CVS-Aetna Branded Obamacare Plans Target 8 States For 2022 Launch

CVS Health is looking to sell individual coverage with the “CVS-Aetna” brand on exchanges under the Affordable Care Act in up to eight states for 2022.

Citing better market conditions and quality low priced health plans it can offer. CVS Health’s Aetna health insurance unit left the ACA’s exchanges four years ago under prior Aetna management along with other insurers that were unable to manage rising costs of uninsured patients signing up for such coverage.

CVS explained the company is just now working with insurance regulators and submitting plans and rates to offer individual coverage under the ACA, which is also known as Obamacare after President Obama. CVS isn’t yet disclosing the states it plans to offer these plans, executives confirmed Tuesday.

The CVS-Aetna move back into the ACA individual business comes under a more supportive White House under President Joe Biden, who was Obama’s vice president when the ACA became law.

Health insurers are already seeing a spike of new individual Obamacare subscribers thanks to new regulations and support to the companies and Americans looking for coverage from the Biden administration. That contrasts with the Donald Trump administration, which attempted to get Congress to repeal the ACA.

CVS sees a large market of Americans that have no coverage and the opportunity to offer a unique product given the company’s network of pharmacies, MinuteClinics, and hundreds of HealthHub store formats.

Here’s what the law means for you: 

  • Almost everyone is required to have health insurance. 
  • Nobody can be denied health insurance coverage. 
  • Most health plans must include preventative care at no cost to you. 
  • For most health plans, your out-of-pocket costs for healthcare can’t exceed a set amount. 
  • You must get a clearly written summary of your benefits and coverage. 
  • Children can stay on the family health plan until they turn 26. 
  • You can buy a health plan through a public exchange, or marketplace. Or you can buy a health plan without going through the public exchange. These plans must cover a defined set of benefits. 
  • If you buy your plan through a public exchange, the government may help you pay for it. 

The law covers most health plans sold today, but some parts don’t apply to plans that were sold before the law was passed.

Visit the Aetna website and Forbes for more information. 
Get contracted and ready to sell Aetna CVS Health plans for 2022! 

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2021 Producer Special Enrollment Period Bonus

Individual and Family Plans: Cigna Health and Life Insurance Company

Program rules: 

Bonus is based on new sales submitted from February 15th to May 31st (from February 8th to May 31st in Colorado) for policies effective as of 6/1/21. In order for sales to qualify, customers must make initial payment and be in active status. 

 Producer must submit a minimum of seven new SEP customers. At that time, any new medical sales bonus due will be paid, starting from the first 2021 SEP application. Customer plan changes do not qualify. 

Bonus program is based on number of customers submitted at the agent level. Customer counts will be capped at six customers per policy.  

Eligible products include all IFP medical products in all markets. 

Cigna reserves the right to charge bonuses back if brokers have over 15% of their membership leave the plan or not maintain continuous coverage for the first four months of their policy contract. 

Cigna will offset any over payment against other compensation due and payable to producer.






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The short version: Most states are launching a “Covid SEP” where your clients will not need a Qualifying Life Event to enroll. This starts February 15th and ends May 15th.







So, this is just like an Open Enrollment Period—where unenrolled clients
can get enrolled, and currently enrolled clients can change plans.

The long version:

From February 15th – May 15th, 2021, the 36 states using the Federal Marketplace, and several other states, will allow consumers to enroll without having to verify a Life Change (also known as a “Qualifying Life Event”) as they normally would when enrolling outside of Open Enrollment.

How it works

When you enroll a client who does not have a Life Change, simply don’t select a Life Change on the application. If the client does have a legitimate Life Change, you should select it—during this Covid SEP, they will not need to provide any follow-up documentation to prove their Life Change.

If your client has a birth or adoption Life Change, be sure to select it, so that the coverage effective date will backdate to the birth/adoption date.

State details

Some of the states which operate their own exchanges (SBMs) are also participating in this Covid SEP. Here’s the list – we’ve bolded states that have different date ranges:

  • California: Feb 15th – May 15th (no life change required for uninsured people only)
  • Colorado: Feb 8th – March 14th (no life change required for uninsured people only)
  • Connecticut: Feb 16th – May 15th (no life change required for uninsured people only)
  • Maryland: Now – March 15th (no life change required for uninsured people only)
  • Massachusetts: Feb 15th – May 23rd
  • Minnesota: Feb 15th – May 15th
  • New Jersey: Feb 15th – May 15th
  • New York: Feb 15th – March 31st (no life change required for uninsured people only)
  • Nevada: Feb 15th – May 15th
  • Pennsylvania: Feb 15th – May 15th
  • Rhode Island: Feb 15th – May 15th
  • Vermont: February 16th – May 14th (no life change required for uninsured people only – and must be done over the phone, not online)
  • Washington: Feb 15th – May 15th
  • Washington DC: Feb 15th – May 15th


How do I change plans for a currently-enrolled client?

To change plans for a currently-enrolled client, go to their Client Profile page by clicking their name or the View button:

The Client Profile will show a “Report changes” and “Change plans” button if the client is still within their window to change plans. If not, it will only show the “Report changes” button:

If you want to change plans without updating the application – click Change Plans if it’s there. If it’s not, then click Report Changes, go through the application without changing anything, change the plan, then submit the application.

If you want to change plans and also update the application – click Report Changes, go through the application and make any changes needed, change the plan, then submit the application.

When is the effective date?

There will be accelerated coverage dates, meaning as long as the enrollment is submitted before the end of the month, the coverage effective date will be the 1st of the following month. The earliest effective date for this SEP is March 1st, unless the client qualifies for a retroactive effective date (e.g. due to birth or adoption).

Can I shop early?

You can browse plans now if you’d like to get a head start. But, if you plan to submit without a life change, then wait until February 15th to submit the application.

Why is this Enrollment Period happening?

The Centers for Medicare & Medicaid Services (CMS) determined that the COVID-19 emergency presents exceptional circumstances for consumers in accessing health insurance. Because of this emergency, they’re providing a Special Enrollment Period for individuals and families to apply and enroll in the coverage they need.

Written by Jeff Kriege

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