Legal Notices

In all instances, the official plan documents, and not the information contained on this website or any other document, will control and govern the operation of a plan. Allstate reserves the right to modify or terminate any plan and/or any plan provisions, terms or specific benefits at any time and for any reason.

Health Insurance Portability and Accountability Act of 1996 (HIPAA)

This notice is being provided to you pursuant to the Health Insurance Portability and Accountability Act of 1996, as amended (HIPAA). HIPAA is a federal law that, in part, requires group health plans to protect the privacy and security of your confidential information.

Certain Allstate employee health and welfare benefit Plans under the Employment Retirement Income Security Act of 1974, as amended (ERISA), are subject to the HIPAA privacy rules.

Pursuant to HIPAA privacy rules, these Plans will not use or disclose your protected health information without your authorization, except for purposes of treatment, payment, health care operations, Plan administration or as required or permitted by law.

This notice is to remind you that a description of the Plans' uses and disclosures of your protected health information and your rights and protections under HIPAA privacy rules is set forth in the HIPAA Notice of Privacy Practices which can be accessed on the Your Benefits Resources™ website under Plan Information or by contacting the Office of the Plan Administrator, 2775 Sanders Road, Suite F5, Northbrook, IL 60062.

Notice of Patient Protections for Certain Coverage Options

The Allstate Cafeteria Plan Medical Plan HMO options generally require the designation of a primary care provider.

  • You have the right to designate any primary care provider who participates in the HMO's network and who is available to accept you or your family members.
  • For children, you may designate a pediatrician as the primary care provider. For information on how to select a primary care provider, and for a list of the participating primary care providers, please log on to Your Benefits Resources™ and use the Provider Direct tool.

You do not need prior authorization from the Allstate Cafeteria Plan Medical Plan, your HMO, or from any other person (including a primary care provider) in order to obtain access to obstetrical or gynecological care from a health care professional in the HMO's network who specializes in obstetrics or gynecology.

  • The health care professional, however, may be required to comply with certain procedures, including obtaining prior authorization for certain services, following a pre-approved treatment plan, or procedures for making referrals.
  • For a list of participating health care professionals who specialize in obstetrics or gynecology, please log on to Your Benefits Resources™ and use the Provider Direct tool.

Special Enrollment Notice

If you are declining enrollment for yourself or your dependents (including your spouse) because of other health insurance or group health plan coverage, you may be able to enroll yourself and your dependents in this plan if you or your dependents lose eligibility for that other coverage (or if the employer stops contributing toward your or your dependents’ other coverage). However, you must request enrollment within 31 days or any longer period that applies under the plan after your or your dependents’ other coverage ends (or after the employer stops contributing toward the other coverage). In addition, if you have a new dependent as a result of marriage, birth, adoption, or placement for adoption, you may be able to enroll yourself and your dependents. However, you must request enrollment within 31 days or any longer period that applies under the plan after the marriage, birth, adoption, or placement for adoption. To request special enrollment or obtain more information, contact the Allstate Benefits Center.

Newborns’ Act Disclosure

Group health plans and health insurance issuers generally may not, under Federal law, restrict benefits for any hospital length of stay in connection with childbirth for the mother or newborn child to less than 48 hours following a vaginal delivery, or less than 96 hours following a cesarean section. However, Federal law generally does not prohibit the mother’s or newborn’s attending provider, after consulting with the mother, from discharging the mother or her newborn earlier than 48 hours (or 96 hours as applicable). In any case, plans and issuers may not, under Federal law, require that a provider obtain authorization from the plan or the insurance issuer for prescribing a length of stay not in excess of 48 hours (or 96 hours).

Women’s Health and Cancer Rights Act of 1998

If you have had or are going to have a mastectomy, you may be entitled to certain benefits under the Women’s Health and Cancer Rights Act of 1998 (WHCRA). For individuals receiving mastectomy-related benefits, coverage will be provided in a manner determined in consultation with the attending physician and the patient for:

  • All stages of reconstruction of the breast on which the mastectomy was performed;
  • Surgery and reconstruction of the other breast to produce a symmetrical appearance;
  • Prostheses; and
  • Treatment of physical complications of the mastectomy, including lymphedema.

These benefits will be provided subject to the same deductibles and coinsurance applicable to other medical and surgical benefits provided under the Allstate Medical Plan, which differ, based on the coverage option you are enrolled in. If you would like more information on WHCRA benefits, contact the Allstate Benefits Center.