1661. Retiree Years of Service Verification IB18 - Alabama
INSTRUCTIONS: ALABAMA RETIREE YEARS OF SERVICE VERIFICATION FORM (Form IB18) Alabama retirees may be required to a complete a form IB18 to verify service credits they have received from the Retirement Systems of Alabama ...
1662. Retiree Re-Employed Form - Alabama
INSTRUCTIONS: ALABAMA RE-EMPLOYED STATE RETIREE HEALTH INSURANCE FORM (Form IB2) Alabama state employees who retire and are then rehired by the state government can reacquire their state health insurance by filing a form ...
1663. Retiree Enrollment Form IB04 - Alabama
INSTRUCTIONS: ALABAMA RETIREE HEALTH INSURANCE ENROLLMENT FORM (Form IB04) Alabama state employees who retire can enroll for health insurance through the state using a form IB04. This document can be obtained from the we ...
1664. Retiree Employment Verification IB16 - Alabama
INSTRUCTIONS: ALABAMA RETIREE EMPLOYMENT VERIFICATION FORM (Form IB-16) Alabama state employees who retire after September 30, 2005 are required to make use of any new employer's health benefit plan for primary cover ...
1665. Retired State Employee Plan Change Form IB15 - Alabama
INSTRUCTIONS: ALABAMA RETIRED EMPLOYEE PLAN CHANGE FORM (Form IB15) Retired Alabama employees of the state can change their health insurance coverage by filing a form IB15. This document can be obtained from the website ...
1666. Refund Request IB10 - Alabama
INSTRUCTIONS: ALABAMA REFUND REQUEST (Form IB10) Alabama government employers can request a refund of premiums paid by their department or an employee by filing a form IB10. The document can be found on the website of th ...
1667. Plan Change Form State Employee IB14 - Alabama
INSTRUCTIONS: ALABAMA STATE EMPLOYEE PLAN CHANGE FORM (Form IB14) Alabama state employees who wish to change their health insurance coverage do so by filing a form IB14. This form can be obtained from the website of the ...
1668. Revoke Election Form IB09 - Alabama
INSTRUCTIONS: ALABAMA REVOKE ELECTION FORM STATE EMPLOYEES' HEALTH INSURANCE COVERAGE (Form IB09) To cancel dependent coverage included in Alabama state employees' health insurance coverage, a form IB09 should be ...
1669. Federal Poverty Level Discount (FPL) Application - Alabama
INSTRUCTIONS: ALABAMA FEDERAL POVERTY LEVEL ASSISTANCE APPLICATION (FPL) (Form 2G) Alabama public education employees who have a combined family income less than or equal to 200% of the Federal Poverty Level may apply fo ...
1670. Dependent Premium Conversion Plan – for Open Enrollment IB08 - Alabama