Key Terms to Remember

Here are some key terms to keep in mind when deciding which benefits are the right choice for you!

The amount or percentage that you pay for certain covered health care services under your health plan. This is typically the amount paid after a deductible is met and can vary based on the plan design.

A flat fee that you pay toward the cost of covered medical services.

A qualified health plan that combines very low monthly premiums in exchange for higher deductibles and out-of-pocket limits.

Provider bills for the difference between the provider’s charge and the allowed amount. Do not agree to balanced billing and immediately reach out to APA for physician claims and ELAP for hospital claims if you receive a balanced bill.

Unlike other medical insurance plans, there is no required limited network. Any doctor or specialist can be seen at your regular copay/coinsured amount for a covered service.

A decision by your health plan that a service, plan, prescription drug or durable medical equipment is medically necessary and if it will be approved to be paid. Your physician should request the preauthorization for you.

A plan year is the 12-month period your benefits coverage lasts, at the end one plan year and start of another deductibles, max out of pocket, and allowances reset. All benefits in this guide run in a plan year that coincides with the calendar year except as noted. If you start midway through the year such as a new employee or through a qualifying event your plan year will still end with the group’s plan year.

Benefits & eligability

Overview of Benefits

Employees are eligible for Medical, Dental and Vision coverage on the 1st of month after hire
with all remaining benefits becoming eligible on 1st of the month following 60 days of full time
employment. You can elect medical, dental, and vision coverage for your spouse and dependent/
adult children up to 26 years old. Your employer reserves the right to request proof of marriage
and birth certificates in order to add dependents.

How to Enroll or Update Benefits

Online: https://aflacatwork.com
Your user name is your social security number with no dashes, and your pin is the last 4 digits of your social plus the last 2 digits of the year you were born.
EXAMPLE: If the last 4 of your SSN is 9876 and you were born in 1954, your pin would be 987654.
Phone: Speak to a benefit enrollment counselor at 1-877-250-9207 9am-6pm EST M – F

Qualifying Events

Eligible employees may enroll or make changes to their benefits elections during the annual open enrollment period. As with most
benefits, once you elect an option you are bound to that choice for the entire plan year unless you experience a “Qualifying Event”. These may include, but not limited to: Changes in employment status, legal marital status or number of dependents, taking an unpaid leave of absence, Dependent satisfies or ceases to satisfy eligibility requirement, a COBRA-qualifying event, Entitlement to Medicare or Medicaid, or a change in the place of residence of the employee, resulting in the current carrier not being available.

Things to Consider

Consider your personal situation and the difference
between the plan options and their costs when making
your decision. You may also elect to waive coverage
Ask yourself the following questions

  • Will your current doctor be in or out-of-network?
  • Do you have any planned surgeries this year?
  • How many family members will you cover?
  • How often do you visit the doctor?
  • Are you planning to have a baby this year?
    By reading this guide cover to cover, you will become
    familiar with your benefits options. After enrolling,
    verify that your payroll deductions are correct. If not,
    please contact your payroll representative.

Enroll In Your Benefits Online

Login to your benefits using your full SSN with no dashes.
Your Pin is the last 4 digits of you SSN and the last 2 digits of your birth year.  

If you have trouble logging into your benefits or have questions about the plans outlined here, call our dedicated enrollment call center at 877-250-9207 for assistance.
The call center is open between 9am-6pm EST, Monday – Friday.

Enroll Online