aflac-medplans-backoffice.prod.intergies.com
Open in
urlscan Pro
3.132.145.210
Public Scan
URL:
https://aflac-medplans-backoffice.prod.intergies.com/
Submission: On May 20 via api from US — Scanned from DE
Submission: On May 20 via api from US — Scanned from DE
Form analysis 3 forms found in the DOM
POST /
<form action="/" data-formtype="zipcode" data-tzthook="zipcode-form" enctype="multipart/form-data" id="form81b34904c5e944b081cb808b07f107e1" method="post" novalidate="">
<input type="hidden" id="State_1" name="ZIPFORM.State" value="">
<div class="form__input">
<input aria-label="Enter ZIP" type="tel" inputmode="numeric" data-mask-pattern="99999" aria-required="true" data-val="true" data-val-explicitlyrequired="Please enter a valid ZIP code." data-val-length="Please enter a valid ZIP code."
data-val-length-max="5" data-val-length-min="5" data-val-regex="Please enter a valid ZIP code." data-val-regex-pattern="^[0-9]{5}" data-val-validregionzip="Please enter a valid ZIP code." id="Zipcode_1" maxlength="5" name="ZIPFORM.Zipcode"
value="">
<label aria-label="Enter ZIP" class="label-before" data-component="movableLabel" for="Zipcode_1"> Enter ZIP </label>
<span class="field-validation-valid" data-valmsg-for="Zipcode_1" data-valmsg-replace="true"></span>
</div>
<div class="form__actions">
<button type="submit" class="form__button button scroll-button" data-component="scroll/button" data-scrollto=".quote-form">Find my plan</button>
</div>
<input name="mvm_form_view_model_mapper_key" value="811fd45b-35c3-40e2-91f8-0a2921735c28" type="hidden">
<div style="position:absolute; left:-9999px; top: -9999px;" aria-hidden="true"><input type="text" name="_firstname_Fs0o6OmV73" value="" autocomplete="new-password" tabindex="-1"><label for="_firstname_Fs0o6OmV73">Leave this field empty</label>
</div><input name="__RequestVerificationToken" type="hidden" value="CfDJ8NfGR7KdGgNOvsVEBFC5qlBvMApCn-IbckrBPjNbS1NB_G_F3HMQFbFnuPTl83Eq2HTJ23zoqIWchYnFSWviU0iPJOLi5prGRjhlRlRz8Ylkp6AJL1E819tyRXcSbUeznJ25mc5FHzMOfQXsYEVWH-g"><input name="ufprt"
type="hidden" value="CfDJ8NfGR7KdGgNOvsVEBFC5qlAFwpLIU3rzpRsmmFVpDuSXRHyoBBY7oBuWjtBfQVItJaadBApgw2L_0eFgZ1WTxG3Nb9IB1zuPk7PvUY-Xm4ZtS-w2CGg1v5ihEPMjq9uGivMuU5rar30n2__iRPYlHVbC1Exg7naLseZukZmSMjpm"><input type="hidden"
name="xxTrustedFormCertUrl" value="https://cert.trustedform.com/5ea22ca229945e7bf8f5252ce72773b15c805b12" id="xxTrustedFormCertUrl_0"><input type="hidden" name="xxTrustedFormToken"
value="https://cert.trustedform.com/5ea22ca229945e7bf8f5252ce72773b15c805b12" id="xxTrustedFormToken_0"><input type="hidden" name="xxTrustedFormPingUrl"
value="https://ping.trustedform.com/0.Dfv6k2Ut0zpXcnWDGwUtxk0SIqaA6Nbb3gwPO0VYVpfr7dCCiPPPVGSrKFa64Tu8trSUjdPS.kAlj4hrEC_-r0Rr9lKGDxw.VGLZ6AK2g-vJNR1eh7w_tQ" id="xxTrustedFormPingUrl_0">
</form>POST /
<form action="/" data-formtype="full" data-tzthook="full-form" enctype="multipart/form-data" id="form2b212870d55144a49803c28030cf68b9" method="post" novalidate="">
<div class="fullform__fields">
<input name="formLibKey" value="4f27131e-a35a-4cc6-ae2d-f6c002df4a7c" type="hidden">
<div class="field">
<div class="fullform__group fullform__group--fullname">
<label for="FullName_6">Full Name</label>
<input maxlength="100" aria-required="true" type="text" data-val="true" data-val-explicitlyrequired="Please enter your full name." data-val-length="Please enter your first and last name." data-val-length-max="25" data-val-length-min="2"
data-val-regex="Please enter your first and last name." data-val-regex-pattern="^(?:[a-zA-Z]{2,}\s)+[a-zA-Z]{2,}$" id="FullName_6" name="FullName" value="">
</div>
<span class="field-validation-valid" data-valmsg-for="FullName_6" data-valmsg-replace="true"></span>
</div>
<div class="field">
<div class="fullform__group fullform__group--zipcode">
<label for="Zipcode_6">ZIP code</label>
<input type="tel" inputmode="numeric" data-mask-pattern="99999" aria-required="true" data-val="true" data-val-explicitlyrequired="Please enter a valid zip code." data-val-length="Please enter a valid zip code." data-val-length-max="5"
data-val-length-min="5" data-val-regex="Please enter a valid zip code." data-val-regex-pattern="^[0-9]{5}" data-val-validregionzip="Please enter a valid ZIP code." id="Zipcode_6" maxlength="5" name="Zipcode" value="">
</div>
<span class="field-validation-valid" data-valmsg-for="Zipcode_6" data-valmsg-replace="true"></span>
</div>
<div class="field">
<div class="fullform__group fullform__group--phone">
<label for="Phone_6">Phone Number</label>
<input inputmode="tel" data-mask-pattern="(999) 999-9999" aria-required="true" type="tel" data-val="true" data-val-explicitlyrequired="Please enter your phone number." data-val-regex="Please enter your phone number."
data-val-regex-pattern="^\d{10}$" id="Phone_6" name="Phone" value="">
</div>
<span class="field-validation-valid" data-valmsg-for="Phone_6" data-valmsg-replace="true"></span>
</div>
<div class="field">
<div class="fullform__group fullform__group--email">
<label for="Email_6">Email Address</label>
<input type="email" inputmode="email" data-mask-pattern="^\s*[\wÀ-ý]+(?:[.+-]?[\wÀ-ý])*\@[A-Za-z](?:-?[A-Za-z0-9])*(?:\.[A-Za-z](?:-?[A-Za-z0-9])*)+\s*$" aria-required="true" data-val="true"
data-val-explicitlyrequired="Please enter your email address." data-val-regex="Please enter a valid email address." data-val-regex-pattern="^\s*[\wÀ-ý]+(?:[.+-]?[\wÀ-ý])*\@[A-Za-z](?:-?[A-Za-z0-9])*(?:\.[A-Za-z](?:-?[A-Za-z0-9])*)+\s*$"
id="Email_6" name="Email" value="">
</div>
<span class="field-validation-valid" data-valmsg-for="Email_6" data-valmsg-replace="true"></span>
</div>
</div>
<div class="fullform__actions">
<button type="submit">Find My Plan</button>
</div>
<div class="fullform__disclaimer">
<input type="hidden" id="LegalTCPA_6" name="LegalTCPA"
value="By entering my contact information and clicking "Find My Plan" above, I consent to receive e-mails, telephone calls, and/or text messages from licensed insurance agents with TZ Insurance Solutions LLC on behalf of Aflac regarding their products and services, at the e-mail and phone number provided above, including my wireless number (if provided) and regardless of whether it is on any do not call list, using an automated telephone dialing system, artificial and/or pre-recorded voice messages. I understand I may also receive text messages about the status of my Aflac application. I understand that my wireless carrier’s standard message and data rates apply. I understand I can make a purchase or speak to a licensed insurance agent without granting this consent by calling 1-844-711-3147 , and I may revoke this consent any time. I agree to this website's Privacy Notice and Terms of Use.">
<p>By entering my contact information and clicking "Find My Plan" above, I consent to receive e-mails, telephone calls, and/or text messages from licensed insurance agents with TZ Insurance Solutions LLC on behalf of Aflac regarding their
products and services, at the e-mail and phone number provided above, including my wireless number (if provided) and regardless of whether it is on any do not call list, using an automated telephone dialing system, artificial and/or
pre-recorded voice messages. I understand I may also receive text messages about the status of my Aflac application. I understand that my wireless carrier’s standard message and data rates apply. I understand I can make a purchase or speak to a
licensed insurance agent without granting this consent by calling <a class="tel" href="tel:+18555781198" data-tzthook-screener-ignore="" aria-label="Call: 1. 8 5 5. 5 7 8. 1 1 9 8.">1-855-578-1198</a>, and I may revoke this consent any time. I
agree to this website's <a rel="noopener" href="/privacy-notice" target="_blank">Privacy Notice</a> and <a rel="noopener" href="https://www.aflac.com/about-aflac/terms-of-use.aspx" target="_blank">Terms of Use.</a></p>
</div>
<input name="mvm_form_view_model_mapper_key" value="4f27131e-a35a-4cc6-ae2d-f6c002df4a7c" type="hidden">
<div style="position:absolute; left:-9999px; top: -9999px;" aria-hidden="true"><input type="text" name="_email_EXxLZSYWT2" value="" autocomplete="new-password" tabindex="-1"><label for="_email_EXxLZSYWT2">Leave this field empty</label></div><input
name="__RequestVerificationToken" type="hidden" value="CfDJ8NfGR7KdGgNOvsVEBFC5qlBvMApCn-IbckrBPjNbS1NB_G_F3HMQFbFnuPTl83Eq2HTJ23zoqIWchYnFSWviU0iPJOLi5prGRjhlRlRz8Ylkp6AJL1E819tyRXcSbUeznJ25mc5FHzMOfQXsYEVWH-g"><input name="ufprt" type="hidden"
value="CfDJ8NfGR7KdGgNOvsVEBFC5qlCxFSmEzU8dNP0JDtGggMzjORnX626RtdyXbuqiODTNUG4WLEQNgUgZCdr4l73H_x1E0Mo7Ldag5VahlpX8E-LVS7kZroDhHU7N5J3hCz6XuoNo19OSPloXW3C_upNG90srSwLtOJo7Ad1l-Xr0XF0N"><input type="hidden" name="xxTrustedFormCertUrl"
value="https://cert.trustedform.com/5ea22ca229945e7bf8f5252ce72773b15c805b12" id="xxTrustedFormCertUrl_1"><input type="hidden" name="xxTrustedFormToken" value="https://cert.trustedform.com/5ea22ca229945e7bf8f5252ce72773b15c805b12"
id="xxTrustedFormToken_1"><input type="hidden" name="xxTrustedFormPingUrl" value="https://ping.trustedform.com/0.Dfv6k2Ut0zpXcnWDGwUtxk0SIqaA6Nbb3gwPO0VYVpfr7dCCiPPPVGSrKFa64Tu8trSUjdPS.kAlj4hrEC_-r0Rr9lKGDxw.VGLZ6AK2g-vJNR1eh7w_tQ"
id="xxTrustedFormPingUrl_1">
</form>POST /
<form action="/" enctype="multipart/form-data" id="form-eapp" method="post"><input name="ufprt" type="hidden"
value="CfDJ8NfGR7KdGgNOvsVEBFC5qlAzvU5y82xNJZOvbdvIADJqMRevf8ZOsJaVmGiSN9LbroxpBVD7pouhn561LqTY35w51e26EMtnYuBAMv2m0ulXuVPu2zCiS4yKhgBb8j-IxsdTDQR5hN4rIsvk4b6aRQJ7ug93gf4uH54e_J_iq62x"><input type="hidden" name="xxTrustedFormCertUrl"
value="https://cert.trustedform.com/5ea22ca229945e7bf8f5252ce72773b15c805b12" id="xxTrustedFormCertUrl_2"><input type="hidden" name="xxTrustedFormToken" value="https://cert.trustedform.com/5ea22ca229945e7bf8f5252ce72773b15c805b12"
id="xxTrustedFormToken_2"><input type="hidden" name="xxTrustedFormPingUrl" value="https://ping.trustedform.com/0.Dfv6k2Ut0zpXcnWDGwUtxk0SIqaA6Nbb3gwPO0VYVpfr7dCCiPPPVGSrKFa64Tu8trSUjdPS.kAlj4hrEC_-r0Rr9lKGDxw.VGLZ6AK2g-vJNR1eh7w_tQ"
id="xxTrustedFormPingUrl_2"></form>Text Content
skip to main Products * 1-855-578-1198 * Products * Accident Insurance * Cancer Insurance * Critical Illness Insurance Get a Quote 1-855-578-1198 * Already an Aflac customer * File a Claim * Individuals * Business Owners * Agents * Brokers HELP PREPARE FOR UNEXPECTED MEDICAL BILLS SO YOU CAN FOCUS ON YOUR HEALTH AND FAMILY. APPLY FOR AN AFLAC INSURANCE POLICY TO HELP WITH UNEXPECTED EXPENSES. Enter ZIP Find my plan Leave this field empty Aflac helps support millions of people around the world. MORE THAN 50% OF AMERICANS AREN’T PREPARED TO PAY AN UNEXPECTED MEDICAL BILL.1 Find out how benefits from an Aflac insurance policy can help with out-of-pocket medical expenses. FIND THE COVERAGE THAT’S RIGHT FOR YOU. ACCIDENT INSURANCE Pays cash benefits that can be used to help with unexpected expenses due to a covered accident. Learn More CANCER INSURANCE2 Pays cash benefits in the event you or a covered family member are diagnosed with cancer. Learn More CRITICAL ILLNESS INSURANCE Pays cash benefits in the event of a covered critical illness. Learn More FAQS WHAT IS A VOLUNTARY INSURANCE PLAN? A voluntary insurance plan provides additional coverage to help pay out-of-pocket costs like deductibles and copays. These plans can help cover expenses for unexpected accidents, as well as illness or death. HOW DO I RECEIVE MY BENEFITS? Aflac pays cash benefits directly to you, unless assigned otherwise. WHY AFLAC? In the event of a covered injury or illness, we will process and pay your claim fast. HOW DO I GET MORE INFORMATION? To find out more about how Aflac can help you, please fill out the form below. FIND A PLAN THAT FITS YOUR NEEDS. PLEASE COMPLETE THE FORM BELOW. Full Name ZIP code Phone Number Email Address Find My Plan By entering my contact information and clicking "Find My Plan" above, I consent to receive e-mails, telephone calls, and/or text messages from licensed insurance agents with TZ Insurance Solutions LLC on behalf of Aflac regarding their products and services, at the e-mail and phone number provided above, including my wireless number (if provided) and regardless of whether it is on any do not call list, using an automated telephone dialing system, artificial and/or pre-recorded voice messages. I understand I may also receive text messages about the status of my Aflac application. I understand that my wireless carrier’s standard message and data rates apply. I understand I can make a purchase or speak to a licensed insurance agent without granting this consent by calling 1-855-578-1198, and I may revoke this consent any time. I agree to this website's Privacy Notice and Terms of Use. Leave this field empty * A+ A.M. BEST* * Aa3 MOODY’s* * A+ S&P* 1-855-578-1198 1 2022-2023 Aflac WorkForces Report. aflacworkforcesreport.com. 2 Cancer insurance is also known as Specified-Disease Insurance in some states. *"Financial Strength Ratings", Aflac.com. Accolades listed are applicable to Aflac of Columbus. Accessed April 2023. https://investors.aflac.com/ratings/default.aspx TZ Insurance Solutions, LLC, a Delaware limited liability company, is a licensed insurance producer (National Producer Number (NPN) 15747136; California Insurance Producer License Number 0H02337; Arkansas Insurance Producer License Number 100104637) has been appointed to act as an agent of Tier One Insurance Company and American Family Life Assurance Company of Columbus. TZ Insurance Solutions, LLC is an [affiliate/subsidiary] of MG LLC d/b/a TRANZACT, a Delaware limited liability company. To read TZ Insurance Solutions LLC's Privacy Notice, click here. For California, Connecticut, and Virginia residents – Do Not Sell/Share My Personal Info, click here. Accessibility Statement & Contact Form | Aflac © 2023 Aflac Incorporated This is a brief product overview only. Coverage may not be available in all states, including but not limited to ID, NJ, NM, NY, or VA. Benefits/premium rates may vary based on plan selected. Optional riders may be available at an additional cost. Policies and riders may also contain a waiting period. Refer to the exact policies and riders for benefit details, definitions, limitations and exclusions. For availability and costs, please complete the form above. Tier One Insurance Company is part of the Aflac family of insurers. In California, Tier One Insurance Company does business as Tier One Life Insurance Company (Tier One NAIC 92908). COVERAGE UNDERWRITTEN BY TIER ONE INSURANCE COMPANY: ACCIDENT: In Delaware, Policy T37000. In Idaho, Policies T37100ID, T37200ID, & T37300ID. In Oklahoma, Policy T37000OK. CANCER/SPECIFIED-DISEASE: In Delaware, Policy T70000. In Idaho, Policy T70000ID. In Oklahoma, Policy T70000OK. In Virginia, policies T70000VA & T70000GVA. CRITICAL ILLNESS: In Delaware, Policy T71000. In Oklahoma, Policy T71000OK. In Virginia, Policy T71100VA. DENTAL, VISION AND HEARING: In Delaware, Policy T80000. In Idaho, Policy T80000ID. In Oklahoma, Policy T80000OK. Dental claims are administered by Aflac Benefits Solutions, Inc. Vision claims are administered by EyeMed Vision Care, LLC. Hearing claims are administered by Nations Hearing. NOTICE: The coverage offered is not a qualified health plan (QHP) under the Patient Protection and Affordable Care Act (ACA) and is not required to satisfy essential health benefits mandates of the ACA. The coverage provides limited benefits. COVERAGE UNDERWRITTEN BY AMERICAN FAMILY LIFE ASSURANCE COMPANY OF COLUMBUS: ACCIDENT: In Delaware, Policy A371AA & A371BA. In Idaho, Policy A37000IDIn Oklahoma, Policy A37000OK. In Virginia, Policies A371AAVA & A371BAVA. DENTAL: In Delaware, Policies A82100R–A82400R. In Idaho, Policies A82100RID–A82400RID. In Oklahoma, Policies A82100ROK–A82400ROK. In Virginia, Policies A82100RVA–A82400RVA. CANCER/SPECIFIED-DISEASE: In Delaware, Policies B70100DE, B70200DE & B70300DE. In Idaho, Policies B70100ID, B70200ID, B70300ID, B7010EPID, B7020EPID. In Oklahoma, Policies B70100OK, B70200OK, B70300OK, B7010EPOK, B7020EPOK. CRITICAL ILLNESS: In Delaware, Policies A74100DE, A74200DE, A74300DE. In Idaho, Policies A74100ID, A74200ID, A74300ID. In Oklahoma, Policies A74100OK, A74200OK, A74300OK. In Virginia, Policies A74100VA, A74200VA, A74300VA. Aflac WWHQ | Tier One Insurance Company | 1932 Wynnton Road | Columbus, GA 31999. * Privacy Notice * Consumer Health Data Privacy Notice * Terms of Use Z2300021 EXP 06/24 By continuing to use this site, you consent to our use of technologies that analyze and monitor activity on our website, may record your activity on this site for compliance and other purposes, and sometimes provide you with tailored advertising. To learn more please visit our Privacy Notice and Terms of Use.