Once you have created your username and password you can download the Aflac app.

The forms below are provided for your convenience. Most plan changes resulting in cancellations, deletions, additions, and conversions must be done during your Open Enrollment period. Qualified Life Events are an exception to these rules and must be approved by your employer's plan administrator. For assistance with this contact your agent or plan administrator. We can assist you with this, see our contact below.

Click the button below to start your change request. Once you have signed the form, it will automatically be sent to our office to review and submit.

Use the form below for:

Address Change

Name Change

Gender Identity/Reassignment

Change to Payroll Deduction

Change to Direct Billing

Delete a Covered Dependent

Change Beneficiary