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Page 4 of 4 ABJ25913X

This material is valid as long as information remains

current, but in no event later than November 15,

2016. Group Voluntary Accident benefits provided

by policy form GVAP1, or state variations thereof.

Off-the-Job Accident Disability Rider provided by rider

R1AP, or state variations thereof.

Coverage is provided by Limited Benefit Supplemental

Health Insurance. The policy is not a MedicareSupplement Policy. If eligible for Medicare, review

Medicare Supplement Buyers Guide available from

Allstate Benefits.

This brochure highlights some features of the policy

but is not the insurance contract. For complete details,

contact your Allstate Benefits Agent. This is a brief

overview of the benefits available under the Group

Voluntary Policy underwritten by American Heritage

Life Insurance Company (Home Office, Jacksonville,

FL). Details of the insurance, including exclusions,

restrictions and other provisions are included in the

certificates issued.

This brochure is for use in the Adecco enrollment

which is sitused in DE.

Allstate Benefits is the marketing name used by American Heritage Life Insurance Company(Home Office, Jacksonville, FL), a subsidiary of The Allstate Corporation.

2013 Allstate Insurance Company. www.allstate.com or allstatebenefits.com.

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BASE ACCIDENT BENEFITS PLANAccidental Death Employee $20,000

Spouse $10,000

Child $5,000

Common Carrier Employee $100,000

Accidental Death Spouse $50,000

Child $25,000

Dismemberment Employee up to $20,0001

Spouse up to $10,0001

Child up to $5,0001

Dislocation and Fracture Employee up to $2,0001

Spouse up to $1,0001

Child up to $5001

Initial Hospital Confinement2 $500

Hospital Confinement3 $100

Intensive Care3 $200

Ambulance Regular Ambulance $100Air Ambulance $300

Medical Expenses up to $250

Outpatient Physicians Treatment4 $25

DISABILITY RIDER BENEFIT PLANOff-the-Job Accident Disability Rider5 $1,000

group voluntary accident

injury benefit schedule

*Knee joint (except

patella). Bone or bones

of the foot (except

toes). Bone or bones

of the hand (except

fingers). **Pelvis(except coccyx). Skull

(except bones of face

or nose). Foot (except

toes). Hand or wrist

(except fingers).

Lower jaw (except

alveolar process).

LOSS OF LIFE OR LIMB PLAN

Life, or both eyes, hands, arms, feet, or legs, or

one hand or arm and one foot or leg $20,000

One eye, hand, arm, foot, or leg $10,000

One or more entire toes or fingers $2,000

COMPLETE DISLOCATION PLANHip joint $2,000

Knee or ankle joint*, bone or bones of the foot* $800

Wrist joint $700

Elbow joint $600

Shoulder joint $400

Bone or bones of the hand*, collarbone $300

Two or more fingers or toes $140

One finger or toe $60

COMPLETE, SIMPLE OR CLOSED FRACTURE PLAN

Hip, thigh (femur), pelvis** $2,000

Skull** $1,900

Arm, between shoulder and elbow (shaft),shoulder blade (scapula), leg (tibia or fibula) $1,100

Ankle, knee cap (patella), forearm (radius or ulna), collarbone (clavicle) $800

Foot**, hand or wrist** $700

Lower jaw** $400

Two or more ribs, fingers or toes, bones of face or nose $300

One rib, finger or toe, coccyx $140

Benefit amountsfor coverage andone occurrence areshown to the left.

Covered spousegets 50% of theamounts shownand children 25%.

Page 2aABJ25913X-Insert-ADECCO

1based on amounts

shown in the Injury

Benefit Schedule below

2payable once/covered

person

3per day, max. 90 days/

injury

4per visit, max. 2 visits/year, 4 if dependents are

covered

5per month, payable up to

12 months

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This insert is part of brochure ABJ25913Xand is not to be used on its own. Allstate Benefits is the marketing name used by American Heritage

Life Insurance Company (Home Office, Jacksonville, FL), a subsidiary of The Allstate Corporation. 2013 Allstate Insurance Company.

www.allstate.com or allstatebenefits.com.

This insert is for use in: DE

ABJ25913X-Insert-ADECCO Page 2b

MODE EE EE + SP EE + CH F

Monthly $22.50 $29.18 $30.67 $34.38

EE =Employee; EE + SP =Employee + Spouse; EE + CH =Employee + Child(ren); and F =Family

premiums

Issue Ages: 18 and over if Actively at Work