Acceptance of Request for Extension

Exhibit 99.19

PNC

Acceptance of Request for Extension

December 13, 2006

Aetna Inc.
000 Xxxxxxxxxx
Xxxxxx Xxxxxxxx, XX 00000

Re: Amended and Restated Five-Year Credit Agreement dated as of January 20, 2006 (the “Credit Agreement”)

Attention: Xxxxxx X. Xxxxx, Vice President, Finance and Treasurer

Dear Al:

We have received your Extension Request, dated December 5, 2006, and pursuant to Section 2.06(c) (Maturity of Loans) of the above-referenced Credit Agreement, we hereby agree to the extension set forth in such request. Upon the effectiveness of the Extension Request in accordance with Section 2.06(c) of the Credit Agreement, the new Maturity Date will be January 20, 2012.

Very truly yours,

PNC Bank, National Association

By:		/s/ Xxxxxx X. Xxxxxxx
		Name: Xxxxxx X. Xxxxxxx
		Title: Managing Director

The PNC Financial Services Group
One PNC Plaza 000 Xxxxx Xxxxxx Xxxxxxxxxx Xxxxxxxxxxxx 00000-0000
www.pnc.ccm