Edited by LM 4/22/22Not Apprvd
Employee Health Plans
Learn more about the AlaskaCare employee health plan benefits, coverages and monthly premiums.
Effective as of January 1,
The health benefits that the State of Alaska provides to its eligible employees is commonly referred to as AlaskaCare. AlaskaCare Health Plans can help you and your eligible dependents pay for medical, dental, pharmacy, and vision expenses.
Aetna is the AlaskaCare Third-Party Administrator for the employee medical plan. A Third-Party Administrator (TPA) is a company the Division hires to process AlaskaCare medical claims. Aetna is one of America’s largest and most experienced providers of health care benefits and services. Their network includes over 690,000 primary care doctors and specialists and more than 5,700 hospitals.
Get the right care for your needs
Health care can be complicated. There’s a lot to know about doctors, hospitals, treatments and services. The resources below provide reliable information to help you make better decisions and choices when you need care.
Call your Health Concierge
The Health Concierge is your single point of contact for all claim, benefit and provider information related to AlaskaCare medical. Call or chat online when you have a problem or question. Find the right specialist. Understand how a claim was paid. Know about programs for specific health conditions and needs. Whether you need a quick answer, help with a difficult issue or someone to explain your benefits, you have an advocate dedicated to your needs.
Medical Plans at a Glance
AlaskaCare offers three medical plans to choose from: Standard, Economy, and Consumer Choice. The three options all cover the same services, including pharmacy benefits, but each option has different deductibles, coinsurance levels, copayments (if applicable) and out of-of-pocket maximums. You can choose the plan that is best for you based what will work best for your family’s needs.
You consider the monthly cost of each option and decide which benefits to purchase. Use the Health Plan Cost Comparison Tool to help you make an informed decision.
- Standard Plan
The Standard Plan offers the lowest deductibles, lowest Out-of-Pocket Maximums, and highest coverage amounts (coinsurance). This option also has higher premiums than the other plans.
- Economy Plan
The Economy Plan offers lower premiums than the Standard Plan, but also has slightly higher deductibles, lower coverage amounts (coinsurance) and higher Out-of-Pocket Maximums.
- Consumer Choice Plan
The Consumer Choice Plan offers a lower-premium medical plan option with a higher deductible than medical plans traditionally offered by AlaskaCare. The Consumer Choice plan is a consumer driven health plan with an employer sponsored Health Reimbursement Arrangement (HRA).
Glossary of Important Terms
Preventive Care—At No Cost
All AlaskaCare employee medical plan options will pay covered preventive services in full when received from an network provider. In-network preventive care services are not subject to deductibles or coinsurance.
See the Preventive Care Coverage Information Flyer and the Women’s Preventive Care Coverage Information Flyer for additional information on covered preventive services.
All other covered medical benefits are subject to the deductible and coinsurance.
AlaskaCare offers a menu of medical plan options so you can find the best fit for you and your family.
|2022 ACTIVE EMPLOYEE PREMIUMS|
|For AVTECTA – AK Vocational Teachers (TA),
APEA – Confidential (KK),
APEA – Supervisory (SS),
ACOA – Correctional Officers (GC), TEAME – Mt. Edgecumbe Teachers (TM),
Employees not covered by collective bargaining (Exempt)
|Plan||Employee Only||Employee & Family|
|Standard Medical Plan||$125||$303|
|Economy Medical Plan||$63||$167|
|Consumer Choice Plan||$25||$71|
|Standard Dental Plan||$37||$102|
|Economy Dental Plan||$0||$0|
|For MEBA – Marine Engineers (BB), IBU – Inlandboatman’s (MM) Only|
|Plan||MEBA Employee Only||MEBA Employee & Family||IBU Employee Only||IBU Employee & Family|
|Standard Medical Plan||$125||$303||$125||$303|
|Economy Medical Plan||$0||$0||$35||$95|
|Consumer Choice Plan||$25||$71||$25||$71|
|Standard Dental Plan||$37||$102||$37||$102|
|Economy Dental Plan||$0||$0||$0||$0|
|Effective: Jan. 1 - Dec. 31, 2022|
The health benefits that the State of Alaska provides to its eligible employees is commonly referred to as AlaskaCare. AlaskaCare Health Plans can help you and your eligible dependents pay for medical, dental, pharmacy and vision expenses.
When you enroll in the AlaskaCare medical plan, you are automatically enrolled in pharmacy benefits. You will receive your pharmacy ID cards from OptumRx in the mail separately from your medical card.
OptumRx is the AlaskaCare pharmacy benefit manager. A pharmacy benefit manager (PBM) is a company the Division hires to process AlaskaCare pharmacy claims. Medical, vision and dental claims are processed by Aetna and Delta Dental, respectively.
You can call OptumRx at (855) 409-6999, TTY 711, for help with:
- finding a network pharmacy near you,
- reviewing the drug formulary,
- enrolling in medication home delivery,
- setting refill reminders, and more.
OptumRx’s retail pharmacy network includes most pharmacies in Alaska. For a list of participating pharmacies near you, use the Pharmacy Locator Tool on the OptumRx app, at OptumRx.com , or call a OptumRx representative at (855) 409-6999, TTY 711.
Medication Home Delivery
You can receive maintenance medication through the mail through OptumRx® home delivery. Enroll in OptumRx® home delivery to get up to a 90-day supply of the medications you take regularly. Your medication will come right to your mailbox. To start home delivery, log in to OptumRx.com , use the OptumRx® App or call (855) 409-6999, TTY 711.
OptumRx Specialty Pharmacy
Specialty medications can be important to maintaining or improving your health—and your quality of life. The OptumRx® specialty pharmacy, provides resources and personalized, condition specific support to help you manage your condition. Using OptumRx for your specialty needs saves you money and means the plan pays less.
Call OptumRx at (855) 427-4682 to enroll in this specialty pharmacy program.
AlaskaCare Employee Plan Formulary
- 2022 AlaskaCare Employee Plan Prescription Drug Formulary
- 2021 AlaskaCare Employee Pharmacy Plan Formulary
- 2020 AlaskaCare Employee Pharmacy Plan Formulary
- 2019 AlaskaCare Employee Pharmacy Prior Authorization
- 2019 AlaskaCare Employee Pharmacy Quantity Limits
- 2019 AlaskaCare Employee Pharmacy Plan Formulary
Maximize your AlaskaCare Pharmacy Benefits
The AlaskaCare Employee Health Plan includes a three-tier pharmacy structure featuring different coinsurance and copayments for medications based on drug type:
- Tier One: Generic Drugs—lowest cost tier
Generic medications are therapeutically, and often chemically, identical to brand medications and are widely available at competitive prices.
- Tier Two: Preferred Brand-Name Drugs—slightly higher cost tier.
Preferred brand drugs are medications for which a generic is either unavailable or offered at discounted prices.
- Tier Three: Non-preferred Brand-Name Drugs—highest cost tier.
Non-preferred brand drugs are medications available in an equivalent generic form, or as a preferred brand drug. These drugs cost more to both the plan and the member, but a lower cost equivalent medication is available.
Members using generic medications may experience a decrease in the cost-share for their prescription. Members using a preferred brand name or non-preferred brand name medication may pay more. Be sure to check the 2018 Aetna Pharmacy Drug Guide and the Exclusion Drug List to see where your prescription is listed. You and your provider can search for a drug, ensure it is not on the exclusion list, and determine if there are lower cost alternatives.
How are drugs assigned to a tier? A tool called a “formulary” is used to assign medications to different tiers. The formulary for the employee plan is the 2018 Aetna Pharmacy Drug Guide. This guide is developed not only with overall value of the medication in mind, but based on drug safety, effectiveness and current use in therapy. Although some medications will no longer be covered (see Exclusion Drug List), the plan still covers the vast majority of prescription drugs, and you are free to choose a generic, preferred brand name or non-preferred brand name medication. Choosing a lower tiered drug when it is appropriate can provide access to the necessary medications to stay healthy, at a cost that is more affordable. Choosing a generic medication means your out-of-pocket cost will be less than if you choose a preferred brand name. Remember the lower the tier, the lower the out-of-pocket costs!
If you choose mail order your copay goes further. Choosing to fill your prescription medications through mail order when appropriate, can save you money. You can receive up to a 90-day supply for one low copayment when using mail order. You can also fill up to a 90-day prescription at a participating retail pharmacy; however, you will pay separate copays for each 30-day supply.
Compound Prescription Limitation
The AlaskaCare Employee Health Plan pharmacy benefits does not cover bulk powders/chemicals/products or other non-FDA approved drugs used in prescription compounding. Compound medications formulated from bulk powder compounds and bioidentical hormones will not be covered prescription drugs because they are not drug products approved by the FDA. Compounds that utilize at least one non-bulk, FDA-approved legend drug may be considered for coverage. If this impacts you, talk with your doctor or pharmacist about alternative options.
Prescriptions with an Over-the-Counter Equivalent
The AlaskaCare Employee Health Plan will not pay for prescription drugs when an over-the-counter equivalent is available. This applies even if prescribed or recommended by your health care provider. Talk to your doctor or pharmacist about over-the-counter alternatives that may be less expensive. Please note this does not affect over-the-counter medications required to be covered under the Affordable Care Act, such as aspirin.
- Compare medication prices at different pharmacies.
- Find lower-cost alternatives.
- Locate network pharmacies.
- Manage medication for covered dependents and spouses.
- View real time benefits and claims history.
- Transfer retail prescriptions to home delivery.
- Track orders.
- Refill home delivery prescriptions.
- Access your ID card, if your plan allows.
- View your claims history.
- Manage medication reminders.
The health benefits that the State of Alaska provides to its eligible employees is commonly referred to as AlaskaCare. AlaskaCare Health Plans can help you and your eligible dependents pay for medical, dental, pharmacy and vision expenses.
A dental third-party claim administrator is a company the Division hires to process AlaskaCare dental claims. Delta Dental of Alaska is the AlaskaCare dental claim administrator. Medical, vision, and pharmacy claims are processed by Aetna and OptumRx, respectively.
Contact Delta Dental of Alaska toll free at (855) 718-1768.
When you enroll in dental benefits you’re part of the Delta Dental of Alaska family and have access to great dental care, close to home and when you’re traveling. Delta Dental of Alaska is part of the Delta Dental Association — the nation’s largest and most trusted dental benefits carrier.
- Members can send a completed Dental Claim Form to Delta Dental for processing:
- Via email:
- Physically mail the claim form and necessary paperwork to the below address:
P.O. Box 40384
Portland, OR 97240-0384
- In addition to the claim form, please include the following information:
- Receipts showing payments of services.
- The cost of all services is required (foreign currency will be converted into USD and reimbursement to the member will be in USD).
- A written summary of services received
- If tooth specific services were rendered include the tooth number on which services were completed.
- ADA Dental codes may not be used by international providers, so a detailed narrative of treatment provided will be very helpful.
- If the narrative/treatment plan is not in English, Delta Dental may have translators who can translate the information received.
- If you are interested in receiving reimbursement via Direct Deposit, please complete and include the Direct Deposit Authorization Form .
Dental Plans at a Glance
AlaskaCare offers two dental plan options: the standard plan and the economy plan.
- Standard Plan
The Standard Plan has greater coverage for more than just preventive dental visits, higher maximum annual benefits, includes limited orthodontic coverage, and includes Preventive services covered at 100% with no deductible for In-Network Dentists.
- Economy Plan
The Economy Plan has no monthly premium, has a lower maximum annual benefit and covers Preventive services covered at 100% with no deductible for In-Network Dentists and a lower.
|AlaskaCare 2022 Dental Plan Summaries|
|Monthly Plan Premiums|
|Employee and Family||$102.00||$0.00|
|Calendar Year Costs|
|Annual Maximum Benefit Per Person||$1,500||$500|
|Deductible Per Person||$25||$25|
|Deductible Per Family||$75||$75|
|Service||Benefit Amount||Benefit Amount|
|Eligible employees and their covered dependents||50% coinsurance up to a $1,000 lifetime maximum||N/A|
|1 Deductible waived, does not apply to annual maximum benefit.
Premiums are subject to change.
Note that although the Preventive plan offers limited coverage for non-preventive procedures, it will still save you money by restricting the cost for those services to Delta Dental's negotiated rates. This only applies when you see a provider in the Delta Dental Premier or PPO networks.
AlaskaCare has provided the above benefit summaries. Moda Health/Delta Dental of Alaska are not responsible, in any way, for the accuracy of such information. For a more detailed description refer to your Member Handbook. If you have any questions about this information, please contact your AlaskaCare plan administrator at (800) 821-2251.
|Effective: Jan. 1 - Dec. 31, 2022|
Oral health is an essential part of staying healthy. Studies have linked oral health to several chronic diseases, including diabetes, heart disease and stroke. Pregnant women who have periodontal disease are more likely to have a premature and underweight baby. Lower your risks by keeping up with your preventive dental services.
No cost for preventive care from network dentists!
Seeing your dentist regularly can help you avoid serious and expensive services down the road. To help you avoid costly dental care in the future, both dental plan options cover preventive care at no cost to you if you use a network provider:
- Preventive (Class I) services, such as cleanings, periodontal maintenance, and routine oral exams, are covered at 100% when using a network provider.
- Preventive services do not count towards your maximum annual dental benefit, giving you more to spend each year on other services that you may need.
Reduce your costs by using a network dentist!
Your dental plan lets you see any licensed dentist you want. But when you see a network provider, you’ll save money. AlaskaCare members have access Delta Dental’s broad Premier network of providers, AND to an additional, narrower network of dental providers: Delta Dental’s PPO network.
When you visit a PPO dentist, you’ll pay less out-of-pocket. You do not need to do anything to enroll in this benefit, but if you want to take advantage of the discounted services, use the dentist locator tool to search for providers who participate in the PPO network, or call Delta Dental of Alaska toll-free at (855) 718-1768.
Oral Health, Total Health Program and Benefits
If you are diabetic or pregnant in your third trimester, the Oral Health, Total Health program offers more ways to care for your teeth and mouth—and keep the rest of your body healthy, too.
If you have diabetes
Diabetes increases the risk of cavities, periodontal (gum) disease, tooth loss, dry mouth and infection. If you have been diagnosed with this disease you may be eligible for four prophylactic (preventive) cleanings or periodontal maintenance visits per year through the Oral Health, Total Health program. Protect your teeth and gums by enrolling today.
If you’re pregnant
Pregnant women who have periodontal (gum) disease are more likely to have a premature and underweight baby. Bacteria can enter the bloodstream through the mouth, and the body’s response to the infection can trigger early labor. If you are expecting, you can enroll in the Oral Health, Total Health program to help prevent gum disease. If you’ve already had two cleanings for the year, you may be eligible for another cleaning or checkup during your third trimester. This added preventive (prophylactic) visit is covered regardless of normal plan frequency limits. That way, you can receive a dental cleaning during the third trimester, no matter what.
To learn more or to enroll, call Delta Dental of Alaska (MODA) toll-free at (855) 718-1768.
Vision is an optional plan offered to AlaskaCare members and their families. Vision Service Plan (VSP) is the administrator for the employee vision plan. If you enroll in the vision plan, the VSP information is located on the back of your Aetna ID card.
Most experts estimate that over 64% of adults need some sort of vision correction. Depending on how often you need new lenses, getting vision insurance may be a good financial fit.
Many hidden medical problems can be detected through an eye exam, so even those with perfect vision should have regular eye exams. If this routine exam is all you need, the vision plan may not be the right financial fit for you.
Review the premiums and the coverage offered under the vision plan before making a decision if this vision coverage is the right fit for you.
|AlaskaCare 2022 Vision Plan Summary|
|Monthly Employee Contribution|
|Employee and Family||$40.00||--|
|Well Vision Exam|
|WellVision Exam||Focuses on your eyes and overall wellness.||$10||Every calendar year|
||$25 (Prescription Glasses Benefit)||Every other calendar year|
||Included in prescription glasses||Every calendar year|
||Included in prescription glasses||Every calendar year|
(instead of glasses)
||Up to $60||Every calendar year|
|Diabetic Eyecare Plus Program||Services related to diabetic eye disease, glaucoma and age-related macular degeneration (AMD). Retinal Screening for eligible members with diabetes. Limitations and coordination with medical coverage may apply. Ask you VSP doctor for details.||$20||As Needed|
|Extra Savings and Discount|
|Glasses & Sunglasses||30% off additional glasses and sunglasses, including lens options, from the same VSP doctor on the same day as your WellVision exam. Or, get 20% off from any VSP doctor within 12 months of your last WellVision exam.|
|Effective: Jan. 1 - Dec. 31, 2022|
What Plan Am I In?
The following employee groups are entitled to the AlaskaCare Health Benefits provided by the State:
- AVTECTA – AK Vocational Teachers Union (TA)
- CEA – Confidential Union (KK)
- APEA – Supervisory Union (SS)
- ACOA – Correctional Officers Union (GC)
- MEBA – Marine Engineers Union (BB)
- TEAME – Mt. Edgecumbe Teachers Union (TM)
- IBU – Inlandboatman’s Union (MM)
- Employees not covered by collective bargaining (Exempt)
Union Health TrustsThe following employee groups are covered by Union health trusts and should contact the trust for details and enrollment in health benefits. Please note all trusts, except Labor Trades and Crafts, are eligible to enroll in Voluntary Supplemental Benefits provided by the state.
- General Government (GGU)
- Labor, Trades and Crafts (LTC)
- Public Safety Employees Association (PSEA)
- Masters, Mates & Pilots
New To Plan
As an active employee your State of Alaska employee benefits include health insurance and life insurance, as well supplemental insurance options that you can decide if you want to take advantage of.
Your plan is determined by what bargaining unit you are in and you are responsible to know and manage your benefits.
You must elect benefits within 30 days of your hire date or after a Qualified Status Change. You may also enroll or change your benefits during the annual Open Enrollment period.
Before enrolling in your new Employee Benefits or changing your current benefits, please review the different options and latest changes to the benefits and plan premiums. Then decide which benefits will be most appropriate for you and your family.
AlaskaCare Members may add, change or delete dependents covered under your health plan at any time by logging into their myAlaska account. Be sure to add eligible dependents when you are first hired and then review the dependents anytime you make future changes to your benefits; adding any necessary updates as your dependents change.
If you experience technical difficulties while trying to enroll contact the Member Service Center at:
Juneau: (907) 465-4460
Outside Juneau: (800) 821-2251
Monday - Thursday: 8:30 a.m. to 4 p.m.
Friday: 8:30 a.m. to 3 p.m. (Alaska Time)
Qualified Status Change
A Qualified Status Change is a change in your family or employment status which allows you to make changes to your coverages.
If you have a "qualified status change" during the year, you can make changes to your coverages (subject to limitations). Changes must be made within 30 days of the event. Examples of qualified status changes include the following:
- You gain or lose a dependent, through birth or adoption, marriage, divorce, or death.
- Your dependent is no longer eligible.
- Your spouse terminates employment, begins an extended period of leave or layoff without pay, or begins new employment.
- Your spouse or you change employment status from full-time to part-time or from part-time to full-time.
- Your spouse has a significant change in his or her health coverage caused by their employment.
You may also change benefits if you move from an AlaskaCare participating group to a non-participating group.
How to Enroll
To enroll in your AlaskaCare Health Benefits, follow these instructions:
- Log in to your myAlaska account:
- Go to myRnB.alaska.gov . This is the myRnB portal.
- On the right side of the page, choose Login using myAlaska. You will be directed to the myAlaska login page, where you will login using your myAlaska ID and password. This is the same ID and password you use to register for your PFD. After you login to myAlaska, you will be redirected back to myRnB.
- On the myRnB page, under Self-Service Tools, choose Online Benefits Enrollment, or if during an Open Enrollment period click on Open Enrollment.
- Review your dependents enrolled under the health plan. Click “Health Dependent Enrollment”.
- Make sure all your eligible dependents are listed. If not, click Add Dependent, fill in the blanks, and click Save Changes.
- If there are ineligible dependents listed, select the dependent from the list on the left side of the page. Click Edit, then Terminate Dependent.
- If you have not yet provided the Social Security number (or other tax identification number) for each of your dependents that you have enrolled, please do so now. Select the dependent from the list on the left, then choose Addition of Missing SSN from the drop-down menu. Be sure to click Save Changes once you have added the information.
- Once your review is complete, click Back to Benefits Enrollment at the top of the page.
- Check your elections and make new elections as needed.
- Under Change Reason, select Open Enrollment from the drop-down menu, then click Change Elections.
- Use the drop-down menus to make new elections. Certify your eligibility, then press Continue.
- Review these elections and the updated premiums, then either click Back to edit your elections, or Submit Elections to enroll.
To enroll in Voluntary Supplemental Benefits (VSB), follow these instructions:
- Navigate to BenefitFocus to enroll. Click here to begin.
- If you did not participate in last years open enrollment for VSB, you will need to create an account. If you already have an account, enter your Username and Password and click Log In.
- Verify your demographic information, then click Save to edit your benefit elections. Follow the wizard for each benefit by selecting or declining, and adding beneficiaries.
- Once your elections are saved, you may make changes to your VSB elections as many times as you wish until the end of your enrollment period.
Open Enrollment is the annual time of year when you can make changes to your current benefits. Typically, Open Enrollment occurs during the first three weeks of November. Unless you are a new hire or have had a Qualified Status Change, then this is the only time during the year where you may make changes to your current benefit. Open Enrollment for employees includes the following:
- AlaskaCare Benefits: For eligible State of Alaska employees who participate in the AlaskaCare health plan to choose medical, dental, and vision benefits as well as to choose to participate in a Health Flexible Spending Account (HFSA).
- Voluntary Supplemental Benefits (VSB): For any eligible employee of the State of Alaska or participating Political sub-divisions to choose VSB, including Life insurance, Critical Illness, and Disability insurances.
If you are unsure what plan you participate in, click here.
Benefit Highlights for
- Covered Drugs for : Premium Drug Formulary
The OptumRx Premium Formulary is a list of medications, pharmacy care products, and services or supplies that have been evaluated by a team of clinical experts and chosen for their safety, cost, and effectiveness. Your AlaskaCare plan covers drugs that are listed on the Premium Formulary, and drugs that are not on the formulary will not be covered effective January 1, . You can review the AlaskaCare Employee Plan Premium Formulary beginning in November. If you have a medical need to use a drug that is not listed on the Premium Formulary, you or your doctor should contact OptumRx at (855) 409-6999 to request an exception. If you are currently taking a medication that is not on the Premium Formulary you will receive a letter notifying you of the change and alternatives to discuss and review with your physician.
- Get Moving with Hinge Health!
Hinge Health can help whether you have chronic or sudden joint pain, are recovering from an injury, or just want more strength and flexibility. Hinge Health offers innovative digital care programs that connect you with a physical therapist or personalized health coach to help you manage musculoskeletal conditions such as back, knee, hip, neck and shoulder pain. Hinge Health’s programs are available at no cost to you and your family members age 18+. You can reach Hinge Health’s Member Care Advocates at (855) 902-2777. Enroll in Hinge Health Now!
- Updated premiums for
Be sure to review the updated plan premiums effective January 1, . Learn more about premiums here.
- Behavioral Health Support at Your Fingertips
Teladoc® now includes behavioral health consultations with a $0 copay. Their board-certified psychiatrists and licensed psychologists, social workers, and family/marriage therapists can help with depression, anxiety, stress, panic disorder, ADHD, schizophrenia, work-related issues, personal issues, and more. You can choose a therapist or psychiatrist who fits your needs and schedule visits 7 days a week, 7am to 9pm, from wherever you are most comfortable. Visit the Teladoc® website or you can call Teladoc® at (855) 835-2362 to request a consult by phone.
- Access to Anchorage-Area Hospitals
Providence Alaska Medical Center and Alaska Regional Hospital are both in-network for AlaskaCare Employee plan members. If you receive care in the Anchorage-area, you will save no matter where you go. Network hospitals and facilities have partnered with AlaskaCare to keep your costs low by offering you discounted rates. We've also expanded the network to include more freestanding surgical and imaging centers in the Anchorage area. A larger network means more choice for you! Find a network provider near you with the DOC Finder Tool or call the Aetna Concierge at (855) 784-8646.
- Remember! You still have great access to high-quality providers at lower costs through the SurgeryPlus network.
If you are considering elective surgeries learn how you can save money through SurgeryPlus.
For more information, please refer to the AlaskaCare Employee Open Enrollment Guide .
For definitions of any terms used in this information page please refer to the AlaskaCare Health Plan Document. This information is only a summary. The AlaskaCare Health Plan Document will prevail whenever there is a difference in interpretation between this information page and the plan document.
If you and/or your dependents lose coverage due to a qualifying event, you and/or your dependents may continue coverage under the plan by electing COBRA coverage and paying the required premium as described in this section. You may elect coverage under the plan that is the same or less than the level of coverage that you or your dependents had at the time your coverage terminates under the plan. For example, if you are covered under the medical plan and have elected the standard plan, you may elect COBRA continuation coverage under either the standard plan or the economy plan. Additionally, you may elect COBRA continuation coverage:
- under the medical plan only; or
- under the medical plan and under the dental plan and/or the vision plan
You may not elect COBRA continuation coverage under the dental plan or the vision plan without also electing COBRA continuation coverage under the medical plan.
Right to Continuation Coverage
If you are a qualified beneficiary, you may elect to continue coverage under the plan after a qualifying event. Only those persons who are covered under the plan on the day before the event which triggered termination of coverage are eligible to elect COBRA continuation coverage, except that dependent children born to or placed for adoption with you while you are on continuation coverage may be added to your coverage if the child is otherwise eligible under the plan. A qualified beneficiary is a person who is covered under the plan on the day before a qualifying event (but also including dependent children born to or placed for adoption with you during the continuation coverage) who is:
- an eligible employee;
- a spouse; or
- a dependent child
The right to continued coverage is triggered by a qualifying event, which, but for the continued coverage, would result in a loss of coverage under the plan. A "loss of coverage" includes ceasing to be covered under the same terms and conditions as in effect immediately before the qualifying event or an increase in the premium or contribution that must be paid by a covered person. Qualifying events include:
- Your death.
- The termination (other than by reason of gross misconduct) of your employment or reduction of your hours that would result in a termination of coverage under the plan.
- Your divorce or legal separation from your spouse.
- Your becoming entitled to Medicare benefits under Title XVIII of the Social Security Act (42 USC § 1395-1395ggg).
- Your child ceasing to be a dependent child under the eligibility requirements of the plan.
If a qualifying event occurs to a qualified beneficiary, then that qualified beneficiary may elect to continue coverage under the medical plan, dental plan and/or vision plan.
Election of Continuation Coverage
Continuation coverage does not begin unless it is elected by a qualified beneficiary. Each qualified beneficiary who loses coverage as a result of a qualifying event has an independent right to elect continuation coverage, regardless of whether any other qualified beneficiary with respect to the same qualifying event elects continuation coverage.
The election period begins on or before the date the qualified beneficiary would lose coverage under the plan due to the qualifying event, and ends on or before the date that is 60 days after the later of:
- the date the qualified beneficiary would lose coverage due to the qualifying event; or
- the date on which notice of the right to continued coverage is sent by PayFlex.
The election of continuation coverage must be made on a form provided by PayFlex and payment for coverage, as described in the notice, must be made when due. An election is considered to be made on the date it is sent to PayFlex.
Period of Continuation Coverage
Termination of Employment or Reduction in Hours
In the case of a qualifying event caused by termination of employment or reduction in hours, the qualified beneficiary may elect to extend coverage for a period of up to 18 months from the date of the qualifying event.
Second Qualifying Event
If a second or additional qualifying event occurs during the initial 18 month continuation coverage period (or during a 29 month maximum coverage period in the case of a disability), the qualified beneficiary may elect to extend the continuation coverage period for a period of up to 36 months from the date of the earlier qualifying event.
If you became entitled to Medicare within 18 months prior to a qualifying event caused by termination of employment or reduction in hours, qualified beneficiaries (other than you) may elect to extend coverage for a period of 36 months from the date of your entitlement to Medicare benefits.
If a qualified beneficiary is determined under Title II or XVI of the Social Security Act to be disabled within 60 days of the initial continuation coverage period due to termination of employment or reduction of hours (even if the disability commenced or was determined to be a disability before the first 60 days of the initial 18 month continuation coverage period), coverage may be continued for all qualified beneficiaries for a period of up to 29 months from the date of the qualifying event.
You must provide notice of a disability determination to PayFlex within 18 months of the qualifying event and within 60 days after the latest of:
- the date of the disability determination by the Social Security Administration;
- the date the qualifying event occurs;
- the date you lose or would lose coverage due to the qualifying event; or
- the date on which you are informed, via the plan or the general COBRA notice, of your obligation to provide such notice and procedures for providing such notice.
You are also responsible for notifying the Division within 30 days of the later of:
- the date of the final determination by the Social Security Administration that you are no longer disabled; or
- on the date which you are informed, via the plan or the general COBRA notice, of your obligation to provide such notice and procedures for providing such notice.
Other Qualifying Events
In the case of any qualifying event not otherwise described above, the qualified beneficiary may elect to extend coverage for a period of up to 36 months from the date of the qualifying event.
Health Flexible Spending Account (HFSA)
Notwithstanding the above, continuation coverage under the health flexible spending account (HFSA) will extend only until the end of the benefit year in which the qualifying event occurs.
End of Continuation Coverage
Continuation coverage will end upon the dates of the following occurrences, even if earlier than the periods specified under section 8.4, Period of Continuation Coverage
- Timely payment of premiums for the continuation coverage is not made (including any grace periods).
- You first become covered under any other group health plan, after the date on which continuation coverage is elected, as an employee or otherwise, unless such other plan contains a limitation (other than a limitation which does not apply by virtue of HIPAA with respect to any pre-existing condition).
- You first become entitled to benefits under Medicare, after the date on which continuation coverage is elected.
- The State ceases to provide any group health plan to any employee
- You cease to be disabled, if continuation coverage is due to the disability.
Notwithstanding the foregoing, the plan may also terminate the continuation coverage of a qualified beneficiary for cause on the same basis that it could terminate the coverage of a similarly situated non-COBRA beneficiary for cause (e.g., in the case of submitting fraudulent claims to the Division).
Cost of Continuation Coverage
You are responsible for paying the cost of continuation coverage. The premiums are payable on a monthly basis. By law, premiums cannot exceed 102% of the full premium cost for such coverage (or 150% for any extended period of coverage due to disability). After a qualifying event, PayFlex will provide a notice with amount of the premium, to whom the premium is to be paid, and the date of each month that payment is due. Failure to pay premiums on a timely basis will result in termination of coverage as of the date the premium is due. Payment of any premium will only be considered to be timely if made within 30 days after the date due.
A premium must be paid for the cost of continuation coverage for the time period between the date of the event which triggered continuation coverage and the date continued coverage is elected. This payment must be made within 45 days after the date of election. PayFlex will provide you notice specifying the amount of the premium, to whom the premium is to be paid, and the date payment is due. Failure to pay this premium on the date due will result in cancellation of coverage back to the initial date coverage would have terminated.
|Effective: Jan. 1 - Dec. 31, 2022|
|COBRA Employee + Family|
|Effective: Jan. 1 - Dec. 31, 2022|
General Notice to Covered Eligible Employee and Spouse
The plan will provide, at the time of commencement of coverage, written notice to you and your spouse of your rights to continuation coverage. This general notice will be provided no later than the earlier of:
- 90 days after your coverage commencement date under the plan; or
- the date on which the Division is required to furnish a COBRA election notice.
Employer Notice to Division
Your employer will notify the Division in the event of your death, termination of employment (other than gross misconduct), reduction in hours, layoff, or entitlement to Medicare benefits within 30 days after the date of the qualifying event.
Covered Eligible Employee/Qualified Beneficiary Notice to Administrator
You must notify the Division of:
- your divorce or legal separation from your spouse;
- a child ceasing to be a dependent child under the eligibility requirements of the plan;
- a second qualifying event; or notice of disability entitlement or cessation of disability.
You must give notice as soon as possible, but no later than 60 days after the later of:
- the date of such qualifying event;
- the date that you lose or would lose coverage due to such qualifying event; or
- the date on which you are informed, via the plan or the general COBRA notice, of your obligation to provide such notice and the plan procedures for providing such notice.
See Election of Continuation Coverage, for timing of notices applicable to disability determinations.
You or another qualified beneficiary, or a representative acting on behalf of you or another qualified beneficiary, may provide this notice. The provisions of notice by one individual satisfies any responsibility to provide notice on behalf of all related qualified beneficiaries with respect to the qualifying event. Failure to provide timely notice will result in your loss of any right to elect continuation coverage.
Division's Notice to Qualified Beneficiary
Upon receipt of a notice of qualifying event, PayFlex will provide to each qualified beneficiary notice of their right to elect continuation coverage, no later than 14 days after the date on which PayFlex received notice of the qualifying event. Any notification to a qualified beneficiary who is your spouse will be treated as a notification to all other qualified beneficiaries residing with such spouse at the time such notification is made.
Unavailability of Coverage
If PayFlex receives a notice of a qualifying event or disability determination and determines that the person is not entitled to continuation coverage, PayFlex will notify the person with an explanation as to why such coverage is not available.
Notice of Termination of Coverage
PayFlex will provide notice to each qualified beneficiary of any termination of continuation coverage which is effective earlier than the end of the maximum period of continuation coverage applicable to such qualifying event, as soon as practicable following PayFlex's determination that continuation coverage should terminate.
Use of a Single Notice
Required notices must be provided to each qualified beneficiary or individual; however:
- a single notice can be provided to you and your spouse if you both reside at your address; and
- a single notice can be provided to you or your spouse for a dependent child if the dependent child resides with you or your spouse.
For more information contact the Division at (907) 465-4460 or email .
The Health Flexible Spending Account (HFSA) provides an opportunity for you to save by setting aside money for health care on a pre-tax basis. You can then use these funds to pay for qualified health care expenses not covered by the plan.
Each benefit year, you decide if you would like to enroll in a HFSA and determine the amount you want to contribute, within the limit, on a pretax basis. During the benefit year, you file claims for eligible medical expenses, and are reimbursed with tax-free dollars from the account. You benefit from reduced taxes because you don’t pay taxes on the dollars you contribute to your account. The federal government imposes certain restrictions on HFSA plans to give you these pre-tax advantages, such as you cannot enroll in, cancel, or change your HFSA amount at any time during the year except during Open Enrollment.
You may carry forward up to $550 from year to year. Otherwise, you must spend down the account for qualified expenses in each benefit year. You have until March 31 of the following year to file claims for the current benefit year.
|2022 Health Flexible Spending Account Rates|
|Minimum Monthly Amount||$25.00|
|Maximum Monthly Amount||$225.00|
|Effective: Jan. 1 - Dec. 31, 2022|
If you do not have any other health coverage, you can elect to have your HFSA set up to “streamline”. This means that any unpaid portion of a claim you incur during the plan year (deductible, your portion of the coinsurance, etc.) is directed to your HFSA account for reimbursement.
You may not elect streamlining if you have other coverage that will coordinate with AlaskaCare.
Your Choice: Once a Year, Every Year!
A HFSA might be a great choice for you – but here are some things to keep in mind:
- You cannot enroll in, cancel, or change your HFSA amount at any time during the year except during Open Enrollment or a qualifying status change.
- You must elect these benefits each open enrollment period. Your HFSA does not automatically continue from one benefit year to the next.
- The benefit year runs from January 1 to December 31. You must budget contributions carefully.
- You may carry over up to $550 of unused funds in your HFSA to the next benefit year, but unused amounts over $550 are forfeit.
- Any amount you carry over to the next year will be added to any HFSA contributions you choose to make in the new benefit year.
- Services for eligible expenses must be received while you are covered by the plan—coverage stops during most periods of leave without pay (LWOP) (your coverage will not stop if you are on FMLA and are in LWOP status) and at termination. Under HFSA, coverage also stops when you move to a bargaining unit which does not participate in the Select Benefits/AlaskaCare health plan.
- Except for the $550 carry over in the HFSA plan, services must be received prior to the end of the benefit year, December 31.
- Claims for the benefit year must be filed within 90 days of the end of the benefit year.
Did you know you can use your HFSA for the following common items?
- Allergy Medicine
- At-home COVID-19 tests *new in 2021
- Birth control
- Cold medicine
- Feminine hygiene products- include, but are not limited to: sanitary napkins, pads, liners, tampons, cups, sponges.
- Fever reducing medicine
- Hand sanitizer *new in 2021
- Masks *new in 2021
- Pain relievers
- Sanitizing wipes *new in 2021
- Sleep deprivation treatment
Visit payflex.com and find the entire list of eligible expenses categorized by eligible, eligible with a letter of medical necessity, and not eligible.
Submitting a Claim
You can submit HFSA claim multiple ways:
- Paper form: Health Flexible Spending Account (HFSA) claim form (PayFlex)
- Online: PayFlex.com
- PayFlex Mobile App
You can submit claims for any approved expenses by filling out the claim information and providing the Explanation of Benefits (EOB) or receipts. Eligible reimbursements will be paid directly to you, not your provider. You have until March 31 after the benefit year ends in which you incurred the claims to request reimbursement.
Effective January 1,
- AlaskaCare Employee Insurance Information Booklet
- Your Rights and Protections Against Surprise Medical Bills
The AlaskaCare Employee Health Plan booklet reflects revisions to the previous Select Benefits Information Insurance booklet for State of Alaska employees covered under the AlaskaCare health plan.
- AlaskaCare Employee Health Plan Amendment 2018-2: SurgeryPlus
Effective August 1, 2018
- AlaskaCare Employee Health Plan Amendment 2018-1
Effective March 1, 2018
- AlaskaCare Employee Health Plan Amendment 2020-1: Medical Foods
Effective August 1, 2020
- AlaskaCare Employee Health Plan Amendment 2021-1: Carryover of Unused Amounts in HFSA
Effective January 1, 2021
- AlaskaCare Employee Health Plan Amendment 2021-2-Hinge Health
Effective July 15, 2021
- AlaskaCare Employee Health Plan Amendment 2021-3: Teladoc Behavioral Health
Effective August 1, 2021
Find a Provider
Coalition Health Centers
The Coalition Health Centers welcome AlaskaCare Employee Health Plan eligible members and dependents in Anchorage and Fairbanks. The Centers offer wellness and preventive care, as well as walk-ins for acute care (unexpected illness or injury.) Appointments are required for wellness and preventive care.
Services received at Coalition Health Centers are not subject to your plan’s annual deductible; you will only be charged a $25 co-pay for the office visit. Do not submit claims for these services. Coordination of benefits does not apply. See the AlaskaCare Employee Health Plan amendment effective March 1, 2018 for additional information.
Payment for sevices at the Centers is as follows:
- Acute/Unexpected Illness/Injury: Co-Pay $25/Office Visit
- Wellness & Preventive Care: Preventive $0/Office Visit
Coalition Health Center schedule
- Monday through Friday
7:30 a.m. – 6:30 p.m. (By appointment)
8:30 a.m. – 4:30 p.m. (Walk-ins welcome for acute care)
Coalition Health Center locations
- Anchorage Coalition Health Center
Ages 5 and up
701 East Tudor Road
Anchorage, AK 99503
- Fairbanks Coalition Health Center
Ages 2 and up
Ridgeview Business Park
575 Riverstone Way, Unit #1
- Online: coalitionhealthcenter.com
Anchorage Network Hospitals
Providence Alaska Medical Center and Alaska Regional Hospital are part of the AlaskaCare network beginning January 1, 2021!
AlaskaCare is committed to providing benefits to help you affordably access the care you need and stay healthy, when and where you need it. Your health care keeps getting better and better! AlaskaCare expanded the Anchorage-area network to include Providence Alaska Medical Center, Alaska Regional Hospital—offering you more convenience and choices in your area! By having both hospitals in-network, you will save no matter where you go. Preferred hospitals and facilities have partnered with the State to control health care costs by setting a fair rate for medical services. By visiting in-network facilities, you keep your out-of-pocket maximum low, and the plan will pay for more on your behalf.
It doesn’t stop there—this network expansion also adds a host of ambulatory surgical and imaging centers, helping you find the right fit for the services you require.
Providence Alaska Medical Center
Providence Alaska Medical Center, a nationally recognized trauma center and Magnet hospital, is part of Providence St. Joseph Health, a not-for-profit network of hospitals, care centers, health plans, physicians, clinics, home health services, affiliated services, and educational facilities.
Visit Providence.org for more information.
Alaska Regional Hospital
Alaska Regional Hospital is proud of the partnership with the State of Alaska and its AlaskaCare health plan members. From providing preventive healthcare and treatment to hosting free health fairs, seminars, and screenings, we are committed to providing plan members and all Alaskans with high quality, cost effective healthcare.
Visit AlaskaRegional.com for more information.
You will also have network access to many more Anchorage-area ambulatory surgical centers. To find an in-network provider, or to see if your provider is in-network, call the Aetna Concierge at (855) 784-8646, or use the online DocFind tool .
When you use an out-of-network facility, the plan benefit percentage for most facility fees at the out-of-network facility will be reduced by 20%, and in most cases, your annual out-of-pocket limit will double. The plan benefit percentage (coinsurance) is the allowed amount that the plan will pay after you meet your deductible.
The allowed amount for out-of-network facilities services will be 185% of Medicare rates. Remember, out-of-network facilities can charge any amount they choose. So, if the facility does not accept the 185% of Medicare rate, they can balance bill you for the rest.
Below is an example of the difference in out-of-pocket costs between using an in-network, preferred provider facility, and an out-of-network (OON) facility in Anchorage for someone who has elected the AlaskaCare economy medical plan:
|2022 OUT-OF-NETWORK COSTS EXAMPLES|
|--||In Network Facility||OON Facility|
|Network Facility Rate in-network or Plan Allowed||$22,950||$22,950|
|185% of Medicare for OON|
|Plan Coinsurance Total||$15,645||$11,175|
|Member Coinsurance Total||$6,705||$11,175|
|Out of Pocket Maximum (includes deductible)||$2,850||$5,700|
|Potential Balance Bill (Billed charges – Plan Allowed)||$0||$4,050 *|
|Effective: Jan. 1 - Dec. 31, 2022|
* In addition to your cost share portion of the plan allowed amount, OON facilities may balance bill you the difference between their billed charges and the plan’s Medicare-based rate for the services.
If you need emergency treatment, please go to the nearest emergency room without regard to the network. Penalties are not applied in the case of emergency treatment or for services not offered at Alaska Regional. Before receiving services in Anchorage that you believe are not offered at Alaska Regional, or if an out-of-network facility sends you a balance bill for the emergency services, contact the Aetna Concierge at (855) 784-8646 for assistance.
Information on network facilities options outside of Alaska contact the Aetna Concierge at (855) 784-8646 or visit the custom DocFind tool online. It is important to use the custom AlaskaCare DocFind tool tool when searching for facility options; Aetna’s public DocFind tool will not accurately reflect AlaskaCare’s preferred facilities.
Most Alaska hospitals and facilities outside of the Anchorage area are network providers, but outside of Alaska there are some out-of-network facilities, so its important to check before receiving services. For a list of network providers, please contact the Aetna Concierge at (855) 784-8646 or visit the custom DocFind tool to help you find a provider that is part of the AlaskaCare network.
Why out-of-network facilities are paid at 185% of Medicare
We use Medicare as our base because they are the largest payer in the county, and they have established a standard measure that accounts for differences like size, location, and the types of patients treated. The Medicare rate is set to pay facilities for their costs plus a profit.
Conquer Back and Joint Pain with Hinge Health!
Whether you have chronic or sudden joint pain, are recovering from an injury, or just want more strength and flexibility—Hinge Health can help. Hinge Health offers innovative digital care programs that connect you with a physical therapist or personalized health coach to help you manage musculoskeletal conditions such as back, knee, hip, neck and shoulder pain. The exercise therapy programs are designed to help you get back to the activities you love.
Hinge Health’s programs are available at no cost to you and your family members age 18+ who are covered by the AlaskaCare Employee Health Plan starting July 15, 2021!
Hinge Health has tailored programs to help you with:
- Conquering musculoskeletal pain or limited movement—Whether you have an occasional dull ache or frequent sharp pain, Hinge Health can help you move freely again.
- Recovering from an injury—Whether you were injured yesterday or years ago, get expert help and recover better than ever.
- Keeping your joints healthy and pain free—Get expert support tailored to your specific needs.
Hinge Health provides the tools you need to get moving again from the comfort of your home. When you enroll, you will receive the Hinge Health welcome kit which, based on your care program, may include:
- A tablet computer
- Wearable sensors that give live feedback in the Hinge Health app
- Access to personalized exercises
You will also be connected with a personal care team including a physical therapist or health coach who will tailor your program to your needs and work with you along the way.
How to use Hinge Health
If you or an eligible dependent would like to enroll, start by contacting Hinge Health:
- Transparency in Coverage
- Children’s Health Insurance Program (CHIP)
- COBRA Coverage Reminder
- Creditable Coverage Notice - Prescription Drug Coverage and Medicare
- HIPAA Privacy Practices
- Mental Health Parity and Addiction Equity Act (MHPAEA)
- Newborns’ and Mothers’ Health Protection Act Notice
- Primary Care Provider Designation
- Special Enrollment Rights
- Summary of Benefits and Coverage (SBC)
- Surprise Medical Bills - Your Rights and Protections
- Taxpayer Identification Number (TIN) or Social Security Number (SSN) of Each Enrollee in a Health Plan
- Women’s Health and Cancer Rights Act of 1998 (WHCRA)
Transparency in Coverage
The Departments of Health and Human Services, Labor and the Treasury finalized the Transparency in Coverage Rule that requires health insurers and group health plans to create a member-facing price comparison tool and post publicly available machine-readable files that include in-network negotiated payment rates and historical out-of-network charges for covered items and services. This machine-readable price transparency file is intended to comply with the CMS price transparency rules at 45 C.F.R. § 180.50. The rules apply to the AlaskaCare Employee Health plan, the AlaskaCare Retiree Health Plan is exempt.
Publicly Available Machine-Readable Files: The files disclose detailed information on the costs of covered items and services such as negotiated rates for in-network providers, historical allowed amount and billed charges for out-of-network providers.
Employee Assistance Program
The AlaskaCare Employee Assistance Program (EAP), administered by Aetna, provides responsive, caring and effective services to help balance your personal and professional life. Some of the areas the EAP can help with include:
- Personal balance
- Emotional wellness
- Marital/relationship issues
- Family issues
- Communication skills
- Stress management
- Alcohol and drug issues
- Work-related issues
- Grief issues
- Financial and legal concerns
AlaskaCare Health & Dental Appeal Guides
- Aetna Employee Health Plan Appeal Guide
- Moda Employee Dental Plan Appeal Guide
- Aetna Health Plan Appeal Form
- Moda Dental Plan Appeal Form
The AlaskaCare health and dental plans provide members with the right to appeal claims and precertifications that have been denied by claims administrators. If your health plan denies payment for a treatment that you believe should be covered, you have the right to challenge that decision through the appeal process. AlaskaCare has added a new level to the appeals process for services or supplies received on or after January 1, 2018. Under the new appeal process, if the third party claims administrator or external review organization uphold their original denial of your appeal, you have the right to appeal to the Division of Retirement and Benefits. Should the Division also uphold the denial, you retain the legal right to take the appeal to superior court.
Appeals Process Part 1
Appeals Process Part 2
State and federal guidelines were developed to address the opioid epidemic in the United States and Alaska. New safety guidelines were adopted for the AlaskaCare plans on January 1, 2018 and were further enhanced on January 1, 2019. The guidelines limit the dispensing of opioids as follows:
- For patients that don’t normally use opioids:
- The plan limits the maximum dosage per day to 50 mme (morphine milligram equivalent) and only allows up to a 7-day supply every 91-days.
- A pre-authorization is required to obtain more than a 7-day supply within any 91-day period.
- For patients that regularly use opioids:
- The plan limits the maximum dose per day to 90 mme and only allows up to a 30-day supply.
- A pre-authorization is required periodically.
- For patients age 19 or under:
- A pre-authorization is required for cough medications that contain opioids, and the prescription is limited to a 3-day supply.
Members are encouraged to discuss the effect of the AlaskaCare opioid dispensing policy with their providers and to contact OptumRx at (855) 409-6999 for support.
Opioids are a type of narcotic pain medication. They can have serious side effects if you don't use them correctly. For people who have an opioid addiction, their problem often started with a prescription. Opioid drugs include:
- Codeine (only available in generic form)
- Hydromorphone (Dilaudid, Exalgo)
- Meperidine (Demerol)
- Methadone (Dolophine, Methadose)
- Morphine (Kadian, MS Contin, Morphabond)
- Fentanyl (Actiq, Duragesic, Fentora, Abstral)
- Oxycodone (OxyContin, Oxaydo)
- Oxycodone and acetaminophen (Percocet, Roxicet)
- Oxycodone and naloxone
- Hydrocodone (Hysingla, Zohydro ER)
- Hydrocodone and acetaminophen (Lorcet, Lortab, Norco, Vicodin)
Forms & Health Brochures
AlaskaCare Employee Form 1095-B Information
State of Alaska employees eligible for health benefits will receive a Form 1095-C, and in some cases a Form 1095-B. These forms contain information about your healthcare coverage and whether your dependents were covered. It is important to keep these forms for your records.
The Affordable Care Act (ACA) includes both an individual mandate and an employer mandate. Under the individual shared responsibility provision of the ACA, individuals must indicate their enrolled dependents, as well as themselves, have had a full year of qualifying healthcare coverage (called minimum essential coverage), qualify for an exemption, or pay a penalty when filing their income taxes. The employer mandate requires that large employers like the State of Alaska, offer affordable healthcare coverage that provides minimum value to most of their full-time equivalent employees or pay a penalty.
Form(s) 1095 are the mechanism that the Internal Revenue System (IRS) will use to determine if these mandates have been met.
Supplemental Non-Emergent Surgery Coverage
AlaskaCare has partnered with SurgeryPlus to offer employees covered by the AlaskaCare Employee Health Plan and their eligible dependents convenient travel benefits for non-emergent surgeries. You get access to a network of top quality medical providers with proven experience in more than 350 procedures types across 40 states.
What’s included with this new benefit?
Surgeons of Excellence
Each board-certified provider has undergone rigorous screening, including specialized training and fellowships, reducing your risk of complications and preventable costs.
Your dedicated Care Advocate will locate the best-fitting provider, schedule all appointments, coordinate medical record transfers, and follow up with you post-procedure to ensure top satisfaction with your procedure experience.
Each procedure is covered under a bundled rate, and the only cost to you is the remaining balance on your deductible, if applicable. 100% of the coinsurance is waived.
Covered Expenses include:
- Episode of Care received through SurgeryPlus benefits
- Airfare for the eligible patient and a companion
- Hotel or other approved accommodations
- Transportation to/from airports
- Pre-loaded debit card with $25 per diem per patient per day (or $50 per patient and companion per day)
How to use SurgeryPlus
If you or an eligible dependent needs surgery, start by contacting SurgeryPlus:
You will be assigned a dedicated Care Advocate who will assist you with:
- Selecting a surgeon
- Scheduling appointments
- Coordinating and booking travel and accommodations
- Providing a pre-loaded debit card with per diem for expenses
- Transferring medical records
- Reviewing benefits
Quality Healthcare at Your Fingertips
Talk to a doctor by phone or video, anywhere, anytime.
Teladoc® is already part of your AlaskaCare Employee Health Plan. You can talk to a doctor in minutes. AlaskaCare Employee Health Plan members have 24/7/365 access to health care for non-emergency conditions by web, phone or mobile app. For example, if you have symptoms of the flu, you can contact Teladoc® and a doctor can evaluate and help with next steps when necessary.
The AlaskaCare Employee Health Plan has partnered with Teladoc® since September 1, 2018 to provide you with a convenient and affordable way to receive quality medical care.
All Teladoc® doctors are board-certified, state-licensed and can treat many health issues, including:
- Cold and flu symptoms
- Skin problems
- Respiratory infections
- Sore throat
- Sinus problems
- Behavioral Health
- ...and more!
How to use Teladoc®
To utilize the benefit, begin by registering your Teladoc® account. There are three ways to register:
During registration, you’ll complete your medical history so when you need Teladoc®, it will be fast and easy. Watch a short video to discover more.
General Medical Consultation
Teladoc® is another alternative to accessing medical care for your non-emergent symptoms 24/7/365. Teladoc® is a convenient and affordable healthcare alternative to expensive and time-consuming E.R. visits or after-hour periods where care is difficult to find. All Teladoc® doctors are board-certified, state-licensed, and can even send a prescription straight to your nearest pharmacy when medically necessary!
Fee: For General Medical Consultation, the copay is $0.
Behavioral Health Consultation
Feel like yourself again. Choose a therapist or psychiatrist who fits your needs and schedule visits 7 days a week from wherever you're most comfortable. Experts specialize in and support a wide range of needs:
- Anxiety, stress, overwhelmed
- Negative thought patterns
- Not feeling like yourself
- Not wanting to get out of bed
- Relationship conflicts
- Trauma and PTSD
- Mood swings
- Medication management
Fee: For Behavioral Health Consultation, the copay is $0.
There’s no reason to wait weeks for the skin care you need. Teladoc® can resolve your skin issues within days by web or mobile app. Licensed dermatologists can treat ongoing or complex skin conditions like psoriasis, skin infection, rosacea, suspicious moles, and many more—quickly, conveniently, and discreetly.
Fee: For Dermatology Consultation, the copay is $0. The first follow-up within 7 days of initial dermatology consultation also has a copay of $0.
As a caregiver for a loved one, you have enough to worry about. That’s why Teladoc® gives you a convenient and affordable way to provide care, letting you arrange a 2- or 3-way video or phone visit with a licensed doctor 24/7 for just $45/visit. Add the individual you care for to your Teladoc® account, even if they’re not covered by your health plan.
Fee: $45 for Caregiver Consultation Fee. This optional service is not covered under the plan and is the members responsibility to pay in full.
The State of Alaska Voluntary Supplemental Benefits (VSB) plan includes life insurance, critical illness, and long & short-term disability. The VSB plan is administered by MetLife and enrollment is managed by BenefitFocus.
Voluntary Supplemental Benefits offer you the opportunity to obtain additional benefits that best suit the needs of you and your family. Please take a moment to watch the video below to learn about all the options offered by the State of Alaska. Note: eligibility or benefits described in this video are subject to change. Please review the individual benefits for up-to-date information.
The following employees are eligible to participate in Voluntary Benefits:
- State employees except members of the Labor, Trades and Crafts (LTC) unit, the Teachers’ Retirement System (TRS), on-call employees, temporary legislative employees, employees of the National Guard (including Emergency Guard), short term non-permanent employees, student interns, leased employees, and emergency employees hired for natural disasters, including emergency firefighters.
- Employees of a participating political subdivision covered under the terms of the political subdivision’s participation agreement.
Enrollment in any plan is optional—choose only the plans and coverage levels that meet your needs. Premiums are paid through payroll deductions and are subtracted from gross wages before taxes are deducted – an added advantage to the plan. Please note, some restrictions apply for life insurance premiums.
You can select from the following options:
- Life Insurances
- Accidental Death and Dismemberment Insurances
- Disability Benefits (short-term and long-term)
- Critical Illness
MetLife is here to support all your VSB needs. Learn about each benefit by visiting metlife.com/stateofalaska . There you will find in depth plan information and helpful videos on each benefit. If you have questions about your VSB options or claims, please contact MetLife.
MetLife Customer Service Contacts
BenefitFocus offers benefits administration on a single platform, simplifying benefit enrollment for everyone. They also provide a mobile app for accessing your benefit information on the go. For enrollment assistance, please contact BenefitFocus .
BenefitFocus Contact Information
- Phone: (844) 939-0543
Open Enrollment Information
You can change or enroll in your VSB options during an open enrollment period or within 30 days of a "qualified status change." Simply click the “Ready to Enroll in VSB? Click Here” button at the top of this page. Qualified Status changes include:
- gaining or losing a dependent through birth, adoption, marriage, divorce, or death.
- dependent is no longer eligible under the terms of the plan.
- spouse terminating employment, beginning an extended period of layoff or leave without pay, or beginning new employment.
- you or your spouse changing employment status from full-time to part-time or vice versa.
Learn About Your Group Life Insurance Options
Life insurance is a cost-effective way to protect your family and your finances. Should something unforeseen happen to you, it helps to ensure that short- and long-term financial obligations could be met.
Group Life Insurance – Basic Life
Basic Life insurance is paid for by participating employers and not an option you need to elect. This insurance is automatically provided to permanent and long-term nonpermanent State of Alaska employees, and eligible employees of participating political subdivisions. Basic Life pays either $10,000 or $2,000, depending on your bargaining unit.
Basic Life insurance provides additional benefits to employees, such as, grief counseling, will preparation, and estate resolution services. Contact MetLife for additional information.
Select Life Insurance
As an employee of the State of Alaska you may choose to enroll in Select Life and Accidental Death & Dismemberment (AD&D) Insurance. Enrollment may occur at time of hire (within 30 days), during open enrollment, or when you have a qualifying status change. Select Life and AD&D will cover only you as the employee. Select Life insurance benefit amounts:
- An amount equal to your basic annual earnings, rounded to the nearest $1,000.
- Pays double the benefit amount if death is accidental.
- Pays up to $100,000 for Supervisory and Confidential Unit employees and up to $60,000 for all others.
Voluntary Supplemental Life Insurance
In addition to Basic Life Insurance funded by the state and optional Select Life Insurance that you can choose to enroll in, you may also choose to enroll in additional Supplemental Life Insurance. Enrollment is optional, pays in a lump sum, and only covers the employee. Supplemental life insurance is available in the following volumes:
Evidence of Insurability is required for $200,000 and $300,000.
Accidental Death and Dismemberment (AD&D) Insurance
Basic Accidental Death and Dismemberment (AD&D) and Travel Accident Insurance are paid for by your participating employer and are not options you need to elect. Travel Accident insurance covers State of Alaska employees while in travel status on State business. For more information on these benefits, contact MetLife.
Supplemental Accidental Death and Dismemberment (AD&D) can be added to your VSB package. If you enroll in AD&D you must enroll in a minimum of $10,000 of Supplemental Life Benefits. This plan pays benefits if your death or dismemberment is caused by an accident. It pays in a lump sum, with the benefit dependent on loss and family structure.
Learn About Your Voluntary Supplemental Benefit Options
Voluntary Supplemental Benefits offers eligible employees with additional choices that could meet the needs of your family. Visit our webpage to learn more about eligibility and options for VSB.
Disability Benefits Insurance
Disability insurance offers an affordable way to protect your income when you are unable to work due to illness or injury. Accidents and injury can happen to anyone, and it can impact your ability to earn money.
Why is having Disability insurance important?
If you are unable to work due to illness or injury, disability insurance can help pay your most important expenses. These include mortgage or rent, car payments, food, childcare/tuition, and utilities.
Short Term Disability Insurance replaces a portion of your income during a disability which could last up to 180 days. Having disability protection can help you cover your essential living expenses and help safeguard your savings, since it replaces a portion of your income lost due to a disability or illness. Short-Term Disability (STD) provides a weekly benefit of 60% of your monthly base pay.
Long Term Disability Insurance replaces a portion of your income during a disability that is expected to last for an extended period of longer than 180 days. Long-Term Disability (LTD) is available in two levels, you can elect to have either 50% or 70% of your monthly base pay covered.
Critical Illness Insurance
Critical Illness Insurance provides financial support in the form of a payment if you or a covered family member is diagnosed with a serious illness. Critical Illness Insurance works to complement your medical coverage—and pays in addition to what your medical plan may or may not cover. Upon diagnosis, it provides you with a lump-sum payment of $15,000 or $30,000 in initial benefits. The payment you receive is yours to spend however you like.
While critical illnesses are always unexpected, they don’t have to be financially devastating. Protect your family’s budget by enrolling in Critical Illness Insurance.