ASEA AFSCME Local 52 Health Benefits Trust is in Alaska

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  • You can then print and fax or mail it to the ASEA Health Trust Administrator for processing.
Form Description Display
Enrollment, Eligibility Appeal Submission Form Use this form to submit an appeal for an enrollment or eligibility appeal. Link to PDF
Medical, Dental or Prescription Appeal Submission Form Use this form to submit an appeal for denied benefits, a denied pre-certification or a denied prior authorization. linkavailable
HCRA or HRA Reimbursement Appeal Submission Form Use this form to submit an appeal for a a HCRA or HRA reimbursement appeal. Link to PDF

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