Health Care Tools & Apps
California
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| Enrollment | |
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Learn about plan features, member tools, enrollment, and value-add programs. |
| Employer Applications | Use form for employer’s medical coverage selections |
| Employee Enrollment Forms | Order via: 1-877-249-2472 or Order via: Aetna Answer Team 1-800-343-6101 (representatives are available 8 am – 5 pm PST) Use form to enroll an employee and their family.* This form should be used for all New Hires, changes and terms. It should be the standard enrollment form utilized for all transactions except regular Plan Changes during renewal. Completed forms can be emailed to: [email protected] Sales Contact Tools https://www.aetna.com/insurance-producer/sales-contact-tool.html |
| Evidence of Insurability | Employee must complete this form for approval of Life Insurance Elections over the Guaranteed Issue Amount which is $20,000 for groups 2-9 employees, $75,000 for groups 10-25 employees and $100,000 for groups 26-50; or Late Enrollee for Life and/or Disability – an individual enrolling more than 31 days from the date first eligible is considered a late enrollee. |
| ER Verification Form | Use to update # of eligible employees in an established group |
| eList tool | The eList Tool is a macro-enabled replacement of the eList template. This tool is to be used for New Business/Renewal submissions with 2-100 eligible employees. New versions are available at different times so always download a new tool for each case. |
| Automated Clearing House New Business Request | For groups to complete to have their first month’s premium released via EFT. For new business only |
| Full-time Equivalent Certification | Use this form for the employer to provide the number of full-time equivalent employees |
| Attestation | Open Enrollment – complete this form for new business groups enrolling during open enrollment – 11/15 to 12/15 for a 1/1 effective date. |
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This standalone form can be used for vision only but if you have multiple products with Aetna, use the multiproduct form when available. Completed form can be emailed to: [email protected] |
| Consumer Directed Products | |
| Aetna HealthFund® One-to-One Powered by PayFlex® | Aetna Flexible Spending Account (FSA) Premium Only Plans (POP) & Aetna HealthFund Health Reimbursement Arrangement for Small Group (HRA) Website to be used for all pre-sale, enrollment and ongoing administration materials and forms. |
| Claims/Reimbursement Forms | |
| Claims/Reimbursement Forms | |
SBC Summary of Benefits Search — aetna.com/sbcsearch/home 
Renewal Procedures
Enter your census or securely send us an excel spreadsheet or a list of employees and get instant proposals for California
Schedule a Skype, Phone or Face to Face meeting
Enrollment Forms
Quotit Paper – PDF
Forms are in Alphabetical Order by Insurance Company
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Pro Apply
ONLINE Enrollment Tools – Instructions
This is a directory listing and may be confusing
Email us for a web link to get your applications going with Pro Apply
PRO-Apply-Flyer
Employee Guide_Pro Apply
Pro Apply_Intake Form
PRO-Apply_-BROKER_Information
User Guide_Pro Enroll_Broker
