Aetna is narrowing their individual on-exchange participation for 2017.
Individuals and families
Aetna believes that everyone should have access to high-quality health care at an affordable cost. Over the past three years, we made significant investments in the individual public exchanges, working closely with regulators and lawmakers to provide options for consumers. Unfortunately, the public exchange environment remains more volatile than expected.
Following a thorough business review, we will reduce our individual on-exchange participation for 2017 to 242 counties, maintaining an on-exchange presence in Delaware, Iowa, Nebraska and Virginia. We will continue to offer an off-exchange individual product option for 2017 to consumers in the vast majority of counties where we offered individual public exchange products in 2016.
Plans impacted by this decision
- These changes do not affect coverage for the 2016 plan year. We will communicate to impacted members before the 2017 open enrollment period begins, and provide resources to assist them in transitioning to other plans as appropriate.
- This decision applies to all 2017 Individual Aetna-branded and Coventry-branded on-exchange plans in the following states: Arizona, Florida, Georgia, Illinois, Kentucky, Missouri, North Carolina, Ohio, Pennsylvania, South Carolina, and Texas. We will continue to offer an off-exchange individual Aetna-branded or Coventry-branded product option for 2017 to consumers in these states.
- This decision does not impact Small Business Health Options Program (SHOP) exchange plans.
- This decision does not apply to other lines of business, such as Private Exchange, Medicaid, Medicare, Employer Group, Student Health and stand-alone dental, vision and pharmacy products.
Policy changes are needed for the public exchanges to remain viable. The public exchange model needs to evolve from its current state to address the inadequate risk adjustment mechanism, increase product diversity and attract the remaining uninsured population who could improve the risk pool.
Moving forward, we are hopeful that we can work with policymakers to create a sustainable solution that meets the needs of the uninsured. With that in mind, we may expand our footprint in the future should there be meaningful exchange-related policy improvements.