Alaska Teamster-Employer Welfare and Pension Trusts

15.1 ENROLLMENT PROCEDURE

It is important that the Trust Customer Service Office has a completed enrollment form for all Participants in its files. It is necessary that Active Employees, COBRA beneficiaries and Retired Participants complete an enrollment form before any claims can be processed. Retired Participants who are Medicare Eligible must complete such enrollment forms as required by TEAMStar in addition to any forms required by the Trust to enroll. If a Participant has not completed an enrollment form or if an additional enrollment form is needed, the Participant may obtain one from the Trust Customer Service Office. The enrollment form is the means by which Active Employees, Retired Participants, and COBRA beneficiaries designate Dependents, as well as the beneficiary of Life Insurance and Accidental Death & Dismemberment benefits.

It is important that you notify the Trust Customer Service Office as soon as possible if:

1. You change your home address.
2. You wish to change your beneficiary.
3. There is any change in your family status, i.e., marriage, birth of a child, adoption, death, divorce, etc. If you do not provide timely notice of these events you and/or your family’s rights to Plan coverage, benefits, and/or benefit options may be lost.

Active Employees, COBRA beneficiaries, and Retired Participants must also submit a marriage certificate in order to enroll a spouse. Additional documentation, such as a birth certificate, will be required to enroll other Dependents. The Trust Customer Service Office can provide the appropriate form needed to enroll new eligible family members or to remove those no longer eligible.

IMPORTANT: Active Employees, Retired Participants, and COBRA beneficiaries are held liable for benefit payments based on any incorrect information about family members, such as failing to notify the Trust Customer Service Office in case of divorce, if a child is no longer a Dependent, or if an adoption is rescinded. In addition, the person failing to provide the required information is liable for other costs incurred by the Plan as a result of the incorrect information. These costs include, but are not limited to, attorney’s fees, administrative costs, and reasonable interest. See the complete Subrogation and Reimbursement Procedure, below.