Plan Features

The basic benefit amounts available are $10,000 – $25,000 (in $5,000 increments) on a Guaranteed Issue basis. Amounts in excess of $25,000 up to $100,000 are available but subject to underwriting guidelines (see an enrollment specialist for details). Up to 100% is payable for covered illnesses from each of Category 1, Category 2, and Category 3 as illustrated below. You choose the amount that best fits you and your family’s needs.

Subject to the conditions in the policy and the Pre-existing Condition Limitation, Allstate Benefits pays this benefit if you are diagnosed for the first time ever with one of the illnesses shown below if:

• The date of the diagnosis is after the policy date and
• The date of diagnosis is while the policy is in force and
• That illness is not excluded by name or specific description in the policy; or
• It is determined, as the result of an autopsy, that the insured died as the result of one of the specified critical illnesses listed in the chart.

The amount payable for each illness is the percentage multiplied by the basic benefit amount selected. The percentage of the basic benefit amount payable for each illness is shown beside the illness. The maximum total percentage of the basic benefit amount payable per category of the illnesses is shown in the last column of the chart. The policy remains in force after a benefit is paid for an illness. However, after 100% of the basic benefit amount has been paid within a category (Category 1, 2, or 3), no more benefits are paid for illnesses associated within that category for a covered person. If you receive a percentage of the basic benefit amount for one illness within a category, and then become eligible for benefits for another illness within the same category, the percentage of the basic benefit amount you receive for the subsequent illness is the lesser of:

• The percentage of the basic benefit amount shown on the chart below for that illness or
• 100% minus the percentage of the basic benefit amount you received for the previous illness(es) in that category.
• Covered spouse and children basic benefit amount is 50% of benefit shown and 100% of the Wellness Benefit.

Allstate Benefits pays this benefit if an insured is diagnosed more than once with the same specified critical illness listed in Category 1 or 2 for which a benefit was previously paid if:

• There is more than 18 months between each diagnosis; and treatment was not received during that 18 month period (for purposes of the preceding statement, treatment does not include medications and follow-up visits to the insured’s physician)
• The subsequent date of diagnosis is while coverage is in force
• The specified critical illness is not excluded by name or specific description in the policy and certificate.

We will pay an amount equal to 25% of the specified critical illness basic benefit amount previously paid for that specified critical illness. We will pay no more than one recurrence benefit per previously paid specified critical illness under Category 1 and 2.

Benefit Category 1 – Group Critical Illness Coverage

Benefit Category 2 – Group Critical Illness Coverage

Benefit Category 3 – Cancer Coverage

Policy GVCIP1

For more information on this benefit, click here.

Conditions and Limits

A diagnosis occurring before your coverage begins is not payable; however, a diagnosis of any covered critical illness or optional benefit after your effective date will be payable. Benefits are subject to the Pre-Existing Condition Limitation as well as all other limitations and exclusions. All critical illnesses must meet the definitions and dates of diagnoses stated in the policy and be diagnosed by a physician while coverage is in effect. Emergency situations outside the U.S. will be considered when you return to the U.S.

Pre-existing Condition Limitation

Benefits are not paid for a critical illness that is caused by a pre-existing condition when the date of diagnosis is within 12 months after the effective date of coverage. A pre-existing condition is a disease or physical condition for which symptoms existed within the 12-month period prior to the effective date, or medical advice or treatment was recommended or received from a medical professional within 12 months prior to the effective date. A pre-existing condition can exist even though a diagnosis has not yet been made.

The exception to the above would be for follow-up care for breast cancer. Routine follow-up care for a person who has been previously determined to be free of breast cancer does not constitute medical advice, diagnosis, care or treatment unless evidence of breast cancer is found during, or as the result of, the follow-up care.

Exclusions

Benefits are not paid for:

• Any act of war or participation in a riot, insurrection, or rebellion
• Intentionally self-inflicted injury
• Engaging in an illegal occupation or committing or attempting to commit a felony
• Suicide while sane or insane
• Injury sustained while being under the influence of alcohol, narcotics, or any other controlled substance or drug unless administered on the advice of a physician
• Participation in aeronautics unless a fare-paying passenger on a licensed common-carrier aircraft operating between established airports
• Substance abuse, including alcohol, alcoholism, drug addiction, or dependence on a controlled substance.

Policy Provider

Group Critical Illness benefits are provided under policy form GVCIP1 or state variations thereof. The coverage provided is limited benefit supplemental critical illness insurance. The policy is not a Medicare Supplement Policy. If eligible for Medicare, review Medicare Supplement Buyer’s Guide available from Allstate Benefits. This is a brief overview of the benefits available under the group policy underwritten by American Heritage Life Insurance Company (Home Office, Jacksonville, FL). Details of the coverage, including exclusions and other limitations are included in the certificates issued. For additional information, you may contact your Allstate Benefits Representative.

The coverage does not constitute comprehensive health insurance coverage (often referred to as “major medical coverage”) and does not satisfy the requirement of minimum essential coverage under the Affordable Care Act.