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Downloadable Forms

For your convenience, we have developed a downloadable insurance forms section. Please feel free to check back here for frequent form updates.

Updated New York ACA Small Group new case submission dates and termination policy

                   
                                                        
     

     
     

     
     

     
     

     
     

Quality health plans & benefits
Healthier living
Financial well-being
Intelligent solutions

   
   

   
   

   
 
 

               

   

   
                                       
     

As you know, there’s a delicate balance between high year-end small group ACA new sales volumes and late or incomplete ACA case submissions. And our goal is to provide access to medical and pharmacy benefits for new members on their effective dates. We’re implementing the following new business submission dates for 4th quarter. 
       
                                                                                                                                                                                                                           

       

Effective         Date   

       
       

Submission         Date

       
       

October 1

       
       

Monday,         September 12

       
       

October 15

       
       

Monday,         September 26

       
       

November 1

       
       

Monday,         October 10

       
       

November 15

       
       

Tuesday,         October 25

       
       

December 1

       
       

Thursday,         November 10

       
       

December 15

       
       

Thursday,         November 24

       

     


       
     
     
     
     
     
     
     
     
     
     

 

 

 

 

 

 

 

 

 

 

 

 

 

 

The following must be submitted to receive the requested effective date:  

  • Master/Employer application (fully completed)
  •       
  • Check copy or ACH form
  •       
  • Enrollment and waivers (fully completed)
  •       
  • Tax/Payroll    

Remember, we cannot process cases that are missing vital information. Incomplete cases will be moved to the next effective date.
      

We will publish our 2017 submission date schedule by November 1st. This will reflect different timelines to account for quarterly volumes.
       
New Small Group ACA termination policy effective October 1
       
As an important small group partner, we want to keep you informed of upcoming policy changes. Starting October 1, we must receive written confirmation of customer renewal acceptance in advance of the customer renewal date for all Aetna small groups.
       
This means that beginning with all October 1 renewal dates, we must receive written confirmation in advance of the policy renewal date. Written confirmation may include signed renewal acceptance from the customer delivered by mail, fax or email. Note: premium payment received in advance of the renewal date will also be considered renewal acceptance.
       
If we haven’t received written acceptance of the renewal, or renewal alternates, from the customer in this time frame, we will initiate termination of the policy on the renewal date.  
       
This change allows us to provide new and renewing members with access to correct medical and pharmacy benefits in a timely manner. And it helps us prevent paying claims incurred after the termination date.
      
Please help us avoid member disruption by sending your group’s renewal intentions before the renewal date.