Click on the PDF symbol to display the form.
- Download the form.
- You can then print and fax or mail it to the ASEA Health Trust Administrator for processing.
| Name | Description | Download |
| CVS/caremark Prescription Drug Claim | Submit this claim form, along with your pharmacy receipts, if you are requesting reimbursements for primary or secondary benefits under the ASEA Plan. CVS/caremark has a web site specifically for ASEA/AFSCME Local 52 Health Benefits Trust members. Using this site, you can manage your prescriptions, view your prescription plan summary, locate a pharmacy, and more. |
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| CVS/caremark Mail Service Order | Use this form to order New and/or to Refill mail service prescriptions. CVS/caremark has a web site specifically for ASEA/AFSCME Local 52 Health Benefits Trust members. Using this site, you can manage your prescriptions, view your prescription plan summary, locate a pharmacy, and more. |
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