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Small Employer Cover Sheet & Checklist Renewal Case Information Aetna Small Group Underwriting 4300 Entryway Place, Arlington, TX 76018 P.O. Box 91507 ? Arlington, TX 76015-0007 Phone (866) 899-4379
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How to fill out employee enrollment change forms:

01
Start by carefully reading the form instructions to understand what information is required.
02
Provide your personal details such as full name, employee ID, contact information, and any other requested identifying information.
03
Fill in the section regarding your current enrollment status, which may include information about your current benefits and coverage.
04
If you wish to make any changes to your enrollment, clearly indicate the desired changes in the appropriate section.
05
Include any supporting documentation that may be required, such as proof of dependent eligibility or a marriage certificate for adding a spouse to your coverage.
06
Review your completed form to ensure all the necessary fields have been filled accurately and legibly.
07
Sign and date the form before submitting it to the appropriate HR department or benefits administrator.

Who needs employee enrollment change forms:

01
Any employee who wishes to make changes to their current benefits and coverage.
02
New hires who need to enroll in the company's benefit programs.
03
Employees who experience a qualifying life event such as marriage, birth of a child, or change in marital status, which may require them to update their enrollment information.
04
Individuals who wish to add or remove dependents from their coverage.
05
Employees who want to make changes during the open enrollment period, which is typically held annually.

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