Choose your state of residence from the map or drop-down menu below.  Then scroll to select the claim form(s) you need.  If you are having issues with the claim form map, please visit our non Flash version.

Submitting Claims

Complete claims forms (excluding Flex One® and Transit One® reimbursement forms) may be submitted by mail or fax to: 

Aflac New York
ATTN: Claims Department
1932 Wynnton Road
Columbus, GA 31999-7251
Fax: 1-877-844-0201

Not sure how to file? Get detailed instructions on expediting your claim.

Reimbursement Forms

Flex One® Request for Reimbursement Form (Medical FSA and/or Dependent FSA)
Flex One® Request for Reimbursement Form (Medical FSA Only)
Transit One® (PDF )

Aflac - Policyholders - Get a Claim Form