ASEA AFSCME Local 52 Health Benefits Trust is in Alaska

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The forms marked "Submittable online" can be completed and processed online as long as you are registered and have logged on to the site.

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  • linkavailable Click on the PDF symbol to download the form.
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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.
Form Description Submittable Online Display
HCRA Reimbursement Form Use this form to submit itemized bills or receipts for reimbursement under your Health Care Reimbursement Account Plan.

Yes

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Health Reimbursement Arrangement Plan Use this form to submit information for eligible expenses incurred by you, your spouse, or other eligible dependents, for which you are requesting reimbursement under the HRA Plan. Remember to also submit the required supporting documentation.

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