What is the average turnaround time required to determine a group or a subscribers eligibility or underwriting status?
A25. For most MBUs, the client determines if a member (subscriber) is eligible and the MBUs’ membership area verifies this eligibility based on the contract requirements. Enrollment/change forms are required for all business units except online and electronic eligibility clients. Paper enrollments take approximately one week. Electronic eligibility information will be entered into the system initially within 48 hours of receipt. We run a test on the eligibility information entered. Any subsequent eligibility information is entered into the system within 24 – 48 hours; this turnaround time is subject to the files being clean, with no problems.
The average turnaround time for a small group (2-50 lives, (1 life, where required by state law)) is determined by the local Aetna underwriting team. State and federal regulations determine how underwriting is applied to the group or the individual. For our Middle Market and National Account customers, underwriting would be applicable on a group basis. We work with each of our customers or their consultant to determine when they need renewal pricing completed. Depending on the complexity of the request, a renewal generally takes between one and three weeks to complete.
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