Aetna Prescription Drug Data Collection Reporting Submission
Plan Sponsor
Plan Sponsor SF ID
Plan Sponsor Unique ID
Also known as Account ID for Small Group
Submitter First Name
Submitter Last Name
Submitter Email
Legal Entity Name
Please select...
Aetna Health Inc. - PA
Aetna Health Inc. (a Louisiana corporation)
Aetna Health Inc. (CT)
Aetna Health Inc. (FL)
Aetna Health Inc. (GA)
Aetna Health Inc. (ME)
Aetna Health Inc. (NJ)
Aetna Health Inc. (TX)
Aetna Health Insurance Company of New York
Aetna Health of California Inc.
Aetna Health of Iowa, Inc.
Aetna Health of Utah Inc.
Aetna HealthAssurance Pennsylvania, Inc.
Aetna Life Insurance Company
Allina Health and Aetna Insurance Company
Banner Health and Aetna Health Insurance Company
Banner Health and Aetna Health Plan Inc.
Innovation Health Insurance Company
Innovation Health Plan, Inc.
Sutter Health and Aetna Administrative Services LLC
Sutter Health and Aetna Insurance Company
Texas Health + Aetna Health Insurance Company
Texas Health + Aetna Health Plan Inc.
Texas Health and Aetna Health Insurance Company
Funding Arrangement
Please select...
Fully Insured
Self-Insured
Split Funded
Total Premium paid by Employer
Currency only: no special characters beyond "." (ex: % or $)
Total Premium paid by Members
Currency only: no special characters beyond "." (ex: % or $)