Contact

For more information concerning benefits, limitations, and costs, please use the form below. An insurance agent will contact you.

Personal Information
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Preferred Method of Contact
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Reason For Contact

Open Enrollment

April 1st - June 15th!

To apply for Aflac group insurance coverage, please complete the Enrollment form in it's entirety and return to your Aflac agent, Jeanne Smith.

Enrollment Form
(download)

Direct Deposit
(download)

Still have questions?