Rescissions are prohibited, except for fraud or intentional misrepresentation of material fact. The rules require prior notice to the enrollee for cancellations.[Section 2712 of H.R. 3590/Section 2301 of H.R. 487]

Aetna’s take and action

For Individual plans, Aetna is in compliance with these regulations. For insured group plans, Aetna is working to ensure required communications are sent to members, upon notification. In addition, since ACA’s Grievance and Appeals provisions require that rescissions are considered adverse determinations, the process for appeals will be applied, where applicable.

Questions and answers

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