Asea Health Trust Forms
New to asea health benefits trust have not enrolled in a flex plan and have a hire date within the past 6 months please register by going to the new employee enrollment page.
Asea health trust forms. Hcra hra forms hcra hra forms these forms can be completed and processed online as long as you are registered and have logged on to the site. Use this section to find the right form document or policy for your needs. If you are registered but not currently logged in you will be redirected to the login page. The forms are not available for on line completion but may be printed and sent in.
State ggu contract 2019 2022 fairbanks north star borough supervisors contract 2018 2021 sitka municipal employees contract 2019 2022. If you have not previously registered on this new asea website you must create a new account by going to the registration page. Use this form to submit an appeal for an enrollment or eligibility appeal. Asea health benefits trust po box 5434 spokane wa 99205 0434.
Asea health trust administrator phone. You can then print and fax or mail it to the asea health trust administrator for processing. Fri 7 30am 4 00pm alaska time fax. Submit this claim form along with your pharmacy receipts if you are requesting reimbursements for primary or secondary benefits under the.
Forms trustees and administrators for the asea health trust work hard to provide you with the information you need to maximize the value of your benefits. Once you are logged in the form will. Enrollment eligibility. Contact information and hours.
If you have any questions regarding the forms contact the administration office at 866 678 8647. Request for benefits form pdf each member using the plan must complete and submit a request for benefits form which must be signed. You can then print and fax or mail it to the asea health trust administrator for processing. Request for benefits claim form.
Medical dental or prescription appeal submission. All forms documents. Appeals forms appeals forms click on the pdf or ms word symbol to display the form. Enrollment eligibility appeal submission form.
Asea health trust asea legal trust. Use this section to find the right form document or policy for your needs. You may change your mind after you enroll either by revising your online enrollment or by completing and turning in a new pt benefits enrollment form via mail email or fax to the asea health trust administrator within 30 days of your date of hire or the date you change bargaining units or move from part time to full time or vice versa. Click here to print a copy.
Leave donation requests. Forms trustees and administrators for the asea health trust work hard to provide you with the information you need to maximize the value of your benefits. Prescription forms prescription forms click on the pdf symbol to display the form. Altered documents are not accepted by the plan.