Aetna Enrollment Documents

Medical, Dental and Life

CEHIT Aetna Enrollment Documents

Below you will find the documents necessary for enrollment

Description Download Audience
Group Enrollment Checklist PDF Employer
Aetna Washington Small Group Enrollment Guide PDF Agent/Employer
Master Application PDF Employer
Addendum to New Business – Requirement for Health Care Reform REQUIRED PDF Employer
ENGLISH Employee Enrollment/Change Form PDF Employee
SPANISH Employee Enrollment/Change Form PDF Employee
CEHIT Adoption Agreement PDF Employee
CEHIT Group HQ PDF Employer
ACH E-check for New Business
For new business submission only
PDF Employer
Deductible Credit Form PDF Employee
Proof of Eligibility Form PDF Employer
Associated Companies Form PDF Employer
1099 Eligibility Verification PDF Broker/Agent
Domestic Partnership Affidavit PDF Employee