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Alertable contact means that this user will appear as a target when creating rules on accounts that this role applies to.

Note that only communicator level roles have the option to toggle this on or off and caregiver roles are explicitly alertable contacts.

For example, you may want family member to be able to send and receive letters as a communicator but disallow alerts from delivering to them. In this case you'd set the user up as a communicator and uncheck the Alertable Contact option.