New Medicare Advantage Administrator

Announcement: New Medicare Advantage Administrator

SEBAC leaders  and Health Care Cost Containment Committee (HCCCC) members Jody Barr (Executive Director, AFSCME Council 4) and Carl Chisem (President, CEUI Local 511) joined Governor Ned Lamont and State Comptroller Natalie Braswell at a press conference on May 31st to announce that Aetna has been selected as the new Medicare Advantage administrator for the state health plan following an in depth request for proposal (RFP) process.

This agreement represents a win for the 57,000 retirees who are 65 years and older and their dependents. With absolutely no changes to our plans or benefits, the State is expected to save about $130 million a year, which will lower the unfunded liability by about $7.5 billion — a 31% reduction. Savings like these are yet another example of a “win-win” coming out of the HCCC and the collective bargaining process.

“It is important to address the rising costs of healthcare across our state. As SEBAC representatives on the Joint Health Care Cost Containment Committee, we work to find solutions without increasing out-of-pocket expenses or changing anyone’s healthcare plan, while also seeking out the most cost-effective solutions and saving the state money,” Chisem stated.

“This is a powerful example of how collective bargaining allows a win-win solution for the public good,” Barr added.

Below, we’ve addressed some of the questions we expect you might have, but please remember that much more information will become available over the next several weeks.

When will the Aetna contract go into effect? The new carrier will start coverage on January 1, 2023.

How long is the contract with Aetna? The Aetna contract will be in effect from January 1, 2023 until December 31, 2025 with an option for two one year renewal to December 31, 2027.

I’m retired, but I’m not 65 yet, how does this impact me? Those that are retired but under the age of 65 will remain on Anthem until they turn 65, at which point they will be moved onto the Medicare Advantage carrier (which will remain UnitedHealthcare until December 31, 2022 and then will be Aetna starting January 1, 2023). If you are on disability insurance and currently covered by UnitedHealthcare you will also be switched to Aetna starting on January 1, 2023.

How can the State save money without changing my plan or benefits?   In order for a potential carrier to be successful in the RFP process, they must meet all of the requirements of our plan and they must clearly demonstrate the capability to administer it.  From there, the inherent competitive nature of the RFP process drives the bidders to provide the same services at a lower cost to the State.  Aetna met all of the requirements of the plan and demonstrated an excellent track record of administering similar plans in other states – and Aetna was able to provide all of this while delivering dramatic savings.  The savings are critical to protecting our benefits long term and were only agreed upon because they maintained the complete integrity of the plan.  Bottom line, savings come from competition – NOT from any decrease in your coverage.

The Healthcare Cost Containment Committee was set up with the goal of identifying “win-win” healthcare plans, programs and strategies that serve to save money while maintaining, and in some cases, improving coverage. This committee set out on the RFP process to identify a carrier that matched the current coverage for Medicare Advantage members and provided the best combination of service to covered members and cost.