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This version of the form is not currently in use and is provided for reference only. Download this version of
Form BEN035
for the current year.
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 Form BEN035?
A: Form BEN035 is a Health Benefits Enrollment/Waiver for Retirees or Benefit Recipients Tiers II & III (With System-Paid Medical) specifically for Alaska.
Q: Who can use Form BEN035?
A: Form BEN035 can be used by retirees or benefit recipients in Tiers II & III (With System-Paid Medical) in Alaska.
Q: What is the purpose of Form BEN035?
A: The purpose of Form BEN035 is to enroll or waive health benefits for retirees or benefit recipients in Tiers II & III in Alaska, specifically for those with system-paid medical.
Q: Do I need to fill out Form BEN035 if I am not a retiree or benefit recipient in Tiers II & III (With System-Paid Medical) in Alaska?
A: No, Form BEN035 is specifically for retirees or benefit recipients in Tiers II & III (With System-Paid Medical) in Alaska. If you are not in this category, you do not need to fill out this form.
Form Details:
- Released on November 1, 2016;
- 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;
- Fill out the form in our online filing application.
Download a fillable 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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