Aetna is new to the Carolinas...Please advise.

[schoolofhardknocks2]

I know many of you write a lot of business with Aetna. They have just now started selling in NC & SC. I would be interested to hear what everyone thinks of there products, what their place in the market may be, or just any general knowledge.

Thanks guys and girls!

 

[somarco]

Underwriting can be more reasonable than many other carriers.

No waivers, only accept with or without rate up.

Middle of the road pricing (at least in GA).

No smoker rates.

Families have the same rate regardless of number of children.

Quick turn around on pre-screen & app underwriting.

I don't do that much with them but would like to do more. They have a good policy with a very good wellness (especially for women) benefit on all plans (including the HSA).

 

[schoolofhardknocks2]

Thanks the info somarco. Commissions seem to be on the low end. 15% to be exact. Is this their standard commissions or are some of you making more with production based contracts? Thanks.

 

[somarco]

That is standard.

Personally, I don't look at commissions. It all evens out as long as I do a good job for my client.

KP pays 11% level, BX pays 10% level, others such as GR pay 15% with the chance to move it up to 22% fairly easily but then they hit you on the renewal.

Aetna does have bonus plans but I never write enough to get into bonus. If I could, I would place most of my business with Aetna. They do a very good job for my clients.

As it stands, I write about 1 case a month with them.

If you let commissions drive you then you will never do the job you need to for your client.

 

[BKrocko]

It is 15% as earned in CO as well. They do run some bonus programs that are easy to obtain though. Right now, if you turn in 10 apps per quarter, it's $50/app bonus. 20 apps is $100/app bonus.

Everything Somarco said is true. I like the fact that the co-pay covers more than just "doctor consultation". So long as it is coded and billed correctly, most proceedures conducted in the office will be covered for just the co-pay (excluding lab and x-ray). They also can accept type 2 diabetes as well as some mild asthma cases.

I think this is the first year they have entered into the individual market, so we could all be in for sticker shock when yearly rate increases happen. Just have to wait and see.

 

[somarco]

Barry -

They actually returned to the individual market maybe 3 or 4 years ago. This is their 3rd year in GA. First two years have been kind.

Aetna was never a power house in the individual med market, but did write their fair share up until maybe 15 years ago. Not sure why they got out of it as the business has always been good as long as the carrier didn't do something stupid.

Normally 10 cases a quarter is relatively easy if the carrier is in the market. They really aren't here . . . about as competitive as Time so that gives you a clue.

They are really easy to work with. In addition to type II they will take bipolar and some other conditions most wont.

 

[BKrocko]

Thanks Bob, I guess it is the first year they have been in CO (so long as anyone can remember). I really like their plans and feel comfortable placing people in them. They have also started a marketing campaign out here including some commercials and billboards. The 3 carriers that are very competitive here this year are Aetna, Humana and World.

I was wondering why you said you would use them more if you could - I may never understand what some carriers are thinking when they price themselves out of the ballpark vs the norm. It's like they don't even bother doing any market research to see what is competitive.

On the other hand, perhaps they laugh to themselves and say "been there, done that" - let the other carriers take a bath in what they consider "sick or polluted markets".

There is one draw back with Aetna I am going to run into next week. I have a type II that I ran through pre screen. He has not seen a doc in a few years and is currently uninsured. They will want an APS - since there is no app fee, it is up to him to schedule and pay for a physical, they do not send a para med his way. I hope the report doesn't show he now has HBP or anything else. You never know how a case like that will turn out.

 

[schoolofhardknocks2]

If you let commissions drive you then you will never do the job you need to for your client.



I could not agree more...the 6 years that I've been in the industry have been spent making less by offering more. With that said, in NC, other than Celtic I don't think there is a carrier that pays less. However, when hearing the commissions for some of the other state's blues and for kp 15% is nice.

 

[schoolofhardknocks2]

It is 15% as earned in CO as well.

My regional sales mgr mentioned that Colorado was one of their most competetive states rate wise.

How is the doctor networks in you guy's area? Here in NC they seem to be good in the metro areas and lean in the rural parts.

 

[somarco]

They are just a bit high on comparable plans. Sometimes they are close enough, especially where a woman is making the decision, to swing it in their favor. The no fee GYN exam is the strongest benefit on the market.

I have talked with them about pricing. They don't have to be the lowest, but at least get in the hunt.

Humana or World are not players here. Understand the new Humana plans are kicking butt. However, they are not here yet.

Even if they do arrive their underwriting stinks.

World is only good in certain areas.

GR is still very strong here. Coventry is the new kid and throwing around some low rates. Service sucks and I think they will jack up rates after the first year.

KP is strong but only in the Atlanta area.

You can peel the label off Aetna, World, Humana & Celtic and never know which is which. All priced about the same on similar plans.

Time is about the highest consistently except when Blue decides they want that title.

I will be interested in hearing what Aetna does on your diabetic. My guess is they will take a pass.