Aetna eoi form 2025

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The document is an Evidence of Insurability Statement for Life and Disability Coverage provided by Aetna Life Insurance Company. It outlines the necessary steps and information required from both the Plan Sponsor and Employee/Member to apply for insurance coverage. The form includes sections for personal details, coverage amounts requested, health information, and privacy notices regarding the handling of personal data. It emphasizes the importance of completing all sections accurately to avoid processing delays.

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

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Got questions?

We have answers to the most popular questions from our customers. If you can't find an answer to your question, please contact us.

How do I get an EOI form?

Most insurance providers have a portal where you can submit your EOI online, making the process as simple as possible. Employees may also choose to submit a paper application provided by HR. Each format should include step-by-step instructions on how to fill it out and submit it.

What is an EOI form for insurance?

The Evidence of Insurability (EOI) Form provides additional information necessary to review a request for more Life Insurance coverage. This service provides instructions for completing the Evidence of Insurability (EOI) Form.

How to get an EOI?

How to Provide Evidence of Insurability to Your Employees. In most cases, employees can complete the entire evidence of insurability process directly through the insurance company. In this digital age, many insurers provide online platforms and portals that allow employees to fill out and submit the form.

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