PoliSub Group Health Plan and Life Plan Participation Information
- Download plan participation information [PDF]
- Who can participate
- Who is covered
- What is covered
- What it costs
- Employer's responsibility
- Life insurance
- The insurers
- How to apply
- More information
Who Can Participate
Under Alaska Statute 39.30.090(a)(3), a governmental unit (a municipality, school district or other political subdivision of the State) may elect to participate in the State-sponsored Political Subdivision Group Health and Life Insurance plan.
Who is Covered
Coverage is mandatory for all eligible employees and optional for their dependents.
The following employees are eligible for coverage:
- Permanent full-time employees that work at least 30 hours a week on a regular basis. Coverage becomes effective on the 31st consecutive calendar day following date of hire.
- Permanent part-time employees that work at least 15 hours a week, but less than 30 hours, on a regular basis may elect to participate. If elected, coverage becomes effective on the 31st consecutive calendar day following date of hire.
- Elected or appointed officials who receive a salary. Coverage becomes effective upon taking the oath of office.
Your eligible dependents for health insurance benefits include:
- Your spouse. You may be legally separated but not divorced.
- Your children from birth up to age 26, who are not eligible to enroll in any other employer-sponsored health plan.
- Your children age 26 and older who are incapable of employment because of a mental or physical incapacity. The incapacity must have existed before age 19 and the children must meet the definition of children:
- Your natural children, stepchildren, foster children placed through a State foster child program, legally adopted children, children in your physical custody and for whom bona fide adoption proceedings are underway, or children for whom you are the legal court appointed guardian;
- Unmarried and chiefly dependent upon you for support;
- You must provide the Claims Administrator with evidence the incapacity exists including proof: the incapacity existed before age 19 and of financial dependency. Children over age 26 are covered as long as the incapacity exists and periodic proof of the continued incapacity may be required.
Children that have access to their own employer group plan must enroll in that plan rather than their parent’s plan.
You must notify the Plan Administrator in writing within 60 days of the date your child no longer meets the eligibility criteria.
If you and your spouse/partner both work for the State, you may both be eligible for coverage as employees. You may also be covered as a dependent under these plans. Similarly, a child can be covered as a dependent of more than one employee.
What Is Covered
There are four plans available. All plans cover the same services but have different deductibles and/or coinsurance (reimbursement) amounts. The Plan Summaries provide an overview of the coverage levels. The booklet provides complete details of the coverage provided.
What It Costs
The premiums for the different plans are shown in the enclosed chart. Premiums are subject to change, generally in July of each year.
The governmental unit may either pay the entire cost of the insurance for its employees and their eligible dependents or share the cost with the employees. The employer is required to pay at least 75% of the cost of employee coverage for all permanent full-time employees and at least one-half of that amount for permanent part time employees.
The Employer’s Responsibility
Employers are required to enroll each eligible employee and, if desired, their dependents, collect any employee premiums, report the eligible members to the insurers monthly, remit premiums, and provide coverage continuation administration for terminated employees or dependents.
The plan also includes a mandatory Basic Life Insurance benefit for employees which pays $2000 plus an additional $5000 accidental death and dismemberment (AD&D) benefit.
Also available is the Optional Life and AD&D benefit which may be purchased by employees. This insurance is equal to the employee's annual salary rounded to the next highest $1,000 (the maximum available is $60,000). When this coverage is elected, the life insurance amounts and premiums must be periodically increased or decreased to take into account changes in employees' salaries.
The current carrier for health insurance is Aetna Inc. The current carrier for life insurance is MetLife.
How To Apply
- State of Alaska
- Division of Retirement and Benefits
- 333 Willoughby Avenue, 6th Floor
- Juneau, AK 99801
Following receipt of these necessary documents, the administrator will review for approval of Group Health and Life participation.
The Participation Agreement contains the following provisions:
- Authorization for health plan participation for a minimum of 2 years.
- Authorization for payment for all required premiums.
- An agreement to pay premiums in accordance with the terms set by the plan administrator.
- An agreement to give at least 90 days advance notice before terminating health plan participation (the administrator has discretion to waive this provision).
- A provision for an effective date which must be the first day of a month.