Aetna eoi form 2026

1. Click ‘Get Form’ to open the Aetna EOI form in the editor.
2. Begin with Section A, ensuring all items are completed. Input the Control Number, Suffix, and Account numbers as required.
3. Provide the Employee/Member’s Social Security Number and ensure both names and addresses are filled in accurately.
4. Fill in the authorized representative's telephone number, date of hire, and both home and work telephone numbers.
5. Complete email addresses for both the Plan Sponsor and Employee/Member. Enter the Annual Earnings in the designated field.
6. Check appropriate boxes for life coverage requests, including current and additional amounts of coverage needed.
7. In Section B, verify that your name and details are accurate. Complete all questions regarding health status for each individual listed.
8. Sign the form where indicated. If spouse coverage is requested, ensure their signature is also included before submission.

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