2018 Aflac Incorporated Benefits Guide

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The Plan may deny you access to your PHI in the Plan’s records.
You may, under some circumstances, request a review of that
denial. If the Plan or its business associates maintain electronic
records of your PHI, you may request an electronic copy of your
PHI. You may also request that your electronic records be sent
to a third party.
You have a right to amend PHI about you that is maintained
by the Plan.
Your request must be in writing and you must give a reason for
the request. Your right to amend is limited. For example, you can
only amend information that is available to you under your right
of access. The Plan may deny your request if the information
was not created by the Plan and the creator of the information
is available to respond to your request. The Plan may deny your
request if the information is accurate and complete.
You have a right to receive an accounting of some (but not
all) disclosures made by the Plan.
You may request an accounting of disclosures of your PHI
made within the six-year period just before the date of your
request. Your request must be in writing. The accounting
will not include disclosures the Plan is permitted to make
for treatment, payment and health care operations, or those
made with your authorization. The accounting will not include
disclosures made to you or close family members involved in
your care. The accounting will not include disclosures made for
purposes of national security, incidental to otherwise permitted
or required disclosures, as part of a limited data set or to
correctional institutions or law enforcement officials. Your right
to an accounting may be suspended in the event of certain
government activities. If you request more than one accounting
within a 12-month period, the Plan may charge
you a cost-based fee for the additional requests.
You have a right to receive a paper copy of this notice.
If you have agreed to receive this notice by email, you also have
a right to receive a paper copy upon request.
You have a right to receive notification of a breach
of your PHI.
You will be notified if your unsecured PHI is acquired, accessed,
used or disclosed in a manner that is not permitted under HIPAA
and the security or privacy of your PHI is compromised.
COMPLAINTS
You may complain to the Plan or to the Secretary of the U.S.
Department of Health and Human Services if you believe your
privacy rights have been violated. Complaints to the Plan should
be made using the form provided by the Benefits Manager.
If your complaint is with an insurer or HMO, you may file a
complaint with the individual named in the insurer’s or HMO’s
notice of privacy practices to receive complaints. Retaliation
against a person who files a complaint is prohibited.
To file a complaint with the Secretary of the U.S. Department
of Health and Human Services, you must submit your complaint
in writing, either on paper or electronically, within 180 days
of the date you knew or should have known that the violation
occurred. You must state who you are complaining about and
the acts or omissions you believe are violations of HIPAA’s
privacy rules. For more information about how to file a complaint
with the Secretary of the U.S. Department of Health and Human
Services you may visit .
CONTACT THE PLAN ABOUT THI S NOT ICE
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 CHI LDREN’ S HEALTH
INSURANCE PROGRAM (CHIP)
If you’re eligible for health coverage from Aflac but can’t afford
the premiums, some states have premium-assistance 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 are not eligible
for Medicaid or CHIP, you will not be eligible for these premium
assistance programs, but you may be able to buy individual
insurance coverage through the Health Insurance Marketplace.
For more information, visit .
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.
How to Apply for
Aflac Coverage