Below please find various forms for you to print and complete.

CVS/caremark Reimbursement:  If you have to pay out of pocket for prescriptions prior to being activated with CVS/caremark you can complete a form and file for a reimbursement.

Aetna Claim Form:  In some circumstances, you may be required to pay upfront for medical services. For example, if you are traveling outside the country, you may be required to pay for medical services with a credit card or cash. If you should pay upfront for a medical service, a manual claim form can be submitted to Aetna along with the invoice from the provider of service.

Request for Access to Records:  To enable members, spouse, child, power of attorney, guardian, or other person to receive protected health information from the EHP, Medical Management, Pharmacy Management and/or TPA related to health plan programs or services. Aetna PHI form.

Aetna Coordination of Benefits:  Aetna – our Third Party Administrator (TPA) – is partnered with COB Smart® to more efficiently identify EHP members who have other insurance coverage. Aetna receives weekly files from COB Smart® with those EHP members matching other insurance and will automatically update your record. This means less paperwork for most EHP members. Some smaller insurance companies may not currently participate in COB Smart®. In these instances, you will be asked by Aetna to complete the COB form. Detailed instructions on how to complete the process are on the form.