Total Benefit Solutions

Total benefit solutions Enrollment Kits

X

0

Forms Selected

Email

Download

Download Forms & Documents

You've selected 10 Form(s). Choose your download option from the button below.

Form Name
Carrier
State
Group Type
Effective Date

Email Forms & Documents

Share 10 Selected Forms. A single email will be sent to all listed recipients. You can also send a copy to yourself.

Form Name
Carrier
State
Group Type
Effective Date

Form Name

Effective Date

Last Updated

This checklist is provided as a guide. The carrier may require additional items and documentation. Please refer to the carrier's underwriting guidelines for a complete list of requirements. Please use the latest version of forms.

Our goal is to process your new group enrollment easily and efficiently in order to provide you and your client with a quick approval. The following list outlines the health plan’s case submission requests:

Aetna International Plans are effective on the 1st of the month. All paperwork is required for submission 30 days prior to the
effective date:
  • AI Group Application
    • Employer address should reflect United States location, unless company is headquartered in Canada. If headquartered in Canada, please list Canadian address.
    • Include total number of employees worldwide in Section A for Eligibility/Participation. A minimum of 51+ employees worldwide is required for eligibility.
  • AI Joinder Agreement
    • The Signed at (City/State) should match the location listed on the group application.
    • Witness signature is also required.
  • Electronic Publishing & Enrollment Agreement (ePub Agreement)
  • Electronic Enrollment Spreadsheet
    • All enrolling members, including dependents, must be listed individually on their own separate line. Dependents should be listed directly under the employee.
    • Salary, Beneficiary, and EOI information are only required for groups purchasing a life policy
  • Implementation Details Sheet