ASEA AFSCME Local 52 Health Benefits Trust is in Alaska

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linkavailable These forms 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.
  • Once you are logged in, the form will prefill with your personal information on file (i.e. name, Health Plan ID, etc.)
  • Complete the form online, attach any required document(s) and submit for processing.

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  • Download the form.
  • You can then print and fax or mail it to the ASEA Health Trust Administrator for processing.
Form Description Process Online Display
HCRA Reimbursement Form Use this form to submit itemized bills or receipts for reimbursement under your Health Care Reimbursement Account Plan.

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Direct Deposit Form Use this form to request that your HCRA and/or HRA reimbursements be deposited directly to your bank account.

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