AFLAC CHANGE FORM


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REQUEST FOR NAME CHANGE - AFLAC

REQUEST FOR NAME CHANGE Please use blue or black ink only and print legibly when completing this form in its entirety. Keep a copy of the supporting documentation and this completed form for your records. Sign, date and Pub on 水, 29 10 2014 06:38:00 GMT
Source: http://www.aflac.com/us/en/docs/policyholders/Name_Change_Form.pdf
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REQUEST FOR BENEFICIARY CHANGE - AFLAC

REQUEST FOR BENEFICIARY CHANGE Please use blue or black ink only and print legibly when completing this form in its entirety. Keep a copy of the supporting documentation and this completed form for your records. Sign ... Pub on 水, 29 10 2014 20:29:00 GMT
Source: http://www.aflac.com/us/en/docs/policyholders/Beneficiary_Change_Form.pdf
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14-SERVICE REQUEST FORM - AFLAC GROUP INSURANCE

Service Request Form 1. Change of Beneficiary (Witness must be someone other than beneficiary) Certificate Number Insured Owner (If other than insured) Address Phone Number It is requested that the beneficiary under the above ... Pub on 火, 28 10 2014 16:48:00 GMT
Source: http://aflacgroupinsurance.com/docs/servicerequest_aflac.pdf
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ACCIDENT WELLNESS BENEFIT CLAIM FORM - AFLAC ...

ACCIDENT WELLNESS BENEFIT CLAIM FORM Failure to complete all sections may result in a delay in processing this claim. Please review your policy for specific benefits covered under your plan. Benefits are payable to you ... Pub on 月, 27 10 2014 21:21:00 GMT
Source: http://aflacgroupinsurance.com/docs/claimforms/ACCWellness.pdf
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PERSONAL SICKNESS INDEMNITY PLAN - CAVALIER INSURANCE ...

Personal Sickness Indemnity Plan Policy Series A-45000 Policy A-45100-VA (Level 1) Policy A-45200-VA (Level 2) Policy A-45300-VA (Level 3) Physician Visits Benefit Aflac will pay the amount for the level chosen when a ... Pub on 土, 25 10 2014 23:32:00 GMT
Source: http://cavalierinsurance.net/pdf/AFLAC-BROCHURE%20SICKNESS.pdf
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SPECIFIED HEALTH EVENT PROTECTION

Definitions The following specified health events must occur after the effective date of coverage for benefits to be payable: Primary Specified Health Event:heart attack, stroke, coronary artery bypass surgery, end-stage renal failure ... Pub on 月, 27 10 2014 19:12:00 GMT
Source: http://srcea.com/aflac/Broshures/Specified%20Health%20Event.pdf
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PERSONAL SICKNESS INDEMNITY PLAN - FLORIDA INSTITUTE OF ...

Personal Sickness Indemnity Plan Policy Series A-45000 Policy A-45100-FL (Level 1) Policy A-45200-FL (Level 2) Policy A-45300-FL (Level 3) Physician Visits Benefit Aflac will pay the amount for the level chosenwhen a ... Pub on 水, 29 10 2014 03:32:00 GMT
Source: http://www.fit.edu/hr/documents/Benefits/Sickness3.pdf
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HEALTH INS ENROLLMENT MONTH OF OCTOBER ENROLLMENT

Cancer Insurance AFLAC/Emily Ingram 601 853-0664 601-856-0097 Dental Insurance Humana Compbenefits/Catchings Agency 601 355-7489 601 355-7513 Dental Insurance Delta Dental-Jack Lane-Creative Grp Benefits 601 ... Pub on 火, 28 10 2014 18:35:00 GMT
Source: http://www.jackson.k12.ms.us/departments/business/publications/benefits_at_a_glance.pdf
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PLAN YEAR JANUARY 1, 2015 — DECEMBER 31, 2015 ENROLLMENT ...

* Employees paid bi-weekly will receive a maximum of 26 checks for the plan year. Employees paid semi-monthly will receive 24 paychecks for the plan year. Sections A. and B. – In Box #1, indicate the total dollar amount you elect ... Pub on 水, 29 10 2014 05:20:00 GMT
Source: http://portal.arbenefits.org/Benefits/ARCAPEnrollment2015.pdf
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MAXIMUM ALLOWABLE ANNUAL CONTRIBUTION IS $2,500.

* Employees paid bi-weekly will receive a maximum of 26 checks for the plan year. Employees paid semi-monthly will receive 24 paychecks for the plan year. Sections A. and B. – In Box #1, indicate the total dollar amount you elect ... Pub on 火, 28 10 2014 02:50:00 GMT
Source: http://portal.arbenefits.org/Benefits/09172013_FBMC_FSAElectionForm%202014PlanYear.pdf
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