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Disclosure Information

Choose the disclosure that applies to your plan

These disclosure documents describe Aetna* health benefits and health insurance plans. Find your plan name. Then find your state.

If no state is listed, read the "General" document at the top of the list. State versions apply only to fully insured plans. If your plan is employer funded, read the "General" disclosure at the top of the list. Not sure? Ask your benefits administrator.

For Arizona, Georgia, New Jersey, New York and Rhode Island, scroll down to find additional disclosure information.

Georgia Consumer Choice Unit
Please note that the phone number for the Georgia Consumer Choice Unit has changed. The new number is 1-800-443-6917, Option 5.

Select a disclosure information category

HMO and Aetna Value Network Plans*
Innovation Health Disclosures
Elect Choice, Open Access Elect Choice, Aetna Select, Open Access Aetna Select and Aetna Choice POS II plans*
QPOS* and Managed Choice POS** Plans
Open Access HMO*, Health Network Option*, Aetna Choice POS*, Open Choice PPO*, Open Access Managed Choice** and Student** Plans
Traditional Choice Indemnity Plan
GA Disclosure Acknowledgement Form
Addendums - If you have a plan in one of the states listed, include this extra disclosure with your main disclosure above.
Aetna Advantage Plans for Individuals, Families and the Self-Employed Disclosures

Arizona Appeals Packets

New Jersey Financial Arrangements Flyer

Financial arrangements between Aetna and its providers

Rhode Island Consumer Disclosures

In accordance with Rhode Island Rules and Regulations for Certifying Health Plans, to follow are documents with valuable consumer information about your health plan. The following documents are provided to prospective and current enrollees via the website or a paper copy can be requested by calling Aetna Member Services at 1-888-982-3862.

The Consumer Rights Disclosure Document contains information about your specific health plan.

Our directory has a list of providers: A paper copy of the directory can be requested by calling 1-888-87-AETNA (1-888-872-3862).

Aetna Student Health Version

Medical PPO with Pharmacy #155

Dental Gatekeeper (DMO/RI) #153

Standalone Vision #196

Dental PPO #154

Indemnity Major Medical with Pharmacy #156

Note about employer-funded plans: State mandates do not apply to self-funded plans governed by ERISA. If you are unsure if your plan is self-funded and/or governed by ERISA, please confer with your benefits administrator. Specific plan documents supersede general disclosures contained within, as applicable.

* Managed Plans offered by HMO entities are: Aetna Health Network OnlySM, Aetna Primary Care® Plan HMO, Aetna Health Network OptionSM, Aetna Open Access® HMO, Aetna Choice® POS and QPOS®.

** Managed Plans offered by Aetna Life Insurance Company are: Managed Choice® POS, Aetna Choice® Plan POS, Aetna Open Access® Managed Choice, Open Choice® PPO, Aetna Choice® Plan PPO, Elect Choice® EPO, Aetna Open Access® Elect Choice, Aetna Choice® POS II, Aetna SelectSM and Open Access Aetna SelectSM.

Dental plans are offered, underwritten or administered by: Aetna Health Inc., Aetna Health of California Inc., Aetna Health Insurance Company of New York, Aetna Health Insurance Company, Aetna Life Insurance Company (Aetna), Aetna Dental Inc., and/or Aetna Dental of California Inc.

Life and Disability
Disability insurance plans/policies are underwritten or administered by Aetna Life Insurance Company (Aetna). Life insurance plans/policies are underwritten by Aetna Life Insurance Company. Material provided is for informational purposes only and is not an offer or invitation to contract. Life and disability insurance plans/policies contain exclusions and limitations. Members should refer to their plan documents for a complete description of benefits, exclusions, limitations and conditions of coverage. While this material is believed to be accurate, it is subject to change.

Policy Forms issued in Oklahoma include: #GR-9/GR-9N, GR-29/GR-29N-29N.


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