Employers

CEHIT offers a broad range of products specifically designed to meet the needs of the small to mid-size employer group.

Employer Forms

Group Enrollment Checklist Checklist of requirements for enrollment

Group Master Application (on or after 9/1/2009) Master enrollment document. Can be used to enroll an entire group

Group Master Application (before 9/1/2009) Master enrollment document. Can be used to enroll an entire group

CEHIT Employer Adoption Agreement Agreement of adoption of Trust Agreement.

Supply Request Form Email us if you require other forms. (E-mail)

VSP Signature Plan Benefits Benefits Overview

VSP Master Application (Vision) VSP Master Application

VSP Employee Enrollment Census Form Enrollment Census Form

EAP Plan Sponsor Broker Flyer EAP Plan Sponsor Broker Flyer

POP Information on Premium Only Plans

125 Information on Section 125 Cafeteria Plans

Transit Information on Transit Reimbursement Accounts

Set Up Flex, POP, Transit Request for Participation in Flexible Spending Accounts, Premium Only Plans and Transit Reimbursement Accounts.

FSA Census Form FSA Census Form

HRA Employer Forms

HRA Employer Brochure Informational brochure for employers

Employee / Member Forms

2009 Employee Application (on or after 9/1/2009) Enrollment form for individual employees.

2008 Employee Application (before 9/1/2009) Enrollment form for individual employees.

Domestic Partnership Affidavit Declaration of domestic partnership

Mail order form Brochure and new participant order form for Aetna's mail-order pharmacy service

Mail order form (Español) Brochure and new participant order form for Aetna's mail-order pharmacy service (in Spanish)

Rx Claim form Claim form used for prescription reimbursement.

Medical Claim form Claim form used for medical expense reimbursement.

Deductible Credit Form Claim form used deductible expense reimbursement.

Direct Deposit Form FSA Direct Deposit Form

EAP Member Flyer EAP Member Flyer.

EAP Wallet Card EAP Wallet Card.

FSA Claim Form FSA Claim Form

FSA Employee Enrollment FSA Employee Enrollment.

Opt Out Form Opt Out Form.

SG EAP Welcome Email Letter for Employees SG EAP Welcome Email Letter for Employees.

Transit Employee Enrollment Transit Employee Enrollment.

HealthEquity HSA (Effective on or after 11/1/2008)

Member Brochure Aetna Informational Brochure

How To Invest Investing with HealthEquity

Member FAQ Freqently Asked Questions

HealthEquity Fee Schedule Fee Schedule

Plan Sponsor Fact Sheet Fact Sheet

How To Enroll How to Enroll

HSA Documents (Effective before 11/1/2008)

HSA Group Enrollment Form Employer Group Enrollment Form

HSA Employer Contribution Form Instruction Sheet Fillable Adobe Acrobat Form.

HSA Brochure Learn about Aetna's Health Savings Account

HSA Frequently Asked Questions Aetna Informational Brochure

HSA: How to enroll Learn more about how to enroll

HSA Investment Choices HSA Investment Choices

HSA Account Fee Schedule Aetna Informational Brochure

U.S. Department of Tresurary: All about HSAs Basic overview of HSAs

HSA Beneficiary Form Beneficiary Designation Form

HSA EFT (Electronic Funds Transfer) Form Electronic Funds Transfer Form

HSA Deposit Slips Deposit slips for HSA accounts.

HRA Documents

HRA Employee Brochure Informational brochure for employees

HRA Employee Direct Deposit Form Employee Direct Deposit Form

HRA Reimbursement Form Reimbursement Form

HRA - Fee Schedule Fee Schedule

HRA Request for Participation Form Request for Participation Form

HRA Census Spreadsheet Census spreadsheet

Informational Brochures

Enrollment Guide Information about enrolling.

Doc Find

Informed Health Line

Employer Administration Materials

(Medical, Dental, Life and STD)

This site is made available to you in an effort help you administer your group plans. For information specific to your plan please contact your broker or agent.

• Provider Directories
  Use Aetna's DocFind® Provider Directory to find participating Physicians, Dentists, other providers, check claim status, change your PCP, request ID cards, contact Member Services, Hospital Comparison Tool and more!
  
  
• Group Administrative Guide (Coming Soon)
  This guide is provided to all employers for their reference in administering eligibility and submitting premium for their CEHIT coverage.

Member & Consumer Materials

Self-Service Centers

The Aetna Navigator™ - [Read about Aetna Navigator ] Member self-service website, allows you to manage your account online. Use it to perform common transactions involving your Aetna medical, dental, prescription drug or flexible spending account (FSA) plans. You can access claims, coverage, and consumer health information as well as decision-support tools and the Aetna Forms Library. Click here to learn more about the Aetna Navigator

• Change Primary Care Physician or Dentist
• Replace ID / Request a new ID card
• And more!

DocFind Provider Directory - [Read about Doc Find ] find participating Physicians, Dentists and other care providers in your area. You can log in from this page if you are currently a member. You can also browse the doctor directory without registering.

Informed Health Line - a telephone service open 365 days a year 24 hours a day to

Plan for Your Health - An online resource which offers you financial planning tips. The site is a partnership of Aetna and the Financial Planning Association.

Aetna Pharmacy

Aetna Pharmacy is a new approach to drugs, benefits and consumer education. By visiting the site, you can find Aetna's Preferred Drug List (Formulary), information about generic drugs, newly-approved medications, tips on taking care of yourself, drug information for thousands of medications, and more.

• Search Rx Formulary Guide - provides up-to-date formularies for prescriptions covered
• Mail Order Rx Refills - Learn more about Aetna's Rx Home Delivery program

Other Aetna Benefits & Information

Health and Wellness Programs - A wide variety of services and products are available to you as a member of Aetna. Programs include Alternative Health Care Programs, Fitness, Flexible Spending Account (FSA), Women's Health, and more.

Global Benefits - Learn more about access to health care, emergency assistance and member service worldwide.

Coverage Policy Bulletins

Consumer-Directed Health Care - Learn more about Aetna's HealthFund options such as the Health Savings Account (HSA), Retiree Reimbursement Account (RRA), Flexible Spending Account (FSA) and the First Dollar Plan.

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