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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 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.
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;
- Fill out the form in our online filing application.
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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