Aetna
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Employer Application Package  |
Employee Application Package for New Group |
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Add Employee to Existing Group Plan |
Employee Waiver
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Employee forms can be faxed to our office at (303) 721-1085. Please confirm that application was received by calling (303) 721-1145. Please call with any questions regarding eligibility or waiting periods.
Plan
Descriptions
PPO Plans
| Health Plan Name |
Office Visit Copay |
Deductible |
Coinsurance |
| Basic
PPO |
$30 |
$3000 |
30% to $6700 |
| Standard
PPO |
$20 | $1000 | 20% to $5K |
| Plan
1 |
$20 | $500 | 10% to $20K |
| Plan
2 |
$20 | $1000 | 10% to $20K |
| Plan
3 |
$20 | $1500 | 20% to $15K |
| Plan
4 |
$25 | $2000 | 20% to $15K |
| Plan
5 |
$25 | $2500 | 20% to $15K |
| Plan
6 |
$25 | $3000 | 20% to $25K |
HSA Plans
Plan Name |
Deductible |
Coinsurance |
Max Out-of-Pocket (includes deductible) |
| $2250/$4500 |
90/10 |
$2500/$5000 |
|
| $2500/$5000 |
80/20 |
$3500/$7000 |