California's managed-care regulator slammed health insurance giant Aetna Inc. on Thursday for "price gouging" after it raised rates on small employers by 21%. This marked the fourth time since 2013 that California officials have found Aetna's premium increases on small businesses unreasonable. Aetna, the nation's third-largest health insurer, is raising rates by 21%, on average, for about 13,000 people covered by small employers. This change in premiums took effect July 1. Shelley Rouillard, director of the California Department of Managed Health Care, said an Aetna executive rejected her request this week to lower the rates.