Small Business Clients, Update Your Contact Info (North East)

Thank you for your interest in Aetna Small Group. Please complete the following information so we can best help you.

All fields marked with a RED asterisk (*) are required in order to proceed.

* Business name

* Your name

* Business address

* City

*State

*5 digit ZIP code

* Business phone number (10 digits)

* Email address (formatted as example@sample.com)

* Group #

This field refers to the identification number assigned to your policy and consists of a series of six numbers.
It may be listed as: Group#, Control#, Policyholder#, Contractholder#

Number of employees in your business

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Do you have Aetna insurance through an employer or are you a Medicare member? Yes No

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Small Business Clients, Update Your Contact Info (North East)

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