It is your responsibility to check with the Administrative Office to make certain you have eligibility. Visit the Eligibility & Reciprocity page for more information.
Medical Benefits Overview
Your collective bargaining agreement or special agreement determines which Plan you are in. The Fund offers five different plans. Your co-pays, deductible and covered services vary by plan. When you became eligible, you should have received the Health & Welfare Summary Plan Description (H&W-SPD) and the Summary of Benefits & Coverage for your plan.
If you need help determining your plan(s), please call the Administrative Office at (800) 478-1246 and ask for a Health & Welfare Representative or email: firstname.lastname@example.org. Your Plan is also identified on your health card.
Deductibles and Co-Payments
Most of the medical plans have deductibles that you must pay before the Plan will pay at the specified reimbursement percentage. To determine your deductible, out-of-pocket maximum, and reimbursement percentage (% payable by the Plan), you may review the Schedule of Benefits for your plan.
Using Preferred Providers
A preferred provider is a health care provider (doctor/clinic/hospital) with whom the Plan has negotiated reduced rates. Using preferred providers can save you money with lower out-of-pocket expenses.
The Trust provides a network of in-state and out-of-state healthcare providers and pharmacies, as well as virtual care, and access to Wellness and Minor Care clinics in Alaska. Most types of medical services are covered; however, all procedures or treatments must be determined medically necessary by a physician.
A significant out-of-network penalty is applied when you choose to use a non-preferred provider when a preferred provider is available.
Some procedures may require pre-authorization to be covered. Pre-authorization is a preliminary review of a proposed procedure or treatment to determine whether the procedure or treatment falls within medically necessary guidelines. The Plan has contracted with Aetna to perform this function.
To pre-authorize your procedure, have your physician or health care provider call Aetna at 1-888-632-3862 option 3.
How to File a Claim
Most health care providers will bill the Plan directly for the services you receive. If they do not, you will need to submit a Medical Dental Reimbursement Form.
Email, fax or mail your completed claim form(s) to the Administrative Office:
Fax: (907) 278-7576
Mail: Alaska Electrical Trust Funds
Attn: Dental Claims
701 E. Tudor, Suite 200
Anchorage, AK 99503
For prompt processing of your claim, make sure that you have an updated Annual Medical/Dental Update Form filed with the Administrative Office.