Tim Eppolito of AXA Equitable Life Insurance Company certified that he has read and understands AXA's policies and procedures for complying with HIPAA requirements. He also certified that he received appropriate training on these policies regarding accessing, using, protecting, and ensuring the privacy of protected health information as required by HIPAA.

1. Do Not Circulate
Certification Pursuant to the Privacy Notice Under
Health Insurance Portability and Accountability Act (HIPAA)
I, ________Tim Eppolito______________ of AXA Equitable Life Insurance Company
(”AXA”) hereby certify that I have:
(A) read and understand the policies and procedures that AXA has established regarding
compliance with HIPAA requirements; and
(B) received appropriate training on those policies and procedures with respect to the
access, use, privacy and protection of HIPAA data, including Protected Health
Information, in order to ensure I comply with applicable HIPAA requirements.
Print Name: _____Tim Eppolito______________________________
Signature: _______ Tim Eppolito______________________________
Date: _____________9/4/2015_______________________