Health Insurance - Aetna Child Only Policies

Aetna will discontinue new business sales of our child-only policies to applicants (under the age of 19) for Aetna Advantage Plans for Individuals, Families and the Self Employed after the 11/1/10 effective date.


This change will allow Aetna to deal with upcoming changes from healthcare reform reguarding guaranteed issue (GI) of coverage for individuals under the age of 19 and no corresponding coverage requirement.
No impact to existing child-only policies.

Discontinuation of child-only coverage in the following states for Aetna Advantage Plans for Individuals, Families and the Self Employed: CT and OH will occur on 11/1/10. The implementation date for the following states MD, and OK is still being established. We will notify you once dates are confirmed for these states. The following states discontinued sales of child-only coverage for Aetna Advantage Plans for Individuals, Families and the Self Employed on 10/1/10: AK, AR, AZ, CA, CO, DC, DE, FL, GA, IL, IN, KS, KY, LA, MI, MO, MS, NC, NE, NV, PA, SC, TN, TX, VA, WV, and WY.

Options:  Other health insurance options available for individuals under age 19:  Be added as a dependent to a parent's plan.

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Removing lifetime and annual dollar limits for essential health benefits

As part of the health care reform law, health insurance companies must remove lifetime and annual dollar limits on covered services (in network and out of network) that the U.S. Department of Health and Human Services (HHS) considers "essential health benefits." This change goes into effect September 23, 2010, although certain annual limits can be removed in phases over the next four years.  

Anthem Blue Cross California:

HHS has not given the final definition of "essential health benefits" yet, but based on the information and examples it has released, as well as our own research of current state and federal mandates, we have come up with a list of approximately 26 services we believe will be affected. There may be variations in certain states. The services still may be subject to copays and other cost shares. 

This provision of the health care reform law also restricts annual or lifetime dollar limits at the plan level except transitional annual dollar limits as defined in the legislation.  

A waiver program will be available for certain types of plans like mini-med and limited benefit plans so they can retain annual plan limits. 

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