The Aetna Life Insurance Company & Aetna Health, Inc. Health Benefits Contract Emergency Approval Resolution of 2025 seeks the Council's approval for a multiyear contract valued at approximately $1.58 billion, allowing Aetna to provide fully insured health benefits to District employees, their dependents, and retirees from January 1, 2026, through December 31, 2030. The contract includes various health plan types such as Preferred Provider Organization (PPO), Health Maintenance Organization (HMO), Consumer-Driven Health Plan (CDHP), and Medicare Advantage. The contract was awarded after a competitive solicitation process, and Aetna has a proven track record of satisfactory performance over the past 20 years. The bill also outlines the District's share of premiums for the first contract year, estimated at $479 million, with a total projected cost of $638 million for four health insurance companies involved.

Additionally, the bill includes provisions for the administration of the D.C. Employees Health Benefits Program, emphasizing compliance with federal and District laws, and mandates that the Contractor must be a licensed health care insurance carrier. It outlines the responsibilities of the Contractor, including managing health savings accounts, ensuring accurate eligibility data, and providing customer service support. The bill also introduces performance metrics and penalties for non-compliance, such as timely resolution of claims disputes and customer satisfaction ratings. Furthermore, it establishes requirements for subcontracting, insurance obligations, and compliance with employment practices, including non-discrimination clauses and hiring preferences for District residents. Overall, the bill aims to enhance the quality and efficiency of healthcare services provided to D.C. employees and their families while ensuring accountability and transparency in the program's operations.