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POLICY LIABILITIES | 12 Months Ended
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Dec. 31, 2023
Insurance Loss Reserves [Abstract] |
POLICY LIABILITIES | POLICY LIABILITIES Future Policy Benefits The liability for future policy benefits is determined as the present value of expected future policy benefits to be paid to or on the behalf of policyholders and certain related expenses less the present value of expected future net premiums receivable under the Company's insurance contracts. Future net premiums receivable are future gross premiums receivable under the contract multiplied by the NPR. The following tables present the changes in the present value of expected future net premiums and the present value of expected future policy benefits by reporting segment and disaggregated by product type for the years ended December 31. The present value of expected future net premiums and the present value of expected future policy benefits are presented gross of internal and external ceded reinsurance.
| 2023
| Aflac Japan |  | Aflac U.S.
(In millions) | Cancer | Medical and Other Health | Life Insurance | Other |  | Accident | Disability | Critical Care | Hospital Indemnity | Dental/Vision | Life Insurance | Other
Present value of expected future net premiums: |  |  |  |  |  |  |  |  |  |  |  |
Balance at December 31, 2022 | $ | 19,298 |  | $ | 16,714 |  | $ | 7,485 |  | $ | 1,256 |  |  | $ | 2,534 |  | $ | 1,635 |  | $ | 4,486 |  | $ | 1,220 |  | $ | 211 |  | $ | 724 |  | $ | 110 |
Beginning balance at original discount rate | 18,221 |  | 16,195 |  | 7,284 |  | 1,242 |  |  | 2,760 |  | 1,775 |  | 5,050 |  | 1,365 |  | 231 |  | 799 |  | 118 |
Effect of changes in cash flow assumptions | (165) |  | (470) |  | 43 |  | (12) |  |  | (16) |  | (51) |  | (494) |  | (142) |  | (9) |  | 61 |  | (9) |
Effect of actual variances from expected experience | (315) |  | (137) |  | (42) |  | (15) |  |  | (58) |  | (29) |  | (223) |  | (73) |  | (17) |  | (25) |  | (2) |
Adjusted beginning of period balance | 17,741 |  | 15,588 |  | 7,285 |  | 1,215 |  |  | 2,686 |  | 1,695 |  | 4,333 |  | 1,150 |  | 205 |  | 835 |  | 107 |
Issuances | 1,034 |  | 418 |  | 335 |  | 26 |  |  | 323 |  | 376 |  | 493 |  | 249 |  | 44 |  | 181 |  | 169 |
Interest accrual | 412 |  | 334 |  | 124 |  | 20 |  |  | 102 |  | 62 |  | 179 |  | 45 |  | 8 |  | 31 |  | 6 |
Net premiums collected (1) | (1,564) |  | (1,261) |  | (1,017) |  | (112) |  |  | (473) |  | (390) |  | (580) |  | (247) |  | (39) |  | (137) |  | (17) |
Foreign currency translation | (1,170) |  | (1,038) |  | (469) |  | (80) |  |  | 0 |  | 0 |  | 0 |  | 0 |  | 0 |  | 0 |  | 0 |
Other | (1) |  | (1) |  | 0 |  | 0 |  |  | (8) |  | (5) |  | (9) |  | (4) |  | (1) |  | (1) |  | 7 |
Ending balance at original discount rate | 16,452 |  | 14,040 |  | 6,258 |  | 1,069 |  |  | 2,630 |  | 1,738 |  | 4,416 |  | 1,193 |  | 217 |  | 909 |  | 272 |
Effect of changes in discount rate assumptions | 1,057 |  | 657 |  | 230 |  | 19 |  |  | (142) |  | (86) |  | (342) |  | (86) |  | (11) |  | (56) |  | 5 |
Balance at December 31, 2023 | $ | 17,509 |  | $ | 14,697 |  | $ | 6,488 |  | $ | 1,088 |  |  | $ | 2,488 |  | $ | 1,652 |  | $ | 4,074 |  | $ | 1,107 |  | $ | 206 |  | $ | 853 |  | $ | 277 |
Present value of expected future policy benefits: |  |  |  |  |  |  |  |  |  |  |  |
Balance at December 31, 2022 | $ | 54,766 |  | $ | 27,419 |  | $ | 31,954 |  | $ | 5,582 |  |  | $ | 3,098 |  | $ | 2,445 |  | $ | 11,489 |  | $ | 2,074 |  | $ | 488 |  | $ | 1,526 |  | $ | 622 |
Beginning balance at original discount rate | 47,677 |  | 27,566 |  | 32,800 |  | 5,940 |  |  | 3,391 |  | 2,636 |  | 12,846 |  | 2,300 |  | 532 |  | 1,778 |  | 624 |
Effect of changes in cash flow assumptions | (147) |  | (507) |  | 65 |  | (27) |  |  | (11) |  | (59) |  | (592) |  | (194) |  | (14) |  | 72 |  | (13) |
Effect of actual variances from expected experience | (385) |  | (154) |  | (51) |  | (15) |  |  | (75) |  | (59) |  | (271) |  | (99) |  | (22) |  | (32) |  | (4) |
Adjusted beginning of period balance | 47,145 |  | 26,905 |  | 32,814 |  | 5,898 |  |  | 3,305 |  | 2,518 |  | 11,983 |  | 2,007 |  | 496 |  | 1,818 |  | 607 |
Issuances | 1,059 |  | 432 |  | 341 |  | 32 |  |  | 331 |  | 392 |  | 505 |  | 258 |  | 46 |  | 185 |  | 169 |
Interest accrual | 1,473 |  | 608 |  | 625 |  | 100 |  |  | 127 |  | 96 |  | 524 |  | 84 |  | 21 |  | 68 |  | 33 |
Benefit payments | (2,987) |  | (1,153) |  | (1,415) |  | (206) |  |  | (464) |  | (465) |  | (893) |  | (274) |  | (59) |  | (105) |  | (48) |
Foreign currency translation | (3,064) |  | (1,769) |  | (2,109) |  | (380) |  |  | 0 |  | 0 |  | 0 |  | 0 |  | 0 |  | 0 |  | 0 |
Other | 0 |  | 0 |  | 0 |  | 0 |  |  | 3 |  | 0 |  | 1 |  | 1 |  | 2 |  | 5 |  | 8 |
Ending balance at original discount rate | 43,626 |  | 25,023 |  | 30,256 |  | 5,444 |  |  | 3,302 |  | 2,541 |  | 12,120 |  | 2,076 |  | 506 |  | 1,971 |  | 769 |
Effect of changes in discount rate assumptions | 6,535 |  | 234 |  | (525) |  | (266) |  |  | (193) |  | (119) |  | (830) |  | (133) |  | (28) |  | (207) |  | 29 |
Balance at December 31, 2023 | 50,161 |  | 25,257 |  | 29,731 |  | 5,178 |  |  | 3,109 |  | 2,422 |  | 11,290 |  | 1,943 |  | 478 |  | 1,764 |  | 798 |
Net liability for future policy benefits | 32,652 |  | 10,560 |  | 23,243 |  | 4,090 |  |  | 621 |  | 770 |  | 7,216 |  | 836 |  | 272 |  | 911 |  | 521 |
Less: reinsurance recoverable | 4,135 |  | 1,521 |  | 0 |  | 0 |  |  | 0 |  | 0 |  | 0 |  | 0 |  | 0 |  | 15 |  | 0 |
Net liability for future policy benefits after reinsurance recoverable | $ | 28,517 |  | $ | 9,039 |  | $ | 23,243 |  | $ | 4,090 |  |  | $ | 621 |  | $ | 770 |  | $ | 7,216 |  | $ | 836 |  | $ | 272 |  | $ | 896 |  | $ | 521 |
(1) Net premiums collected represent the portion of gross premiums collected from policyholders that is used to fund expected future benefit payments.
| 2022
| Aflac Japan |  | Aflac U.S.
(In millions) | Cancer | Medical and Other Health | Life Insurance | Other |  | Accident | Disability | Critical Care | Hospital Indemnity | Dental/Vision | Life Insurance | Other
Present value of expected future net premiums: |  |  |  |  |  |  |  |  |  |  |  |
Balance at December 31, 2021 | $ | 25,893 |  | $ | 21,174 |  | $ | 10,847 |  | $ | 1,586 |  |  | $ | 3,283 |  | $ | 1,862 |  | $ | 6,023 |  | $ | 1,467 |  | $ | 264 |  | $ | 834 |  | $ | 153 |
Beginning balance at original discount rate | 22,470 |  | 18,681 |  | 10,064 |  | 1,461 |  |  | 2,999 |  | 1,760 |  | 5,391 |  | 1,380 |  | 241 |  | 780 |  | 135 |
Effect of changes in cash flow assumptions | (639) |  | 317 |  | (494) |  | 25 |  |  | (52) |  | 5 |  | (38) |  | 42 |  | 10 |  | (1) |  | (12) |
Effect of actual variances from expected experience | (284) |  | 61 |  | (81) |  | (10) |  |  | (152) |  | (43) |  | (421) |  | (111) |  | (20) |  | (16) |  | 6 |
Adjusted beginning of period balance | 21,547 |  | 19,059 |  | 9,489 |  | 1,476 |  |  | 2,795 |  | 1,722 |  | 4,932 |  | 1,311 |  | 231 |  | 763 |  | 129 |
Issuances | 947 |  | 639 |  | 221 |  | 62 |  |  | 355 |  | 384 |  | 537 |  | 273 |  | 33 |  | 146 |  | 0 |
Interest accrual | 459 |  | 364 |  | 146 |  | 22 |  |  | 105 |  | 57 |  | 193 |  | 45 |  | 9 |  | 27 |  | 5 |
Net premiums collected (1) | (1,734) |  | (1,376) |  | (1,229) |  | (123) |  |  | (496) |  | (382) |  | (612) |  | (261) |  | (42) |  | (131) |  | (17) |
Foreign currency translation | (2,997) |  | (2,488) |  | (1,343) |  | (195) |  |  | 0 |  | 0 |  | 0 |  | 0 |  | 0 |  | 0 |  | 0 |
Other | (1) |  | (3) |  | 0 |  | 0 |  |  | 1 |  | (6) |  | 0 |  | (3) |  | 0 |  | (6) |  | 1 |
Ending balance at original discount rate | 18,221 |  | 16,195 |  | 7,284 |  | 1,242 |  |  | 2,760 |  | 1,775 |  | 5,050 |  | 1,365 |  | 231 |  | 799 |  | 118 |
Effect of changes in discount rate assumptions | 1,077 |  | 519 |  | 201 |  | 14 |  |  | (226) |  | (140) |  | (564) |  | (145) |  | (20) |  | (75) |  | (8) |
Balance at December 31, 2022 | $ | 19,298 |  | $ | 16,714 |  | $ | 7,485 |  | $ | 1,256 |  |  | $ | 2,534 |  | $ | 1,635 |  | $ | 4,486 |  | $ | 1,220 |  | $ | 211 |  | $ | 724 |  | $ | 110 |
Present value of expected future policy benefits: |  |  |  |  |  |  |  |  |  |  |  |
Balance at December 31, 2021 | $ | 72,747 |  | $ | 36,021 |  | $ | 42,720 |  | $ | 7,322 |  |  | $ | 3,949 |  | $ | 2,871 |  | $ | 15,388 |  | $ | 2,552 |  | $ | 616 |  | $ | 1,843 |  | $ | 837 |
Beginning balance at original discount rate | 56,807 |  | 31,398 |  | 39,002 |  | 6,787 |  |  | 3,594 |  | 2,670 |  | 13,079 |  | 2,300 |  | 549 |  | 1,694 |  | 645 |
Effect of changes in cash flow assumptions | (721) |  | 352 |  | (550) |  | 96 |  |  | (70) |  | 5 |  | (43) |  | 40 |  | 13 |  | (1) |  | (15) |
Effect of actual variances from expected experience | (333) |  | 83 |  | (91) |  | (10) |  |  | (177) |  | (48) |  | (465) |  | (130) |  | (23) |  | (21) |  | 7 |
Adjusted beginning of period balance | 55,753 |  | 31,833 |  | 38,361 |  | 6,873 |  |  | 3,347 |  | 2,627 |  | 12,571 |  | 2,210 |  | 539 |  | 1,672 |  | 637 |
Issuances | 960 |  | 646 |  | 222 |  | 68 |  |  | 364 |  | 397 |  | 550 |  | 282 |  | 34 |  | 149 |  | 0 |
Interest accrual | 1,599 |  | 642 |  | 670 |  | 106 |  |  | 128 |  | 94 |  | 539 |  | 85 |  | 21 |  | 62 |  | 32 |
Benefit payments | (3,050) |  | (1,375) |  | (1,248) |  | (202) |  |  | (456) |  | (483) |  | (823) |  | (277) |  | (62) |  | (103) |  | (45) |
Foreign currency translation | (7,585) |  | (4,180) |  | (5,205) |  | (905) |  |  | 0 |  | 0 |  | 0 |  | 0 |  | 0 |  | 0 |  | 0 |
Other | 0 |  | 0 |  | 0 |  | 0 |  |  | 8 |  | 1 |  | 9 |  | 0 |  | 0 |  | (2) |  | 0 |
Ending balance at original discount rate | 47,677 |  | 27,566 |  | 32,800 |  | 5,940 |  |  | 3,391 |  | 2,636 |  | 12,846 |  | 2,300 |  | 532 |  | 1,778 |  | 624 |
Effect of changes in discount rate assumptions | 7,089 |  | (147) |  | (846) |  | (358) |  |  | (293) |  | (191) |  | (1,357) |  | (226) |  | (44) |  | (252) |  | (2) |
Balance at December 31, 2022 | 54,766 |  | 27,419 |  | 31,954 |  | 5,582 |  |  | 3,098 |  | 2,445 |  | 11,489 |  | 2,074 |  | 488 |  | 1,526 |  | 622 |
Net liability for future policy benefits | 35,468 |  | 10,705 |  | 24,469 |  | 4,326 |  |  | 564 |  | 810 |  | 7,003 |  | 854 |  | 277 |  | 802 |  | 512 |
Less: reinsurance recoverable | 0 |  | 1,579 |  | 0 |  | 0 |  |  | 0 |  | 0 |  | 0 |  | 0 |  | 0 |  | 9 |  | 0 |
Net liability for future policy benefits after reinsurance recoverable | $ | 35,468 |  | $ | 9,126 |  | $ | 24,469 |  | $ | 4,326 |  |  | $ | 564 |  | $ | 810 |  | $ | 7,003 |  | $ | 854 |  | $ | 277 |  | $ | 793 |  | $ | 512 |
(1) Net premiums collected represent the portion of gross premiums collected from policyholders that is used to fund expected future benefit payments. The following tables present the weighted-average interest rates and weighted-average liability duration (calculated using the original discount rate) by reporting segment and disaggregated by product type as of December 31.
| 2023
| Aflac Japan |  | Aflac U.S.
| Cancer | Medical and Other Health | Life Insurance | Other |  | Accident | Disability | Critical Care | Hospital Indemnity | Dental/Vision | Life Insurance | Other
Weighted-average interest, original discount rate (1) | 3.9 % | 2.6 % | 2.1 % | 1.8 % |  | 3.9 % | 4.2 % | 4.6 % | 4.4 % | 4.3 % | 3.7 % | 5.4 %
Weighted-average interest, current discount rate (1) | 1.8 % | 2.3 % | 1.7 % | 2.1 % |  | 5.3 % | 5.3 % | 5.3 % | 5.3 % | 5.3 % | 5.3 % | 5.3 %
Weighted-average liability duration (years) | 13.1 | 24.9 | 16.3 | 17.3 |  | 8.1 | 5.6 | 11.3 | 9.3 | 7.9 | 13.6 | 9.4
(1) The weighted-average interest rates are calculated using the reserve balances as the weights. No adjustments were made to observable market information.
| 2022
| Aflac Japan |  | Aflac U.S.
| Cancer | Medical and Other Health | Life Insurance | Other |  | Accident | Disability | Critical Care | Hospital Indemnity | Dental/Vision | Life Insurance | Other
Weighted-average interest, original discount rate (1) | 4.1 % | 2.6 % | 2.1 % | 1.8 % |  | 3.8 % | 4.2 % | 4.6 % | 4.4 % | 4.3 % | 3.7 % | 5.4 %
Weighted-average interest, current discount rate (1) | 1.6 % | 2.2 % | 1.6 % | 1.9 % |  | 4.8 % | 4.7 % | 4.8 % | 4.8 % | 4.8 % | 4.8 % | 4.8 %
Weighted-average liability duration (years) | 13.7 | 26.9 | 17.3 | 18.2 |  | 8.5 | 5.6 | 12.0 | 9.4 | 8.1 | 13.1 | 9.6
(1) The weighted-average interest rates are calculated using the reserve balances as the weights. No adjustments were made to observable market information. The following table presents a reconciliation of the disaggregated rollforwards above to the ending future policy benefits presented in the consolidated balance sheets as of December 31. The deferred profit liability for limited-payment contracts and the deferred reinsurance gain liability are presented together with the liability for future policy benefits in the consolidated balance sheets and have been included as reconciling items in the table below.
(In millions) | 2023 |  | 2022
Balances included in future policy benefits rollforward: |  |  |  |  |  |  |
Aflac Japan |  |  |  |  |  |  |
Cancer |  | $ | 32,652 |  |  |  |  | $ | 35,468 |  |
Medical and other health |  | 10,560 |  |  |  |  | 10,705 |  |
Life insurance |  | 23,243 |  |  |  |  | 24,469 |  |
Other |  | 4,090 |  |  |  |  | 4,326 |  |
Aflac U.S. |  |  |  |  |  |  |
Accident |  | 621 |  |  |  |  | 564 |  |
Disability |  | 770 |  |  |  |  | 810 |  |
Critical care |  | 7,216 |  |  |  |  | 7,003 |  |
Hospital indemnity |  | 836 |  |  |  |  | 854 |  |
Dental/vision |  | 272 |  |  |  |  | 277 |  |
Life insurance |  | 911 |  |  |  |  | 802 |  |
Other |  | 521 |  |  |  |  | 512 |  |
Corporate and other |  | 4,225 |  |  |  |  | 686 |  |
Deferred profit liability |  | 1,806 |  |  |  |  | 1,740 |  |
Deferred reinsurance gain liability |  | 1,012 |  |  |  |  | 692 |  |
Intercompany eliminations (1) |  | (5,017) |  |  |  |  | (667) |  |
Total |  | $ | 83,718 |  |  |  |  | $ | 88,241 |  |
(1) Elimination entry necessary due to the internal reinsurance transactions with Aflac Re and to recapture a portion of policy liabilities ceded externally as a result of the reinsurance retrocession transaction. See Note 8 for additional details. Discount rates are determined using upper-medium grade (low-credit-risk) fixed-income instrument yields that reflect the duration characteristics of the liability. Locked-in discount rates are determined separately for each issue-year cohort as a single discount rate, calculated as the weighted-average of monthly upper-medium grade (low credit risk) fixed-income instrument forward curves in the calendar year, where the weights are the annualized premiums issued for each month of the cohort. The single discount rate for each issue-year cohort is determined by solving for a rate that produces an equivalent net premium ratio to the forward curve and will remain unchanged after the calendar year of issue. Discount rates are updated each reporting period and require estimation techniques (e.g., interpolation, extrapolation) for determination of points on the curve for which there is limited or no observable market data. The Company constructs a current discount rate curve separately for discounting cash flows used to calculate each of the Japan and U.S. liabilities for future policy benefits, reflective of the characteristics of the corresponding insurance liabilities, such as currency and tenor. In the Aflac Japan segment, all long-duration insurance policies are denominated in yen. A significant portion of policies are characterized by tenors exceeding the availability of liquid market data in Japan for single-A rated (as a proxy for upper-medium grade) corporate yen-denominated debt. The discount rate curve is designed to prioritize the observable inputs where available, while past the last liquid point, the data is derived based on estimation techniques consistent with the fair value guidance in ASC 820. The Aflac Japan segment curve utilizes liquid market indices tracking publicly traded yen-denominated single-A corporate debt for the initial 10-year tenor. For the bonds within these market indices where only local ratings are available, the Company prioritizes the bonds with local ratings that are equivalent to a single-A rating based on international rating standards. For the discount rates applicable to tenors for which the Japan single-A debt market is not liquid but there is sufficient observable market data and/or the observable market data is available for similar instruments (between 10 and 30 years), the Company estimates tenor-specific single-A credit spreads and applies them to risk-free government rates. Lastly, for the tenors where there is limited or no observable single-A or similar market data or risk-free government rates (beyond 30 years), the discount curve is derived by extrapolation of risk-free rates beyond their last liquid point following the Smith- Wilson method and grading of the estimated forward credit spread anchored by the ultimate forward rate. The ultimate forward rate is based on the economic value-based solvency regime, which is consistent with the International Association of Insurance Supervisors (IAIS) Insurance Capital Standards (ICS) (which is expected to be introduced in Japan in 2025), and is adjusted for credit and inflation components. For the Aflac U.S. segment where all long-duration insurance policies are denominated in U.S. dollar and substantially all have cash flow duration within 30 years, for which the U.S. upper-medium grade fixed-income market is liquid and observable, the Company uses data from a liquid fixed-income market index tracking single-A U.S. corporate debt. For the insignificant portion of the policies with cash flow tenors exceeding 30 years, the discount curve beyond that tenor is extrapolated following the Smith-Wilson method from year 30 to the same ultimate forward rate calculated for the Japan discount curve at year 60 and held constant thereafter. The use of the same ultimate rate for U.S. and Japan segments is based on the assumption of long-term global economic convergence. For the years ended December 31, 2023, 2022 and 2021, the Company recognized approximately $(460) million, $13.7 billion and $2.7 billion, respectively, in other comprehensive income (loss) net of tax due to changes in the future policy benefits estimate from updating the discount rate assumptions. There were no changes to the methods used to determine the discount rates during the years ended December 31, 2023 and 2022. Mortality rate assumptions are based on industry tables and adjusted for the Company's actual or expected experience where credible or appropriate. These assumptions typically vary by age, gender, and other demographic characteristics such as smoking status. Morbidity assumptions are based on the Company's internal data and consider emerging experience. These assumptions are reflective of the coverage and benefits provided and generally vary by age, gender, duration, and any other material policyholder characteristics. In cases where a calendar-year trend is significant, future cash flow projections may include a trend adjustment. In Japan, separate lapse assumptions are set based on actual or expected experience. These lapse and total termination rate assumptions vary by line of business and with policyholder characteristics such as duration. In the U.S., the majority of the future cash flows are modeled using total termination rates (which include both lapse and mortality) and are adjusted for actual experience. Policy provisions, such as reaching premium paid-up status, are taken into account when setting assumptions. In 2023 and 2022, the variance of actual experience from expected experience was primarily due to favorable variances in morbidity assumptions as compared to actual experience. There were no changes to the inputs or methods used in measuring the liability for future policy benefits in 2023 and 2022. In 2023, the Company's annual assumption review process resulted in favorable changes to its morbidity and termination assumptions, largely due to reflecting more recent favorable U.S. morbidity experience. In 2022, the Company's annual assumption review process resulted in favorable changes to its morbidity assumptions due to favorable claims experience, primarily. The following table summarizes the amount of net earned premiums recognized in the consolidated statements of earnings by reporting segment and disaggregated by product type for the years ended December 31.
(In millions) |  | 2023 |  | 2022 |  | 2021
Net earned premiums: |  |  |  |  |  |
Aflac Japan |  |  |  |  |  |
Cancer |  | $ | 4,063 |  |  | $ | 4,716 |  |  | $ | 5,731 |
Medical and other health |  | 2,631 |  |  | 2,917 |  |  | 3,570 |
Life insurance |  | 1,532 |  |  | 1,769 |  |  | 2,282 |
Other |  | 149 |  |  | 161 |  |  | 186 |
Aflac U.S. |  |  |  |  |  |
Accident |  | 1,288 |  |  | 1,317 |  |  | 1,366 |
Disability |  | 1,256 |  |  | 1,179 |  |  | 1,170 |
Critical care |  | 1,749 |  |  | 1,758 |  |  | 1,801 |
Hospital indemnity |  | 725 |  |  | 725 |  |  | 733 |
Dental/vision |  | 214 |  |  | 199 |  |  | 188 |
Life insurance |  | 475 |  |  | 396 |  |  | 350 |
Other |  | 45 |  |  | 38 |  |  | 42 |
Corporate and other |  | 400 |  |  | 145 |  |  | 180 |
Reinsurance ceded |  | (404) |  |  | (419) |  |  | (504) |
Total |  | $ | 14,123 |  |  | $ | 14,901 |  |  | $ | 17,095 |
The following table summarizes the amount of interest expense related to insurance contracts recognized in total benefits and claims, net in the consolidated statements of earnings by reporting segment and disaggregated by product type for the years ended December 31.
(In millions) |  | 2023 |  | 2022 |  | 2021
Interest expense: |  |  |  |  |  |
Aflac Japan |  |  |  |  |  |
Cancer |  | $ | 1,061 |  |  | $ | 1,140 |  |  | $ | 1,428 |
Medical and other health |  | 274 |  |  | 278 |  |  | 330 |
Life insurance |  | 501 |  |  | 524 |  |  | 631 |
Other |  | 80 |  |  | 84 |  |  | 102 |
Aflac U.S. |  |  |  |  |  |
Accident |  | 25 |  |  | 23 |  |  | 21 |
Disability |  | 34 |  |  | 37 |  |  | 39 |
Critical care |  | 345 |  |  | 346 |  |  | 343 |
Hospital indemnity |  | 39 |  |  | 40 |  |  | 40 |
Dental/vision |  | 13 |  |  | 12 |  |  | 13 |
Life insurance |  | 37 |  |  | 35 |  |  | 33 |
Other |  | 27 |  |  | 27 |  |  | 27 |
Total |  | $ | 2,436 |  |  | $ | 2,546 |  |  | $ | 3,007 |
The following tables summarize the amount of undiscounted expected future gross premiums and expected future policy benefits and expenses and discounted (discounted at the current period discount rate) expected future gross premiums and expected future policy benefits and expenses by reporting segment and disaggregated by product type as of December 31. These tables are presented gross of internal and external ceded reinsurance. Future gross premiums represent the expected amount of future premiums to be received. For limited-payment policies, the premiums are collected over a shorter period than the policy term over which benefits are provided. As a result, once the policy reaches premium paid-up status, the future gross premiums can be significantly less than the future benefit payments. Further, benefits and expenses are generally greater in the later years of a policy. These are the primary factors that result in future gross premiums lower than future benefit and expense payments for certain lines of business of the Company.
| 2023 |  | 2022
(In millions) | Gross Premiums |  | Benefits and Expenses |  | Gross Premiums |  | Benefits and Expenses
Undiscounted expected future gross premiums and expected future policy benefits and expenses: |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
Aflac Japan (1) |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
Cancer |  | $ | 59,169 |  |  |  |  | $ | 66,427 |  |  |  |  | $ | 65,454 |  |  |  |  | $ | 73,009 |  |
Medical and other health |  | 38,583 |  |  |  |  | 39,884 |  |  |  |  | 43,954 |  |  |  |  | 44,005 |  |
Life insurance |  | 12,677 |  |  |  |  | 42,541 |  |  |  |  | 14,685 |  |  |  |  | 46,166 |  |
Other |  | 1,781 |  |  |  |  | 7,448 |  |  |  |  | 2,012 |  |  |  |  | 8,175 |  |
Aflac U.S. |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
Accident |  | 9,095 |  |  |  |  | 4,548 |  |  |  |  | 9,481 |  |  |  |  | 4,636 |  |
Disability |  | 5,776 |  |  |  |  | 3,177 |  |  |  |  | 5,858 |  |  |  |  | 3,267 |  |
Critical care |  | 19,886 |  |  |  |  | 20,626 |  |  |  |  | 21,069 |  |  |  |  | 22,113 |  |
Hospital indemnity |  | 4,922 |  |  |  |  | 3,025 |  |  |  |  | 5,164 |  |  |  |  | 3,338 |  |
Dental/vision |  | 1,162 |  |  |  |  | 726 |  |  |  |  | 1,208 |  |  |  |  | 759 |  |
Life insurance |  | 2,719 |  |  |  |  | 3,260 |  |  |  |  | 2,375 |  |  |  |  | 2,787 |  |
Other |  | 724 |  |  |  |  | 1,396 |  |  |  |  | 333 |  |  |  |  | 1,147 |  |
Total |  | $ | 156,494 |  |  |  |  | $ | 193,058 |  |  |  |  | $ | 171,593 |  |  |  |  | $ | 209,402 |  |
(1) Prior-year amounts reflect the immaterial revision of amounts disclosed in the Company's Quarterly Reports on Form 10-Q for 2023 to correctly apply the yen/dollar exchange rate in effect for the period presented.
| 2023 |  | 2022
(In millions) | Gross Premiums |  | Benefits and Expenses |  | Gross Premiums |  | Benefits and Expenses
Discounted expected future gross premiums and expected future policy benefits and expenses: |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
Aflac Japan |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
Cancer |  | $ | 48,363 |  |  |  |  | $ | 50,161 |  |  |  |  | $ | 53,278 |  |  |  |  | $ | 54,766 |  |
Medical and other health |  | 30,757 |  |  |  |  | 25,257 |  |  |  |  | 34,693 |  |  |  |  | 27,419 |  |
Life insurance |  | 11,240 |  |  |  |  | 29,731 |  |  |  |  | 12,951 |  |  |  |  | 31,954 |  |
Other |  | 1,512 |  |  |  |  | 5,178 |  |  |  |  | 1,697 |  |  |  |  | 5,582 |  |
Aflac U.S. |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
Accident |  | 6,369 |  |  |  |  | 3,109 |  |  |  |  | 6,510 |  |  |  |  | 3,098 |  |
Disability |  | 4,488 |  |  |  |  | 2,422 |  |  |  |  | 4,468 |  |  |  |  | 2,445 |  |
Critical care |  | 12,417 |  |  |  |  | 11,290 |  |  |  |  | 12,659 |  |  |  |  | 11,489 |  |
Hospital indemnity |  | 3,419 |  |  |  |  | 1,943 |  |  |  |  | 3,483 |  |  |  |  | 2,074 |  |
Dental/vision |  | 807 |  |  |  |  | 478 |  |  |  |  | 821 |  |  |  |  | 488 |  |
Life insurance |  | 1,914 |  |  |  |  | 1,764 |  |  |  |  | 1,663 |  |  |  |  | 1,526 |  |
Other |  | 467 |  |  |  |  | 798 |  |  |  |  | 228 |  |  |  |  | 622 |  |
Total |  | $ | 121,753 |  |  |  |  | $ | 132,131 |  |  |  |  | $ | 132,451 |  |  |  |  | $ | 141,463 |  |
Loss expense as a result of net premium ratio capping for the years ended December 31, 2023, 2022 and 2021 was immaterial. Other Policyholders' Funds As of December 31, 2023 and December 31, 2022, the largest component of the other policyholders' funds liability was the Company's annuity line of business in Aflac Japan. The Company's annuities have fixed benefits and premiums. The following table presents the changes in other policyholders’ funds for the years ended December 31.
(In millions) | 2023 |  | 2022
Other policyholders' funds: |  |  |
Fixed annuities account balance, beginning of period (1) | $ | 6,423 |  |  | $ | 7,410 |
Premiums received | 126 |  |  | 150 |
Transfers from WAYS conversions | 229 |  |  | 214 |
Surrenders and withdrawals | (59) |  |  | (52) |
Benefit payments | (419) |  |  | (367) |
Interest credited | 53 |  |  | 57 |
Foreign currency translation and other | (414) |  |  | (989) |
Fixed annuities account balance, end of period | 5,939 |  |  | 6,423 |
Other deposit type reserves | 230 |  |  | 220 |
Total | $ | 6,169 |  |  | $ | 6,643 |
(1) Aflac Japan fixed annuities The following table presents other policyholders’ funds balances by range of guaranteed crediting rates as of December 31.
|  | 2023 |  | 2022
(In millions) |  | Range of Guaranteed Minimum Crediting Rates (2) |  | At Guaranteed Minimum |  | Cash Surrender Value |  | Range of Guaranteed Minimum Crediting Rates (2) |  | At Guaranteed Minimum |  | Cash Surrender Value
Fixed annuities (1) |  | 0.5% - 2.3% |  | $5,939 |  | $5,850 |  | 0.5% - 2.3% |  | $6,423 |  | $6,326
(1) Aflac Japan fixed annuities (2) Weighted-average crediting rate of 1.5% at December 31, 2023 and December 31, 2022. Aflac Japan’s fixed annuities have guaranteed fixed crediting rates which results in the policyholders' funds balances being able to cover all guaranteed benefit amounts. The reserves are adequate to fully fund future benefits at any given time. See Note 1 for additional information on policy liabilities.

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