ASEA AFSCME Local 52 Health Benefits Trust is in Alaska

Quick Links

Developed in conjunction with Joomla extensions.

Click to print page contents Click to email article You are not logged in

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.

linkavailable Click on the PDF or MS Word 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.
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.


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.


You will be logged out in 10 minutes.

Click "Keep me logged in" to remain on the secure site or "Log me out" to log out now.