Aetna Plan Changes - Do We Remain AOR?

[cadylou]

Aetna is saying that people can call them direct & they are also telling Brokers to tell the member to execute a plan change if they want a different plan. I guess this means the AOR would be stripped off if the member contacts them?

I don't know why I'm even asking, but they've sent yet another flyer to brokers indicating that they want to make our plan changes "easy" and leave us time to focus on selling by enabling these simple "plan changes".

anyone else have any experience with this? I haven't had anyone do a plan change without me doing a new app to retain the business, so . . . .I just wondered how this worked. it would be nice not to have to reapply every year - I'm too busy & my clients hate all of this . . . .

 

[yorkriver1]

Our Blue Cross/Shield carrier here is doing this, and emphasizes they are keeping our information in the account. Haven't asked Aetna, or don't recall from the sales meeting. I will call their broker services # later & ask.

 

[cadylou]

Our Blue Cross/Shield carrier here is doing this, and emphasizes they are keeping our information in the account. Haven't asked Aetna, or don't recall from the sales meeting. I will call their broker services # later & ask.

I was told by my Coventry rep that the only way to retain AOR on a plan change, is to fax in a form they provide. Of course, on that form there is no space for our information as the agent. No way to provide this electronically either - just a paper form, requiring a wet signature from the client that has to be faxed in It's not provided with any of the letters they send.

I'm told that if they call member services with a plan change, we're toast & it's a house account. buh bye . . . . .

 

[AllenChicago]

I meant to post this earlier, but forgot. Some Aetna and Coventry marketplace clients have vanished. They're missing from HC.gov, and therefore can't be renewed for 2016. Here's an e-mail that Aetna-Coventry sent out on 11.2.15..

--start copy/paste--

"Some Aetna and CoventryOne current members must take action to enroll by December 15, 2015

Individual Pre-65

Recently your Aetna and CoventryOne current members got a letter from us about their plan information for 2016. We said we’d automatically enroll them in a plan for 2016. But for some members, the Marketplace can’t automatically enroll them in a 2016 plan.

Since the time the November 1 renewal notices were released, CMS has identified that all insurance carriers have some individuals that can't re-enroll and will not be eligible for 2016 passive renewal. We are therefore proactively contacting these individuals in an effort to keep them enrolled in an appropriate and affordable plan.

These members will be mailed a letter informing them that they must take action to enroll by December 15, 2015, or they won’t have coverage on January 1, 2016. If they take action after December 15, they won’t have coverage until February 1, 2016 or after.

If you receive a call from an impacted member, let them know they have three ways to take action. They can:.
•Complete a 2016 Marketplace application with your assistance
•Contact their Marketplace to complete a 2016 application. Or go to www.healthcare.gov and log in. If they forgot their username or password, follow the steps on the website. If they don’t find a pre-filled 2016 application waiting for them, they should just start a new one.
•Call us at 1-855-849-4750. We’ll walk them through the process.

We're here to help!

If you have any questions, contact your sales representative or the Aetna National Broker Support Unit at 1‐888‐54‐Aetna (1‐888‐542‐3862). Representatives are available Monday ‐ Friday from 7:30 a.m. to 6:00 p.m. Central time."

--end copy/paste--

The e-mail says that several insurers are affected. So far, I've only found it happening to Aetna/Coventry. Has anyone found clients with other companies who have disappeared from the Marketplace? If you have hundreds, there's no way to know, unless they call you, HC.gov, or the insurer to ask why they didn't get a renewal letter.