Aflacresource PDF
Aflacresource PDF
Aflacresource PDF
Resource Guide
For Informational and Training Purposes Only. These materials contain proprietary information and
material that is owned by Aflac and/or its licensors, and is protected by applicable intellectual
property and other laws, including but not limited to copyright. By accessing these materials, you
agree that you will not use such proprietary information or materials in any way whatsoever except
for informative and training purposes only. You further agree not to modify, loan, sell, distribute, or
create derivative works based on these materials. Any use not specifically permitted herein shall be
considered to be a material breach of your Agent's contract with Aflac and is strictly prohibited. Any
use not specifically permitted herein is strictly prohibited and may subject you to civil and criminal
penalties. Aflac herein refers to American Family Life Assurance Company of Columbus and/or
American Family Life Assurance Company of New York.
This is a brief product overview only. Coverage may not be available in all states. Benefits/premium
rates may vary based on plan selected. Optional riders are available at an additional cost. The policy
has limitations and exclusions that may affect benefits payable. Please refer to FFS for state specific
availability and limitations and exclusions.
Prospective Agents
Beginning January 1, 2019, prospective agents must complete comprehensive training that requires
successful completion of the training program prior to having access to the Company’s systems and
materials for soliciting the Company’s insurance products. The minimum passing score is 90%. If a
prospective agent fails to achieve a passing score in three attempts, or does not attempt testing,
during the 20-day test window, the prospective agent will not be contracted and will be ineligible to
reapply to contract with Aflac for 12 months.
Existing Agents
Beginning January 1, 2019 , existing agents will receive communication describing the training
requirement and the window for completion. Existing agents will have 60 days to complete the
training requirement. The minimum passing score is 90%. If an agent fails to achieve a passing
score in three attempts, or does not attempt testing, during the 60-day period, termination
procedures will commence. Once terminated, an agent will be ineligible to re-contract for 90 days.
Beginning January 1, 2019, terminated agents who wish to re-contract must complete
comprehensive training that requires successful completion of the training program prior to having
access to the Company’s systems and materials for soliciting the Company’s insurance products.
The minimum passing score is 90%. If the terminated agent fails to achieve a passing score in three
attempts, or does not attempt testing, during the 20-day test window, the terminated agent will not
be contracted and will be ineligible to reapply to contract with Aflac for 12 months.
What’s Inside?
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When Paul, John, and Bill Amos founded Aflac in 1955, they knew that they were selling a
promise. That promise is summed up in Aflac's brand statement:
“We help provide our policyholders with peace of mind that comes from knowing they can be
prepared for whatever life may bring.”
Keeping this promise, providing caring, personal service to our customers every day doesn't just
happen. It takes work.
We have many great examples to follow. The Amos brothers set the first example. They made
promises to everyone who bought Aflac's products, and when life threw those people a curve,
they kept those promises right away. It's the way Aflac began. It's how we operate today.
Living up to the commitments we make to our customers, to our fellow agents and coordinators,
to Aflac employees, and to all the people who rely on Aflac is just the way we work. This is The
Aflac Way.
Communicate regularly
Respond immediately
Know your stuff
Treat everyone with respect and care
Your problem is my problem
Shoot straight
Cover the customer, not your behind
Securing and servicing accounts in an ethical, professional manner protects the Aflac brand, the
agent, and the consumer. Resources to assist the agent in ethical servicing of accounts is available
on Field Force Services. They include:
In the midst of unexpected or undesirable circumstances, Aflac agents are expected to conduct
themselves professionally.
Preparation
If a phone call to the Customer Service Center, or CSC, is necessary, have all materials available
and research completed so the CSC team can focus immediately on the challenge. Advance review
of the circumstance by agents – coupled with good probing and questioning skills by the CSC team
– will allow for prompt validation and correct action to resolve the challenge.
Conduct
In interactions with all Aflac staff, choose language and behavior that avoids abusive words
(cursing), belittling comments (personally derogatory), yelling and bullying (demanding answers/
actions). Please know that there is never a circumstance that would warrant such negativity, so
Aflac staff are authorized to end their phone call with someone engaging in any of these behaviors
after being asked to discontinue them. We should be dedicated to the success of one another.
Harassment
Harassing behavior can take many forms, including verbal abuse and intimidating behavior. Sexual
harassment includes harassing conduct of a sexual nature, including unwelcome, unsolicited and
discriminatory sexual advances. Regardless of the form harassment takes, it will not be tolerated.
Conflict of Interest
During the sale of insurance coverage, if a situation arises in which an agent’s self-interest
interferes with their obligation to act in the best interests of a customer, it is called a conflict
of interest.
Individuals representing Aflac cannot participate in any portion of the sales process, including
soliciting and negotiating, until they’re appropriately licensed and appointed.
The Aflac Agent is responsible for:
Obtaining and maintaining required license(s)
Paying applicable state fees
Requesting and obtaining appointments from Aflac prior to soliciting any business
To request an appointment, the agent must submit a copy his/her license to Field Contracting:
via email at [email protected] or
via fax at 706-660-7533
Sending a copy of their license(s) in order to be appointed in non-resident states
Maintaining state licensing requirements by complying with state and federal laws and through
state-certified continuing education programs
Maintaining Errors and Omissions insurance coverage to help protect you in the event you are
sued for malpractice
To receive any commissions, an agent from sales must be licensed and appointed as of the date
applications are signed, even if they are not selling in that state.
As an Aflac Agent, you'll gain access to many robust compensation opportunities including
the following:
First year commissions
Renewals compensation
Stock bonus opportunities
Incentives and bonuses-including contests like Aflac Builder's Club (ABC)
Aflac's Field Oversight Enforcement Committee (FOEC) meets on a regular basis to review all agent
misconduct and fraud. The FOEC takes disciplinary action up to and including termination.
For example, if someone who is not licensed or not appointed signs or submits an application, Aflac
won’t process the business, the individual will not earn commission, and the individual will be subject
to review by Aflac’s Field Oversight Enforcement Committee (FOEC). One of the FOEC’s
responsibilities is to review cases of reported fraud and take disciplinary action.
Incentive Programs
Contest Manipulation
Contests are designed to reward you for product sales, recruiting, and persistency. Agents must act
according to Aflac’s ethical standards. Aflac has a zero tolerance policy regarding contest
manipulation. Failing to comply with state regulations or circumventing company policy to qualify for
a contest is contest manipulation, and it’s strictly prohibited. Contest manipulation will result in
chargebacks and will result in disciplinary action up to and including termination.
Qualifying for a contest can be difficult, but commissions are simple: you only get yours. Borrowing
and lending are not allowed! In other words, splitting commissions for contest qualification is not
allowed.
Contest Chargebacks
If Aflac discovers an agent or coordinator won a contest or reward based on invalid business, we’ll
charge the agent for the amount of the contest winnings, as well as charge back their hierarchy.
Chargebacks apply to all contests to include WWHQ and field-run contests.
Contest Tracking
These records must be available to Aflac and state regulators for three years:
Contest time frame
Qualification criteria (i.e., AP, accounts,
productive recruits, etc.)
Monetary value of each prize awarded
This is fraud!
Training Offerings
To help you be successful as an Aflac agent, Aflac offers New Associate
Flight School (NAFS), training on our enrollment and benefit administration
platform, Everwell™, additional product training, and more.
To access the first two modules of NAFS, Everwell, product and other
training, visit Academy Connect. Additionally, you’ll find resources you may
need to get started selling our Aflac products on Field Force Services.
Continuing Education
As an Aflac agent you are responsible for continuing education that is
required by some jurisdictions.
Twisting
Twisting refers to using misleading
information about the benefits of a
customer’s existing policy with
another carrier to get the customer to
surrender that policy and buy Aflac
coverage. The intent is to generate first
year commissions.
Churning
Churning refers to using misleading
information to get a customer to replace
an existing Aflac policy with another Aflac
policy. The primary goal is to increase
commissions or sales.
Policy Administration
Altering any forms or policy request after the
insured has signed
Providing any commission as a rebate or
inducement to a policyholder
Collecting any premiums (other than
the initial premium on direct) without
specific written authorization from Aflac
Worldwide Headquarters
Claims Administration
Withholding/not disclosing relevant
documentation or information related to
a claim
Cashing claim checks. Includes providing
cash in exchange for the check as well
as presenting the check for cash at a
financial institution
Failure to forward claims documentation
the same day of receipt. Field office workers
who receive claims filing information must
forward to WWHQ the same day of receipt
General Administration
Failing to comply with applicable federal
and state insurance laws and regulations
Use of Aflac protected information,
proprietary information, logos, etc.,
without prior approval
Failure to cooperate with an investigation or
inquiry from Aflac’s Special Investigation Unit
as stated in the Agent’s Agreement
Agents need to explain a Suitability Notice to potential policyholders in all US states and territories.
The existing requirements for Minnesota, Missouri, and Idaho remain in effect.
The form itself is short but must be signed by the proposed policyholder after the agent has
explained the form and had a brief discussion about it. In their conversation, the agent must ensure
the customer understands the impact of the premium on his or her paycheck or income. The agent
also needs to ensure that the customer believes the impact that the total Aflac premium for this
coverage and any other Aflac coverage has on his or her or their paycheck/income is appropriate.
The agent will ensure that the customer believes his or her existing health insurance coverage, with
Aflac and/or with other carriers, is suitable. Finally, the agent will let the proposed insured know that
s/he can contact Aflac and/or other insurance carriers to assist her/him in evaluating the suitability
of insurance coverage.
Remember, selling policies that the customer cannot afford, doesn't want, or doesn't need is a
Prohibited Practice. Knowingly doing so will result in administrative action, up to and including
termination and possible fines.
Agents will receive notification via email when the new Suitability Notice is available. The notice will
also be on FFS.
Taking time to learn about a customer’s insurance needs and financial objectives and obligations
Using salary illustration to show the impact of premium payments on take home pay
When replacing a Life, Accident, Sickness, or Health Policy with another, specific rules and
regulations apply and may be state-specific. Specific requirements for replacement sales
(replacement of other carriers’ policies or moving policies between Aflac and Aflac Group) and
internal replacements (changing to a new Aflac policy or rider) vary by state and line of business.
Aflac agents must consult their state-specific administrative guidelines, which are on Field
Force Services.
Replacing Existing Life Insurance from Another Company
A Replacement Notice or Life Replacement Form must be completed if the applicant wishes to
replace his or her existing life insurance from another company with our policy. Known as form
A-4166, this is a two-part carbonless form that varies by state.
Replacing Existing Aflac Life Insurance
Please note, when submitting a life insurance application intended to replace any existing Aflac
Life insurance policy, you will need to include a Life Cancellation Request or signed request from
the policyholder to cancel the original coverage. The replacement form lets Aflac know the applicant
intends to replace the current coverage, but it does not give Aflac permission to cancel the
existing policy.
Duplicate coverage exists when two or more like policies or riders covering the same person are in
force simultaneously. Aflac policy language does not allow policyholders or their spouses to hold
duplicate coverage. Aflac’s New Business department analyzes applications to determine if an
applicant or spouse already has like coverage.
If existing like coverage is found, Aflac will not issue a new policy.
You can help determine if an applicant or spouse has like coverage. When talking with a potential
customer, ask the following questions:
Do you have any other insurance with Aflac?
Does anyone we covered have any other insurance with Aflac?
If the applicant answers yes, depending on the product, you can convert the coverage. Do not
submit a new application. If you do not convert the coverage, Aflac cannot issue the business.
Only individuals authorized by Aflac Worldwide Headquarters are permitted to discuss Aflac
or its products and materials with the media.
You are not permitted to discuss Aflac insurance products in your capacity as an Aflac sales
agent with any media including radio and television.
Aflac has specific policies concerning records retention and management. Once contracted,
Aflac agents must complete applications appropriately. This includes completing product
applications accurately and according to state requirements. Agents must ask applicants every
question and ensure that the applicant reads the documents in their entirety. This includes all
disclosure statements.
Regarding Complaints
There will always be opportunities for improvement. As such, customer or state insurance
department complaints may occur. Complaints are considered concerns of the policyholder,
beneficiary, applicant, insured, and/or the business owner. Customers may send complaints
verbally or by mail, phone, fax, as well as through social media. If an agent receives a complaint
directly, they must promptly notify Aflac Worldwide Headquarters. The Aflac Trust may be involved
after intake by the complaint area if agent misconduct is alleged.
If an agent receives an agent related complaint directly, they must promptly notify the Aflac Trust
using one of the methods on page 28 of this guide.
Some states, such as Idaho, Minnes ota, and Missouri have taken a strong position
against value-added s ervic es. Value -added s ervic es may be perc eived as gifts, which
are prohibited in s ome states. It is a Prohibited Practic e to as k a customer to travel to
another state to obtain a value-added s ervic e not available in their state. Value -added
services may not be us ed as an induc ement to purchas e insuranc e. In addition, it is a
Prohibited Practic e to us e value -added s ervic es as an induc ement to move from
individual to group or vic e vers a.
As an Aflac agent, you'll learn more about Value -Added Services as you c omplete
the curriculum on Ac ademy Connect. Agents must know and comply with the regulations
in their states. Chec k with your Market Trainer or the Market Conduct team if you
have questions.
Value-Added Services are non-insurance items or services with the exception of AD&D.
Value-Added Services Disclaimer: The value-added services that are the subject of this training course and made available on Everwell are offered by
multiple providers. Aflac’s affiliation with the value-added service providers is limited only to a marketing alliance. Other than this marketing alliance,
Aflac and the value-added service providers are not affiliated in any way. Aflac makes no representations or warranties regarding the value-added
service providers, and is not responsible for any of the products or services provided by the value -added service providers. The value-added services
may not be available in all states, and benefits may vary by state. Each value-added service provider offers its products and services subject to its
own terms, limitations and exclusions. Refer to plan details in Everwell™ for further information on terms, limitations and exclusions.
The Departments of Insurance and the States strictly regulate laws concerning gifts. Make sure you
get prior approval from your Market Conduct team before offering or providing any item or service
that may be considered a gift. Market Conduct approvals must be submitted with reimbursement
requests. All pre-approval requests should be submitted BEFORE items are purchased or given
away and before reimbursement is submitted. Submit approval requests to:
Individual: [email protected]
Group: [email protected]
The request should include:
The state
Proposed gift, cost/value of the gift
Manner in which the gift is to be presented
Where the gift will be distributed
Once you receive compliance approval, you may proceed with your purchase. Your reimbursement
must be submitted to treasury and travel within six (6) days of gift purchase. Please include a copy
of the Compliance Approval, your writing number, if applicable, and any other pertinent information
required by the treasury and travel department.
Advertising Compliance is Aflac’s regulatory entity created to ensure that all of Aflac’s advertising,
and all advertising done by agents and brokers on behalf of Aflac, is compliant with laws and
regulations governing the sale and marketing of insurance. Advertising Compliance helps protect
Aflac's marketing initiatives and brand identity from fines and violations levied by state departments
of insurance (DOIs).
Additionally, Aflac agents are asked to assist in our compliance effort through periodic audits of
practices. Findings and recommendations are shared with Aflac‘s compliance officers for action.
Regulatory Inquiries
If an Aflac agent is contacted, visited, questioned, or detained by any state, local, or federal agency,
s/he must immediately contact The Aflac Trust via one of the following methods:
Phone- 800-578-3107
Fax- 706-660-7159
Email- [email protected]
Address- P.O. Box 5288, Columbus, GA 31999
When a market conduct examination is implemented, Aflac requires complete cooperation with
Market Conduct examiners.
The consequences of committing fraud can range from a warning, suspension, and demotion, to
contract termination. Aflac will charge back bonuses, advanced commissions, contests, awards, and
prizes that were granted based on fraudulent business. If Aflac discovers an agent or coordinator
won a contest or award based on invalid business, Aflac will charge the agent for the amount of the
contest winnings, as well as charge back their hierarchy. Chargebacks apply to all contests to
include WWHQ and field-run contests. In addition, Aflac may terminate commissions and report the
fraud to the appropriate department(s) of insurance, which could lead to fines and insurance license
revocation, and reporting to state and/or federal authorities, which could lead to prosecution.
If you provide false or misleading statements to Aflac regarding your insurance sales activity or
knowingly allow false or misleading statements on a customer's application for coverage or claim
form, your contract may be suspended or terminated.
Aflac expects members of its field force to conduct business with the highest level of honesty,
integrity, and fairness. By doing so, you will establish and maintain a firm foundation for a successful
career with Aflac.
Know and avoid Prohibited Practices which include acts that violate procedures, industry codes,
branding, or security.
Consider this example of bogus business: An agent was accused of creating “bogus business.” An
anonymous caller reported an agent had used names from obituaries to open false accounts. After
investigation, the agent was terminated for cause and reported to the Department of Insurance.
To prevent HIPAA violations, always verify three pieces of information (i.e. name, address, phone
number) for each claim filing or upload to ensure correct policy information. Also, be sure to close
your internet browser after each SmartClaim® submission.
HIPAA established health care fraud as a federal criminal offense. Many people believe health care
fraud is a victimless crime, but insurance companies pay the price and are ultimately forced to share
the cost with consumers. Health care fraud may lead to higher premiums and out-of-pocket
expenses, reduced benefits and coverage.
It's important to educate yourself about the Health Care Landscape in order to prevent fraudulent
activity. The changing health care landscape is a complex issue in the insurance industry. Aflac has
a number of resources to support agents and business owners. Use the material on:
The Health Care Reform page under the Business Insights tab on Field Force Services to help
your clients and to educate yourself on many health care reform topics
Aflac.com/health-care-reform to refer clients to an employer’s guide, videos, employee
communications, and more
Aflac
Aflac’s position regarding fraudulent
activity includes the following:
Aflac will take appropriate action,
up to and including the
termination of your agreement
Termination of commissions
(first-year and renewals)
Reporting of the fraud to the
department of insurance (may
lead to revocation of license and
substantial fines)
Repayment of losses incurred
by Aflac
Prosecution by federal and/or
state authorities
The Department of
Insurance (DOI)
If the DOI has found an agent/
producer has engaged in fraudulent
activity, an agent/producer may be
subject to any or all of the following:
• Revocation of license
• Cease and Desist order
• Penalties/fines
• Probation
• Any other action deemed
appropriate by a state
Effective Date
The date(s) coverage begins as shown in the policy schedule or any attached endorsements or
riders. The effective date is not the date you signed the application for coverage.
Elimination Period
The number of consecutive days at the beginning of the insured’s period of disability for which no
benefits are payable. See the policy schedule for the elimination period selected. Each new
benefit period is subject to a new elimination period.
Benefit Period
The maximum number of days after the elimination period, if any, for which the insured can be
paid benefits for any one or successive periods of disability.
Waiting Period
Benefits are not payable for any illness, disease, or disorder that is diagnosed by a physician or
medically treated before coverage has been in force the specified period of time from the
effective date as shown in the policy schedule.
Dependents
In most states, children up to 26 years of age may be covered under Aflac policies.
Free Look Period
Refers to the period of time when many states allow new customers time to decide whether or
not to accept an insurance policy as issued.
KEY POINTS:
Aflac Accident plans provide a wide range of benefits to
assist with expenses associated with an injury, such as
emergency treatment, hospital, ICU, appliances, medical
exams, follow-up visits, and therapy. Beyond medical
expenses, Aflac Accident plans may provide benefits for
transportation, lodging, and accidental death.
Aflac Accident plans are designed to provide
policyholders with benefits throughout the different
stages of care. Policyholders can submit accident claim
forms along the way, such as claims for emergency
treatment, hospitalization, follow-up visits, and therapy.
The policy belongs to the consumer and is guaranteed-
renewable. Individual Aflac policies are individually
owned and portable.
There are no deductibles, copayments, or coinsurance
requirements. There are also no network restrictions.
Policyholders have the freedom to choose their medical
treatment provider. Aflac pays regardless of other
insurance as there is no coordination of benefits with
other insurance policies.
Keep in mind that benefits, limitations and exclusions
vary by state.
Moving Forward with Aflac 42
Aflac’s Individual Short-Term
Disability Plans
KEY POINTS:
Aflac provides disability benefits upon the validation of a
policyholder's disability that is the direct result of a covered sickness
or injury, while their policy is in force. Disability due to normal
pregnancy or childbirth is paid as a sickness. Pregnancy benefits are
payable after a policy has been in effect for greater than ten months.
Disability benefits are paid for only one disability at a time.
Additionally, a Short-Term Disability policyholder will no longer
receive total disability benefits when s/he is released by his/her
physician to perform the material and substantial duties of his/her
current full-time job, or s/he begins to work at any job.
Keep in mind that benefits, limitations and exclusions vary by state.
KEY POINTS:
In most states, Cancer coverage from Aflac can provide benefits not only for treatment, but also for
wellness visits.
Aflac Cancer plans have Wellness and Initial Diagnosis Benefits built into the base plan for all plan
options. Wellness benefits are not available in some states.
Aflac Cancer plans offer benefits that are not common among all providers, thus giving more choices
in coverage and care. Some benefits include the National Cancer Institute Benefit, Bone Marrow
Donor Screening Benefit, and Initial Diagnosis and Hospitalization Benefits for children.
Cancer coverage from Aflac pays for treatment of cancer and associated cancerous conditions,
including direct extension, metastatic spread, or recurrence.
Aflac Cancer plans are offered to individuals at a wider age band; whereas, many other providers tend
to limit new sales after age 70. Aflac policies are individually owned and portable, which means if the
policyholder purchased the Cancer policy, they are able to keep the policy inforce even if they leave
that employer.
Aflac's Cancer coverage excludes premalignant conditions.
Keep in mind that benefits, limitations and exclusions vary by state.
Moving Forward with Aflac 45
Aflac’s Individual Hospital
Indemnity Plans
KEY POINTS:
Aflac's Hospital Indemnity Plan is customizable. It has
optional riders that allow policyholders to create a unique
plan specific to their needs.
It offers a health savings account (HSA) compatible option.
Aflac's Hospital Indemnity base policy is eligible for pre-tax
deduction under the Internal Revenue Code Section 125.
Aflac individual policies are individually owned and portable.
Policyholders are able to keep the policy in force even if
they leave their employer.
Not all products and services are available in all states.
Please refer to FFS for state specific availability.
KEY POINTS:
Aflac's Lump Sum Critical Illness is available to all applicants
guaranteed-issue at $10,000, meaning no underwriting is
required to obtain coverage. Amounts in excess of $10,000
must be approved through the WWHQ special exceptions
requests process.
Aflac's Lump Sum Critical Illness is HSA compatible and
guaranteed-renewable. The benefits are payable as a lump
sum, once per person, per lifetime, excluding subsequent
event coverage. There are no deductibles, copayments, or
network restrictions. In addition, a cancer coverage rider is
available with Aflac's Lump Sum Critical Illness. Some critical
care plans include a waiver of premium; Aflac's Lump Sum
Critical Illness does not.
KEY POINTS:
Aflac's Specified Health Event plans do not require annual deductibles.
There are three options (Base, Base + ICU, Base + ICU + Heart) and two riders (First Occurrence
Benefit Rider, Specified Health Event Recovery Rider) available, allowing the customer to choose
the coverage that best fits their needs.
The policy offers an increased first benefit for children.
To be eligible for the paralysis benefit, paralysis must be continuous.
1 - United States Renal Data System. 2017 USRDS annual data report: Epidemiology of kidney disease in the United States. Nationa l Institutes of
Health, National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD, 2017.
Aflac's Dental plan was created for employers who do not currently have dental insurance. Aflac
dental coverage offers a wide variety of benefits that include, but are not limited to:
Wellness exams (Dental Wellness Benefit)
X-rays
Fillings
Pain management
Oral surgery
Gum treatment
Prosthetic repair/services
Crowns
Aflac’s Dental plan does not have network restrictions and policyholders can visit any dentist they
choose. The plan has no pre-certification requirements, meaning if the policy covers the treatment,
policyholders do not have to receive Aflac's permission to receive it.
Individual Dental coverage from Aflac may be appropriate for a customer because coverage is
individually owned and guaranteed-renewable, there is no provider network, and the product line is
based on a table of allowance concept.
Aflac Dental plan's Wellness Benefit is payable for any covered person for one listed treatment
per visit.
The plan does not require underwriting and the plan also offers no annual deductible. Instead of
having to meet a deductible each and every year, Aflac only requires policyholders to meet waiting
periods once; however, if the policy lapses and is reinstated, all waiting periods start over.
In addition, in most states, Aflac's Family Dental coverage provides coverage for dependents
who are under 26 years of age, allowing families to cover their children until they get coverage
for themselves.
KEY POINTS:
Aflac's Dental coverage waiting period is defined as the period after the effective date of coverage
for which benefits are not payable.
Aflac's dental policy includes two optional riders: the Orthodontic Benefit rider and the Cosmetic
Benefit rider. The Cosmetic Benefit is payable on an after-tax basis only.
Aflac’s individual policies are individually owned and portable, which means if the policyholder
purchased the Dental policy through payroll deduction at his/her employer, they are able to keep
the policy in force even if they leave that employer.
Vision Now coverage from Aflac may be appropriate for a customer because there are no network
restrictions and it goes beyond the traditional exams and materials, and provides benefits for
serious eye conditions. In addition to an exam benefit and a choice of materials benefits, Aflac will
pay for specific eye diseases and disorders, eye surgeries, and permanent visual impairment, all
without network restrictions. Eye exams are not subject to a waiting period, meaning eye exams
are payable during the first 30 days of coverage. The vision policy is guaranteed -renewable for the
policyholder’s lifetime.
Vision coverage from Aflac is designed to provide five main vision benefits. They are:
Eye Examination Benefit
Vision Correction Benefit
Specific Eye Diseases/Disorders Benefit
Eye Surgery Benefit
Permanent Visual Impairment Benefit
For you, the Aflac agent, there is no competition! While employers may have a choice of insurers
for short-term disability, cancer, or hospital confinement indemnity insurance, Vision Now is
available only from Aflac.
The Specific Eye Diseases/Disorders Benefit is payable once per covered disease or disorder, per
covered person and will be paid in addition to any other benefit in the policy. This benefit pays
when a covered person is first diagnosed after the effective date by an ophthalmologist or
physician as having any of the following:
Glaucoma (excluding preglaucoma and/or borderline glaucoma)
Proliferative diabetic retinopathy
Retinal detachment
Retinitis pigmentosa
Macular degeneration
The Eye Examination Benefit pays for an eye examination performed by an optometrist
or ophthalmologist.
The Vision Correction Benefit is paid when a charge is incurred for vision correction materials or for
refractive error correction surgery. As a note, vision correction materials, such as frames and
lenses, are materials prescribed by an optometrist or ophthalmologist and are used for the ongoing
correction of refractive error. Glasses not prescribed by an optometrist or ophthalmologist, such as
over-the-counter reading glasses, are not eligible for the Vision Correction Materials Benefit.
LIMITATIONS AND
EXCLUSIONS:
This policy does not cover:
Services that are not recommended
by an optometrist, ophthalmologist, or
a physician
Cosmetic surgery that is not due to
eye disease, disorder, or injury
Treatment or diagnosis received
while outside the territorial limits of
the United States or, if outside the
United States, outside the territorial
limits of the place where the policy
was issued
Intentionally self-inflicting bodily
injury or attempting suicide, while
sane or insane
KEY POINTS:
Traditional vision insurance covers only exams
and materials, and in some cases, a small
discount on laser surgery. Vision Now takes
vision insurance to the next level by paying
benefits for eye surgeries, specific diseases,
and permanent visual impairment.
Eye exams are payable in the first 30 days of
coverage.
Vision coverage key points include the
following:
No provider network
Policyholders have the freedom to choose
any eye-care provider
Comprehensive benefits
Types of providers:
An ophthalmologist is a licensed physician
specializing in diagnosis, care, and treatment
of refractive, medical, and surgical problems
related to eye diseases and disorders.
An optometrist, on the other hand, is a licensed
doctor of optometry who specializes in vision
problems; treating vision conditions with
spectacles, contact lenses, low-vision aids, and
vision therapy; and prescribing medications for
certain eye diseases and disorders.
A physician is a legally qualified person who is
licensed as a physician by the state to treat the
type of condition for a claim.
As a reminder, the provider, whether an
ophthalmologist, optometrist or physician, may
not be a member of the policyholder’s
immediate family.
Aflac is committed to providing coverage to meet each policyholder’s individual needs. Overselling is
a Prohibited Practice and is not tolerated at Aflac. Agents must be diligent in offering products and
levels that are suitable for an applicant’s financial situation. Ensure applicants understand the total
premiums for their purchases and the impact on their income.
Don’t encourage applicants to purchase products if:
• They’ve said they can’t afford it
• You know it will not be suitable for their financial situation
• They know they’ll likely have to discontinue it due to cost
KEY POINTS:
The policy can be purchased after-tax only
Policies can be transferred from payroll to
direct or direct to payroll with no change
in rates
For Life Solutions forms, visit Web Ordering
Permanent coverage advantage that builds
cash value
Long-term investment vehicle
Policy/rider may not be available in all states,
please refer to your state's policy/rider for
benefits, limitations, and exclusions.
Keep in mind that benefits, limitations and
exclusions vary by state.
KEY POINTS:
Eligible to convert to Whole Life policy if the date of conversion is
earlier than the end of the initial term period or on or before the
policy anniversary date following the named insured's 65th birthday
Exchange request required
Policyholders can take the coverage with them (bank draft or
direct bill) if they change jobs or retire
You may focus on the need to increase the total amount of life
insurance coverage and to enhance group coverage with an Aflac
policy, whether through Whole Life, Term Life, or a combination of
the two
Group insurance typically covers the employee only, while Aflac’s
policies may provide coverage to the primary insured, spouse, and
child(ren) through specified riders
KEY POINTS:
Juvenile Term Life insurance for ages 0
through age 24
Juvenile Term and Whole Life offer
varying face amounts - $10k, $20k,
or $30k
Juvenile Term Life can convert to Whole
Life on the policy anniversary date after
the insured’s 25th birthday, if requested
Whole Life face amount doubles at
conversion; Term Life face amount can
as well with an increase to premium
Cash and loan values accumulate in
the third year after conversion for whole
life policies only
Keep in mind that benefits, limitations and
exclusions vary by state.
Aflac Life Insurance may be appropriate for a customer because Aflac offers Whole Life, Term Life,
and Juvenile Life. It pays a lump sum amount for the face amount of the policy to the beneficiary
upon the insured’s death.
Aflac Life Insurance helps give family members financial peace of mind by ensuring that financial
obligations are met after the insured’s death. Benefits can be used to assist to help cover immediate
needs such as:
Funeral costs
Uninsured medical expenses
Bills
Benefits can be used to assist in covering future needs such as:
Rent/mortgage payments
Monthly family expenses
College expenses
Retirement planning
Pays an Accelerated Death Benefit in the event of a terminal illness
With some plans, Aflac offers a Waiver of Premium Rider. With that rider, if the insured is totally
disabled, Aflac will not require premium payment for the duration of the disability. That means the
insured's life insurance policy would stay in force, with no additional payments, while the benefit was
in effect.
Keep in mind that benefits, limitations and exclusions vary by state.
A Replacement Notice / Life Replacement form must be completed if the applicant wishes to
replace his or her existing life insurance from another company with our policy. Known as form
A-4166, this is a two-part carbonless form that varies by state.
Please note, when submitting a life insurance application intended to replace any existing Aflac
life insurance policy, you will need to include a Life Cancellation Request or signed request from
the policyholder to cancel the original coverage. The replacement form lets Aflac know the
applicant intends to replace the current coverage, but it does not give Aflac permission to cancel
the existing coverage.
Keep in mind that a declining health status is not a valid reason for replacing a customer’s
insurance coverage.
Suitability
At Aflac, we pride ourselves on acting with integrity and running an ethical business and expect
our agents to do the same. We call this the Aflac Way. Aflac is committed to providing coverage
to meet each policyholder’s individual needs.
Agents must be diligent in offering products and levels that are appropriate for an applicant’s
financial situation. Ensure applicants understand the total premiums for their purchases and the
impact on their income.
Don’t encourage applicants to purchase products if:
They’ve said they can’t afford it
You know it will not be suitable for their financial situation
They know they’ll likely have to discontinue it due to cost
The goal of both the information security and privacy polices is to protect sensitive information.
However, there are differences between the two concepts.
The role of Information Security is the technical and physical protection of Aflac and customer data.
Information Security protects that data from unauthorized access, use, disclosure, modification,
and/or destruction. This means that Aflac agents, their employees, and subcontractors should abide
by information and security laws and regulations that require technical and physical safeguards.
These safeguards must be in place to protect customer data.
Privacy, on the other hand, ensures Aflac, Aflac agents, their employees, and subcontractors abide
by privacy laws and regulations to protect our customers' personal health and financial information
from intentional and accidental unauthorized use, access, or disclosure.
Think about security in your day-to-day work. Ensure all information assets, processes, functions,
facilities, and resources are designed, built, and operated in a secure manner.
Protect your clients' information. The goal is to protect Aflac and its customers. We need
to protect them from intentional and accidental unauthorized use, access, disclosure, modification,
and/or destruction of information.
Follow the rules. All users of Aflac systems and applications are required to adhere to all
information security policies.
Health records are sensitive. Protect the confidentiality of Personal Health Information (PHI)
and financial information. Protected Health Information (PHI) and financial information should be
protected whether communicated verbally or in writing.
Privacy is the right of an individual to control the use and disclosure of his or her personal
information. Aflac, Aflac agents, their employees, and subcontractors are required by law to protect
our customers’ personal information. Laws protecting the individual's personal information include:
HIPAA. The Health Insurance Portability and Accountability Act is the law that protects Protected
Health Information (PHI).
HITECH. The Health Information Technology for Economic and Clinical Health Act enhances
HIPAA and extends rules to business associates such as Aflac agents, their employees, and
subcontractors. Business associates have a legal obligation to follow the privacy and security
provisions of their business associate agreements and HITECH provisions.
GLBA. The Gramm-Leach-Bliley Act protects personal financial information.
Together, HIPAA, HITECH and GLBA protect personal financial information and personal
health information.
Regarding Aflac’s Security and Privacy Policy, keep in mind the following:
Aflac’s privacy policy protects PHI from intentional and accidental unauthorized use, access,
or disclosure
It is recommended that you read a little of each policy every day
Policy documents are comprehensive in nature and can be overwhelming
Breaking them down into chapters is helpful
Due to the HIPAA HITECH Omnibus Final Rule, business associates, such as Aflac associates and
agents, their employees, and their subcontractors, are required to abide by certain guidelines in the
Privacy and Security Rules.
Subcontractors are persons or entities who create, receive, maintain, and/or transmit PHI on behalf
of a business associate (BA). The BA is held directly liable for compliance with certain rules of the
HIPAA Privacy, Security, and Breach Notification Rules and may be subject to civil and criminal
liability for violations of these requirements.
As a business associate of Aflac, you are required to:
Adopt an incident/breach management process to properly notify Aflac of all privacy and security
incidents/breaches
Read the Business Associate Agreement/Contract and the Protected Information Guidelines and
follow all guidelines/requirements indicated within
Ensure the Privacy and Security rules from the Health and Human Services (HHS) department
are followed
Enter into a written agreement with any of its subcontractors that create, receive, maintain, or
transmit Aflac insured PHI that provides for privacy and security protections, that they have at
least as stringent (if not more stringent) security protections as those provided in the Protected
Information Management (PIM) Guidelines
In addition to contractual obligations, BAs are directly liable for compliance with certain
provisions of the HIPAA Privacy and Security laws
Access to Aflac information is limited to an individual's functions related to his or her work
responsibilities. You should only have access to what you need to perform your role.
Protect the data on your devices by using a complex PIN or password. A complex password
contains upper and lower case letters, numbers, and special characters.
Lock your screen when you're not using the device or when you walk away, even for a
moment. To lock your screen, press Ctrl-Alt-Delete and press Enter, or use Windows key + L.
Disclosure Do not disclose PHI, financial information, or any personal information unless you
have received the proper authorizations to do so—this applies whether it is communicated orally or
in writing.
Check to ensure you provided the correct policy number, name, and transmittal when
submitting claims or other correspondence.
PINs Keep passwords and PINs confidential. Nev er disclose them to anyone. You are
responsible for any transactions that occur under your PIN or User ID and password.
Shred all documents that include health and financial data and use a secure recycle bin.
Privacy Only conduct enrollments in secure, private locations.
Passwords Don't tape your passwords to your laptop or computer.
Before you leave an office, enrollment site, or other location, check to ensure no confidential
information has been left behind.
Keep laptops in secure locations. Do not leave a laptop in the seat of your car where it is
visible to someone walking by the car.
Cover confidential information when you leave your workstation. This includes both digital
and stationary information.
Clean Desk It’s important to keep a clean desk. Keeping your desk clean reduces stress, complies
with the basic privacy principles for safeguarding personal information, and reduces the opportunity
for theft or loss.
Mobile devices allow us to communicate anytime, anywhere. They empower us with on-the-go
functionality that used to require the use of a PC; however, with flexibility and convenience come
risk. It’s a good practice to use separate mobile devices for work and personal web surfing.
Before you had a laptop, did you take your computer home with you? Did you ever have to worry
about forgetting it on a table at a coffee shop? Of course not.
Mobile devices and the applications that reside on them require the use of User IDs and
passwords that help protect the information on the device; therefore, they require extra care. The
following are some ideas for keeping your mobile devices safe:
Lock your Aflac mobile devices in a desk drawer or file cabinet at the end of the day.
Lock them in the trunk of your car when you don't need them for an appointment. Do not lock
them in the trunk overnight.
Make passwords complex. Protect the data on your devices by using complex
passwords and PINs. Don't use passwords that are easy to guess or contain ‘Aflac’ or ‘Duck.’
Instead, try using a pass-phrase. A complex password contains upper and lower case letters,
numbers, and special characters. Always lock the screen when your devices aren't in use.
Never store passwords on or near your devices.
Don't share your password with anyone. This includes your coordinator, administrator,
or other agents. Remember, you are responsible for all transactions that take place using your
User ID and password. Make sure no one is “shoulder surfing” when you enter your password
on your devices.
Get help! If your mobile device is lost or stolen, contact Aflac's IT Service Center or
email [email protected] immediately.
Email is widely used as a form of business communication. If used properly and safely, it can be
highly effective. Never ask your customers to provide account credentials or personal information
via email.
Before sending an email, ask yourself a
few questions:
Should I send it?
Is the content appropriate?
Is the message business-appropriate? Use your Aflac-issued email
address (us.aflac.com) for
Is it encrypted?
all business transactions.
Is email the best way to communicate
the message? Do not use a personal email
Would a face-to-face meeting or phone call account (i.e. Gmail, Hotmail,
be better? Yahoo) for business
Who should get the email? Does everyone on transactions.
the distribution list really need it? Delete old information.
Are the recipient email addresses accurate? Delete your email messages
Is this personal, or is it work-related? when the information is no
Remember, it's not a good idea to mix longer needed.
work and personal email. It's too easy to
Too much spam? Visit this
accidentally send sensitive work information
to a personal contact. Aflac News article to learn
how to reduce spam.
Did I remove sensitive information and
attachments prior to forwarding it?
Am I sending the minimum amount of
information required?
Does the email require encryption?
If you answer yes to one of the questions below, your communication requires email
encryption. If you need assistance with encryption, please send an email to
[email protected].
Does the email or attachment contain sensitive information such as SSNs, credit card
number, or health information?
Am I sending an external email as part of my work as an Aflac agent?
Phishing is defined as a scam by which an email user is duped into revealing personal or
confidential information the scammer can use illicitly.
To avoid email phishing attempts:
Refrain from opening unsolicited emails
Refrain from opening attachments or clicking on links from unknown senders
Never provide personal or customer account information in response to an
email request
If you receive a suspicious email, such as one that is coming from an unknown sender asking for
personal information, what should you do first? Do not click on any links or open any attachments
and promptly contact [email protected].
Internet Usage
Not all websites are safe. Ensure your anti-virus software is up-to-date
Scan software you download to ensure it's virus-free
It’s a good practice to use different devices for personal and work-related Internet use