Form BEN035 Health Benefits Enrollment / Waiver for Retirees or Benefit Recipients Tiers II & Iii (With System-Paid Medical) - Alaska

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Form BEN035 Health Benefits Enrollment / Waiver for Retirees or Benefit Recipients Tiers II & Iii (With System-Paid Medical) - Alaska

What Is Form BEN035?

This is a legal form that was released by the Alaska Department of Administration - a government authority operating within Alaska. As of today, no separate filing guidelines for the form are provided by the issuing department.

FAQ

Q: What is the BEN035 form?
A: The BEN035 form is the Health Benefits Enrollment/Waiver form for Retirees or Benefit Recipients Tiers II & III with System-Paid Medical in Alaska.

Q: Who is eligible to use the BEN035 form?
A: Retirees or Benefit Recipients in Tiers II & III with System-Paid Medical in Alaska are eligible to use the BEN035 form.

Q: What is the purpose of the BEN035 form?
A: The BEN035 form is used to enroll or waive health benefits for Retirees or Benefit Recipients in Tiers II & III with System-Paid Medical in Alaska.

Q: Is the BEN035 form specific to Alaska?
A: Yes, the BEN035 form is specifically for Retirees or Benefit Recipients in Tiers II & III with System-Paid Medical in Alaska.

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Form Details:

  • Released on April 1, 2020;
  • The latest edition provided by the Alaska Department of Administration;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;

Download a printable version of Form BEN035 by clicking the link below or browse more documents and templates provided by the Alaska Department of Administration.

Download Form BEN035 Health Benefits Enrollment / Waiver for Retirees or Benefit Recipients Tiers II & Iii (With System-Paid Medical) - Alaska

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