The forms marked "Submittable online" can be completed and processed online as long as you are registered and have logged on to the site.
- If you are not registered, click on "Not Registered" at the top of the page and follow the registration instructions.
- If you are registered, but not currently logged in, you will be redirected to the login page.
- Click on the PDF symbol to download the form.
- Go to Contact Us.
For the forms not marked "Submitable online":
- Download the form.
- You can then print and fax or mail it to the ASEA Health Trust Administrator for processing.
Name | Description | Submittable online |
Download |
Deferral of Health Benefits | This form, for seasonal employees, allows you to defer your coverage for one or two calendar months, extending your coverage one or two months past the date your coverage would otherwise terminate. | Yes | |
Wildland Fire and Resource Technicians, Natural Resource Technicians, and Foresters Deferral of Health Benefits | This form, for LTNP Division of Forestry employees, allows you to defer your coverage for one or two calendar months, extending your coverage one or two months past the date your coverage would otherwise terminate. |
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Employee Information | Use this form to report your personal information (name, address, etc.) or your work status. | Yes | |
Family Information | Use this form to submit information about yourself, your spouse and your dependents. This form also allows you to report other insurance coverage for you and your dependents, for Coordination of Benefits. | Yes | |
Benefits Enrollment for Full-Time Employees | Enroll online or use this form to enroll by email, mail or fax if you are a full-time employee. You may change your mind after you enroll either by revising your online enrollment or by completing and turning in a new FT Benefits Enrollment Form via mail, or fax to the ASEA Health Trust Administrator within 30 days of your date of hire or the date you change bargaining units, or move from part-time to full-time or vice versa. | ||
Benefits Enrollment for Part-Time Employees | Enroll online or use this form to enroll by email, mail or fax if you are a part-time employee. You may change your mind after you enroll either by revising your online enrollment or by completing and turning in a new PT Benefits Enrollment Form via mail, email or fax to the ASEA Health Trust Administrator within 30 days of your date of hire or the date you change bargaining units, or move from part-time to full-time or vice versa. | ||
Health Benefits ID Card | This handy card gives you contact numbers and claims information you can share with your provider. |