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Aetna Avenue OK Small Group Enrollment Guide
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1/10/2010
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Download
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Aetna HRA Census Form
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9/29/2009
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Download
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Employer Dental Certification
Description:
Stand Alone Dental Cases
(pdf
, 88k)
Version: GR 68544 6-09
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7/28/2010
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Download
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HSA Health Equity Employer Enrollment Form
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9/13/2009
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Download
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HSA Health Equity Installation Guide
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9/13/2009
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Download
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Middle Market (51+) Group Questionnaire
Description:
Used for 51+ Groups Only
(doc
, 43k)
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5/5/2010
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Download
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OK Eligibility Form for 1099 EES
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8/27/2009
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Download
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OK Initial Premium ACH Form
Description:
May be used for the initial premium
(pdf
, 136k)
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8/27/2009
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Download
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OK Proof of Eligibility Form
Description:
Used for owners, offices, etc that are not on the OK wage & tax report
(pdf
, 29k)
Version: 05/19/06
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7/28/2010
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Download
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OK Small Business Employee Eligibility Form
Description:
To be used for employees not on the quarterly wage & tax report
(doc
, 30k)
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8/27/2009
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Download
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OK Small Business Employer Application
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2/3/2011
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Download
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OK Small Business Group Appraisal Form
Description:
May be used for groups of 26 or more, with prior coverage. 75% of those enrolling must be on the current plan.
(pdf
, 37k)
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6/12/2011
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Download
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OK Small Business Submission Checklist
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8/27/2009
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Download
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OK Small ER Funding Certification Form
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8/4/2010
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Download
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PEO Questionnaire
Description:
Used to determine if Aetna will write a group that is part of a PEO
(doc
, 36k)
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8/27/2009
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Download
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Aetna Dental PPO Member Brochure
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2/20/2010
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Download
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Aetna FOC Member Brochure
Description:
Summary for members of how dental FOC functions
(pdf
, 508k)
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2/20/2010
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Download
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Application to Cover Handicapped Child
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7/28/2010
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Download
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FSA Enrollment Form
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9/13/2009
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Download
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Handicapped Child Attending Physician Statement
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7/28/2010
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Download
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HSA Health Equity Beneficiary Form
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9/13/2009
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Download
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HSA Health Equity Custodial Agreement
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9/13/2009
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Download
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HSA Health Equity Employee Enrollment Form
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9/13/2009
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Download
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Member Preventive Care Flyer
Description:
Only applies tonew plans and renewing plans with a 10/1/10 effective or beyond
(pdf
, 480k)
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9/23/2010
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Download
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OK Small Business Employee Enrollment
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2/3/2011
|
Download
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OK Small Business Employee Enrollment-SP
Description:
Spanish version
(pdf
, 63k)
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8/27/2009
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Download
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Aetna COBRA Brochure
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1/10/2010
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Download
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Aetna Enroll
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1/10/2010
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Download
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Aetna Enroll HR Administrator Guide
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3/7/2010
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Download
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Aetna Notice of Occurrence - State Continuation
Description:
Form may be forwarded to the via fax - fax number is 866-651-3120
(doc
, 41k)
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7/26/2010
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Download
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Aetna Small Business Administration Manual
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1/10/2010
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Download
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Aetna, FSA, COBRA, POP Pricing
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1/10/2010
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Download
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COBRA ARRA Extension Guidance
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3/7/2010
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Download
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COBRA Flyer
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1/10/2010
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Download
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HSA Transfer-Rollover Form
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9/13/2009
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Download
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Member Health Care Reform Notice
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9/23/2010
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Download
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OK ARRA Letter & OK State Continuation Form
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9/29/2009
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Download
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Aetna - Value of Generics
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8/19/2010
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Download
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Aetna FSA Claim Form
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9/29/2009
|
Download
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Aetna HRA Claim Form
|
9/29/2009
|
Download
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Aetna Save A Copay
Description:
Explains Aetna's save a copay program
(pdf
, 137k)
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8/19/2010
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Download
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Dental Claim Form
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7/28/2010
|
Download
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Disability Attending Physician's Statement
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7/28/2010
|
Download
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Disability Claim Form
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7/28/2010
|
Download
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Mail Order Pharmacy Claim Form
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7/28/2010
|
Download
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Medical Claim Form
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7/28/2010
|
Download
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Pharmacy Claim Form
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7/28/2010
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Download
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Term Life Claim Form
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7/28/2010
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Download
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Vision Claim Form
|
7/28/2010
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Download
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Aetna Empower Tools
Description:Online Tools Presentation targeted to employees
(
, 0k)
For more information: Click Here
|
8/23/2010
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Website
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Aetna Enroll Broker Guide
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3/7/2010
|
Download
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