mandated benefits


Aetna Pays Over $1M For Thin Health Coverage, False Marketing To Students

This just in from Massachusetts attorney general Martha Coakley:

Aetna life insurance to pay more than $1 million for allegedly failing to cover mandated health insurance benefits and deceptively marketing student health insurance

At Least $500,000 in Restitution for Affected Massachusetts Consumers

BOSTON – After allegedly failing to cover certain medical services as required by state law and deceptively marketing its coverage to Massachusetts college students, Aetna Life Insurance Company (Aetna Life) will pay more than $1 million in civil penalties and restitution, Attorney General Martha Coakley announced today.

“When Massachusetts consumers buy health insurance, they should be able to feel confident that the coverage complies fully with Massachusetts law,” AG Coakley said. “Our office will continue to monitor the marketing and payment practices of health insurers to make sure that Massachusetts consumers are not being misled or denied benefits to which they are legally entitled.”

The AG’s complaint, filed along with the consent judgment in Suffolk Superior Court today, alleges that Aetna Life violated the state’s Consumer Protection Act by falsely marketing the scope of the coverage it offered to students. The alleged violations include overstating in marketing materials the aggregate maximum amount of certain Aetna coverage as $500,000 when it was really $50,000. The complaint also alleges that Aetna Life did not cover health services required by state law including mental health care, “pap” test screening, mammography, and preventive care for children up to age six. Continue reading