Benefit Document Library
Welcome to the document library for the Alaska Teamster-Employer Welfare and Pension Trusts. Here you’ll find forms, notices and up-to-date documents regarding your health and pension benefits.
These printable forms are in PDF format. To read and print them, you need the free Adobe Acrobat Reader (which is probably already installed in your system). Click here if you do not have Adobe Reader installed on your system.
General Forms & Documents
You can complete the forms listed below right on your computer. DocuSign forms can be completed and submitted entirely online. PDF forms can be completed on your computer and then printed. Simply click on a field in the form and type in the appropriate information. Then print the completed form, sign and email or mail it to the Trust Office.
Health & Welfare
Common Forms
You can complete the forms listed below right on your computer. DocuSign forms can be completed and submitted entirely online. PDF forms can be completed on your computer and then printed. Simply click on a field in the form and type in the appropriate information. Then print the completed form, sign and email or mail it to the Trust Office.
Authorization for Release of Protected Health Information Form
The Health Insurance Portability and Accountability Act of 1996 (HIPAA) protects the health information of each patient. The Alaska Teamster Welfare Trust (the “Plan”) is prohibited from releasing protected health information except in very specific circumstances. You have the right to request that the Plan release your protected health information to another party (such as a family member); however, you must provide such permission in writing.
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Status Change/Special Enrollment Form
Use this form for a new enrollment, to add family members, or to change the status of a family member.
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Time Loss Claim Form
Claims form for Weekly Disability benefits for Health Plan participants.
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VSP Member Reimbursement Form
To request reimbursement for out-of-network vision services. Submit the reimbursement form to VSP along with a legible copy of your itemized receipt.
DownloadPlan Documents
Summary of Material Modifications – October 2018 – January 2025
Summary of Plan Benefit Changes adopted by the Board of Trustees
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Summary Plan Description
This is your benefits booklet known as the Summary Plan Description of the Alaska Teamster-Employer Welfare Trust for active and retired participants.
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Summary of Benefits Coverage (SBC-Active)
This is a summary of your benefits and coverage. If you want more detail about your coverage and costs, you can get the complete terms in the policy or plan document or by calling 1-800-478-4450.
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Summary Annual Report – June 30, 2024
Describes the status of the fund at the end of Plan Year 2024.
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No Surprises Act, Effective July 2022
Your Rights and Protections Against Surprise Medical Bills
DownloadBrochures and Resources
Costco Mail Order Pharmacy
Mail order service is required for those patients who require medications on a recurring basis. The medications will be mailed directly to your home.
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Costco Formulary (Preferred Drug) List
Please log in to Costco Health Solutions Member Portal for a list of preferred drugs for plan participants and health care providers.
Visit
Using Your Vision Service Plan Benefit
Vision Service Plan benefits at a glance, information on using your Vision Service Plan benefits, and more.
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HealthCare Strategies
As part of Alaska Teamster-Employer Welfare Trust’s continued efforts to provide employees with a robust, affordable health benefit plan, we have partnered with HealthCare Strategies, Inc. (HCS) to help us in our mission. Please read the enclosed information for important details regarding this program.
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Glossary of Health Coverage and Medical Terms
This glossary defines many commonly used terms, but isn’t a full list.
DownloadPension & Retirement
Common Forms
You can complete the forms listed below right on your computer. DocuSign forms can be completed and submitted entirely online. PDF forms can be completed on your computer and then printed. Simply click on a field in the form and type in the appropriate information. Then print the completed form, sign and email or mail it to the Trust Office.
Annual Retiree Certification
To be assured you are receiving monthly pension benefits to which you are entitled, retirees must complete this form annually.
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Benefit Resumption Following Non-Covered Employment
If you return to work and, after your Suspendible Employment ends, you wish to resume your retirement benefit; please complete the Resumption of Benefits Following Non-Covered Suspendible Employment form. In addition, please provide a copy of your termination slip from the employer.
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Suspendible Employment Determination
Describe employment or contemplated employment by an employer who does not contribute to the Plan on this form.
DownloadPlan Documents
Summary Plan Description
This is your benefits booklet known as the Summary Plan Description of the Alaska Teamster-Employer Pension Plan applicable to retirements after June 30, 2016.
DownloadMail printed and signed forms to the Trust Office:
Alaska Teamster-Employer Welfare and Pension Trusts
520 E. 34th Avenue Suite 107
Anchorage, AK 99503-4116
Don’t see what you are looking for? Contact the Trust Office at (907) 751-9700 during regular business office hours Monday through Friday 8:00 AM to Noon and 1:00 PM to 5:00 PM (The Trust Office is closed for lunch Noon – 1:00 PM) or email us at benefits@959trusts.com for assistance.