For Insureds...

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Some of the forms below are in PDF format and require Adobe Acrobat Reader. If you do not have Acrobat Reader installed click on the link at the bottom of this page to get a free copy.

Application: Click here to fill out a Tricare Extra Standard Online Application form for new enrollees, to add yourself as a member when changing from active to retired status or to add dependents.
Check-O-Matic: If you would like to pay your premiums on a Monthly basis and have ASI conveniently withdraw your monthly premiums directly from your checking account then Click Here to download our Check-O-Matic Application form in PDF Format. Please Note: If you are a new customer and will be filling out your application on-line, then you do NOT have to fill out this form because it is already included in the on-line application.
Filing Claims: Click here to download the ASI claim form if you have satisfied your pre-existing period (please disregard Instruction #2 on the claim form, the online form does not have a reverse side, it is all contained on one page) or Click here to download the ASI claim form for insureds still within the pre-existing period. Remember in addition to filing your claim, a copy of the Tricare EOB is necessary to pay your claim so please write your certificate # on the EOB and fax it to 301-816-1125 or mail it to P.O. Box. 2510, Rockville, MD 20847-2510.
Change Request Form: If you need to make changes to your coverage, are converting dependents from active duty to retired status or want to request a duplicate ID card or policy then Click here to fill out a Change Request form
Privacy: Please read our privacy statement by Clicking here to download our Privacy letter in PDF format.

Adobe Acrobat Reader must be installed to view some of the documents on this site. Click here to download (Free).

For Tricare Assistance call 1-888-363-2273 or go to their website by clicking on the link below:

Tricare Help

For information on (DEERS) call 1-800-538-9552 or click on the link below:

Association & Society Insurance Corporation
P.O. Box 2510, Rockville, MD 20847-2510
Phone:301-816-0045 x255, Toll-free:800-638-2610, Fax:301-816-1125