ACCEPTANCE/AUTHORIZATION: I hereby request all …
ACCEPTANCE/AUTHORIZATION: I hereby request all coverage(s) checked “yes” above for which I am or may become eligible under the group coverages issued by AHL. I AUTHORIZE my employer to deduct from my salary or wages, if applicable, the necessary premium for the coverages requested.
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allstatevoluntary.comTendon, Ligament, Rotator Cuff or Knee Cartilage Surgery - surgery for torn, ruptured, or severed tendon, ligament, rotator cuff or knee cartilage; pays the reduced amount shown for arthroscopic exploratory surgery2 Ruptured Disc Surgery - diagnosis and surgical repair to a ruptured disc of the spine by a physician2
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