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Aetna drops occupational coverage in 48 states

Florida is the state most heavily affected by the change because state law doesn't require businesses with fewer than four employees to carry workers compensation.

Aetna U.S. Healthcare says it will no longer offer occupational health coverage, except in Kentucky and Kansas. Occupational coverage pays for work-related injuries, including short-term disability. According to company spokesperson Elizabeth Sell, the decision is a result of Aetna's ongoing efforts to standardize its policies with Prudential Healthcare, which Aetna acquired last year. (Prudential did not offer occupational coverage at all.) The acquisition makes Aetna the country's largest provider of health benefits with more than 21 million members.

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The move to drop the product began May 1, 2000, when Aetna decided it would no longer issue or renew occupational-coverage riders. However, depending on the rider's expiration date, some people could have almost one year to look for other options, Sell says.

The rider to be discontinued is attached to Aetna's indemnity plan, Traditional Choice, its preferred-provider organization plan, Open Choice, and its managed care plan, Managed Choice. Sell did not have figures for how many Aetna customers would be affected by the change, but she says the occupational riders represent only a small percentage of the insurer's business. She adds that Aetna will not offer a replacement or alternative plan.

Kentucky and Kansas, the only states where Aetna is required by contract with the states' departments of insurance to continue offering the coverage, were spared in the decision. Florida is the state most heavily affected by the change, according to Sell, because state law doesn't require businesses with fewer than four employees to carry workers compensation. More than half of Aetna's occupational-coverage riders were sold there, she adds.

For workers left without coverage, regional insurance pools are a good alternative, according to Nina Bottcher, a spokesperson for the Florida Department of Insurance. According to Bottcher, small businesses in Florida with 50 and fewer workers can join these pools to purchase health benefits, including workers compensation. This is less expensive for the consumer, Bottcher says, than trying to find an insurer that will provide individual occupational coverage.

Editor's Note: Aetna has completed its coverage reduction, and no longer offers occupational health coverage in Kansas or Kentucky. Jan. 9, 2007

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