Use our online PDF editor to complete this evidence of insurability form in about 10 minutes. No software installation is required. Work directly in your browser and download the completed form when you are finished.
Step 1: Open the form editor
Click the Get Form Here button at the top of this page. The PDF editor opens in your browser and loads the form automatically. You can type, select, and sign directly in the editor without downloading any additional software.
Step 2: Complete Part A (plan sponsor information)
Part A is typically completed by your employer or HR representative. If you are completing this section yourself, enter the following details accurately:
- Plan sponsor name and full mailing address
- ATTN contact name at the plan sponsor
- Employee or member full legal name
- Employee Social Security number
- Account number and ATTN field
- City, state, and ZIP code for both the sponsor and the employee
The plan sponsor signature and date are required in this section before the completed form can be submitted to Aetna.
Step 3: Enter your coverage request (Part B)
Part B is completed by the employee applying for coverage. Enter your coverage request details for each applicable category:
- Basic life coverage amount requested
- Supplemental life coverage for yourself, spouse, or children
- Short-term and long-term disability coverage amounts
- Current coverage amount and the new requested amount
- Reason for the request: new hire, late applicant, salary increase, life event, or other
Record both the current and requested amounts for each coverage type you are changing or adding.
Step 4: Complete the health questionnaire
The health questionnaire is in Part B. Answer every question honestly and fully. Do not leave any question blank. Write "None" or "N/A" for questions that do not apply to you. The questionnaire asks about:
- Current pregnancies and expected due dates
- Planned or recent surgeries or outpatient procedures
- All prescription medications, dosages, and how often you take them
- Diagnoses within the past 5 to 10 years, including cancer, arthritis, AIDS or HIV, immune system disorders, and nervous system conditions
- Any hospitalizations or specialist consultations in the past 5 years
Aetna reviews submitted health data against third-party medical records during underwriting. Any omission discovered during this review may result in coverage denial.
Step 5: Review and finalize
Before submitting the form, review all sections to confirm that every required field is complete. Pay special attention to the medications section and the list of past diagnoses. Make sure all individual names, diagnosis dates, and details are entered correctly. Sign and date all required signature fields. Click Done to download the completed PDF to your device. Store a copy for your personal records before sending it to your plan sponsor or to Aetna.
Frequently asked questions about the Aetna EOI form
How long does Aetna take to process an EOI form?
Aetna typically completes the review in 3 to 8 weeks. The timeline depends on the completeness of your submission and whether Aetna requests additional medical documentation. You will receive a written approval or denial letter once the review is finished. Complex applications or incomplete submissions may extend the review period beyond 8 weeks.
Can I complete and submit the EOI form online?
You can complete and download the form using our online PDF editor. The completed form must then be submitted to Aetna or your plan sponsor using the method specified in your enrollment materials. Most employers accept submissions by mail, fax, or through a secure HR portal. Confirm the preferred submission method with your HR department before sending.
What happens if Aetna denies my EOI application?
If Aetna denies your coverage request, you can submit an Aetna Appeal Form along with supporting medical evidence to request a reconsideration. You may also apply for a lower coverage tier that falls within the guaranteed-issue limit, which does not require EOI approval. Review the denial letter carefully, as it specifies the appeal deadline and the documentation required.
What is the guaranteed-issue limit for Aetna coverage?
The guaranteed-issue limit varies by employer plan but typically ranges from one to two times annual salary for life coverage. Amounts above this threshold require EOI approval. Disability coverage has separate thresholds based on monthly benefit amounts and salary percentage. Check your employee benefits guide or contact your HR department for the specific GI amount that applies to your plan.
Do I need to see a doctor before submitting the EOI form?
You do not need a doctor visit to submit the form. However, Aetna may request an independent medical examination after reviewing your submission if additional health information is needed. Providing documentation from your treating physician upfront can help speed up the review process. The Aetna Attending Physician Statement is a standard supporting document for this purpose.
Can I submit an EOI form for a spouse or dependent?
Yes. Part B of the form includes sections for spouse life and children's life coverage. If the requested benefit for a spouse or dependent exceeds the plan's guaranteed-issue limit, you must complete the health questionnaire on their behalf. The plan sponsor must still sign Part A before the form is submitted. Contact your HR department to confirm the GI limit that applies to dependent coverage under your plan.
What if I leave a question blank on the health questionnaire?
Leaving any health question blank may cause Aetna to return the form for completion, which delays your underwriting review. Write "None" or "N/A" for any question that does not apply to you. Blank responses are treated differently from a documented "None" answer and may flag the submission as incomplete during the initial review.
Can my employer see my health information on the EOI form?
Your employer's HR department typically handles routing the form to Aetna, but health information disclosed in Part B is kept confidential under HIPAA and is not shared with your employer for employment purposes. Aetna uses your health disclosures only to determine coverage eligibility. If you have concerns about confidentiality, contact Aetna directly to ask about their privacy practices for EOI submissions.
How do I find out what my guaranteed-issue limit is?
Your guaranteed-issue limit is listed in your employee benefits guide or Summary Plan Description (SPD). You can also contact your HR representative or benefits administrator for the specific amount. The Aetna benefits enrollment portal, if available through your employer, may display GI limits alongside your coverage options during open enrollment.
Related insurance forms
If you are applying for similar coverage through another insurer, the MetLife Evidence of Insurability form follows a comparable process with different plan-specific requirements. Employees managing life insurance details may also need the life insurance beneficiary form to designate or update beneficiaries. For disability-related processes, see the disability claim form for filing a claim once coverage is approved.
