How to Reconcile and Pay
Your Aflac Invoice
American Family Life Assurance Company of Columbus (Aflac)
Worldwide Headquarters y Columbus, Georgia 31999
aflac.com
Welcome to
ii
A Fortune 500 company, Aflac insures more than 40 million people worldwide. We are a leader
in insurance coverage marketed at the worksite in the United States. We are a leader in cafeteria
plan services.
This reference guide outlines the services that Aflac offers payroll accounts. As you review the
document, you will find information about paying your invoices, instructions on filing claims,
answers to frequently asked questions, and much more! We hope this guide will prove beneficial
to you.
If you have any questions about your account, please call us toll-free at 1-800-99-AFLAC
(1-800-992-3522) or visit our Web site at aflac.com.
We are pleased to have you as a member of our Aflac Family and look forward to serving you
and your employees.
iii
Table of Contents
SAMPLE INVOICE - SECTION A .............................................................................................. 1
SAMPLE INVOICE - SECTION B…………………………………….……………………….2
SAMPLE INVOICE - SECTION C…………………………......................................................3
HELPFUL TIPS - RECONCILING…………………………………………………………….5
AFLAC MISSED DEDUCTION EVENT CODES…………………………………………….6
SAMPLE PREMIUM STATEMENTS…………………………………………………………7
ALTERNATIVE METHODS TO RECONCILE…………………………………………….11
BENEFIT SERVICES………………………………………………………………………….12
CLAIMS…………………………………………………………………………………………13
FAQS…………………………………………………………………………………………….14
ACCOUNT CORRESPONDENCE…………………………………………………………...16
POLICYHOLDER/EMPLOYEE CORRESPONDENCE…………………………….…….17
1
SAMPLE INVOICE – SECTION A
An example of your Aflac invoice is provided on the next pages, along with explanations for each field.
PREMIUM STATEMENT
PREMIUM DUE DATE: 10/01/2007 INVOICE NO: 000001
MODE OF PAYMENT: Monthly ACCOUNT NO: A1234
DATE PREPARED: 09/11/2007 PAGE NO: 1
Attn: Jane Doe
COMPLETE IF YOUR MAILING ADDRESS OR POINT OF CONTACT HAS CHANGED.
ABC Company
1234 Elm Lane
Columbus, GA 31999
ATTENTION CAFETERIA PLAN SPONSORS
Coverage modifications made prior to the end of the current cafeteria plan year must be made on account of, and attributable to a change in status
(i.e., marriage, divorce, birth, adoption, death, or change in employment status). You, as plan sponsor, bear sole responsibility for
making this determination.
PLEASE USE THE REVERSE SIDE OF THIS STATEMENT FOR REPORTING CURRENT MAILING ADDRESS OF EMPLOYEES NO
LONGER PARTICIPATING WITH THIS INSURANCE PROGRAM.
PLEASE UPDATE TOTAL NUMBDER OF FULL-TIME EMPLOYEES IN THE SPACE PROVIDED BELOW.
Field Description
PREMIUM DUE DATE Date the statement is due for payment.
MODE OF PAYMENT Frequency of payment.
28-Day – One invoice every 28 days (13 times a year)
Biweekly – One invoice every 2 weeks (26 times a year)
Monthly – One invoice per month (12 times a year)
DATE PREPARED Date the statement was prepared
INVOICE NUMBER Aflac-assigned statement number
ACCOUNT NUMBER Aflac’s identification number for your account
ADDRESS BLOCK Name of your company, point of contact, and mailing address
Note: It is a good idea to verify that this information is accurate to help us keep our records
accurate.
ADDRESS CORRECTION Information to be corrected if your company’s mailing address and/or point of contact have
changed (by marking out the current information and writing in the new address and/or point of
contact)
INFORMATION BLOCK Information about Aflac coverage or new services and Aflac’s customer service number(s)
SECTION A
CLAIM FORMS ARE NOW AVAILABLE ONLINE AT AFLAC.COM.
IF YOU HAVE ANY QUESTIONS ABOUT YOUR STATEMENT, PLEASE CALL 1-800-99-AFLAC (1-800-992-3522).
**IMPORTANT**
A COPY OF THIS STATEMENT MUST BE REMITTED WITH YOUR PREMIUM IF ADJUSTMENTS ARE REQUIRED
2
SAMPLE INVOICE – SECTION B
Section B of the premium statement cover page is a remittance document. It is to be returned with your payment to
ensure prompt processing.
INVOICE NO.
{DATA}
ACCOUNT NO.
{DATA}
DUE DATE
{DATA}
MODE
{DATA}
TOTAL NO.
OF EMP.
{DATA}
AMOUNT DUE
${DATA}
AMOUNT PAID
$_________
SEND PAYMENT TO:
AFLAC {DATA}
ATTN: REMITTANCE PROCESSING SERVICES {DATA}
1932 WYNNTON ROAD {DATA}
COLUMBUS, GEORGIA 31999-0001 {DATA}
PLEASE DO NOT STAPLE, FOLD, OR BEND
PLEASE MAKE SURE CHECK IS SIGNED AND PAYABLE TO AFLAC.
In this section, we will address only the fields that were not defined in Section A.
Field Description
TOTAL NO. OF EMPLOYEES Total number of full-time employees in your company
AMOUNT DUE Total amount due for this statement
AMOUNT PAID Total amount paid for this statement
On the back of your invoice, space is available for you to provide the current mailing address of employees who are no
longer participating in Aflac’s insurance program. We will mail letters telling them how they may continue their Aflac
coverage.
SECTION B
3
SAMPLE INVOICE – SECTION C
PREMIUM DUE DATE: 10/01/2005 INVOICE NO: 000001
MODE OF PAYMENT: Monthly ACCOUNT NO: A1234
DATE PREPARED: 09/11/2005 PAGE NO: 1
POLICY
CONTRACT
TYPE
COVERAGE
CT
DEPT
NO.
EMPLOYEE
NUMBER
NAME
RM
PREMIUM
TOTAL
PREMIUM
EC
LINE
NO.
12345678
ICARE
F
Jones, William
6.00
12345679
CANCER
F
Jones, William
20.00
26.00
02345619
DENTAL
I
Adams, John NEW
5.00
5.00
TOTAL AMOUNT DUE:
PAGE TOTAL:
(+,-) TOTAL ADJUSTMENTS: ADJUSTMENTS:
AMOUNT PAID: PAGE SUB-TOTAL:
CT – COVERAGE TYPE
F FAMILY
I INDIVIDUAL
P PRIMARY and SPOUSE
S SINGLE PARENT FAMILY
RM – REMARKS
PA PAID IN ADVANCE OF
INVOICE DUE DATE
CV PENDING CONVERSION ON
POLICY
PC PENDING CONVERSION ON
PAID AHEAD POLICY
EC – EVENT CODES
T EMPLOYMENT TERMINATED (BILL AT HOME)
C CANCEL AT REQUEST OF EMPLOYEE
D EMPLOYEE DECEASED
L LEAVE WITHOUT PAY (NO DEDUCTION)
N FIRST MISSED DEDUCTION
F FAMILY MEDICAL LEAVE
R RETIRED
0 OTHER (EXPLANATION ATTACHED)
SECTION C
4
SAMPLE INVOICE – SECTION C, CONTINUED
Section C of the premium statement is the invoice page. If you are paying the amount billed, without any adjustments on
this page, it is not necessary to include this page with your payment. If adjustments are being made to an invoice page,
please return that page with the entire payment. Always include Section B of your invoice with your payment.
Various print sequences are available to assist you with your statement reconciliation. If you would like to change the
current print sequence of your statement, please call 1-800-99-AFLAC (1-800-992-3522) or visit us at aflac.com
.
In this section, we will address the fields that were not defined in Sections A and B.
Field Description
POLICY CONTRACT Eight-character policy number assigned by Aflac
POLICY TYPE Type of coverage requested on corresponding policy number (Cancer, Accident, etc.)
CT Denotes Individual (I), Family (F), Primary and Spouse (P), or Single-Parent Family (S)
coverage for the corresponding policy number
DEPARTMENT NUMBER Four-digit department number (if your account requires these)
EMPLOYEE NUMBER Ten-digit employee identification number (if your account requires these)
If correction is needed to employee number, indicate it here.
NAME Policyholder or billing name (employee)
NEW "NEW" (prints for newly issued policies)
RM Remarks associated with corresponding policy number (listing of remark codes is provided at the
bottom of the invoice)
PREMIUM Premium amount due for each policy
TOTAL PREMIUM Total premium due for all policies for each policyholder
EC Reason for nonpayment (a list of event codes is provided at the bottom of the invoice). To
prevent any interruption in coverage for the employee, please provide a reason for all
nonpayments.
Note: Use “O” for other, and include an explanation so we may assist with policy changes other
than those associated with nonpayment.
LINE NUMBER Automatically generated line count
TOTAL AMOUNT DUE Total amount of invoice
TOTAL ADJUSTMENTS The total amount added or deducted from the billed amount
Note: If there are adjustments indicated here, this page must be returned with payment.
AMOUNT PAID The total amount submitted with the premium statement
PAGE TOTAL Total premium for each page of the invoice
ADJUSTMENT The total adjustment for each page with premium adjustments
PAGE SUBTOTAL The total amount from the page that will be submitted with the premium statement
Please remit deductions for all employees. If an employee does not appear on your invoice, add the name of
the employee and the amount deducted on the last page of your invoice.
5
REVIEW EACH EMPLOYEE’S DEDUCTION FOR ANY DISCREPANCIES.
M
ARK THROUGH THE MISMATCHED DEDUCTION BESIDE THE POLICY IN QUESTION AND
INDICATE THE DEDUCTION THAT WAS MADE
.
A
DD ANY NEW EMPLOYEES WHOSE NAMES DO NOT APPEAR ON THE INVOICE. INCLUDE THE
REMITTED PREMIUM AMOUNT FOR EACH ONE
.
E
XPLAIN WHY THERE ARE NO DEDUCTIONS FOR THE EMPLOYEES UNDER THE COLUMN
LABELED EC.
N
OTE: A LIST OF THE MISSED DEDUCTION EVENT CODES IS PROVIDED ON THE NEXT PAGE.
THESE CODES SHOULD ALSO BE USED WHEN PAYING FOR AN EMPLOYEE AND INDICATING THAT
HE OR SHE SHOULD BE REMOVED FROM THE INVOICE
.
A
DD THE TOTAL PREMIUMS FOR EACH PAGE AND PUT THE GRAND TOTAL ON THE FIRST
PAGE
.
R
EVIEW THE INVOICE TO ENSURE THAT ALL MISSED DEDUCTIONS HAVE BEEN INDICATED
AND AN EXPLANATION PROVIDED
.
P
ROVIDE THE CORRECT ADDRESS FOR INSUREDS NO LONGER PARTICIPATING ON THE
PAYROLL ACCOUNT
.
S
END PAYMENT AND A COPY OF THE INVOICE TO AFLAC WORLDWIDE HEADQUARTERS.
Helpful Tips for Reconciling Your
Aflac Invoice
6
AFLAC MISSED DEDUCTION EVENT CODES
THESE CODES CAN ALSO BE USED WHEN PAYING FOR EMPLOYEES WHO SHOULD BE REMOVED FROM THE
INVOICE
.
Event
Code
Description Information needed to
reconcile billing
Action taken by Aflac
T
Employment
Terminated
Bill at home
• Use “T” to indicate the employee
has terminated employment and
must be removed from billing.
• Give the date of termination.
• Can also be used when the last
deduction is made.
• Remove the employee from the account
invoice and send confirmation.
• Provide a letter to the employee offering
continuation of coverage on direct bill.
C
Cancel at Request
of Employee
If participating in
cafeteria plan, refer
to plan documents
• Use “C” to indicate the employee
has elected to cancel Aflac coverage
and must be removed from billing.
• Can also be used when last
deduction is made.
• Required – Include written
authorization from employee to
cancel.
• Remove the employee from the account
invoice and send confirmation.
• Provide a letter to the employee offering
continuation of coverage on direct bill if
authorization is not received.
D
Employee
Deceased
• Use “D” to indicate the employee
must be removed from billing due to
death.
• Give the date of death, if available.
• Provide a letter to the employee’s estate,
notifying termination of coverage or
• Provide a letter to the employee’s spouse,
offering continuation of coverage if applicable.
L
No Deduction
On Leave without
Pay
Other than FML
• Use “L” to indicate the employee is
on leave and premiums will not be
remitted during period of leave.
• Give expected length of time
employee will be on leave.
• Provide a letter to the employee, requesting
that premium be remitted by employee until
he/she returns to work.
N
Missed First
Deduction
New Policy
• Use “N” to indicate new policy for
employee and that the first
deduction has been missed.
• Give reason for missing the first
deduction.
• Provide a letter/report to the account
requesting that missed and current premiums
be remitted with next invoice payment.
F
Family Medical
Leave Act
• Use “F” to indicate the employee is
on Family Medical Leave.
• Give the expected length of time
employee will be on leave.
• Provide a letter to the account requesting
notification upon employee’s return to work.
R
Employee Retired
• Use “R” to indicate employee is
retiring and must be removed from
billing.
• Remove the employee from the account
invoice.
• Provide letter to employee, offering
continuation of coverage on direct bill.
O
Other
Explanation
Attached
• Indicate any changes to be made to
the invoice, but not listed in this
chart.
• Aflac will handle appropriately according to
requested changes.
Examples of sample premium statements are provided on the following pages.
7
SAMPLE PREMIUM STATEMENTS
T
ERMINATION, NO PREMIUM REMITTED
PREMIUM STATEMENT
THE BUNN CORPORATION PREMIUM DUE DATE: 02/01/06 INVOICE NO: 123456
ATTN: JEAN BUNN MODE OF PAYMENT: MONTHLY ACCOUNT NO: A1234
PO BOX 123 DATE PREPARED: 01/15/06 PAGE NO: 2
BARKLEY, PA 10030
POLICY
CONTRACT
POLICY
TYPE
CT
DEPT
NO
EMPLOYEE
NUMBER
NAME
RM
PREMIUM
TOTAL
PREMIUM
EC
LINE
NO.
A1234567 ACC I DOE, JOHN 26.50 26.50 00001
A1234566 HOSP F DOE, JANE 30.50
00002
A1234565 CANCER F DOE, JANE 40.00 70.50 00003
A1234564 INT CARE
I
DONALD,
DAVID
23.00 23.00
T
1/1/06
00004
Example shows employment terminated effective 1/1/06.
TOTAL AMOUNT DUE:
PAGE TOTAL:
(+,-) TOTAL ADJUSTMENTS: ADJUSTMENTS:
AMOUNT PAID: PAGE SUB-TOTAL:
CT – COVERAGE TYPE
F FAMILY
I INDIVIDUAL
P PRIMARY and SPOUSE
S SINGLE PARENT FAMILY
RM – REMARKS
PA PAID IN ADVANCE OF
INVOICE DUE DATE
CV PENDING CONVERSION ON
POLICY
PC PENDING CONVERSION ON
PAID AHEAD POLICY
EC – EVENT CODES
T EMPLOYMENT TERMINATED (BILL AT HOME)
C CANCEL AT REQUEST OF EMPLOYEE
D EMPLOYEE DECEASED
L LEAVE WITHOUT PAY (NO DEDUCTION)
N FIRST MISSED DEDUCTION
F FAMILY MEDICAL LEAVE
R RETIRED
0 OTHER (EXPLANATION ATTACHED)
8
CANCELLATION, PREMIUM REMITTED
PREMIUM STATEMENT
THE BUNN CORPORATION PREMIUM DUE DATE: 02/01/06 INVOICE NO: 123456
ATTN: JEAN BUNN MODE OF PAYMENT: MONTHLY ACCOUNT NO: A1234
PO BOX 123 DATE PREPARED: 01/15/06 PAGE NO: 2
BARKLEY, PA 10030
POLICY
CONTRACT
POLICY
TYPE
CT
DEPT
NO
EMPLOYEE
NUMBER
NAME
R
M
PREMIUM
TOTAL
PREMIUM
EC
LINE
NO.
A1234567 ACC I FRANKLIN, JOHN 16.50 16.50
C
2/1/06
00001
A1234566 HOSP F GREEN, JANE 29.50 00002
A1234565 CANCER F GREEN, JANE 35.00 64.50 00003
Example shows employee elected to cancel coverage effective 2/1/06.
TOTAL AMOUNT DUE:
PAGE TOTAL:
(+,-) TOTAL ADJUSTMENTS: ADJUSTMENTS:
AMOUNT PAID: PAGE SUB-TOTAL:
CT – COVERAGE TYPE
F FAMILY
I INDIVIDUAL
P PRIMARY and SPOUSE
S SINGLE PARENT FAMILY
RM – REMARKS
PA PAID IN ADVANCE OF
INVOICE DUE DATE
CV PENDING CONVERSION ON
POLICY
PC PENDING CONVERSION ON
PAID AHEAD POLICY
EC – EVENT CODES
T EMPLOYMENT TERMINATED (BILL AT HOME)
C CANCEL AT REQUEST OF EMPLOYEE
D EMPLOYEE DECEASED
L LEAVE WITHOUT PAY (NO DEDUCTION)
N FIRST MISSED DEDUCTION
F FAMILY MEDICAL LEAVE
R RETIRED
0 OTHER (EXPLANATION ATTACHED)
9
ADDING AN INSURED
PREMIUM STATEMENT
THE BUNN CORPORATION PREMIUM DUE DATE: 02/01/06 INVOICE NO: 123456
ATTN: JEAN BUNN MODE OF PAYMENT: MONTHLY ACCOUNT NO: A1234
PO BOX 123 DATE PREPARED: 01/15/06 PAGE NO: 2
BARKLEY, PA 10030
POLICY
CONTRACT
TYPE
COVERAG
E
CT
DEPT
NO
EMPLOYEE
NUMBER
NAME
RM
PREMIUM
TOTAL
PREMIUM
EC
LINE
NO.
A1234567 ACC I KIMBLE, JIMMY 14.95 14.95
00001
A1234564 ACC I 123456789 Add On:
Louie, Bob
20.50 20.50
Example shows employee who does not appear on invoice.
Please provide the policy number when an employee is added to the invoice.
TOTAL AMOUNT DUE:
PAGE TOTAL:
(+,-) TOTAL ADJUSTMENTS: ADJUSTMENTS:
AMOUNT PAID: PAGE SUB-TOTAL:
CT – COVERAGE TYPE
F FAMILY
I INDIVIDUAL
P PRIMARY and SPOUSE
S SINGLE PARENT FAMILY
RM – REMARKS
PA PAID IN ADVANCE OF
INVOICE DUE DATE
CV PENDING CONVERSION ON
POLICY
PC PENDING CONVERSION ON
PAID AHEAD POLICY
EC – EVENT CODES
T EMPLOYMENT TERMINATED (BILL AT HOME)
C CANCEL AT REQUEST OF EMPLOYEE
D EMPLOYEE DECEASED
L LEAVE WITHOUT PAY (NO DEDUCTION)
N FIRST MISSED DEDUCTION
F FAMILY MEDICAL LEAVE
R RETIRED
0 OTHER (EXPLANATION ATTACHED)
10
OTHER EXPLANATION ATTACHED
PREMIUM STATEMENT
THE BUNN CORPORATION PREMIUM DUE DATE: 02/01/06 INVOICE NO: 123456
ATTN: JEAN BUNN MODE OF PAYMENT: MONTHLY ACCOUNT NO: A1234
PO BOX 123 DATE PREPARED: 01/15/06 PAGE NO: 2
BARKLEY, PA 10030
POLICY
CONTRACT
TYPE
COVERAG
E
CT
DEPT
NO
EMPLOYEE
NUMBER
NAME
RM
PREMIUM
TOTAL
PREMIUM
EC
LINE
NO.
A1588878 ACC
I F
Smith, Joey
35.00 42.00 35.00 42.00
O
00028
A6646450 HOSP F Smithers, Herman 36.00 00029
A6646451 CANCER F Smithers, Herman 26.50 62.50 00030
P2325611 INT CARE I Truman, Blake 32.50 32.50 00031
A2312355 HOSP F Turner, Tom 36.00 00032
A2312356 CANCER F Turner, Tom 26.50 62.50 00033
P2114522 STD I Williams, Wilma 7.50 7.50 00034
“O” = Joey Smith is paying for family coverage.
This sample shows premium discrepancy( remitting something other than what Aflac billed). Explanation provided.
TOTAL AMOUNT DUE:
PAGE TOTAL:
(+,-) TOTAL ADJUSTMENTS: ADJUSTMENTS:
AMOUNT PAID: PAGE SUB-TOTAL:
CT – COVERAGE TYPE
F FAMILY
I INDIVIDUAL
P PRIMARY and SPOUSE
S SINGLE PARENT FAMILY
RM – REMARKS
PA PAID IN ADVANCE OF
INVOICE DUE DATE
CV PENDING CONVERSION ON
POLICY
PC PENDING CONVERSION ON
PAID AHEAD POLICY
EC – EVENT CODES
T EMPLOYMENT TERMINATED (BILL AT HOME)
C CANCEL AT REQUEST OF EMPLOYEE
D EMPLOYEE DECEASED
L LEAVE WITHOUT PAY (NO DEDUCTION)
N FIRST MISSED DEDUCTION
F FAMILY MEDICAL LEAVE
R RETIRED
0 OTHER (EXPLANATION ATTACHED)
11
ONLINE SERVICES/ONLINE BILLING
In addition to Express Reconciliation, Aflac has provided you with the ability to manage your account
online, including submitting payments. To use the Online Services option, Aflac requires you to
register your account online. Conducting business online is fast and easy! Additional information about
our Online Services/Online Billing feature can be found by visiting aflac.com or by calling us toll-free
at 1-800-99-AFLAC (1-800-992-3522).
EXPRESS RECONCILIATION
Aflac has the ability to accept your premium deduction information electronically! To use the Express
Reconciliation option, Aflac requires you to send a data file consisting of your participating employees’
deduction information for a given billing period. Additional information about Express Reconciliation
can be found by visiting aflac.com or by calling us toll-free at 1-800-99-AFLAC (1-800-992-3522).
PAY BY PRINTOUT
Aflac can also accept your payroll deduction information via printout. To utilize this process, Aflac
requires that you send a deduction report consisting of your participating employees’ deduction
information for a given billing period, a check for the amount listed, and a list of employees who have
terminated employment or canceled coverage. It’s as simple as printing the payroll deduction
information sheet, preparing a check for the amount on the printout, attaching the bottom portion of the
Aflac premium statement, and sending all documents to Aflac Worldwide Headquarters.
Alternative Methods to Reconcile your
Aflac Invoice
12
Benefit Services provides our Section 125 Cafeteria Plan service. A cafeteria plan is an employee
benefits plan that allows employees to pay their share of the cost of benefits on a pre-tax basis.
Since not all employees require the same level of coverage, employees are allowed to choose
qualified benefits that best suit their needs. By doing this, employees redirect a portion of their
salaries to cover eligible benefit costs, which ultimately saves money for the employees and
decreases the overall taxable payroll for the employer. The amount saved by choosing this method
will vary for each participant depending on family status, deductions, tax rates, and actual premium
amounts. We also provide other services, including the following:
Transit Plan Services
This is our Section 132 service. Similar to a Section 125 plan, this service allows tax-saving of
transportation benefits for employees who incur parking expenses at or near their place of work
and/or transit expenses for transportation on a bus, subway, train or ferry while commuting to work.
To enroll, employees must submit a Transit Plan Document Request, which can be obtained
through the Aflac Web site or by calling 1-800-323-5391.
Single-Point Billing Services
Single-point billing (SPB) helps to relieve an employer of complex and costly administrative
functions. It involves the consolidation of multiple benefit products from multiple providers onto a
single statement. SPB helps employers add new benefits if they have limited or no additional slots
in their current payroll system or feel that the addition of new benefits is more work for their staff.
This service is offered in conjunction with Aflac insurance products through an alliance partner.
COBRA Services
COBRA is a federal law giving former employees and their families the right to temporarily
continue health coverage under certain circumstances. Employers with 20 or more full- or part-time
employees are required to comply with COBRA. The tasks involved with compliance can be
tedious and manually extensive, and the penalties for noncompliance can be severe. Employers can
shift the liability and burden, allowing them to refocus on their core business functions by using this
service through an Aflac alliance partner.
Customer Service
Customer Service is available to plan administrators and participants through our toll-free number
1-800-323-5391, Monday through Friday from 8 a.m. to 7 p.m. Eastern Time. Benefit Services also
has an IVR system which is available to participants and accounts 24 hours a day, 7 days a week at
1-877-353-9487.
Toll-Free FSA Claims Fax Number
Request for Reimbursement forms for flexible spending accounts can now be faxed toll-free to
Aflac Benefit Services at 1-877-353-9256.
Benefit Services/Flex One
®
Overview
13
The mission of the Aflac Claims department is to fulfill the promises of our policy contracts during
a claimant’s time of need. We strive to instill the values of commitment, integrity, and compassion
in our employees as we teach them the Aflac Claims philosophy. We value all our policyholders
and are dedicated to providing them with the excellent claims service they expect and deserve.
2008 Statistics
• Aflac processed 7.1 million claims in 2008
• Aflac paid $1.8 billion of benefits in 2008
Features
• Toll-free Claims fax (1-877-442-3522)
• Paperless processing
• Overnight claims processing capability
• 350 plus employees dedicated to processing our policyholders’ claims
Claims forms and filing instructions, specific to your state and plan, are available through
Aflac’s online Policyholder Services.
To access policy and claim information:
• Go to aflac.com.
• Click on Policyholders.
• Click on Policyholder Services.
• Enter required information and log in today.
If you or your employees have questions about filing a claim, please contact your associate or Aflac
Worldwide Headquarters at 1-800-99-AFLAC (1-800-992-3522).
Claims Overview
14
How do I remove an employee from our company’s invoice?
The codes at the bottom of the Aflac invoice are used to remove an employee. The codes indicate
different reasons for the removal (e.g., T=Terminated, D=Deceased, R=Retired). Draw a line
through the policy(s) and policyholder’s name to be removed, and place the appropriate code in
the adjacent column. Since all Aflac policyholders have the option of continuing their coverage on
a direct basis, also complete the employee information section located on the back of the
remittance page to make sure we have the employee’s correct address. For those accounts that
submit invoice changes via Aflac's Web site, the reason codes listed above are available for use
and are required for all policyholders for whom payment will not be remitted.
In addition to making your changes on the invoice, you may also fax your request directly to us at
1-706-596-3100 or contact us through Aflac’s Web site, aflac.com. Simply select the Manage
Accounts option and then the Online Services option to request changes to an invoice.
Policyholders may also change information on individual policies by requesting a Change Form
(H-L0046) from the servicing associate. You may also contact your associate to complete this form
through our SmartApp
®
system.
How do I request a duplicate copy of my invoice?
You may request a duplicate copy of your invoice by calling 1-800-99-AFLAC (1-800-992-3522),
by faxing a request to 1-706-596-3100, or by contacting us through Aflac’s Web site, aflac.com.
Select the Manage Accounts option and then the Online Services option to complete the online
request for a duplicate invoice.
When should I start deductions and how do I know how much to deduct?
To be sure that you are able to remit the full amount due, please begin deductions at least one month
before the due date of your first invoice. Your associate/agent can provide you with your invoice due
date and will give you premium deduction authorization forms (PDA forms) or a premium
spreadsheet for your records. This information provides you with the individual amounts to be
deducted from each employee’s paycheck based on the frequency of the deductions. For example,
if you deduct premiums 26 times a year, a biweekly amount is listed on the PDA form.
Frequently Asked Questions
15
Why are requested changes not shown on the next invoice?
Often, the next month’s invoice has been prepared before we receive the requested change;
therefore, the change is not shown. It is important to notify us immediately when employee changes
occur. You can contact us through Aflac’s Web site, aflac.com, or fax the employee changes to us
at 1-706-596-3100. Simply select the Manage Accounts option and then the Online Services option
to notify Aflac of these changes. However, please notate any adjustments on the invoice you are
currently paying.
May I pay invoices out of sequence?
No, it is not advisable to pay invoices out of sequence. Aflac encourages all customers to pay their
invoices in order of receipt. For example, if you have a May and a June invoice due, you need to
the pay the May invoice before paying the June invoice. If you are paying both invoices with one
payment, please write this information on the remittance document and check stub.
What if I don’t pay the invoice on time?
To be sure that your employees’ coverage is not interrupted, submitting payment by the due date
listed on your invoice is important. If payment is not received within ten days of the invoice due date,
we will send you a reminder notice. If payment isn’t received within 25 days of the due date, we will
send you a second reminder notice. If payment isn’t received after 40 days, we will discontinue billing
your account and will send letters to policyholders offering them the opportunity to continue their
coverage through direct billing.
Will my company’s employees be notified if our account lapses?
Yes, your employees receive letters from Aflac indicating that the payroll account has lapsed due
to nonpayment. Your company’s employees are then provided the option to continue coverage on a
direct-billed basis.
Your employees also have the option of continuing select Aflac coverage on a direct-billed basis if
the employee is no longer employed at the account or if coverage has been canceled for this
employee by the account.
How will Aflac contact me if I’ve requested information or changes to my account?
Aflac contacts you in writing about status changes, premium questions, overage/shortages of
premiums, etc. The most important thing to remember about correspondence received from Aflac
is to review it thoroughly and follow any instructions provided. If you have any questions, please
call us at toll-free at 1-800-99-AFLAC (1-800-992-3522).
How do I receive a refund for premiums remitted for a terminated employee?
To receive a refund, attach a request to your next invoice, including the effective date of
termination as well as all applicable policy numbers, or contact us through Aflac’s Web site at
aflac.com. Simply select the Manage Accounts option and then the Online Services option to notify
Aflac of your request.
If an employee leaves employment during a deduction period, reimburse the employee for the
amount deducted; Aflac cannot accept partial payments. You may also request a refund for
premiums remitted for a terminated employee by faxing a request to 1-706-596-3100.
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The following is a brief description of correspondence you may receive from Aflac about late
payments and/or employee missed deductions.
Late Pay Letter
Ten days past the invoice due date, Aflac will send you a friendly reminder that your invoice
payment is past due and will request payment. Action is required as soon as possible to avoid any
unnecessary notification to your employees. Your servicing associate will receive a courtesy
copy.
Lapse-Pending Letter
Twenty-five days past the invoice due date, Aflac will send notification that your invoice is past
due and that your account is in a lapse-pending status. Your servicing associate will receive a
courtesy copy.
Account Lapsed Notification Letter
Forty days past the invoice due date, Aflac will send notification that your account has lapsed.
Your employees will be contacted and offered continuation of coverage on direct basis.
Unexplained Missed Deduction Letter With Report
You will receive this letter/report when an invoice payment has been processed and there is an
employee(s) for whom payment was not remitted and no explanation was provided
• Section A – New policyholder’s first missed deduction with no explanation
• Section B – New policyholder’s second consecutive missed deduction with no
explanation
Note: All policyholders appearing on section B of the report will be removed from
future invoices and notification of policy termination will be mailed to the policyholder.
• Section C – Existing policyholder’s missed deduction with no explanation
Note: All policyholders appearing on section C of the report will be removed from
future invoices to you account. However, if the payment for those identified was
omitted in error and both the missed and current payments are received with your next
invoice payment, the policy will be added back to your account and will continue to
appear on future invoices received from Aflac.
Note: To avoid unnecessary notification to your employees,
call us at 1-800-99-AFLAC (1-800-992-3522)
or fax us at 1-706-596-3100
with explanations for all employee missed deductions listed on this report.
Account Correspondence
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The following is a brief description of correspondence your employees may receive from Aflac.
New Policyholder First Notification Letter
This letter will be sent to the policyholder/employee ten days after the Unexplained Missed
Deduction Letter With Report is sent to you. This letter advises the policyholder/employee to
contact his or her payroll administrator to ensure deductions have started and to request that the
missed premium payment and the current premium payment be remitted with the next invoice.
New Policyholder Second Notification Letter
This letter will be sent to the policyholder/employee ten days after the Unexplained Missed
Deduction Letter With Report is sent to you. This letter advises the policyholder/employee that
Aflac did not receive required premium from the employer as requested in our previous letter
and advises him or her that the policy has terminated and the termination effective date.
Note: Employee will be removed from future billings at this time.
Existing Policy First Notification Letter
This letter will be sent to the policyholder/employee ten days after the Unexplained Missed
Deduction Letter With Report is sent to you. This letter will advise the policyholder/employee of
the missed payment and will request the premium payment needed to continue coverage if
premiums are no longer being payroll deducted. This letter serves as a conservation attempt and
if the premium payment requested is received, Aflac will transfer the policy to direct bill. If
payment is not received within 15 days, a follow-up letter will be sent to the
policyholder/employee.
Note: Employee will be removed from future billings at this time.
Existing Policy Second Notification Letter
This letter will be sent to the policyholder/employee if a response is not received to the previous
letter. The letter will notify the policyholder/employee that the premium needed to keep the
coverage has not been received and will request the premium needed to continue the coverage. If
payment is not received within 16 days, the policy will terminate.
Note: If both the missed and current premium payments are received with your next invoice
payment for the policyholder, the policy will be added back to your account.
Policyholder/Employee
Correspondence
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Direct Bill Offer – Policyholder/Employee Requests Cancellation of Coverage
Letter
This letter will be sent to the policyholder/employee when Aflac is advised that the policyholder/
employee has elected to cancel Aflac coverage. This letter is used as a conservation attempt and
will offer the option to continue coverage on a direct basis.
Note: Employee will be removed from future billings at this time.
Direct Bill Offer – Policyholder/Employee Retired Letter
This letter will be sent to the policyholder/employee when Aflac is advised that the policyholder/
employee has retired from the account. This letter is used as a conservation attempt and will
offer the option to continue coverage on a direct basis.
Note: Employee will be removed from future billings at this time.
Direct Bill Offer – Policyholder/Employee Terminates Employment Letter
This letter will be sent to the policyholder/employee when Aflac is advised that the policyholder/
employee has terminated employment. This letter is used as a conservation attempt and will offer
the option to continue coverage on a direct basis.
Note: Employee will be removed from future billings at this time.
Direct Bill Offer – Policyholder/Employee on Leave of Absence Letter
This letter will be sent to the policyholder when Aflac is advised that the policyholder/employee
is on a leave of absence. This letter explains to the policyholder/employee how to remit
premiums to Aflac while on leave. The policyholder/employee will be removed from your
invoice until he/she returns to work unless premiums are remitted with the invoice payment.
Direct Bill Offer – Account Lapsed/Cancels Letter
This letter is mailed to the policyholder/employee providing the opportunity to continue
coverage on a direct basis if your account cancels coverage with Aflac or if coverage lapses due
to nonpayment of outstanding invoices. This letter is used as a conservation attempt and will
offer the option to continue coverage on a direct basis.
Direct Bill Offer – Follow-Up Letter
This letter is mailed to the policyholder/employee providing a second opportunity to continue
coverage on a direct bill basis if a response is not received to the first offer.
