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Reference
Appendix and Legal Notices
Health Benefits Coverage Under Federal Law
Women’s Health and Cancer Rights Act of 1998
If you have had, or are going to have, a mastectomy, you
may be entitled to certain benefits under the Women’s
Health and Cancer Rights Act of 1998 (“WHCRA”). For
individuals receiving mastectomy related benefits, coverage
will be provided in a manner determined in consultation
with the attending physician and the patient for:
• All stages of reconstruction of the breast on which
the mastectomy was performed,
• Surgery and reconstruction of the other breast to
produce a symmetrical appearance,
• Prostheses, and
• Treatment of physical complications of the mastec-
tomy, including lymphedema.
These benefits will be provided subject to the same
deductibles and coinsurance applicable to other medical
and surgical benefits provided under the medical benefit
option. Therefore, the deductibles and coinsurance as
noted in your SPD may apply. If you would like more
information on WHCRA benefits, call the claims admin-
istrator at the number listed on the back of your medical
identification card.
Newborns’ Act Disclosure
The medical benefits offered under the Aflac Employee
Health Plan and health insurance issuers generally may
not, under federal law, restrict benefits for any hospital
length of stay in connection with childbirth for the mother
or newborn child to less than 48 hours following a vaginal
delivery, or less than 96 hours following a cesarean
section. However, federal law generally does not prohibit
the mother’s or newborn’s attending provider, after
consulting with the mother, from discharging the mother
or her newborn earlier than 48 hours (or 96 hours as
applicable). In any case, the Aflac Employee Health Plan
and insurance issuers may not, under federal law, require
that a provider obtain authorization from the plan or the
insurance issuer for prescribing a length of stay not in
excess of 48 hours (or 96 hours).
Special Enrollment
You and your eligible dependents may enroll in the Aflac
Employee Health Plan’s medical benefit option under the
following circumstances:
•
Individuals Losing Other Coverage
– If you
declined coverage under the medical benefit option
when it was first available because of other health cov-
erage, and that coverage is later lost on account of:
• Exhaustion of COBRA continuation coverage,
• Lost eligibility for other coverage, or
• Termination of employer contributions towards
the other coverage, you and your eligible
dependents may enroll in the medical benefit
option within 30 days after the date you lost
that other coverage. Your enrollment will take
effect on the date of your loss of coverage.
The change in your benefit contributions will
begin on the first payroll period following your
election change request.
