Get Aetna Gr-67853-34 2017

Filling out the Aetna GR-67853-34 form is an essential step for obtaining life and disability coverage. This guide provides clear instructions to ensure that users can easily complete the form accurately and efficiently.

Follow the steps to successfully complete the Aetna GR-67853-34 form.

1. Press the ‘Get Form’ button to access the form and open it for completion.
2. In Section A, fill out all required items thoroughly. Ensure the Control Number, Suffix, and Account numbers are provided in the specified fields.
3. Enter both the Employee/Member’s and your name and address in the designated spaces.
4. Include your email address and the Employee/Member’s email address.
5. Check the boxes for the individuals requesting Life coverage and enter the current amount of coverage, the requested additional amount, the resulting total coverage, and the Guarantee Issue amount for each individual.
6. Mark the appropriate Disability boxes and input the current and requested amounts or percentage of coverage.
7. Next, provide the completed form to the Employee/Member for their submission to Aetna.
8. In Section B, confirm that the Employee/Member's name, address, and Social Security Number are accurate.
9. Provide Height and Weight information to avoid the form being returned unprocessed.
10. Answer all health-related questions concerning the individuals listed, providing details where necessary.
11. If required, users can then save changes, download, print, or share the form as needed.

Complete your forms online today to ensure your coverage needs are met.