Alaska Administrative Code

(a) For a new law benefit recipient electing major medical insurance under AS 14.25.168(d) or AS 39.35.535(c), the effective date of that coverage is(1) the date of appointment to a continuing monthly benefit if the election is made in accordance with 2 AAC 39.310(a); (2) January…

(a) A new law benefit recipient may discontinue major medical insurance coverage at any time for a recipient's covered dependent. Once coverage has been discontinued it may be reelected only in accordance with (c) of this section or during an open enrollment period. (b) An altern…

An open enrollment period will be held once a year during the months of October and November, during which only a new law benefit recipient may add or change coverage for the following year. This open enrollment period does not apply to an alternate payee. Notes 2 AAC 39.360 Eff.…

(a) If major medical insurance coverage is elected during an open enrollment period, the new law benefit recipient and any eligible dependents are subject to a pre-existing condition limitation. Under this limitation, only the first $1,000 of covered medical expenses relating to …

(a) A new law benefit recipient who elects major medical insurance coverage under AS 14.25.168(d) or AS 39.35.535(c) may discontinue participation in that plan at any time by submitting a signed, written request to the administrator. If the request is received or postmarked on or…

(a) If necessary, the administrator may change the premiums and the terms of major medical insurance coverage. (b) To change the benefits provided under major medical insurance coverage, the administrator shall (1) propose changes to the coverage; in drafting the proposal, the ad…

In 2 AAC 39.300 - 2 AAC 39.399, unless the context otherwise requires (1) "administrator" means the commissioner of the Department of Administration or their designee; (2) "alternate payee" means a person who is receiving a continuing monthly benefit under a qualified domestic re…

The provisions of 2 AAC 39.500 - 2 AAC 39.590 apply only so long as the plan administrator determines that a self-insured program of medical coverage is provided to enrollees. If a self-insured program ceases to exist, the plan administrator and the board will not hear appeals fr…

Before appealing to the plan administrator or to the board under 2 AAC 39.500 - 2 AAC 39.590, an enrollee must fully utilize any appeal procedures provided by a claims payer under a contract entered into under AS 39.30.090-39.30.095. Notes 2 AAC 39.510 Eff. 5/28/99, Register 151 …

(a) An enrollee may appeal to the plan administrator from a final decision by the claims payer denying the enrollee's claim in whole or in part. A "final decision by the claims payer" is a decision that is not subject to any further review by the claims payer. (b) The enrollee's …

(a) Except as provided in (b) of this section, if an enrollee is not satisfied with the decision of the plan administrator under 2 AAC 39.520(c), the enrollee may appeal to the board within 30 days after receiving the plan administrator's decision. Unless the recipient requests a…

(a) The plan administrator and the board may review claims of an emergency nature on an expedited basis, including use of shortened schedules, telephonic proceedings, and other procedures necessary to facilitate prompt determinations. "Emergency" as used in this section is limite…

In this chapter, (1) "board" means the Public Employees' Retirement Board; (2) "claim" means a claim for benefits under the major medical insurance coverage provided under AS 39.35.535; (3) "claims payer" means the third-party administrator of benefit claims and payments under a …

The provisions of 2 AAC 39.600 - 2 AAC 39.690 apply only so long as the plan administrator determines that a self-insured program of medical coverage is provided to enrollees. If a self-insured program ceases to exist, the plan administrator and the board will not hear appeals fr…

Before appealing to the plan administrator or to the board under 2 AAC 39.600 - 2 AAC 39.690, an enrollee must fully utilize any appeal procedures provided by a claims payer under a contract entered into under AS 39.30.090-39.30.095. Notes 2 AAC 39.610 Eff. 5/27/99, Register 151 …

(a) An enrollee may appeal to the plan administrator from a final decision by the claims payer denying the enrollee's claim in whole or in part. A "final decision by the claims payer" is a decision that is not subject to any further review by the claims payer. (b) The enrollee's …

(a) Except as provided in (b) of this section, if an enrollee is not satisfied with the decision of the plan administrator under 2 AAC 39.620(c), the enrollee may appeal to the board within 30 days after receiving the plan administrator's decision. Unless the enrollee requests a …

(a) The plan administrator and the board may review claims of an emergency nature on an expedited basis, including use of shortened schedules, telephonic proceedings, and other procedures necessary to facilitate prompt determinations. "Emergency" as used in this section is limite…

In this chapter, (1) "board" means the Alaska Teachers' Retirement; (2) "claim" means a claim for benefits under the major medical insurance coverage provided under AS 14.25.168; (3) "claims payer" means the third-party administrator of benefit claims and payments under a contrac…

(a) A bargaining unit of the executive branch of the state may be exempted from the coverage of the group insurance policy or policies covering state employees, their spouses, and eligible dependents by entering into a collective bargaining agreement that meets the requirements o…

The term "dependent children," referring to children who are covered by a group insurance policy or policies covering eligible state employees, is defined by the terms of (1) a collective bargaining agreement, with respect to employees covered by that agreement; the agreement may…

(a) Beginning July 1, 2004, the commissioner of administration will approve an exemption under 2 AAC 39.900 only if the requirements of this section are met. (b) All plans covering state employees to which the state contributes must follow the requirements of 2 AAC 39.915 regardi…

(a) Beginning July 1, 2004, all plans covering state employees to which the state contributes must coordinate benefits as provided in this section. (b) A plan without coordination provisions is always the primary plan. (c) If all plans have a coordination provision, the primary p…

(a) Coverage of the spouse of an eligible state employee will be reduced to 30 percent under the commissioner's health plan obtained under AS 39.30.090-39.30.095, if the spouse is a state employee participating in a plan exempted under 2 AAC 39.900 and(1) waives coverage; or (2) …

In 2 AAC 39.900 - 2 AAC 39.925, unless the context requires otherwise, (1) "catastrophic coverage" means a health care insurance plan that(A) provides benefits for hospital and medical care with a lifetime maximum benefit per insured of at least $250,000; and (B) has a deductible…

An eligible state employee may be exempted from coverage under a group health benefit plan for state employees, in whole or in part, if the employee elects to voluntarily waive the medical, dental, or vision coverage for the eligible state employee in the format provided by the p…

(a) An eligible state employee who elects to waive coverage under the medical, dental, or vision benefit plan must signify election to waive each benefit in a format provided by the plan administrator. Except as provided in this section, an employee electing to waive coverage mus…

The rate of employer contribution for an eligible state employee's position shall remain the same regardless of whether the employee has made an election to waive coverage under 2 AAC 39.960. Notes 2 AAC 39.970 Eff. 1/1/2017, Register 220, January 2017 Authority:AS 39.30.090 AS 3…

The date a state employee signifies election to waive coverage is the date of postmark of the written notification of the election or the date it is received by the plan administrator, whichever is earlier. If a postmark is illegible or undated, the postmark day is presumed to be…

During the open enrollment period of each benefit year, an eligible state employee wishing to waive coverage under the medical, dental, or vision plan must signify election to waive each component of the group health benefit plan coverage being waived. An eligible state employee'…

In 2 AAC 39.950 - 2 AAC 39.995, unless the context otherwise requires: (1) "eligible state employee" means an employee of the State of Alaska who is eligible to be covered by the group health benefit plan and is not exempted from coverage pursuant to 2 AAC 39.900 - 2 AAC 39.925; …

(a) A person is eligible for a bonus upon establishing that he or she is at least 65 years old, fulfills the residency requirements of 2 AAC 40.040 and submits an initial application or an application for reinstatement on or before December 31, 1996. (b) A person less than 65 yea…

(a) An application must be submitted to the Department of Administration on a form prescribed by the administrator. The administrator will reject, without a determination of eligibility, an application made before the applicant(1) is sixty-five years of age; or (2) meets the resi…

(a) The administrator will consider a valid birth certificate or delayed certificate of birth as conclusive proof of an applicant's age. (b) In the absence of a birth certificate or delayed certificate of birth, the applicant may submit other documents to establish the applicant'…

(a) For the purposes of this chapter, a resident of the state is a person who(1) maintained his or her principal place of abode in the state during the entire eligibility period; (2) except for absences allowed under 2 AAC 40.045, was physically present in the state during the en…

(a) An applicant who was absent from Alaska during the eligibility period is eligible for a bonus if(1) under AS 15.05.010 and 15.05.020, the applicant was eligible to register to vote in Alaska immediately before an absence in the eligibility period; (2) the administrator determ…

Notes 2 AAC 40.050 Repealed 12/1/90. State regulations are updated quarterly; we currently have two versions available. Below is a comparison between our most recent version and the prior quarterly release. More comparison features will be added as we have more versions to compar…

(a) Within 15 days after determining that an applicant is ineligible for the bonus program, the administrator will send the applicant a notice of denial by certified mail explaining the reasons for that determination and stating the applicant's right to an administrative hearing …

(a) The administrator will send a validation form to each eligible applicant no later than the fifth day of the month following the first month for which an applicant qualifies for benefits under this chapter. An applicant meets the age requirement of this chapter the month follo…

Notes 2 AAC 40.070 Repealed 12/1/90. State regulations are updated quarterly; we currently have two versions available. Below is a comparison between our most recent version and the prior quarterly release. More comparison features will be added as we have more versions to compar…

(a) Bonuses will be issued only to individuals who satisfy the validation procedures of 2 AAC 40.080. (b) A bonus will be mailed to each qualified individual. Mailing of bonuses will be scheduled so that payments are received near the first of each month. No payment will be maile…

(a) Each regular monthly bonus will be accompanied by a validation form. To receive a bonus for the month specified on the validation form, a recipient shall(1) comply with the information requirements specified on the form and with the signature requirements of 2 AAC 40.160 and …

(a) An isolated absence from Alaska of 60 days or less is not sufficient cause for loss of a bonus payment. (b) A recipient who is absent from Alaska for 61 - 75 continuous days forfeits two bonus payments. A recipient who is absent from Alaska for more than 75 continuous days fo…

(a) The administrator will suspend bonus payments(1) for absences as provided in 2 AAC 40.090; (2) pending completion of disqualification proceedings under 2 AAC 40.110; or (3) for any month in which the recipient (A) resides in a nursing home for one or more days, unless all the…

(a) A recipient is not qualified for a bonus for any month in which the recipient(1) resides in a nursing home for one or more days, unless all the costs of care for the recipient are paid entirely from private sources; (2) is confined for 10 or more days in a state or federal me…

Notes 2 AAC 40.115 Repealed 12/1/90. State regulations are updated quarterly; we currently have two versions available. Below is a comparison between our most recent version and the prior quarterly release. More comparison features will be added as we have more versions to compar…

(a) If the administrator determines that a recipient should be disqualified, the administrator will notify the recipient by certified mail of the reason for and effective date and duration of the proposed disqualification. The notice will set out the following procedure:(1) a rec…