AlaskaCare Employee News | December 2020

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December 2020 | #98

Six Happy Health Items for 2021!

AlaskaCare: Better Benefits, Lower Costs

  1. More hospital choices in Anchorage!
    Beginning 2021, both Alaska Regional Hospital and Providence Alaska Medical Center are now preferred network providers!

  2. Reduced Premiums!
    Open Enrollment for 2021 health plans closed last month. For those of you who were previously enrolled in the Standard plan and did not participate in open enrollment, enjoy next year’s savings on the reduced monthly premiums. If you chose the Standard plan for next year, it will offer more savings. 

    AlaskaCare Standard Medical Plan 2020 Monthly Premium 2021 Monthly Premium
    Employee Only $140             $120 *Reduced!
    Employee and Family $340             $290 *Reduced!
  3. Variable Copay Solution Program—Reduce your copay to $0! 
    If you use a specialty medication you may be able to reduce your drug copayments to $0! AlaskaCare can help you eliminate your out-of-pocket costs for certain specialty medications through the Variable Copay Solution program by applying rebates that are available from drug manufacturers. If you or someone in your household has one or more specialty prescriptions, contact Optum Specialty pharmacy at (855) 427-4682 to find out if your medication is eligible for a $0 copay and to learn more about how to enroll in this program.

  4. Better prices for specialty medications with Optum Specialty!
    AlaskaCare is bringing you deeper discounts on high-cost specialty medications! By partnering with Optum Specialty pharmacy to serve as the sole network specialty pharmacy you could pay less for your prescriptions. If you are currently filling your specialty medications through a different pharmacy, OptumRx will be in contact with you soon to help you transition your prescriptions to Optum Specialty pharmacy. You can still fill your non-specialty medications at the network pharmacy of your choice.

  5. Increased Health Flexible Spending Account Rollover!
    If you have the Health Flexible Spending Account (HFSA), you can now rollover $550 of unused funds into the next benefit year. This is an increase from $500 in the previous year. This amount is in addition to the annual benefit amount that is selected for the new benefit year.

  6. Lower Rates for Select Life, Supplemental Life, and Long-Term Disability!
    Eligible State of Alaska employees and employees of participating Political sub-divisions will experience up to 15% reduction in monthly premiums.

More Hospitals In-Network in Anchorage

  We are excited to announce, Alaska Regional Hospital and Providence Alaska Medical Center are part of the AlaskaCare network beginning January 1, 2021!  

AlaskaCare is committed to providing benefits to help you affordably access the care you need and stay healthy, when and where you need it. Your health care keeps getting better and better!

This means AlaskaCare is bringing more convenience and choices in your area! By having both hospitals in-network, you will save no matter where you go. Preferred hospitals and facilities have partnered with the State to control health care costs by setting a fair, predetermined rate for medical services. By visiting in-network, you keep your out of pocket maximum low and the plan will pay for more on your behalf. It doesn’t stop there—this expansion also adds a host of Ambulatory Surgical and Imagine Centers, helping you find the right fit for services required.

Alaska Regional Hospital

Alaska Regional Hospital is proud of the partnership with the State of Alaska and its AlaskaCare health plan members. From providing preventative healthcare and treatment to hosting free health fairs, seminars, and screenings, we are committed to providing plan members and all Alaskans with high quality, cost effective healthcare.

Visit for more information.

Providence Alaska Medical Center

Providence Alaska Medical Center, a nationally recognized trauma center and Magnet hospital, is part of Providence St. Joseph Health, a not-for-profit network of hospitals, care centers, health plans, physicians, clinics, home health services, affiliated services, and educational facilities.

For more information about PAMC, visit

Welcome the Following Providers to the Network

Aetna’s Alaska Network Continues to Grow!
Help us welcome all new network providers:


  • Aurora Family Medical Clinic
  • Martin Kaszubowski, MD PC
  • Akins Mobile Health & Clinical Consultants
  • Anodyne Pain & Wellness of Anchorage
  • Exhale Massage & Body Work
  • Perception Physical Therapy
  • Alaska Shoulder & Orthopedic Institute
  • Arctic Aurora
  • Talking with Ty Speech Therapy
  • Royal Body Care Massage
  • Myobalance, LLC  
  • Alaska Pediatric Surgeons/Oncology

Palmer / Wasilla

  • Maple Springs of Palmer
  • Integrative Wellness Solutions
  • Anesthesia Care Associates  
  • True Hope Counseling and Consulting
  • First Choice Physical Therapy
  • Alaska Facial Plastic Surgery & ENT  
  • Karis Integrative Medicine


  • Resource Center for Parents
  • Nurses Diversified Systems  
  • Jammin Salmons PT & Nutritional Therapies  
  • AK Prosthetic & Orthotic

Kenai / Soldotna

  • South Central Family Practice, PC
  • North Star Therapy


  • Enhance Orthopedics
  • Tranquility Behavioral Health

Using network providers can provide substantial benefits to members through the elimination of what is known as balance billing. The AlaskaCare plans limit payment of covered services to the recognized charge for the service provided. An out-of-network provider may bill you for the difference, or the balance, between the recognized charge and the actual charge. This is often referred to as balance billing and solely the member’s responsibility to pay. Network providers have agreed to accept, as payment in full, the negotiated charge. Therefore, you are not subject to balance billing when you use a network provider.

You will also have network access to many more Anchorage-area ambulatory surgical centers. To find an in-network provider, or to see if your provider is in-network, call the Aetna Concierge at (855) 784-8646, or use the online DocFind tool.

COVID-19 Vaccine—Your AlaskaCare Plan Has You Covered!

When the time comes, know that your COVID-19 vaccine will be covered. Vaccine distribution began this week and due to limited supplies will occur in phases, focusing first on high-risk health workers, first responders, and older adults living in long-term care facilities. As more vaccine becomes available, additional groups will be eligible for vaccination. It is expected to take many months to vaccinate the entire U.S. population. 

Rest assured that the AlaskaCare health plan is covering the vaccine at no cost to you during the public health emergency. When available during the public health emergency, you can receive any FDA approved COVID-19 vaccine at any authorized vaccine provider, which may include pharmacies, public health clinics, physician offices, and hospitals. For all other members the COVID-19 vaccine is covered by the AlaskaCare plan under either your medical or pharmacy plan, depending on the authorized vaccine provider.

For more information, check out the links below:

Emergency Medical Transportation Services

Emergency Medical Transportation: Planning Ahead Can Save You Money
Each year, thousands of Alaskans find themselves in sudden, unexpected health situations that require emergency medical transportation, commonly referred to as medevac. Life-saving air medical transportation can be expensive. Emergency medical transportation flights in Alaska can cost tens of thousands of dollars. Air ambulance and emergency medical transportation services are a covered benefit under the AlaskaCare plan, subject to the requirements for a medical emergency and the plan provisions. However, not all providers of emergency medical transportation services are in-network, which can impact your out-of-pocket costs.

In-Network Medical Transportation
If the emergency medical transport service provider is in-network, the provider and the plan have already agreed on prices for services and your costs are fully covered under the plan subject to standard cost sharing and applicable to plan provisions. You won’t receive a balance bill from in-network providers for any difference between what they bill and what the plan pays. LifeMed Alaska and Medevac Alaska are in-network providers for the AlaskaCare Plans and accepts Aetna’s reimbursement as payment-in-full for our members.

Bedside Membership Agreements
In 2018 guidelines were created by the State of Alaska, Division of Insurance to clarify the ability for air ambulance membership agreements to be sold to individuals who are use the services without a waiting period. This allows any conscious patient to sign up for an air ambulance provider prior to use of such services. This includes emergency bedside situations at the hospital, as patients enter the aircraft, while on the aircraft, and perhaps even after leaving the aircraft. Knowing this vital information can protect you and your family financially.

Out-of-Network Network Medical Transportation
When a provider does not participate in the network, the provider and the plan have not agreed on what amount will be reimbursed for this service. For most charges from out-of-network providers, the AlaskaCare plan pays at the 90th percentile of the prevailing charge rate for the geographic region where the service was provided. This prevailing charge rate is based on data collected by FAIR Health, an independent health care data aggregator. An out-of-network provider may balance bill you for the difference between their charge and what the AlaskaCare plan has paid. You can find more information about FAIR Health here.

What Do I Need to Know About Balance Billing?
Balance billing is a type of healthcare billing that occurs when an out-of-network provider bills a plan member for the difference between the out-of-network provider's charge and the amount paid by a member's benefit plan for the out-of-network service. This situation can happen when a provider does not participate in a member's provider network, because the provider and the plan do not have a contractual agreement about the amount that will be reimbursed for their services.

For example: Under the terms of Rose’s health plan, after she meets her deductible she is responsible for 20% of the cost of services and the plan is responsible for the remaining 80% (until Rose meets her out-of-pocket costs for the year, at which point her plan will pay 100%). Rose has already met her deductible for the year and visits an out-of-network provider. She is billed $1,200 for the service, but her plan has determined that the recognized charge for that service is $1,000. According to the terms of her plan, Rose is responsible for $200, and the plan is responsible for $800. Because the provider is out-of-network they may bill Rose for the balance, or the additional $200 that is not covered by her plan – bringing her total charge to $400.

Suggestions for Protecting Yourself from Balance Billing by medical transportation Providers

  • Use an in-network provider when possible. LifeMed Alaska and Medevac Alaska are in-network providers for AlaskaCare members that services individuals located in Alaska.

Consider membership options from out-of-network providers servicing your community. We are always trying to contract with out-of-network providers so you do not have to worry about balance billing, but it is not always possible. If you think you may need emergency medical transportation services from an out-of-network provider, consider researching the options available in your area. Some out-of-network providers offer the opportunity to purchase an annual membership that can provide additional protection from balance billing. As you evaluate the best choice for your personal circumstances, keep in mind that the providers and membership options available in each area may differ. If you would like to know if a specific provider participates in Aetna’s network, call Aetna at (855) 784-8646.

Health Flexible Spending Account (HFSA)

The Health Flexible Spending Account (HFSA) provides an opportunity for you to save by setting aside money for health care expenses on a pre-tax basis. You decide the amount you want to contribute each month, up to the Internal Revenue Service (IRS) limit. You can also use your HFSA to pay for qualified health care expenses not covered by your insurance. Find out if an expense is eligible as an expense here.

How a HFSA Works
During each benefit year, you contribute a predetermined amount from each paycheck to the account. When you incur medical expenses, you file claims and are reimbursed with tax-free dollars from the account. You benefit from reduced taxes because you don’t pay taxes on the dollars you contribute to your accounts.

How to Receive Reimbursement
To be reimbursed for eligible medical expenses, claims for reimbursement to the HFSA may be submitted in one of the following ways:

  • Streamlining
    If you do not have any other health coverage, you can elect to have your HFSA set up with “streamlining.” Streamlining automatically sends the unpaid portion of your eligible medical claim (deductible, your portion of the coinsurance, etc.) directly to your HFSA account for reimbursement.

  • Non-Streamlining
    • Direct Claims Submission
      With this option, you submit your claims to PayFlex on the Request for Reimbursement form after receiving your EOB from the plan or any other health plan in which you participate.

    • Over the Counter (OTC) Claims Submission With this option, you submit claims to PayFlex on the HFSA OTC Claims form regardless of whether you have elected streamlined or direct claims submission.

For questions you can call PayFlex directly at (888) 678-8242, Mon-Fri 4 a.m. – 4 p.m. AST, and Sat 6 a.m. – 11a.m. AST, or visit

Flu Shots

Fight the Flu before it comes. The best and easiest way is to vaccinate yourself and your family. Trivalent and Quadrivalent influenza (flu) shots, along with the pneumococcal (pneumonia) shot, are temporarily* covered by your AlaskaCare plan during the COVID-19 public health emergency.

  • If you get your flu or pneumonia shot at a network pharmacy, AlaskaCare will cover 100% of the cost. Call OptumRx at (855) 409-6999 to find a pharmacy in the network.

  • If you use an out-of-network pharmacy for your flu or pneumonia shot(s), an upfront cost applies which can be reimbursed by submitting a claim to OptumRx for the plan’s portion.

  • If you go to your doctor’s office for your flu or pneumonia shot(s), the standard deductible and coinsurance will apply.

* The preceding temporary administrative changes are prospective in nature and shall remain in effect until earlier of the date of: 1) the termination of the suspensions contained in the applicable COVID-19 Disaster Order of Suspension; 2) the termination of the Declaration of Public Health Disaster Emergency issued by Governor Mike Dunleavy; or 3) the national public health emergency is terminated by the Secretary of Health and Human Services; including any extensions or amendments thereof. The temporary administrative changes listed above are in response to a State of Alaska and federally recognized health emergency and do not provide a vested right to coverage for any individual. The Division of Retirement and Benefits retains the sole discretion to rescind or modify these temporary administrative changes depending on the circumstances.

COVID-19: What Your Health Plan is Doing for You

In response to the COVID-19 national public health emergency declared on January 31, 2020 and the State of Alaska public health disaster emergency declared on March 11, 2020 by Governor Mike Dunleavy, the Division of Retirement and Benefits has implemented temporary plan changes and suspensions in the AlaskaCare health plans. Learn how your health plan is supporting you.

Sign Up for Insights Into DHSS's COVID-19 Response
Subscribe to DHSS Insights for behind-the-scenes news about Alaska’s COVID-19 response and other efforts to protect the health and well-being of Alaskans. Stay informed and help put a lid on COVID!

We Value Your Feedback!

As an employee of the State of Alaska, your input is valued and important. Below, please see a list of ways to contact us with your feedback. Also, a full list of AlaskaCare health plan and partner contact information can be found on our website.

AlaskaCare – Plan Administrator

  • Toll Free: (800) 821-2251
  • In Juneau: (907) 465-4460
  • TDD: (907) 465-2805
  • Fax: (907) 465-3086
  • Email:
  Come visit us:
State Office Building
6th Floor
333 Willoughby Avenue
Juneau, AK 99801 
Send us a letter: 
State of Alaska
Division of Retirement and Benefits
P.O. Box 110203
Juneau, AK 99811-0203

Health Benefit Contact Information

Division of Retirement and Benefits
Member Services: (907) 465-4460 | Toll-Free: (800) 821-2251

Medical Benefits: Aetna
Member Services: (855) 784-8646

Dental Benefits: Moda/Delta Dental
Member Services: (855) 718-1768

Pharmacy Benefits: OptumRx
Member Services: (855) 409-6999

Specialty Pharmacy: BriovaRx
Enrollment Services: (855) 427-4682

Health Flexible Spending Accounts (HFSA): PayFlex
Member Services: (800) 416-7053

Surgery Plus
Member Care Advocate: (855) 715-1680

Vision & Audio Benefits: Aetna VSP
Member Services: (855) 784-8646

Member Services: (855) 835-2362