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webordering.aflac.comThe Aflac Cancer Care plan is here to help you and your family better cope financially—and emotionally—if a positive diagnosis of cancer ever occurs. That way you can worry less about what may be ahead. Aflac herein means American Family Life Assurance Company of Columbus. Added Protection for You and Your Family AFLAC
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www.aflac.com(To include the type of room and level of care.) Admission/discharge date and time. (Must be included.) Proof of services Pathology report is required for all skin cancer claims and the initial claim for an internal cancer diagnosis. Patient’s name and date of birth. Patient’s relationship to policyholder. What you need to file a claim
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www.emoryhealthcare.orgsports injury, cancer treatment or complex surgery, our specialized care is unmatched, and that’s because of each of you. As a member of Team EHC, you play a vital role in defining a new standard of care for humankind. We are pleased to recognize your contributions with a benefit package that offers a robust selection of
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Aflac Specified Health Event Protection
webordering.aflac.comA. HOSPITAL INTENSIVE CARE UNIT BENEFIT: Aflac will pay the following benefits when a covered person incurs a charge for confinement in a Hospital Intensive Care Unit or a Step-Down Intensive Care Unit for a covered Sickness or Injury: 1. Confinement in a Hospital Intensive Care Unit: Sickness Injury Days $ 700 per day $ 800 per day 1–7
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www.aflacgroupinsurance.comPost Office Box 84075 * Columbus, GA. 31993 Phone (800) 433-3036 * Fax (866) 849-2970 groupclaimfiling@aflac.com CRITICAL ILLNESS CLAIM FORM
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