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Get Aetna Gc-1560-4 2014-2026
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How to fill out the Aetna GC-1560-4 online
Filling out the Aetna GC-1560-4 form online is an essential step for employees seeking to file a disability claim. This guide will provide clear and comprehensive instructions to make the process straightforward and efficient.
Follow the steps to fill out the Aetna GC-1560-4 online effectively.
- Press the ‘Get Form’ button to retrieve the Aetna GC-1560-4 form and open it for editing.
- Begin with the Employer Information section by entering the employer's name, control number, and address, including ZIP code.
- In the Employee Information section, provide your Social Security number, full name, birthdate in MM/DD/YYYY format, address with ZIP code, and daytime telephone number.
- Complete the Basic Income section by indicating your weekly or monthly earnings, and describe your job duties briefly.
- Answer the questions regarding your employment status, including whether your employment has terminated or if you are currently on layoff, as well as your current employment elsewhere.
- In the Claim Information section, indicate if your absence is work-related and whether the claim is related to an accident. If applicable, provide the date and time of the accident.
- Describe the nature of the illness or injury for which you are making the claim. Also, include your expected return to work date.
- In the Release section, sign and date the authorization for Aetna to access necessary health care information. Ensure it is done in MM/DD/YYYY format.
- Review the Misrepresentation section, understanding the implications of providing false information.
- Complete your signature and date in the Employee's Signature area, again using MM/DD/YYYY format.
- If there is an Attending Physician’s Statement, ensure your physician completes the required details and signs it.
- Once all sections are filled, you can save your changes, download the completed form, print it for your records, or share it as needed.
Complete your Aetna GC-1560-4 form online today to ensure your disability claim is processed swiftly.
You can also print and mail claims forms to Aetna Voluntary Plans, PO Box 14079, Lexington, KY 40512-4079, or Fax to 1-859-455-8650. Claims forms are available for download from the bottom of the screen when you access the member portal or call Member Services. Have questions?