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California health insurance - Health Exchange in California - Aetna Leaves Market

Aetna To Leave the California Individual and Family Market

 

Aetna California health insurance logo and branding for individual and family plans

We wrote last week on the California Health Exchange's list of participating carriers for the individual market and there were some notable exceptions.

 

One of those carriers, Aetna of California, officially notified the public and their current individual membership that they will no longer participate in the Individual market in California.

 

Let's take a closer look at their statement and what it means for their members and California individuals and families.

 

You can always run your quote here:

 

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The official statement from Aetna

 

We'll boil down the key points of their statement.

 

Starting July 1st, Aetna will no longer offer their Advantage plans for individuals, families, and self-employed Californians.

 

Applications which request effective dates Aug 1st or after will be closed at this time.

 

Any application that is still in process as of June 24th, 2013 (no matter what effective date is requested) will also be closed.

 

This means that applications finalized before June 24th with a requested effective date prior to August 1st will likely be extended coverage (if approved) but only temporarily as we'll see in the next paragraph.

 

Effect on existing Aetna IFP members

 

All existing Aetna IFP members including the recent additions mentioned above will be allowed to remain on their policy till Dec 31st, 2013 after which, their coverage will end.

 

This times exactly with the start of the Health Exchange plans on the market Jan 1st 2014 which are guaranteed issue (no qualification is required based on health).

 

A member can cancel their coverage between now and Dec 31st, 2013 by contacting member services (number on back of ID card).

 

We'll have the new rates and benefits available October 1st for Exchange and non-Exchange plans available from all the major carriers for Jan 1st effective dates.

 

We'll notify via our Facebook feed when the new rates are available.

 

The cancellation of coverage and participation of the market described above does not apply to Aetna's California Group health insurance or Medicare offerings.

 

So that's the official newsfeed...what's our take on it?

 

You can access the online application here:

 

How to apply for California obamacare

Our take on Aetna's notification

 

Ultimately, Aetna's market share for the California IFP market was slightly greater than 5% so they're not a huge player in the market but they are one of the big, nationwide health insurance carriers which is unsettling.

 

Their are four major carriers participating in the California Exchange (Anthem Blue Cross, Blue Shield of California, Kaiser, and Health Net) plus many regional players.

 

We've been around the health insurance market long enough to also remember what big fans Aetna's leadership was about Health Reform only to have them not participate in the largest marketplace (California) which is disconcerting.

 

The other issue is that anyone with a Grandfathered Status will lose that protection which can mean very large increases in premium if they don't qualify for health subsidies.

 

There's a chance that Aetna will wait out the first year to see how it all settles down but a cynic might also say they want to avoid the more high risk applicants that will flock to the program Jan 1st, 2014 at initial enrollment. Time will tell.

 

If you're a Aetna member

 

You can quickly quote all the major carriers available on the California market through our Quote page and starting October 1st, the new rates will be available from all major carriers.

 

We're happy to walk through the options with you.

 

Call us at 800-320-6269 with any questions. Our services are free to you as licensed health agents.

Access the California Self-employed Health quote online

Frequently Asked Questions
▸ Why did Aetna leave the California individual health insurance market?
Aetna officially notified the public and existing members of its exit from California's individual and family (IFP) market. Carriers periodically exit state markets for business or regulatory reasons; a licensed agent can help you find comparable coverage from carriers still active in California.
▸ What happens to my Aetna plan if I was already enrolled in California individual coverage?
Existing Aetna individual and family plan members in California generally receive notice of cancellation and a special enrollment period to transition to a new plan. It's important to act promptly so you avoid a gap in coverage.
▸ Which carriers still offer individual health insurance in California?
Several carriers participate in California's individual and family market, including through Covered California. Options and availability vary by region, so a California carrier comparison or a current quote is the best way to see what's available where you live.
▸ Can I get help finding a new plan after Aetna's exit at no extra cost?
Yes - working with a licensed California agent like those at CalHealth.net (Goodacre Insurance Services, licensed since 1994) is free to you; you pay the same premium as going directly to the carrier. Agents can compare all available options across the state on your behalf.
▸ Does Aetna still offer any health insurance products in California?
Aetna's exit specifically affected the individual and family (IFP) market; availability in other markets such as employer group or Medicare may differ. Contact a licensed agent or reach out to CalHealth.net for current information on what Aetna or other carriers offer in your specific market.
The answers above are general information about California health insurance and may change as rates, plans, and rules are updated each year. They are not a substitute for personalized advice. For current, personalized guidance, please contact us, email help@calhealth.net, or call 800-320-6269. Serving California since 1994.
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