Policy Change Forms for Business

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The following changes to policy information require the policyholder to complete a Change Form. Each type of change has its own specific form.

Aflac Change Forms:

Name Change – Download the name change form.

Change Beneficiary – Download the form to change a beneficiary on a policy.

Delete a Person from Policy/Certificate – Download the form to DELETE a person from a policy/certificate.

Request for Gender Identity Change/Reassignment – Download the form to request a gender identity change or reassignment.

Add a Person to a Policy/Certificate – Please call Aflac toll free at 800.992.3522 to add a person to an existing policy/certificate.

The above Change Forms must be completed by the policyholder wishing to make the change.

Aflac New York Change Forms:

Name Change – Download the name change form.

Change Beneficiary – Download the form to change a beneficiary on a policy.

Delete a Person from Policy/Certificate – Download the form to DELETE a person from a policy/certificate.

Request for Gender Identity Change/Reassignment – Download the form to request a gender identity change or reassignment.

Add a Person to a Policy/Certificate – Please call Aflac New York toll free at 800.366.3436 to add a person to an existing policy/certificate.

The above Change Forms must be completed by the policyholder wishing to make the change.

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Except in New York, individual insurance and group dental and vision insurance is offered by American Family Life Assurance Company of Columbus. In NY both group and individual coverage is offered by American Family Life Assurance Company of New York. Group policies are offered by Continental American Insurance Company (CAIC). CAIC is not licensed to solicit business in New York, Guam, Puerto Rico or the Virgin Islands. In CA, CAIC does business as Continental American Life Insurance Company (CAIC NAIC 71730)

Dental and Vision plans are administered by Aflac Benefit Solutions, Inc.

Aflac Worldwide Headquarters | Columbus, GA

Aflac Group | Columbia, SC

American Family Life Assurance Company of New York | Albany, NY

Aflac’s Premium Life, Absence and Disability Services are available in all states, except Puerto Rico, Guam or the Virgin Islands, and are offered by Continental American Insurance Company (CAIC). Self-funded plans and absence services are administered by CAIC in all states but NY. In NY, self-funded plans and absence services are administered by and insurance is offered by American Family Life Assurance Company of NY. Administrative services are not insurance and are not considered legal advice. Products may not be available in all states and may vary depending on state law.

Direct to Consumer Business is underwritten by Tier One Insurance Company, doing business as Tier One Life Insurance Company in California (Tier One NAIC 92908)

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Notifications from Aflac

Individuals & Families

Business Owners

Agents

Brokers

Change Forms

The following changes to policy information require the policyholder to complete a Change Form. Each type of change has its own specific form.

Aflac Change Forms:

Aflac New York Change Forms: