Saturday, June 20, 2026

Health Care Documents

Announcements
Announcements
All Alaska Longshore Plan Update New Release 3.24.2020
Free Drive-up COVID-19 Testing in Anchorage Alaska
Express Scripts and COVID-19 3.30.2020
Health Care Recent Mailings
Health Care Recent Mailings
November 2018 SMM
Transporation Benefit
Privacy Notice
Express Scripts and COVID-19 3.30.2020
Express Scripts News Release COVID-19 3.19.2020
2023 Open Enrollment Notice
Health Care Forms
Health Care Forms
IBU Enrollment Form with Coordination of Benefits Form (Fillable)
All Alaska Beneficiary Designation Form (Fillable)
All Alaska Autopay ACH Form (Fillable)
IBU Affidavit Domestic Partner Form (Fillable)
IBU Disabled Dependent Affidavit Form (Fillable)
IBU Dental Claim Form (Fillable)
IBU Medical Claim Form (Fillable)
All Alaska Supplemental Reimbursement Form (Fillable)
IBU VSP Out of Network Reimbursement Form (Fillable)
IBU Timeloss/Disability Waiver Claim Form (Fillable)
PPS Order Form (Fillable)
Moda - Rx Drug Claim Form - Commercial Plans (Fillable)
All Alaska Authorization for Release of PHI Form (Fillable)
All Alaska Transportation Benefit Claim Form (Fillable)
Health Care Amendments and Changes
Health Care Amendments and Changes
COMING SOON
Health Care Documents / Summary Plan Description
Health Care Documents / Summary Plan Description
All Alaska Longshore Health & Welfare Summary Plan Description - 01.01.2026
All Alaska Longshore Self-Funded Retiree Summary Plan Description 1.01.2026
Uniform Glossary of Health Coverage and Medical Terms
Nondiscrimination Notice
Summary of Benefits and Coverages
Summary of Benefits and Coverages
Self-Funded Medicare Retiree SBC
2021 IBU Trust SBC
2022 IBU Trust SBC
2023 IBU Trust SBC