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  • Gc 1362 Atena Forms

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Aetna Life Insurance Company Designation of Beneficiary Before executing this form refer to other side. Please keep a copy for your records. Group Policyholder Name Group Policy Number City of Ft.

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How to fill out the Gc 1362 Atena Forms online

Filling out the Gc 1362 Atena Forms online is a straightforward process, but it is essential to ensure accuracy to facilitate the timely processing of your designation of beneficiary. This guide will walk you through each component of the form, providing clear instructions to help you complete it effectively.

Follow the steps to accurately complete your Gc 1362 Atena Forms.

  1. Click ‘Get Form’ button to obtain the form and open it in the online editor.
  2. Fill in the group policyholder name and group policy number accurately. This information is usually provided by your employer or insurance provider.
  3. Enter the employee or retiree's name and address, followed by their social security number. Ensure that this information matches the official documents to avoid any processing issues.
  4. Designate the beneficiaries by providing their names, addresses, and relationships to you. Include the gender of each beneficiary to ensure clarity.
  5. For each beneficiary, input their social security number and date of birth in the designated fields. This information is necessary for proper identification.
  6. Specify the percentage of benefits each primary beneficiary will receive, ensuring that the total does not exceed 100%. If there are contingent beneficiaries, identify them and follow a similar procedure.
  7. If applicable, complete the spousal consent section if you are in a community property state. It is advisable to have your spouse sign this section to waive any legal claims they may have on the benefits.
  8. Review all entered information carefully for accuracy and completeness. Corrections can be made by crossing out the erroneous information, adding the correct details, and initialing the changes.
  9. Once everything is verified, you may save your changes, download the form, print it for your records, or share it as needed.

Start filling out your Gc 1362 Atena Forms online today to ensure that your beneficiary designations are accurately recorded.

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Timely Filing of Claims Corrected claims must be submitted within 365 days from the date of service. days from primary insurer's EOB date or 180 days from date of service, whichever is later. Failure to submit claims within the prescribed time period may result in payment delay or denial.

If you can't find your 1095-B or 1099-HC, you can call us for a replacement copy. Remember that not everyone gets both forms. The phone number is (866) 682-6745 (TTY: (800) 497-4648 for people who are deaf, hard of hearing, or speech disabled). We are open Monday through Friday from 8:00 a.m. to 5:00 p.m.

The best place to find details about your coverage and benefits is your secure member website. It takes only a few minutes to register. And you only need your member number, which is on your Aetna ID card. You can still get benefits and coverage information by calling the number on your ID card.

To request a copy of your 1099-Miscellaneous form, please contact Aetna Provider Tax Line @ 855-849-7539 or 860-273-8400.

If you haven't received your Form 1099-HC, contact your insurance carrier. You may also enter into your tax return: The name of your insurance carrier or administrator. The subscriber number for your plan (this number can be for either for individuals or groups).

Mail to: SRC, an Aetna Company. Attn: Claim Department. PO Box 14094. Lexington, KY 40512-4094. Fax to: 1-859-455-8650. Phone: 1-888-772-9682. TO BE COMPLETED BY EMPLOYEE. TO BE COMPLETED BY DENTIST.

Aetna does not provide care or guarantee access to dental services. Not all dental services are covered. See plan documents for a complete description of benefits, exclusions, limitations and conditions of coverage. Plan features and availability may vary by location and/or group size and are subject to change.

For those that previously received their Form 1095-B in the mail, you can receive a copy of your Form 1095-B by going out to the Aetna Member Website in the Message Center under the Letters and Communications tab or by sending us a request at Aetna PO BOX 981206, El Paso, TX 79998-1206.

The patient should not return to the primary care physician to request a referral after the service is rendered; primary care physicians should not issue retroactive referrals.

To download an electronic copy of your Form 1099-HC, you may sign into your medical insurance carrier's online account, or contact their member services at the number on your ID card for more information.

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
Privacy Notice
Legal Hub
Content Takedown Policy
Bug Bounty Program
About Us
Help Portal
Legal Resources
Blog
Affiliates
Contact Us
Delete My Account
Site Map
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate WorkFlow
DocHub
Instapage
Social Media
Call us now toll free:
+1 833 426 79 33
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232