Sutter Health | Aetna to Expand Insurance Product Offerings in Northern California

FOR IMMEDIATE RELEASE

May 12, 2021

CONCORD, Calif. – Sutter Health | Aetna today announces its plans to offer fully insured products to employers across Northern California for the 2022 enrollment season. The announcement follows issuance of a Certificate of Authority from the California Department of Insurance (CDI), designating the joint venture healthcare company as an independent insurance carrier in the state.

Sutter Health | Aetna currently offers self-insured Exclusive Provider Organization (EPO) and Preferred Provider Organization (PPO) commercial health plans to large employers in its 16-county service area. Today, if an employer wants a fully insured product, it must select an Aetna plan that includes the Sutter Health | Aetna performance network. Upon CDI approval, the joint venture will be able to sell its own fully insured products to employers, unlocking the full value of the Sutter Health | Aetna member experience.

The joint venture’s integrated delivery, retail, and financing system (IDRFS) model aims to revolutionize healthcare. Built on the strong foundations of its parent companies and further complemented by the capabilities of CVS Health®, Sutter Health | Aetna’s IDRFS platform virtually integrates payer, provider, and retail stakeholders. Plus, through coordinated and proactive care delivery, the platform is designed to offer the market high-quality care at an affordable cost.  

“The support and investment by Sutter Health and Aetna for the fully insured license further demonstrates the organizations’ commitment to the coordinated care model created by our virtually integrated delivery, retail, and finance system,” said Sutter Health | Aetna CEO Jeb Dunkelberger. “Independent licensure for Sutter Health | Aetna supports the most progressive form of value-based care, further demonstrating our organizations’ collective commitment to the clinical and financial experience of our members and underscores our commitment to materially evolving the market via affordable, high-quality care and customized member experiences.”

“Our collaboration with Aetna on a joint venture was driven by our desire to invest in value-based payment models that reward our integrated delivery system for outcomes and efficiency and not volume,” says Phil Jackson, CEO of Health Plan Partnerships & Products at Sutter Health. “With its own fully insured license, Sutter Health | Aetna will be well positioned to deliver on these tenets and return value back to the purchasers of healthcare.” 

“Employers across the region should see this as one of the strongest signals that Sutter Health | Aetna is fully aligned to their interests,” said Kristen Miranda, Aetna’s Senior Vice President of Markets. “Through this fully insured licensure, the joint venture’s vision organically aligns to that of the member – accessible, affordable, innovative, and community-based.”

About Sutter Health | Aetna

Sutter Health | Aetna is a joint venture that brings together Sutter Health’s network of nationally recognized, high-quality doctors and hospitals with Aetna’s health plan expertise, data, analytics and health information technology, and shared care management capabilities. This joint venture aims to deliver a differentiated, personalized experience for members and is designed to improve efficiency and lower the cost of care, resulting in greater affordability.

For more information about Sutter Health | Aetna, visit SutterHealthAetna.com

Health benefit plans are administered by Sutter Health and Aetna Administrative Services LLC. Sutter Health and Aetna Insurance Company received its Certificate of Authority from the California Department of Insurance and plans to offer and/or underwrite health insurance products upon approval. Sutter Health | Aetna is the brand name used for products and services provided by Sutter Health and Aetna Administrative Services LLC. Sutter Health | Aetna is an affiliate of Sutter Health and of Aetna Life Insurance Company and its affiliates (Aetna). Aetna plans are offered, underwritten and/or administered by Aetna Life Insurance Company and/or its affiliates.

About Sutter Health

Sutter Health’s integrated, not-for-profit network of aligned clinicians, employees and volunteers support more than 3 million Northern Californians in communities across 22 counties. Headquartered in Sacramento, Calif., the Sutter Health system provides access to high quality, affordable care through its network of hospitals, medical foundations, ambulatory surgery centers, urgent and walk-in care centers, telehealth, home health and hospice services.

For more information about the Sutter Health network visit: 

sutterhealth.org | facebook.com/sutterhealth | youtube.com/sutterhealth | twitter.com/sutterhealth

About Aetna

Aetna, a CVS Health business, serves an estimated 34 million people with information and resources to help them make better informed decisions about their health care. Aetna offers a broad range of traditional, voluntary and consumer-directed health insurance products and related services, including medical, pharmacy, dental and behavioral health plans, and medical management capabilities, Medicaid health care management services, workers' compensation administrative services and health information technology products and services. Aetna's customers include employer groups, individuals, college students, part-time and hourly workers, health plans, health care providers, governmental units, government-sponsored plans, labor groups and expatriates. For more information, visit aetna.com and explore how Aetna is helping to build a healthier world.

About CVS Health

We are a diversified health services company with more than 300,000 employees united around a common purpose of helping people on their path to better health. In an increasingly connected and digital world, we are meeting people wherever they are and changing healthcare to meet their needs. Built on a foundation of unmatched community presence, our diversified model makes us an integral part of people’s everyday health. From our innovative new services at HealthHUBTM locations, to transformative programs that help manage chronic conditions, we are making healthcare more accessible, more affordable and simply better. Learn more about how we’re transforming health at cvshealth.com.

Our Collaboration

We’re a health care company that brings together Sutter Health’s network of nationally recognized, high-quality doctors and hospitals with Aetna’s leading health plan expertise, cutting-edge data, analytics and health information technology, and shared care management capabilities. Together we bring a performance network†† to market with a goal to deliver a differentiated and personalized experience for members, designed to improve efficiency and lower the cost of care.

Great care, great value, always there for Northern Californians. 

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Many of the hospitals and physician organizations in the Sutter Health network have been recognized for quality achievements from The Joint Commission, The Leapfrog Group®, Integrated Healthcare and APG††Performance network refers to a network of providers who are clinically integrated.

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What's New

Health benefit plans are administered by Sutter Health and Aetna Administrative Services LLC. Sutter Health | Aetna is the brand name used for products and services provided by Sutter Health and Aetna Administrative Services LLC. Sutter Health | Aetna is an affiliate of Sutter Health and its affiliates (Sutter) and of Aetna Life Insurance Company and its affiliates (Aetna). Aetna, CVS Pharmacy, Inc. (which owns CVS® HealthHub® locations), and MinuteClinic, LLC (which either operates or provides certain management support services to MinuteClinic-branded walk-in clinics) are part of the CVS Health family of companies.

This material is for information only and is not an offer or invitation to contract. Health insurance plans contain exclusions and limitations. Not all health services are covered. See plan documents, consult with HR/Benefits Manager or call the member services number on the back of your ID card for details on benefits, exclusions, limitations and conditions of coverage. Providers are independent contractors and not our agents. Provider participation may change without notice. Sutter Health | Aetna does not provide care or guarantee access to health services. Plan features and availability are subject to change and may vary by location. Information is believed to be accurate as of the production date; however, it is subject to change.

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