Aetna has advised that effective immediately ACA clients with 5+ enrolling can get AFA quotes using census underwriting.
ACA clients with 2-4 enrolling will still need medical apps/individual medical questionnaires.
Here’s how this change fits into Aetna’s other quoting thresholds in NJ:
|
Incumbent plan type |
When IMQs are required |
|
ACA Fully Insured |
2-4 enrolled employees |
|
Level Funded |
2-4 enrolled employees |
|
No incumbent (a startup/virgin group) |
2-50 enrolled employees* |
As usual, a group with more than 5 enrolled employees could need to do medical questionnaires if they don’t get enough hits from census underwriting.
*Clients with 51-100 eligible employees and no incumbent coverage will use the same IMQ threshold as ACA fully insured plans.