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Aetna

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Underwriting Guidelines | Enrollment Forms | Miscellaneous Forms | Product Grids

Underwriting Guidelines

Underwriting Guidelines

05/15/10

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Enrollment Forms

Checklist	05/18/11
Employer Application	05/18/11
Employee Application	05/18/11
Funding Attestation	11/16/10
Pre-Screen Form (5-50 enrolling)	05/18/11

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Miscellaneous Forms

Sample Agent of Record

01/29/10

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Product Grids (Health Care Reform)

Effective for plan years beginning on September 23, 2010, or the group's first renewal after this date, certain preventative services are no longer subject to member cost-sharing, such as deductibles, copayments and coinsurance. All benefit grids on this page reflect these stated changes.

POS Plans

POS 2.4	05/19/11
POS 3.4	05/19/11
POS 4.4	05/19/11
POS 5.4	05/19/11
POS 6.4	05/19/11
POS 7.4	05/19/11
POS 7.4 ($10 Generic Rx)	05/19/11

POS - No Referral

POS NR 1.4	05/19/11
POS NR 2.4	05/19/11
POS NR 3.4	05/19/11
POS NR 4.4	05/19/11
POS NR 5.4	05/19/11
POS NR 6.4	05/19/11
POS NR 7.4	05/19/11

POS - Cost Sharing

POS CS 3.4	05/19/11
POS CS 4.4	05/19/11
POS CS 5.4	05/19/11
POS CS 6.4	05/19/11

POS - Cost Sharing - No Referral

POS CS NR 1.4	05/19/11
POS CS NR 2.4	05/19/11
POS CS NR 3.4	05/19/11
POS CS NR 4.4	05/19/11
POS CS NR 5.4	05/19/11

POS - Consumer Directed

POS CD NR 1.4

05/19/11

POS - HSA Compatible - No Referral

POS HSA NR 1.4	05/19/11
POS HSA NR 2.4	05/19/11
POS HSA NR 3.4	05/19/11

Health Network Option - HRA

HNO HRA 1.4

05/19/11

PPO Plans

PPO 1.4	05/19/11
PPO CS 1.4	05/19/11
PPO HAS 1.4	05/19/11

Download all Aetna Product Grids (ZIP)

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