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  • Deletion Form Hl0046.12b.doc

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REQUEST FOR DELETION Please use blue or black ink only and print legibly when completing this form in its entirety. American Family Life Assurance Company of Columbus Aflac Attn Policy Service Department 1932 Wynnton Road Columbus GA 31999-7000 For information call toll-free 1-800-99-AFLAC 1-800-992-3522 Name of Policyholder Last Name First Name MI Policy Number Policy Type Date of Birth Person to be Deleted Sex Male Relationship Title Female Insured Reason for Deletion Spouse Divorce Child Death Request Date of Divorce/Death/Request New Policy/Contract Holder s Full Name Birth Date of New Policy/Contract Holder Billing Name only applicable if policy on payroll New Coverage Desired Individual One-Parent Family Two-Parent Family Named Insured-Spouse Only Policyholder s Signature Date Is this a Section 125 account If yes you must have the Plan Administrator s Signature. Section 125 Account Approval Date Section 125 Plan Administrator Signature Form H-L0046 HL0046. 12B. Keep a copy of the....

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of your check prior to taxes (pre-tax), you can only cancel during open enrollment to be effective the first of the following calendar year, unless due to a valid change in status.

How do I cancel my Aflac benefits? To cancel your Aflac insurance policy Subscription, follow these easy steps: Call customer service on 800-992-3522. Ask to speak with a representative. Provide them with your policy number and customer details.

What if I want to cancel my coverage? A. Call our Customer Service Center at 800.433. 3036 for cancellation procedures.

With Aflac Always, your benefits are protected through automatic payments even if you change jobs, your employer stops providing payroll deductions for your premium or you retire. You choose how you pay. Select how your premiums are paid (e.g., bank draft) and when. It's ready to go to work for you, 24/7.

To add or remove someone from your policy: Please reach out to your Aflac agent who will be able to assist you in adding someone to you coverage or you can connect with us via chat or email 24/7, or via phone at 800.99. AFLAC (800.992. 3522) 8 a.m.-7 p.m. ET.

To remove someone: Log into MyAflac.com. Click on 'Policy Summary/Forms/History' for the policy on which you would like to make changes. Click on 'Remove Person Online' in the right-hand section under 'Online Policy Changes'.

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Keywords relevant to Deletion Form HL0046.12B.doc

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  • legibly
  • Wynnton
  • policyholder
  • Deletion
  • Attn
  • applicable
  • administrators
  • entirety
  • GA
  • completing
  • holders
  • documentation
  • DELETED
  • holder
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© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
All Forms
Search all Forms
Industries
Forms in Spanish
Localized Forms
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232