We care about Aflac’s policyholders affected by the recent weather:
To help provide relief for North Dakota policyholders residing in North Dakota who were affected by the severe summer storms and tornadoes, Aflac will provide a premium grace period starting June 21, 2025, and ending Aug. 20, 2025. This grace period also provides an extension of filing deadlines for claims and leniency for any other action required under the policy. Aflac will provide a replacement copy of the policy upon request by the policyholder.
For Network Dental and Vision Members:
This grace period also provides an extension of filing deadlines for claims; relaxation of prior authorization, precertification, and referral requirements; access to appropriate out-of-network providers due to unavailability on in-network providers or the members’ displacement; and leniency for any other action required under the certificate. A replacement copy of the certificate will be provided upon request by the certificate holder. Affected members should contact Aflac Benefit Solutions (formerly Argus Dental and Vision) at 855-819-1873, Option 1, for assistance.
We care about Aflac’s policyholders affected by the recent wildfires:
To help provide relief for Oregon policyholders residing in Oregon who were affected by the wildfires, Aflac will provide a premium grace period starting July 16, 2025, and ending Sept. 15, 2025. This grace period also provides an extension of filing deadlines for claims and leniency for any other action required under the policy. Aflac will provide a replacement copy of the policy upon request by the policyholder.
For Network Dental and Vision Members:
This grace period also provides an extension of filing deadlines for claims; relaxation of prior authorization, precertification, and referral requirements; access to appropriate out-of-network providers due to unavailability on in-network providers or the members’ displacement; and leniency for any other action required under the certificate. A replacement copy of the certificate will be provided upon request by the certificate holder. Affected members should contact Aflac Benefit Solutions (formerly Argus Dental and Vision) at 855-819-1873, Option 1, for assistance.
We care about Aflac’s policyholders affected by the recent wildfires:
To help provide relief for Oregon policyholders residing in Crook County who were affected by the wildfires, Aflac will provide a premium grace period starting July 12, 2025, and ending Sept. 10, 2025. This grace period also provides an extension of filing deadlines for claims and leniency for any other action required under the policy. Aflac will provide a replacement copy of the policy upon request by the policyholder.
For Network Dental and Vision Members:
This grace period also provides an extension of filing deadlines for claims; relaxation of prior authorization, precertification, and referral requirements; access to appropriate out-of-network providers due to unavailability on in-network providers or the members’ displacement; and leniency for any other action required under the certificate. A replacement copy of the certificate will be provided upon request by the certificate holder. Affected members should contact Aflac Benefit Solutions (formerly Argus Dental and Vision) at 855-819-1873, Option 1, for assistance.
We care about Aflac’s policyholders affected by the recent flooding:
To help provide relief for Texas policyholders and/or certificate holders residing in Bandera, Bexar, Burnet, Caldwell, Coke, Comal, Concho, Gillespie, Guadalupe, Kendall, Kerr, Kimble, Llano, Mason, McCulloch, Menard, Reeves, San Saba, Tom Green, Travis, and Williamson counties who were affected by the flooding, Aflac will provide an extended premium grace period starting July 2, 2025, and ending Sept. 8, 2025. This grace period also includes an extension of filing deadlines for claims and leniency for any other actions required under the policy and/or certificate. Aflac will provide a replacement copy of the policy and/or certificate upon request by the policyholder and/or certificate holder.
For Network Dental and Vision Members:
This grace period also includes an extension of filing deadlines for claims; temporary relaxation of prior authorization, precertification, and referral requirements; access to appropriate out-of-network providers due to unavailability of in-network providers or member displacement; and leniency for any other actions required under the certificate.
Affected members should contact Aflac Benefits Solutions (formerly Argus Dental and Vision) at 855-819-1873, option 1, for assistance.
We care about Aflac’s policyholders affected by the recent wildfires:
To help provide relief for Oregon policyholders residing in Klamath County who were affected by the wildfires, Aflac will provide a premium grace period starting July 8, 2025, and ending Sept. 08, 2025. This grace period also provides an extension of filing deadlines for claims and leniency for any other action required under the policy. Aflac will provide a replacement copy of the policy upon request by the policyholder.
For Network Dental and Vision Members:
This grace period also provides an extension of filing deadlines for claims; relaxation of prior authorization, precertification, and referral requirements; access to appropriate out-of-network providers due to unavailability on in-network providers or the members’ displacement; and leniency for any other action required under the certificate. A replacement copy of the certificate will be provided upon request by the certificate holder. Affected members should contact Aflac Benefit Solutions (formerly Argus Dental and Vision) at 855-819-1873, Option 1, for assistance.
We care about Aflac’s policyholders affected by the recent wildfires:
To help provide relief for Oregon policyholders residing in Umatilla County who were affected by the wildfires, Aflac will provide a premium grace period starting July 2, 2025, and ending Sept. 02, 2025. This grace period also provides an extension of filing deadlines for claims and leniency for any other action required under the policy. Aflac will provide a replacement copy of the policy upon request by the policyholder.
For Network Dental and Vision Members:
This grace period also provides an extension of filing deadlines for claims; relaxation of prior authorization, precertification, and referral requirements; access to appropriate out-of-network providers due to unavailability on in-network providers or the members’ displacement; and leniency for any other action required under the certificate. A replacement copy of the certificate will be provided upon request by the certificate holder. Affected members should contact Aflac Benefit Solutions (formerly Argus Dental and Vision) at 855-819-1873, Option 1, for assistance.
We care about Aflac’s policyholders affected by the recent wildfires:
To provide relief for New Mexico policyholiders and/or certificate holders residing in Grant County and affected by the Trout Fire, Aflac will provide the following protections for policyholders and/or certificate holders: Provide an extended premium grace period from Thursday, Jun. 12, 2025 through Monday, Sep. 15, 2025. Offer policyholders and/or certificate holders a payment plan of no less than six (6) months if unable to pay the delinquency after the extended day grace period (This applies to all coverages except life.). Work with policyholders and/or certificate holders on premium payments to prevent lapse and cancellation of policies. Waive late fees and penalties. Waive early refill time limits on active prescriptions. Allow additional time for actions required under the policy and/or certificate and the submission of documents due to limited access to service and mobility. Provide an extension of filing deadlines for claims and leniency for any other action required under the policy and/or certificate. Provide a copy of the policy and/or certificate to the policyholder and/or certificate holder upon request.
In addition to the above, Aflac through Aflac Benefits Solutions will provide the following protections for Network Dental and Vision members and providers: Waive cost sharing and deductibles. Permit one eyeglass or contact lens replacement and one hearing aid replacement during the pendency of the Emergency Order, waiving frequency limitations. Permit one replacement for dentures or other prosthodontic devices during the pendency of this Emergency Order, waiving frequency limits. Waive additional fees, charges, referrals, eligibility and prior authorization requirements for medically necessary services, whether emergent or not. This applies to benefits and services obtained from both in- and out-of-network providers. Extend medical providers' reporting requirements for claims submissions and for additional information relating to claims. Fully reimburse out-of-network providers at the usual, customary, and reasonable rate.
Affected members should contact Aflac Dental and Vision (formerly Argus Dental and Vision) at 855-819-1873, option 1, for assistance.
We care about Aflac’s policyholders affected by the recent wildfires:
To help provide relief for Oregon policyholders residing in Jefferson County who were affected by the wildfires, Aflac will provide a premium grace period starting June 16, 2025, and ending Aug. 18, 2025. This grace period also provides an extension of filing deadlines for claims and leniency for any other action required under the policy. Aflac will provide a replacement copy of the policy upon request by the policyholder.
For Network Dental and Vision Members:
This grace period also provides an extension of filing deadlines for claims; relaxation of prior authorization, precertification, and referral requirements; access to appropriate out-of-network providers due to unavailability on in-network providers or the members’ displacement; and leniency for any other action required under the certificate. A replacement copy of the certificate will be provided upon request by the certificate holder. Affected members should contact Aflac Benefit Solutions (formerly Argus Dental and Vision) at 855-819-1873, Option 1, for assistance.
We care about Aflac’s policyholders affected by the recent wildfires:
To help provide relief for California policyholders residing in Los Angeles County affected by the wildfires, Aflac will provide a premium grace period starting Dec. 9, 2024, and ending Aug. 18, 2025. This grace period also provides an extension of filing deadlines for claims and leniency for any other action required under the policy. Aflac will provide a replacement copy of the policy upon request by the policyholder.
For Network Dental and Vision Members:
This grace period also provides an extension of filing deadlines for claims; relaxation of prior authorization, precertification, and referral requirements; access to appropriate out-of-network providers due to unavailability on in-network providers or the members’ displacement; and leniency for any other action required under the certificate. A replacement copy of the certificate will be provided upon request by the certificate holder. Affected members should contact Aflac Benefit Solutions (formerly Argus Dental and Vision) at 855-819-1873, Option 1, for assistance.
We care about Aflac’s policyholders affected by the recent wildfires:
To help provide relief for Oregon policyholders residing in Wasco County who were affected by the wildfires, Aflac will provide a premium grace period starting June 11, 2025, and ending Aug. 11, 2025. This grace period also provides an extension of filing deadlines for claims and leniency for any other action required under the policy. Aflac will provide a replacement copy of the policy upon request by the policyholder.
For Network Dental and Vision Members:
This grace period also provides an extension of filing deadlines for claims; relaxation of prior authorization, precertification, and referral requirements; access to appropriate out-of-network providers due to unavailability on in-network providers or the members’ displacement; and leniency for any other action required under the certificate. A replacement copy of the certificate will be provided upon request by the certificate holder. Affected members should contact Aflac Benefit Solutions (formerly Argus Dental and Vision) at 855-819-1873, Option 1, for assistance.
We care about Aflac’s policyholders affected by the recent weather:
To help provide relief for Maryland policyholders residing in Allegany and Garrett Counties affected by the flooding, Aflac will provide a premium grace period starting May 13, 2025, and ending July 14, 2025. This grace period also provides an extension of filing deadlines for claims and leniency for any other action required under the policy. Aflac will provide a replacement copy of the policy upon request by the policyholder.
For Network Dental and Vision Members:
This grace period also provides an extension of filing deadlines for claims; relaxation of prior authorization, precertification, and referral requirements; access to appropriate out-of-network providers due to unavailability on in-network providers or the members’ displacement; and leniency for any other action required under the certificate. A replacement copy of the certificate will be provided upon request by the certificate holder. Affected members should contact Aflac Benefit Solutions (formerly Argus Dental and Vision) at 855-819-1873, Option 1, for assistance.
We care about Aflac’s policyholders affected by the recent weather:
To help provide relief for California policyholders residing in Trinity County affected by the Dec. 15, 2024, and Dec. 29, 2024, winter storms, Aflac will provide billing leniency for impacted insureds, an extension of filing deadlines for claims and leniency for any other action required under the policy. Aflac will provide a replacement copy of the policy upon request by the policyholder. Affected members should contact Aflac at 800-992-3522 for assistance.
For Network Dental and Vision Members:
This also provides an extension of filing deadlines for claims and leniency for any other action required under the certificate. Affected members are not required to obtain prior approval when accessing appropriate out-of-network providers when in-network providers are unavailable. The cost-sharing for out-of-network will be in amount equal to cost-sharing affected members would have paid for the provision of that service in-network. A replacement copy of the certificate will be provided upon request by the certificate holder. Affected members should contact Aflac Benefit Solutions (formerly Argus Dental and Vision) at 855-819-1873, Option 1, for assistance.
We care about Aflac’s policyholders affected by the recent levee failure:
To help provide relief for California policyholders residing in San Joaquin County affected by the Oct. 21, 2024, Victoria Island Levee failure, Aflac will provide billing leniency for impacted insureds, an extension of filing deadlines for claims and leniency for any other action required under the policy. Aflac will provide a replacement copy of the policy upon request by the policyholder. Affected members should contact Aflac at 800-992-3522 for assistance.
For Network Dental and Vision Members:
This also provides an extension of filing deadlines for claims and leniency for any other action required under the certificate. Affected members are not required to obtain prior approval when accessing appropriate out-of-network providers when in-network providers are unavailable. The cost-sharing for out-of-network will be in amount equal to cost-sharing affected members would have paid for the provision of that service in-network. A replacement copy of the certificate will be provided upon request by the certificate holder. Affected members should contact Aflac Benefit Solutions (formerly Argus Dental and Vision) at 855-819-1873, Option 1, for assistance.
We care about Aflac’s policyholders affected by the recent wildfires:
To help provide relief for California policyholders residing in Los Angeles and Ventura Counties affected by the wildfires, Aflac will provide billing leniency for impacted insureds, an extension of filing deadlines for claims and leniency for any other action required under the policy. Aflac will provide a replacement copy of the policy upon request by the policyholder. Affected members should contact Aflac at 800-992-3522 for assistance.
For Network Dental and Vision Members:
This also provides an extension of filing deadlines for claims and leniency for any other action required under the certificate. Affected members are not required to obtain prior approval when accessing appropriate out-of-network providers when in-network providers are unavailable. The cost-sharing for out-of-network will be in amount equal to cost-sharing affected members would have paid for the provision of that service in-network. A replacement copy of the certificate will be provided upon request by the certificate holder. Affected members should contact Aflac Benefit Solutions (formerly Argus Dental and Vision) at 855-819-1873, Option 1, for assistance.
New messages from Aflac |
View Notifications opens a dialog
Close X dismisses the notification alert
By Carolyn Smith and John Hickman, Alston & Bird, LLP
There is still some confusion related to the taxability and reporting requirements for health indemnity benefits when the premium is paid by the employer or by the employee on a pretax basis. Much of the confusion comes from articles and information based on outdated and unintentionally confusing IRS guidance issued in December 2016. The IRS clarified and superseded this guidance in a memorandum dated April 24, 2017 (irs.gov/pub/irs-wd/201719025.pdf). This advisory provides a detailed look at IRS guidance to help clear up confusion. The bottom line is that the IRS has confirmed the tax exclusion for benefits received under pretax-paid health indemnity policies up to the amount of the unreimbursed medical expenses incurred. This information may be of interest to agents, brokers and employers.
Long-standing IRS rules and Revenue Ruling 69-154
The taxation of benefits under fixed indemnity health policies is governed by IRS Code section 105(b). In 1969, the IRS issued an important ruling under this code section, Revenue Ruling 69-154. This ruling concluded that when a fixed indemnity health policy is paid for on a pretax basis, benefits are taxable only to the extent that they exceed the individual’s unreimbursed medical expenses (i.e., only “excess benefits” are taxable).
Under Revenue Ruling 69-154, determining the amount, if any, of taxable benefits under a fixed indemnity health policy paid for with pretax dollars involves a variety of factors that are known only to the employee (and not the employer or insurer). These factors include any other fixed indemnity health policies the individual has, the total amount of medical expenses and the amount of reimbursed medical expenses. If the employee has more than one fixed indemnity health policy, such as a policy paid with after-tax dollars, the calculation may be more involved, as the employee may need to allocate expenses between their various policies. The employee will make this determination with their tax advisor when filing their personal income taxes for the year in question.
The IRS unintentionally confuses the issue
In December 2016, the IRS released a memo focused on shutting down abusive tax shelters involved with so-called “wellness programs.” In that memorandum, the IRS used overly broad language, which caused confusion about whether the tax exclusion rules under Code section 105(b) and Revenue Ruling 69-154 continued to apply to fixed indemnity health policies. Many incorrectly thought the December 2016 memorandum meant that pretax health indemnity benefits were always taxable. This led to the incorrect conclusion that employer withholding and reporting obligations applied to such coverage when funded on an employer-paid or pretax salary reduction basis. Following soon after the December 2016 memo was issued, the IRS received a number of comments asking for clarification on these issues.
The IRS clears the air
In April 2017, as a result of the many comments received, the IRS issued revised guidance. This new guidance specifically confirmed the continued application of Revenue Ruling 69-154 and its conclusion with respect to the taxation of fixed indemnity health benefits
What does all this mean?
The April 2017 IRS memorandum reconfirms that if an indemnity health policy is paid for by the employer or by the employee with pretax salary reduction funds, benefits are excludable up to the amount of unreimbursed medical expenses. Stated differently, only the excess amount paid above unreimbursed medical expenses is taxable. Further, since some portion of the benefits may be received tax-free, and neither the employer nor the insurer can know what that portion is, only the employee/ policyholder will know what amounts to include in income (excess benefits) and should report such amounts on their personal Form 1040. It’s up to the employee/policyholder to identify and report any amount of excess benefits, including income on their personal Form 1040.
If an indemnity health policy is paid for by the employee on an after-tax basis, then the entire amount of the benefits is tax-free.
Conclusion
If you see materials about the taxation of benefits from an indemnity health policy paid for on a pretax basis, it’s important to make sure that the materials are referencing the IRS memorandum dated April 2017, which confirmed the long-settled rules. Materials that indicate such benefits are always taxable are most likely looking only at the prior December 2016 memorandum, not the most recent IRS guidance. Aflac’s advisory titled The IRS clears the air on taxation of fixed indemnity benefits provides further guidance on this issue.
The information above is provided for general informational purposes and is not provided as tax or legal advice for any person or for any specific situation. Employers and individuals should consult their own tax or legal advisers.
Aflac herein means American Family Life Assurance Company of Columbus and American Family Life Assurance Company of New York. Aflac herein means American Family Life Assurance Company of Columbus and American Family Life Assurance Company of New York. WWHQ | 1932 Wynnton Road | Columbus, GA 31999.
