Get Colorado Employee Enrollmentchange Form 51-100 - Aetna

The Colorado Employee Enrollment/Change Form 51-100 - Aetna is essential for employees looking to enroll in health coverage or make changes to their current coverage. Completing this form accurately and entirely is crucial for ensuring timely processing of your enrollment.

Follow the steps to fill out the form online.

1. Click ‘Get Form’ button to access the Colorado Employee Enrollment/Change Form 51-100 - Aetna and open it in your chosen online editor.
2. Begin with Section A, Employee Information. Fill in your Aetna ID number, company name, effective date, and select the applicable enrollment type such as new hire, returning employee, or open enrollment.
3. Continue by providing personal details including your social security number, name, address, job title, and contact numbers. Be sure to indicate your primary language spoken and number of dependents.
4. Move to Section B, Coverage Selection, and choose the appropriate medical and dental plans by checking the applicable boxes. Ensure that all options are clearly marked.
5. In Section C, list all individuals you are enrolling or adding, including their personal details such as name, sex, date of birth, and type of coverage.
6. Complete Section D if any applicants are enrolled in Medicare; provide the necessary details regarding their coverage.
7. If you are declining coverage, fill out Section E. This requires a reason for waiving coverage and an acknowledgment of your decision by signing where indicated.
8. For Section F, Coordination of Benefits, indicate whether you will have other health insurance alongside this coverage and provide the necessary details.
9. Section G, Health Questionnaire, must be filled out clearly for accuracy. All questions regarding health history and current medications must be completed.
10. Review all details entered for accuracy and completeness. Once satisfied, save your changes using the online tool's options, and you can choose to download or share the completed form directly.

Complete and submit your Colorado Employee Enrollment/Change Form 51-100 - Aetna online to ensure your health coverage is processed without delay.