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District of Columbia Employer Application and Joinder Agreement - Aetna. District of Columbia Employer Application and Joinder Agreement

District of Columbia Employer Application and Joinder Agreement - Aetna. District of Columbia Employer Application and Joinder Agreement 2026

District of Columbia Employer Application and Joinder Agreement - Aetna. District of Columbia Employer Application and Joinder Agreement Preview on Page 1

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4.8 out of 5

108 votes

The document is an Employer Application and Joinder Agreement for group coverage provided by Aetna, targeting businesses with 2 to 100 eligible employees. It outlines the necessary information for employers to apply for various insurance plans, including life, disability, and dental coverage. The application requires details about the company, employee classifications, medical and dental coverage selections, employer contributions, and compliance with regulations such as COBRA. Additionally, it includes sections for employer eligibility, employee status, and a signature section confirming the accuracy of the provided information.

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Click ‘Get Form’ to open the District of Columbia Employer Application and Joinder Agreement in our editor.
Begin by entering your Company Name (Legal Name) and DBA/Doing Business As if applicable. Ensure that the Street Address is complete, as P.O. Boxes are not acceptable.
Fill in the City, State, and ZIP code for both the primary address and billing address if different. Include your Phone Number and Fax Number.
Provide details for the Company Contact including Name, Title, Date of Birth (for eBilling), and Email Address. If there are different contacts for Billing or Enrollment, include their information as well.
Select your Medical Coverage options from the provided choices. Be sure to answer any questions regarding funding or flex plans accurately.
Complete the Dental Coverage Selection section by indicating whether you choose a Contributory or Voluntary Plan.
Review all sections carefully before signing at the end of the document to ensure all information is accurate and complete.

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Versions	Form popularity	Fillable & printable
2012	4.8 Satisfied (108 Votes)
2012	4.4 Satisfied (383 Votes)

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Is Aetna through employer?

Aetna health benefits through your employer. With an Aetna health plan, you get the care you deserve. Care thats more convenient and easier to access. Thats how healthier happens together.

What does insurance through employer mean?

Employer-sponsored health insurance is a health policy selected and purchased by your employer and offered to eligible employees and their dependents. These are also called group plans.