News
Aetna called to reimburse college students for health coverage
By Attorney General's office
Jun 25, 2008 - 1:17:29 PM

Attorney General Richard Blumenthal today asked Aetna to reimburse approximately 1,300 college students in Connecticut -- and more nationwide -- for health insurance charges on thousands of claims that students were improperly forced to pay out of pocket.

In cooperating with Blumenthal’s broader ongoing investigation into health insurance charges, Aetna disclosed this week it discovered that thousands of college students -- in Connecticut, New Jersey and New York -- were underreimbursed for out-of-network health services.

In a letter to Aetna today, Blumenthal requested a full accounting of affected claims and immediate restitution for students. Each student may have multiple claims, raising the reimbursement due.

“More than 1,300 Connecticut college students deserve immediate payment for health care costs that they were improperly forced to pay out of pocket,” Blumenthal said. “Aetna commendably is cooperating with my ongoing investigation into the health insurance industry and has rightfully recognized and revealed these unfair under-reimbursements. I appreciate that Aetna has disclosed the problem -- a good first step -- but now must pay students all it owes. We ask full and immediate reimbursements. We are seeking more details – a full accounting of the harm to patients; and a promise that all under-reimbursed receive money back.”

Aetna and other insurance companies pre-determine reimbursement rates for out-of-network services. When out-of-network health care providers charge more than an insurer’s pre-determined rate, patients may be forced to pay the difference.

Aetna’s internal rules require that these pre-determined reimbursement rates be updated at least every six months so that patients are reimbursed fairly -- and in line with the most up-to-date industry information.

Despite Aetna’s own policies, Aetna Student Health, formerly the
Chickering Group, which provides student health insurance plans, failed to properly update out-of-network fee data -- with some of the fee standards more than a year old. As a result, college students in Connecticut were underreimbursed on thousands of claims.

Affected Connecticut students attend the University of Connecticut, Quinnipiac University, Connecticut College, and Central, Southern, Eastern and Western Connecticut State University.

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