You are given a text that consists of multiple sentences. Your task is to perform abstractive summarization on this text. Use your understanding of the content to express the main ideas and crucial details in a shorter, coherent, and natural sounding text. 
Text: Dan Amos, Chairman and CEO of Aflac Incorporated will begin with an overview of our operations in Japan and the US.
Fred Crawford, President and CEO of Aflac Incorporated will then touch briefly on conditions in the fourth quarter and discuss key initiatives including how we are navigating the pandemic.
Members of our US executive management team joining us for the Q&A segment of the call are Teresa White, President of Aflac US; Virgil Miller, President of Individual Benefits; Rich Williams, President of Group Benefits; Eric Kirsch, Global Chief Investment Officer and President of Aflac global investments; Al Riggieri, Global Chief Risk Officer and Chief Actuary; June Howard, Chief Accounting Officer; and Steve Beaver, CFO of Aflac US.
We are also joined by members of our executive management team in Tokyo at Aflac Life Insurance Japan.
Charles Lake, Chairman and Representative Director, President of Aflac International; Masatoshi Koide, President and Representative Director; Todd Daniels, Director and CFO; and Koji Ariyoshi, Director and Head of Sales and Marketing.
Although we believe these statements are reasonable, we can give no assurance that they will prove to be accurate because they are prospective in nature.
Actual results could differ materially from those we discuss today.
We encourage you to look at our annual report on Form 10-K for some of the various risk factors that could materially impact our results.
aflac.com and includes reconciliations of certain non-US GAAP measures.
I'll now hand the call over to Dan.
At this time last year, it would have been very difficult to foresee the gravity of what was soon to unfold for society and for the company do to COVID-19.
I'm proud of our employees, our sales distribution and Board of Directors for their decisive people-first initiatives we spearheaded early on in both the United States and Japan to protect our workforce and to be here for our policyholders throughout this trying time.
We were able to reinforce our financial strength and operations, as well as our distribution franchise with digital and virtual investments to the position of our company for the future growth.
Adjusted earnings per diluted share excluding the impact of foreign exchange increased 10.8% in 2020.
While benefiting from a lower effective tax rate, we were pleased with the results when you consider the pandemic pressure on revenues, accelerated investment in our core technological platforms and the initiatives to drive future earned premium growth and efficiency.
Investing in growth and innovation will continue to be critical strategic focus this year.
There is one central message it had been emphasizing with our management team.
It is imperative that we control the factors we have the ability to control and what we don't have control over, we must monitor continually to be ready to adapt.
Despite the fact that sales in both US and Japan had been suppressed considerably due the constraints of face-to-face opportunities, we did not sit still.
We maintained forward motion as we absorbed accelerated investment in our platform while continuing strong earning performance.
In 2020, Aflac Japan generated solid overall financial results with a stable profit margin of 21.2%, an extremely strong premium persistency of 95.1%.
The relaunch of our new cancer rider drove a sequential improvement in both cancer insurance and total sales in the fourth quarter.
As a result, total sales were down 22.2% for the quarter and 36.2% for the year.
In Japan, we introduced our new medical product in January and even up against difficult comparisons of last January that were pre-COVID sales, it is a positive launch exceeding our expectations.
We are encouraged by the reception of both the consumers and our sales force.
While these sales results represent sequential improvements relative to last quarter, the effective reduced face-to-face activity are evident and we continue to promote virtual sales.
Our goal in Japan is to be the leading company for living in your own way.
This is a declaration of how we tailor our products to fit the needs of customers during the different stages of their lives and reach them where are they want to buy through agencies, strategic alliance and banks.
Now turning to Aflac US, we saw a stable profit margin of 19.3% amid a year of intense investments in the future of our business and the global pandemic conditions.
However, this backdrop continues to notably impact our sales results in this segment as well, largely due to reduced face-to-face activity.
As expected, we saw modest sequential sales improvement in the quarter with a decrease of 27.2% for the quarter and 30.3 for the year.
In the US, we continue to feel the impact of limited access at the work site especially among our career agents who have historically relied upon face-to-face meetings to engage small business owners and their employees.
However, we remain cautiously optimistic for continued modest sequential sales improvement contingent upon the pace of the economic recovery and as a results, expect to see a wider second half of 2021.
Fred is responsible for acquisitions and he will cover that shortly.
But while these acquisitions may not have an immediate effect on the top line, they better position Aflac for future long-term sales in the United States.
As part of the Vision 2025 in the US, we seek to further develop a world where people are better prepared for unexpected health expenses, the need for the products we offer is a strong or stronger than ever has been and at the same time we know consumer habits and buying preferences have been evolving and we are looking to reach them in ways other than the traditional media and outside the work site.
This is part of the strategy to increase access, penetration and retention.
Even while working remotely for the greater part of the year, we remain true to our culture and identity as a socially responsible company.
We stepped up our engagement with our employees through virtual town meetings and weekly touch base letters.
Additionally, diversity continues to play an important role at Aflac as it has for decades.
I have always believed that in order to accomplish our goals and serve the community where we have a presence, we must surround our sales with a group of people who bring different perspectives to the table.
We have done that for years, at the end of 2020, nearly 50% of Aflac's US employees were minorities, 66% were women, 23% of our US senior officers were minorities and 30% were women.
And then when you think of Aflac's Board of Directors, 36% were minorities and 36% were women.
Diversity has always played an important role within ESG and [Indecipherable] with executive oversight of our ESG efforts.
He will provide greater detail on our 2021 key objectives.
I've always said that the true test of strength is how one handles adversity.
While pandemic conditions are ongoing, I'm pleased that 2020 confirmed what we knew all along and that is that Aflac is strong, adaptable and resilient.
We strive to be where people want to purchase insurance that applies to both Japan and the United States.
In the past, this is met meeting face to face with individuals to understand their situation propose a solution and close the sale.
However, the pandemic clearly demonstrates the need for virtual means.
In other words, non-face-to-face sales to reach potential customers and provide them with the prediction that they need.
Therefore we have accelerated investments to enhance the tools available for our distribution in both countries.
Related to capital deployment, we placed significant importance on continuing to achieve strong capital ratios in the United States in Japan on behalf of our policyholders and shareholders.
When it comes to capital deployment, we pursue value creation through a balance of actions including growth investments, stable dividend growth and disciplined tactical stock repurchase.
It goes without saying that we treasure our record of dividend growth.
The fourth quarter's declaration mark the 38th consecutive year of dividend increases.
Additionally, the Board approved a first quarter dividend increase of 17.9%.
Our dividend track record is supported by the strength of our capital and cash flows.
At the same time, we remain tactical in our approach to share repurchase, buying back $1.5 billion of our shares in 2020.
We have also focused on integrating the growth investments we have made in our platform.
As always, we are working to achieve our earnings per share objectives while also ensuring we deliver on our promise to our policyholders.
By doing so, we look to emerge from this period in a continued position of strength and leadership.
I don't think it's coincidental that we've achieved our success while focusing on doing the right things, pull our policyholders, shareholders, employees, distribution channel, business partners and communities.
In fact, I believe that go hand in hand.
I'm proud of what we have accomplished in terms of both our social purpose and financial results, which have ultimately translated into strong long-term shareholder return.
Now let me turn the program over to Fred.
I'm going to touch briefly on conditions in the fourth quarter with respect to the pandemic.
I'll then provide an update on key initiatives in Japan and the US, Japan has experienced approximately 400,000 COVID-19 cases and 6,000 confirmed since inception of the virus.
While quite low as compared to other developed countries and the US, these statistics have more than doubled since the end of the third quarter.
Earlier this week, the government of Japan extended their state of emergency for Tokyo and 9 other prefectures through March 7.
This action includes the suspension of domestic tourism campaign and entry of foreigners into Japan.
We have responded with again moving more of our workforce to working from home, unlike the state of emergency declared last year in the initial stages of the virus.
Government restrictions are more balanced with economic recovery considerations and we have not prohibited face-to-face consultations and/or closed our sales shops.
Meanwhile, Prime Minister, Suga has announced a goal of beginning vaccinations mid-February.
Through the fourth quarter, Aflac Japan's COVID-19 impact totaled approximately 3400 unique claimants with incurred claims totaling JPY1 billion.
We continue to experience a significant reduction in paid claims for medical conditions other than COVID-19 as Japan manages hospital capacity and discourages more routine visits.
Despite the recent rise in infection rates in Japan, we continued to track well below our stress assumptions.
As Dan outlined, sales have clearly been impacted, but when looking at policies in force, the impact of reduced sales on earned premium has largely been offset by improved persistency with the reduction in reported revenue driven primarily by paid up policies.
Finally, pandemic related expenses in the quarter totaled JPY1.8 billion which includes the rollout of virtual distribution tools, employee teller working equipment and distribution support.
Turning to the US, there are nearly 27 million COVID-19 cases and 450,000 deaths as reported by the CDC.
For Aflac US in 2020, COVID-19 claimants totaled 23,000 with incurred claims of approximately 71 million in the quarter and $128 million for all of 2020.
We are now in a better position to back test the correlation of US rates of infection to paid claims in order to build an estimate for incurred claim reserves.
It's fair to say this is still very difficult to estimate as IBNR often works from years of reliable data to establish trends.
While our reserves assume elevated claims, we continue to see the length of stay in hospital and transition to ICU traveling below our expectations.
We have seen limited impact to our reported persistency numbers, however, we believe this is in part attributed to the combination of reduced sales where lapse rates tend to be much higher in the first year, and the state executive orders requiring premium grace periods.
Executive orders are still in place in 11 states as of the end of the quarter with 5 states having open-ended expiration dates.
We have reduced pressure on lapse rates through proactive work with our policyholders including converting from payroll deduction to direct bill and encouraging a review of wellness benefits.
Turning to key operating initiatives, 2020 was an important year in setting the stage for growth once we move clear of pandemic conditions.
Beginning with Japan after launching and promoting a simplified cancer rider in the 4th quarter, we successfully launched our refreshed medical product called EVER Prime in January.
As Dan noted in his comments, it's early and our associates channel is having to navigate pandemic conditions, but January medical sales are promising.
Introduced in October of 2020, we have technology in place to allow agents to pivot from face-to-face to virtual sales and an entirely digital customer experience.
True virtual sales in Japan is relatively limited.
In addition, the majority of applications are still filed in paper form, although digital applications have been adopted in face-to-face consultations.
Excluding traditional non-face-to-face means of distributing products like worksite, direct mail and call center sales, we estimate only 2% to 3% of our sales are currently digital end-to-end.
However, we understand some of our agencies have significantly adopted virtual tools to supplement face-to-face consultations.
We have discussed our paperless initiative across all operations in Japan.
This is a JPY10 billion investment with approximately JPY2.8 billion spent in the fourth quarter and JPY4.8 billion spent in 2020.
We are projecting another JPY4.3 billion spend planned for 2021.
This investment has a 3-year payback and will reduce the production and circulation of over 80 million pieces of paper per year.
In summary, we expect the combination of product development, improved pandemic conditions and the return of Japan posed to distributing Aflac cancer insurance will drive growth as we look toward the second half of 2021.
Turning to the US, we focused our efforts in 2020 on setting the table for 2021, including a national launch of network, dental and vision completing our group benefit acquisition and standing up our new direct to consumer digital platform.
On the operation side, we rolled out a new and upgraded enrollment platform called Everwell 2.0 in September, which requires time for full adoption and stabilizing the platform.
2020 was an important year to introduce digital tools, increase adoption rates and take on any corrective action before 2021.
In addition, under Teresa White's leadership, we have reorganized the US forming a group benefits in individual division.
Rich Williams, will now lead our group benefits division, which includes Aflac voluntary group, Aflac network, dental, vision, Argus, our dental TPA and our new Aflac premier life, absence management and disability business.
Virgil Miller will lead our individual benefits division, which includes Aflac's individually issued and small business focused worksite products and our new consumer market's business targeting workers not at the traditional worksite both divisions pull from shared service US operating platforms.
This new alignment provides focus for each division within the US business segment and allows Aflac to offer tailored products and services for our career agency teams and broker partners based on the unique markets they serve.
Like Japan, we have all the tools in place for agents to conduct business without a face-to-face meeting.
However, most sales are being driven on a continuum of face-to-face and digital interaction.
We estimate about 15% of our traditional individual sales are completed without some form of face-to-face interaction.
This excludes digital direct to consumer, which is naturally non-face-to-face.
Turning to more specifics on our key growth initiatives, on January 12, we announced the national rollout of Aflac dental and vision.
Our dental and vision products are now available in 40 states with more coming online throughout the year.
This is a broad launch that is available to large and small companies and distributed through agents and brokers.
In November, we closed on our Zurich Group Benefits acquisition, the new platform managed to contribute to sales in the quarter with 5 million in production.
This is more of a turnkey launch meaning products are filed and we are open for business in 2021 under the Aflac brand.
Finally, we officially launched our new digital direct-to-consumer platform in the first week of January.
We offered critical illness, accident and cancer and are approved to sell all 3 products in approximately 30 states with more states and products coming online throughout the year.
As highlighted during our investor conference, we are addressing expenses over 2 horizons.
In 2020, we took actions to realize approximately $100 million of annualized run rate expense savings on a go-forward basis.
Actions included restricting hiring, rationalizing distribution expenses and a voluntary separation plan that resulted in a 9% reduction to our US workforce.
Longer term expense initiatives center on our group division and the migration onto a new administrative platform as well as integration of the Zurich Group Benefits business.
As you are all aware, we have adopted a conservative buy-to-build acquisition strategy.
The build efforts taken together impacted our expense ratio in the fourth quarter by 160 basis points and is expected to impact the 2021 ratio by approximately 180 basis points.
Our global investments team remains focused on asset quality, monitoring economic conditions and sourcing new investment opportunities.
Portfolio actions prior to and in the early days of the pandemic lowered our exposure to prolonged economic weakness and we ended 2020 with a modest amount of asset losses.
We continue to watch closely our middle market loan and traditional real estate -- transitional real estate portfolios.
While we have seen ratings downgrades, our portfolios are resilient consisting of diversified first-lien loans conservatively underwritten to high quality borrowers.
We have further refined our approach to managing the unhedged dollars in Japan, both lowering our hedge ratio and maintaining our out-of-the-money protection for extreme moves in foreign exchange.
These unhedged dollars provide diversification and income benefits as well as lowering our enterprise exposure to the Yen.
As has been our practice for 2021, we have locked in lower hedge costs with floating-rate loan yields benefiting from LIBOR floors.
Finally, we are pleased with the performance of our strategic investment in alliance with Varagon Capital Partners during 2020 contributing to corporate investment income.
We are working to establish similar strategic alliances that leverage the capabilities of our asset management subsidiary and further the performance of our insurance segments.
As commented on by Dan, we have refocused our efforts in key areas to drive tangible ESG initiatives in 2021.
We are focused on the following, building off our published ESG investment policy.
Aflac Global Investments is advancing a responsible investing framework that includes the establishment of a core ESG team and formal governance process.
We initiated work with third-party experts to measure draft and eventually disclose a formal plan to be carbon-neutral on or before 2014 and carbon net-zero emissions on or before 2015.
We pledged to continue hitting key milestones on our important women and leadership initiative as part of a diversity and inclusion in Japan and targeting 30% of leadership positions in Japan filled by women by 2025.
In the US, we seek to advance our already strong diversity statistics by broadening our influence through identifying and providing capital to organizations that advanced diversity and inclusion as well as social justice and economic mobility.
Finally, we pledged to advanced reporting and disclosure framework in compliance with SASB and TCFD reporting standards.
We will provide further disclosures on ESG initiatives in our proxy material and on our ESG hub, esg.
Wrapping up my comments, we believe the investments made in the past 2 years and accelerated during the pandemic, positioned us for future growth and efficiency in the face of what we believe to be temporary weakness in sales and earned premium.
I'll now pass on to Max to discuss financial performance in more detail.
We finished the year with stable fourth quarter earnings in a year marked by significant mortality and morbidity events as well as continued low interest rates.
For the quarter, adjusted earnings per share increased 3.9% to $1.7 and a full year earnings per share was a record $4.96, up 11.7% year-over-year.
Adjusted book value per share including foreign currency translation gains and losses to 19.1% both for the quarter and full year.
The adjusted ROE excluding the foreign currency impact was 12.1% in the fourth quarter and a respectable 15.1% for the full year, a material spread to our cost of capital.
This quarter benefited from favorable marks on our alternate investment portfolio to the amount of $47 million pre-tax above our long-term return expectations, a very good outcome on our building alternatives portfolio.
We also booked a severance charge associated with our previously announced voluntary separation program or VSP.
In our US and corporate segments, totaling pre-tax $43 million included in adjusted earnings.
Turning to our Japan segment, total earned premium for the quarter declined 3.5%, reflecting mainly first sector policies paid-up impacts.
While earned premium for our third sector products was down 1.9%.
For the full year, total earned premium was down 2.8% while totally policies in force declined by a lesser rate at 1.2%.
As policies in force are not impacted by the paid-up status, it tends to serve as a better indicator of the growth of the underlying business.
Persistency has been on our positive trajectory ___[08:08]___ slightly sequentially to 95.1%, up 70 basis points year-over-year.
Japan's total benefit ratio came in at 68.9% for the quarter, down 110 basis points year-over-year.
And the third sector benefit ratio was 58.6% down 150 basis points year-over-year.
The main driver for the lower benefit ratio was a higher than normal IBNR release due to the sustained lower-paid claims environment in 2020.
We estimate that this lower the benefit ratio by roughly 130 basis points compared to what we would deem a normal IBNR release to be.
For the full year, the reported total benefit ratio was 69.9%, up 40 basis points year-over-year.
And our third sector benefit ratio was 59.7%, also up 40 basis points year-over-year, largely due to improved persistency.
The expense ratio in Japan was 23%, up 130 basis points year-over-year.
The main driver was our people less initiative, which kicked in at a higher gear as we digitize our operations and drive efficiencies throughout the value chain to future state with significantly reduced paper usage.
This investment increased our quarterly expense ratio by 85 basis points.
For the quarter, adjusted net investment income increased 11.9% in Yen terms, led by strong returns in our alternatives portfolio, but also strong results from the loan book, like real estate and middle market loans.
For the full year, adjusted net investment income was 4.4%.
The pre-tax margin in the quarter was 20.9%, up 110 basis points year-over-year.
As the combined effect from the lower benefit ratio and higher expense ratio was still positive.
For the full year, the pre-tax margin was a respectable 21.2%.
Turning to US results, the earned premium was down 2.3% for the quarter due to weaker sales results.
Persistency improved 160 basis points to 79.3%.
This was driven by emergency orders in various states and by lower sales in 2020 as new policies lapse at a higher rate than in-force policies older than one year.
We're moving these factors would result in a stable year-over-year persistency rate and we view that as a good outcome to-date.
Given a pandemic environment's impact on our policyholders and reflecting our efforts to retain accounts and keep premium in-force.
For the full year, earned premium was down 0.9%.
Our total benefit ratio came in at 51.6%, which was 250 basis points higher than Q4 2019.
Pandemic conditions continue to be very relevant when analyzing our benefit ratio.
Due to the recent increase in infection rates, we estimate incurred claims impact of $72 million of which 58 million was an increase to IBNR, resulting in an impact to the benefit ratio of 5.1 percentage points from COVID-related claims.
This is somewhat offset by favorable non-COVID related claims activity generating an underlying benefit ratio of 46.5%.
COVID and non-COVID-related claims tend to have a negative correlation, which clearly can be seen in our quarterly results throughout 2020.
We would expect this pattern to continue in early 2021.
Going forward, we still expect the guided range of fab of 48% to 51% to be a reasonable future benefits ratio.
Our expense ratio in the US was 43.5%, up 60 basis points year-over-year.
The severance charge for our VSP explains 220 basis points of the rise.
While the residual is primarily driven by digital investments and the reduction in revenues, the full year expense ratio landed at 38.6%.
Adjusted net investment income in the US was up 1.1% due to strong alternative investment income, while the portfolio book yield contracted 22 basis points year-over-year.
Full year adjusted net investment income declined 2.1%.
As both the benefit and expense ratio rose, profitability did come under pressure with a pre-tax margin of 11.6% in the quarter.
For the full year, we still reported a solid pre-tax margin of 19.3% in line with recent historical average.
In our corporate segment, the pre-tax loss widened to $47 million in the quarter compared to 9 million from a year ago.
Lower net investment income on our short duration hold Holdco cash position, increased retirement expenses and $8 million of DSP severance expense were the main components of the delta.
For the full year, the Corporate segment pre-tax loss was $115 million.
Our capital position remains strong and stable.
We ended the quarter with an SMR of north of 9% in Japan.
And an RBC of approximately 525% in Aflac Columbus.
Holding company liquidity stood at $4 billion, $2 billion above our minimum balance.
With a leverage of 23%, we continued to travel in the middle of our stated leverage range of 20% to 25% offering ample debt capacity.
The continued spread of COVID-19 leads us to remain cautious in how we manage our capital base, make investments and deploy capital to the benefit of the shareholder.
In the quarter, we repurchased $500 million of our own stock and paid dividends of $196 million offering good relative IRR on these capital deployments.
For the full year, we paid $798 million of dividends and return an additional $1.5 billion to shareholders in the form of share repurchases.
We will continue to be flexible and tactical in how we manage the balance sheet and deploy capital in order to drive strong risk adjusted ROE with meaningful spread to our cost of capital.
A recent example is the Board's decision to increase the quarterly dividend by 17.9% to $0.33 per share.
Before going into Q&A.
I would characterize our 2020 financial performance as solid despite significant external challenges.
As we look forward into 2021, we do not see any fundamental drivers causing us to change the outlook provided at our Financial Analyst Briefing in November.
In order to achieve these objectives, we remain laser focused on executing on our growth initiatives, expense efficiency and continue to drive ROE at a significant spread to our cost of capital.
Carol, we will now take the first question please.

user
compname reports fourth quarter net earnings of $951 million, reiterates increase in first quarter cash dividend of 17.9%.
aflac - in yen terms, aflac japan's net premium income was ¥333.8 billion for quarter, or 3.5% lower than year ago.
aflac - pandemic conditions continue to impact sales results both in united states & japan, as well as earned premium & revenues.
expect pandemic conditions to remain with us through first half of 2021.

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