This version of the form is not currently in use and is provided for reference only. Download this version of Form BEN101 for the current year.
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.
Q: What is the BEN101 Alaskacare Retiree Dental-Vision-Audio (DVA) Election Form?
A: The BEN101 form is a form used for making elections for retiree dental, vision, and audio benefits in Alaska.
Q: What benefits does the BEN101 form cover?
A: The BEN101 form covers dental, vision, and audio benefits for retirees in Alaska.
Q: Who is eligible to use the BEN101 form?
A: Retirees who are enrolled in Alaskacare and eligible for dental, vision, and audio benefits can use the BEN101 form.
Q: When should I submit the BEN101 form?
A: The BEN101 form should be submitted within the specified enrollment period or as instructed by Alaskacare.
Q: What happens if I don't submit the BEN101 form?
A: If you don't submit the BEN101 form, you may not be eligible for dental, vision, and audio benefits as a retiree in Alaska.
Q: Can I make changes to my elections after submitting the BEN101 form?
A: Depending on the rules and guidelines provided by Alaskacare, you may be able to make changes to your elections after submitting the BEN101 form.
Q: Are there any costs associated with the BEN101 form?
A: The costs associated with the BEN101 form, such as premiums or copayments, will be determined by Alaskacare and may vary depending on your selected benefits.
Q: Who should I contact if I have questions or need assistance with the BEN101 form?
A: For questions or assistance with the BEN101 form, you should contact the customer service of Alaskacare.
Form Details:
Download a printable version of Form BEN101 by clicking the link below or browse more documents and templates provided by the Alaska Department of Administration.