Accident Expense Protection
from Allstate Benefits
Protection for accidental injuries on- and off-the-job, 24-hours a day
Benefits are paid to you
CHOOSE
Choose this plan to help
protect yourself and any
family members from
accidental injury expenses
USE
You or a covered family
member experience an
accidental injury and seek
medical attention
Even when you live well, accidents happen. Treatment can be vital to recovery,
but it can also be expensive. And if an accident keeps you away from work
during recovery, the financial worries can grow quickly.
ON-THE-JOB
Work
4.9m
OFF-THE-JOB
Home
8.3m
Non-auto
3.6m
Auto
2.0m
The number of injuries (in millions)
suffered by workers in one year,
both on- and off-the-job.1
Most major medical insurance plans only pay a portion of the bills. Our coverage can
help pick up where other insurance leaves off and provide cash to help cover
the expenses.
With accident insurance from Allstate Benefits, you can gain the advantage of financial
protection, thanks to the cash benefits paid directly to you. You also gain the
financial empowerment to seek the treatment needed to get well.
CLAIM
You go online and file a
claim. The cash benefits
are paid to you, to use
however you wish
Key Features
• Guaranteed Issue coverage,
meaning no medical questions
to answer
• Coverage available for spouse
and child(ren)
• Premiums are affordable and
are conveniently payroll
deducted
• Coverage can be continued, as
long as premiums are paid to
Allstate Benefits
See reverse for plan details
Here’s How It Works
Our coverage pays you cash benefits that correspond with hospital and intensive
care confinement. Your plan may also include coverage for a variety of occurrences,
such as: dismemberment; dislocation or fracture; ambulance services; physical
therapy and more. The cash benefits can be used to help pay for deductibles,
treatment, rent and more.
With Allstate Benefits, you can protect your finances against life’s slips and falls.
Are you in Good Hands? You can be.
Offered to the employees of:
Kimberly-Clark
THIS IS NOT A POLICY OF WORKERS’ COMPENSATION INSURANCE. THE EMPLOYER DOES NOT BECOME A
SUBSCRIBER TO THE WORKERS’ COMPENSATION SYSTEM BY PURCHASING THIS POLICY, AND IF THE EMPLOYER
IS A NON-SUBSCRIBER, THE EMPLOYER LOSES THOSE BENEFITS WHICH WOULD OTHERWISE ACCRUE UNDER THE
WORKERS’ COMPENSATION LAWS. THE EMPLOYER MUST COMPLY WITH THE WORKERS’ COMPENSATION LAW
AS IT PERTAINS TO NON-SUBSCRIBERS AND THE REQUIRED NOTIFICATIONS THAT MUST BE FILED AND POSTED.
National Safety Council, Injury Facts®, 2014 Edition
1
ABJ30640X
Allstate Benefits | allstatebenefits.com
YOU DECIDE how to
use the cash benefits
Our cash benefits provide you
with greater coverage options
because you get to determine
how to use them.
Finances
Can help protect your HSAs,
savings, retirement plans
and 401ks from being
depleted
Travel
You can use your cash benefits
to help pay for expenses while
receiving treatment in another
city
Home
You can use your cash
benefits to help pay the
mortgage, continue rental
payments, or perform
needed home repairs for
your after care
Expenses
The lump-sum cash benefit
can be used to pay your
family’s living expenses such
as bills, electricity and gas
Accident Expense Protection Benefits
Benefits Are Paid For:
Initial Hospital ConfinementDaily Hospital Confinement
Intensive Care
Accident Physician’s Treatment
Ground or Air Ambulance Urgent Care
X-ray
Emergency Room Services
Dislocation/Fracture
Dismemberment
Accidental Death
Common Carrier Accidental Death
Functional Loss
Burns
Lacerations Brain Injury Diagnosis
Skin Graft Coma with Respiratory Assistance
Paralysis
Ruptured Spinal Disc Surgery
Open Abdominal or Thoracic Surgery General Anesthesia
Eye Surgery
Appliance
Blood and Plasma
Medicine
Medical Supplies
Physical, Occupational, or Speech Therapy
Prosthesis
Non-Local Transportation
Rehabilitation Unit
Post-Accident Transportation
Family Member Lodging
Residence/Vehicle Modification
Broken Tooth
Miscellaneous Outpatient Surgery
Pain Management
Accident Follow-up Treatment
Tendon, Ligament, Rotator Cuff or Knee Cartilage Surgery
Computed Tomography (CT) Scan and Magnetic Resonance Imaging (MRI)
Access Your Benefits and Claim Filings
Accessing your benefit information using MyBenefits has never been easier.
MyBenefits is an easy-to-use website that offers you 24/7 access to important information
about your benefits. Plus, you can submit and check your claims (including claim history),
request your cash benefit to be direct deposited, make changes to personal information,
and more.
For use in the Kimberly-Clark enrollment sitused in TX.
This material is valid as long as information remains current, but in no event later than September 1, 2018.
Accident Expense Protection benefits are provided by policy form GVAP6 and the following riders, or state
variations thereof: Accidental Death, Dismemberment and Functional Loss Rider GP6ADD, Accident Treatment and
Urgent Care Rider GP6AUC, Benefit Enhancement Rider GP6BE, Dislocation/Fracture Rider GP6DF, and
Emergency Room Services Rider GP6ERS.
Allstate Benefits is the marketing name
used by American Heritage Life Insurance
Company, a subsidiary of The Allstate
Corporation. ©2015 Allstate Insurance
Company. www.allstate.com or
allstatebenefits.com
Coverage is provided by Limited Benefit Supplemental Accident Insurance. The policy is not a Medicare Supplement
Policy. If eligible for Medicare, review Medicare Supplement Buyer’s Guide available from Allstate Benefits. This
information 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.
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.
Insurance
Frequently Asked Questions (FAQs)
Overview
These FAQs serve to explain the differences and similarities between the Accident Expense Protection
provided by Allstate Benefits, Personal Accident Insurance (PAI) provided by Zurich American, and Accidental
Death and Dismemberment (AD&D) Insurance provided by Minnesota Life. Some of the information in these
FAQs may not apply to you.
Accident Expense Protection can act as a supplement to your medical plan coverage in that it adds an extra
level of protection from the financial impact of an accident. The policy will pay a cash benefit based on the
medical care required for a covered injury as defined in the policy, and can be used to help cover unexpected
expenses incurred as a result of an accident that may help you protect your savings, or pay for your family’s
general living expenses. Coverage is available for you and your eligible dependent(s) in a tiered design. There
is only one level of benefit available under Accident Expense Protection, with no optional benefit levels.
PAI and AD&D Insurance generally pay a benefit based on dismemberment, loss of function of a limb or
sense organ, or even death as a result of an accident.
PAI pays a benefit for a covered loss or injury such as the loss of both hands or feet, a loss of sight to one or
both eyes or even death as a result of an accident. The policy pays a principal sum (in most cases) which
means the total amount of your elected coverage at the time of the covered loss. The coverage you elect will
be the benefit payment if you suffer a covered loss or injury as a result of an accident. Coverage is available
for you and your eligible dependent. Children cannot be covered under this policy.
AD&D Insurance is coverage provided by K-C and is limited to only a few groups. If you’re eligible, you’re
automatically enrolled. The policy pays a benefit if you suffer a covered loss as a result of a covered accident
or death. The benefit payable for a covered loss is the principal sum of coverage which is equal to the full
amount of your basic group life insurance coverage. Coverage is only available for you.
While all the policies pay a benefit in cases of death caused by an accident, death is only one of the covered
accident-caused events.
FAQs
Q1: How do I pay for coverage under these policies?
A1: Accident Expense Protection and PAI is 100% employee-paid through after-tax and pre-tax payroll
deductions, respectively. AD&D Insurance is paid for by K-C. Your cost for Accident Expense Protection and
PAI depends on the level of coverage you elect.
Q2: Who can I cover under these policies?
A2: Accident Expense Protection coverage is available for you and your eligible dependent(s). PAI coverage
is available for you and your eligible dependent. AD&D Insurance coverage is available for you only.
Q3: How are benefits paid under the policies?
A3: Benefits are paid as cash directly to the employee upon verification of a covered injury or loss. PAI does
have an optional monthly installment payment option, with interest.
*This is an example only. The coverage has exclusions and limitations. Your individual experience may also
vary. Please refer to the brochure for full details of the coverage.
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Q4: How do I submit a claim for benefits under these policies?
A4: Accident Expense Protection claims should be submitted directly to Allstate Benefits website
(allstatebenefits.com/mybenefits). You can view your claims history and set up direct deposit for claim
payments on the site.
PAI and AD&D claims should be submitted by contacting the K-C Benefits Information Line at 800-551-2333
Monday through Friday as soon as possible after a covered loss to begin the claim process. Empyrean
representatives are available 9 a.m. to 5 p.m. ET and Fidelity representatives are available from 8 a.m. to 8
p.m. ET. If you’re calling from outside of the U.S., dial your country’s toll-free AT&T Direct Access number
(found at att.com/traveler or from your local operator) and then dial 800-551-2333.
Q5: How would a claim be handled if I had a motorcycle accident and broke my leg?
A5: Accident Expense Protection would pay a benefit(s) for covered injuries as a result of the accident. For
certain covered injuries, there’s a defined benefit amount payable at the time of accident. For example, if you
broke your tibia or fibula (lower leg), the defined benefit amount payable would be $2,200. Additionally, if you
required transportation via ambulance to the hospital that benefit would pay you $200 ($600 if by air). Further,
if you required hospitalization, you’d receive $1,000 (initial hospitalization) and $200 per day that you were
hospitalized. If you required an X-ray, the benefit payable would be $200.*
PAI or AD&D pay a benefit as a result of a loss. Since a broken leg does not constitute as a loss of your leg,
you would not be eligible for a benefit from the PAI or AD&D policy.
Q6: How would a claim be handled under each of these policies if I have an accident and cut off the
thumb and index finger of my left hand?
A6: Accident Expense Protection would pay a benefit(s) if you required transportation via ambulance to the
hospital in the amount of $200 ($600 if by air). If you required hospitalization, you’d receive $1,000 (initial
hospitalization and payable once per year) and $200 per day you were hospitalized. If you required an X-ray,
the benefit payable would be $200. If you required an ER visit, the benefit would be $100. In addition, you
would receive $4,000 for the loss of your entire thumb and index finger.*
PAI: The loss of the thumb and index finger of the same hand is a covered loss under the policy and would
pay you 25% of the principal amount of your coverage. For example, if you elected $100,000 of coverage, the
benefit payable to you would be $25,000 for the loss.
AD&D: The loss of the thumb and index finger of the same hand is a covered loss under the policy and would
pay you 25% of your AD&D coverage. For example, if you have $64,000 of coverage, the benefit payable to
you would be $16,000 for the loss.
Q7: How much coverage can I elect under these policies?
A7: Accident Expense Protection coverage pays a benefit based on the type of care required resulting
from an accident according to the Benefit Schedule. This coverage is not elected based on dollar amounts.
You’ll be able to elect coverage based on who you want to cover and the premium you pay will be based on
your election. The coverage options are: Employee (employee only); Employee + 1 (employee + spouse or
employee + child); Employee + 2 (Family).
PAI coverage can be elected for you only or you and your eligible dependent. You can elect coverage for
yourself from a minimum of $10,000 to a maximum of $1,000,000. Coverage for your eligible dependent is
limited to 50% of your coverage so the maximum coverage for your spouse would be $500,000.
AD&D coverage is automatically provided, if you are eligible, equal to the full amount of your basic group life
coverage.
*This is an example only. The coverage has exclusions and limitations. Your individual experience may also vary. Please
refer to the brochure for full details of the coverage.
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Q8: Am I covered for on-the-job and off-the-job accidents under these policies?
A8: All three policies offer 24-hour protection, which means you would be covered for accidents that occur on
or off the job, 24 hours a day, seven days a week, subject to the limitations and exclusions in the policy.
Q9: Are these policies portable if I terminate from K-C?
A9: Accident Expense Protection coverage is portable. You would continue to pay premiums directly to
Allstate Benefits.
PAI coverage can be converted to individual coverage.
AD&D coverage ends on the day you separate from K-C. No conversion policy is available.
Accident Expense Protection is provided by Supplemental, Limited Benefit Insurance, form GVAP6 or state
variation thereof, underwritten by American Heritage Life Insurance Company. The coverage has limitations
and exclusions. For costs and complete details, contact your Allstate Benefits representative or refer to
brochure number ABJ30640X. Allstate Benefits is the marketing name for American Heritage Life Insurance
Company (home office: Jacksonville, FL), a subsidiary of The Allstate Corporation.
NOTE: This is intended to be a brief description and cannot present all the details of the policy provisions. In
all cases, the provisions of the applicable policy will govern. Kimberly-Clark reserves the right to make
changes to its benefit programs at any time.
May 2017
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