Lawsuit Alleges Aetna's Limited-Benefits Plans Misleading

The consumer advocacy group Citizens for Economic Opportunity on Wednesday filed suit in a Connecticut court alleging that limited-benefits health insurance plans sold by Aetna subsidiary Strategic Resources Company mislead consumers into thinking they have more comprehensive coverage than the plans provide, the AP/Houston Chronicle reports. The suit names Aetna, SRC and the state Department of Insurance, which in September 2005 authorized SRC to market the plans in Connecticut (Haigh, AP/Houston Chronicle, 10/25). The group, which filed the suit in Hartford Superior Court, alleges that the plans are designed to help employers recruit and retain employees by misleading them into thinking they will have sufficient health coverage if they become ill, the Hartford Courant reports. SRC, which was acquired by Aetna in 2004, sells plans with annual benefits caps as low as $1,000. Aetna said most of the SRC plans offered by Connecticut employers have $10,000 annual benefits caps and that no employer in the state is offering policies with $1,000 annual caps. Eight employers statewide offer the plans, which are designed for part-time and seasonal workers who otherwise likely would be uninsured, Aetna said.

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The state insurance department on Wednesday in a statement said that it requires Aetna to "clearly disclose in each policy" that the plans do not include comprehensive coverage and that the insurer is required to submit to the state quarterly reports stating who has purchased the plans "to ensure that companies are not using this product to replace traditional, comprehensive policies." The department said it is reviewing the suit. State Attorney General Richard Blumenthal (D) said he is "strongly concerned" about why the insurance department approved the plans, adding that his office will investigate. Phil Wheeler, president of the advocacy group, said, "These plans are designed not to be there when you need them. It's like having an empty fire extinguisher on the wall" (Levick, Hartford Courant, 10/26).

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