dependent A
*********Dependent B