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Reference
Appendix and Legal Notices
Contact the Plan about This Notice
For further information about the content of this notice
or about filing a complaint, call the Benefits Department
at 706-317-0770. Send written requests or other written
communication to:
Benefits Department
Aflac Incorporated
P.O. Box 5248
Columbus, GA 31906-0248
Medicaid and the Children’s Health
Insurance Program (CHIP)
If you’re eligible for health coverage from Aflac but can’t
afford the premiums, some states have premium-as-
sistance programs that can help pay for coverage with
funds from their Medicaid or CHIP programs. If you or
your dependents are already enrolled in Medicaid or CHIP
and you live in a state listed below, contact your state
Medicaid or CHIP office to find out if premium assistance
is available.
If you or your dependents aren’t currently enrolled in
Medicaid or CHIP and you believe you might be eligible
for one of these programs, contact your state Medicaid or
CHIP office or dial 877-KIDS NOW or visi
to find out how to apply. If you qualify, ask the state
if it has a program that may help pay the premiums for an
employer-sponsored plan.
If you or your dependents are deemed eligible for
premium assistance under Medicaid or CHIP, the Aflac
Employee Health Plan is required to allow you or your
dependents to enroll in the medical benefit option –
provided you or your dependents are eligible for but not
already enrolled in this option. This is called a “special
enrollment” opportunity, and you must request coverage
within 60 days of being determined eligible for premium
assistance.
As of Jan. 31, 2013, these states in which Aflac
empoyees are located participated in premium-assistance
programs. Contact your state for more information:
GEORGIA – Medicaid
(Click on Programs, then Medicaid,
then Health Insurance Premium Payment (HIPP))
800-869-1150
ALABAMA – Medicaid
855-692-5447
SOUTH CAROLINA – Medicaid
888-549-0820
NEW YORK – Medicaid
800-541-2831
NEBRASKA – Medicaid
800-694-3084
IOWA – Medicaid
888-346-9562
Other participating states include Alaska, Arizona,
Colorado, Florida, Idaho, Indiana, Kansas, Kentucky,
Louisiana, Maine, Massachusetts, Minnesota, Missouri,
Montana, Nevada, New Hampshire, New Jersey,
North Carolina, North Dakota, Oklahoma, Oregon,
Pennsylvania, Rhode Island, South Dakota, Texas,
Utah, Vermont, Virginia, Washington, West Virginia,
Wisconsin and Wyoming.
