Archive for Carrier Updates

Aetna to Withdraw from the NJ Small Employer ACA Market in 2018

Due to mounting financial losses and an uncertain marketplace outlook, Aetna has made the decision to leave the Individual market in New Jersey.

Regrettably, this decision also impacts their New Jersey small employer ACA insured medical products. New Jersey law requires a carrier to withdraw from the insured small employer market if it is withdrawing from the individual market. As such, Aetna will withdraw all of its commercial (fully insured) medical plans offered in the small employer health insurance market.

Aetna will still be offering their Aetna Funding Advantage (AFA) product to groups of 5 or more.

What this means:

Health insurance coverage for Aetna plans will end at midnight on the day before its renewal date, beginning with January 1, 2018 renewals.

* Notices will be sent to covered employees 180 days prior to non-renewal.

 * Renewals will continue to be produced and serviced as usual through 12/15/17 renewal dates.

 Click here for Aetna’s release.

Upon your renewal we will look at other options for you and your employees such as Horizon, AmeriHealth, United Healthcare/Oxford and Qualcare.  You may also have the option of the Aetna Funding Advantage (AFA) as well.

Questions? Contact Amy Webb.

Are You a Burlington or Camden County Employer? Aetna’s New Partnership with Virtua Could Mean Health Plan Savings of 10-12%.

Aetna and Virtua are teaming up to provide a new health benefits plan that works for employers and its employees in Burlington, Camden and Gloucester counties, NJ. It encourages insurers to continue to use the Virtua medical team that families have come to know and trust as part of their community. This plan is delivering a 10-12% savings compared to broad network Aetna plans.

Aetna Whole Health plans are changing the ‘payment model’ for benefits. That’s because doctors and hospitals are paid, in part, to keep their patients healthy. And members who use doctors and facilities in the Aetna Whole Health – Virtua network will save the most money and enjoy:

  • A network of 360+ primary care doctors and 1000+ additional specialist physicians
  • 3 conveniently located acute care hospitals
  • 5 urgent care facilities and 2 additional freestanding emergency room locations
  • Same – and next-day primary care appointments
  • Coordinated care from a team of primary care doctors, nurses, care managers and other providers
  • Access to Aetna’s broader network of primary care doctors and specialists (at out of network rates)

Get the care you want from Virtua, a regional healthcare leader in South Jersey. Virtua has been consistently named one of the Best Places to Work by the Philadelphia Business Journal, and has received many other honors.

For more information about Aetna’s Whole Health Plan, contact Amy Webb, president of Saratoga Benefits today at (856) 642-2949 or via email.



Are You Currently Insured by Health Republic?

If so, we can help! In order to avoid a gap in your insurance coverage on Jan 1, 2017, act now to find out about other carrier options.

Health Republic Insurance of New Jersey has announced that it will no longer be selling and renewing individual and small group insurance in the state as a result of being placed in rehabilitation by the New Jersey Department of Banking and Insurance (DOBI).

Read more…

Updates to Select Drug Program® Formulary

AmeriHealth New Jersey routinely updates our drug formulary and reviews the list of drugs requiring prior authorization as part of our procedures for safe prescribing. These changes are approved by our Pharmacy and Therapeutics Committee.

Please view the list of changes to the Select Drug Program formulary that are effective April 1, 2016. All impacted members will receive a letter from FutureScripts®, 30-days prior to the effective date of the drug formulary updates.

Standard quarterly changes to the Select Drug Program® formulary effective April 1, 2016, include:

  • Additions of generic and brand drugs to the formulary
  • Deletions of brand drugs from the formulary
  • Additions to the list of drugs that require prior authorization
  • Additions to the list of drugs with quantity limits
  • Deletions to the list of drugs that require prior authorization

If you have any questions please feel free to contact our office at 856-642-2949 or email