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Materials & Forms

Aetna Voluntary Plan Claim

AVP - Medical Benefits Request

Aetna Voluntary Plans Spanish
 

Dental Claim

AVP - Dental Benefits Request

AVP - Dental Benefits Request Spanish
 

Vision Claim

AVP - Vision Benefits Request

AVP - Vision Benefits Request Spanish

 
Short Term Disability Claim

Aetna Voluntary Plans - STD Disability Employee Request

Aetna Voluntary Plans - STD Disability Employee Request Spanish
 

Life Claim 

AVP - Group Life - Proof of Death

AVP - Group Life - Proof of Spanish

 
Affidavit of Sole Survivors

AVP - Aetna Affidavit of Sole Survivors

AVP - Aetna Affidavit of Sole Survivors Spanish
 

Protected Health Information

AVP - Authorization for Release of Protected Health Information

AVP - Authorization for Release of Protected Health Information (Spanish)

 
Transition of Care   

Aetna Voluntary Plans - Aetna Transition Coverage Request

Aetna Voluntary Plans - Aetna Transition Coverage Request (Spanish)

Aetna Voluntary Plans - Aetna Transition Coverage Request  (For CA Traditional Fully Insured Members Use Only)

Aetna Voluntary Plans - Aetna Transition Coverage Request Spanish (For CA Traditional Fully Insured Members Use Only)


Member Request for Estimates form (Massachusetts and Rhode Island Only)

Member Request for Estimate - AVP

Member Request for Estimate - AVP (Spanish)

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