Page 110 - QCS.19 SPD - HSA

All Savers®
Alternate Funding

Federal Women’s Health

and Cancer Rights Act of 1998

The Federal Women’s Health and Cancer Rights Act of 1998 requires that benefits must be provided for:
• Reconstruction of a surgically removed breast;

• Surgery and reconstruction of the other breast to produce a symmetrical appearance; and
• Prostheses and treatment of physical complications from all stages of mastectomy, including lymphedemas.
These benefits are subject to applicable terms and conditions under your health plan, including copayments,
deductible and coinsurance provisions. They are also subject to medical insurance limitations and exclusions.

Administrative services provided by United HealthCare Services, Inc. or their affiliates. Stop-loss insurance is underwritten by
All Savers Insurance Company in all states (except MA, MN and NJ), UnitedHealthcare Insurance Company in MA and MN,
and UnitedHealthcare Life Insurance Company in NJ. 3100 AMS Blvd., Green Bay, WI 54313, 1-800-291-2634.
MT-1177784.0 8/18 ©2018 United HealthCare Services, Inc. 18-9239-C