Insurance

Pak A MESSA Choices (No Deductible) Benefit Highlights for SASA/Unaffiliates

Pak A MESSA Choices (No Deductible) Summary Plan Description for SASA/Unaffiliates

Pak C MESSA Choices (Deductible $500/$1,000) Benefit Highlights for SASA/Unaffiliates

Pak C MESSA Choices (Deductible $500/$1,000) Summary Plan Description for SASA/Unaffiliates

Pak D MESSA Choices (Deductible $300/$600) Benefit Highlights for SASA/Unaffiliates

Pak D MESSA Choices (Deductible $300/$600) Summary Plan Description for SASA/Unaffiliates

Pak E MESSA Choices (Deductible 1,000/$2,000) Benefit Highlights for SASA/Unaffiliates

Pak E MESSA Choices (Deductible 1,000/$2,000) Summary Plan Description for SASA/Unaffiliates

PAK A, C, D RX MESSA Saver RX Prescription Benefit Highlights for SASA/Unaffiliates

PAK E RX 3 TIER With Mandatory Mail RX Prescription Benefit Highlights for SASA/Unaffiliates

Delta Dental Benefit Highlights for SASA/Unaffiliates

VSP 3 Plus P Vision Benefit Highlights for SASA/Unaffiliates

VSP 3 Plus P Vision Plan Description Book for SASA/Unaffiliates

Pak A MESSA Choices (Deductible $500/$1,000)  Benefit Highlights for SEA/ESOS/MESPA 

Pak A Messa Choices Plan Description Book for SEA/ESOS/MESPA

Pak A Messa Choices Summary Plan Description for SEA/ESOS/MESPA

Pak A MESSA 3 TIER RX Prescription RX Benefit Highlights for SEA/ESOS/MESPA

Pak C MESSA ABC Plan 1 (High Deductible $1400/$2800) Benefit Highlights for SEA/ESOS/MESPA

Pak C MESSA ABC Plan 1 Plan Description Book for SEA/ESOS/MESPA 

Pak C MESSA ABC Plan 1 Summary Plan Description for SEA/ESOS/MESPA

Pak C MESSA ABC Plan 1 RX Prescription Benefit Highlights for SEA/ESOS/MESPA 

Pak D MESSA Choices (Deductible $1,000/$2,000) Benefit Highlights for SEA/ESOS/MESPA

Pak D Messa Choices Plan Description Book for SEA/ESOS/MESPA

Pak D Messa Choices Summary Plan Description for SEA/ESOS/MESPA

Pak D MESSA 3 TIER RX Prescription Benefit Highlights for SEA/ESOS/MESPA

Pak E MESSA ABC Plan 2 (High Deductible $2,000/$4,000) Benefit Highlights for SEA/ESOS/MESPA

Pak E MESSA ABC Plan 2 Plan Description Book for SEA/ESOS/MESPA

Pak E MESSA ABC Plan 2 Summary Plan Description for SEA/ESOS/MESPA

Pak E MESSA ABC Plan 2 RX Prescription Benefit Highlights for SEA/ESOS/MESPA

Paks A - E MESSA RX Mandatory Mail Highlights for SEA/ESOS/MESPA

Pak F MESSA Essentials (Deductible $375/$750) Benefit Highlights for SEA/ESOS/MESPA

Pak F MESSA Essentials Plan Description Book for SEA/ESOS/MESPA

Pak F MESSA Essentials Summary Plan Description for SEA/ESOS/MESPA

Pak F MESSA Essentials RX Prescription Benefit Highlights for SEA/ESOS/MESPA

Delta Dental Benefit Highlights 100% for SEA/ESOS/MESPA

Delta Dental Benefit Highlights 50% Dual Coverage for SEA/ESOS/MESPA

 VSP-3 Plus Vision Benefit Highlights for SEA/ESOS/MESPA

VSP 3 Plus Plan Description Book for SEA/ESOS/MESPA

Delta Dental for SASA/Unaffiliates

MESSA Medical for SASA/Unaffiliates

 VSP-3 - Vision for SASA/Unaffiliates

Basic Flexible Spending Account FSA effective September 2016 - August 2017 

AMERIFLEX Flexible Spending Account FSA effective after September 2017

Colonial Life Optional Plans

Office of Retirement Services - ORS

GLP Strategic Administrative Group 403b

Delta Dental for SEA/ESOS/MESPA

MESSA Medical for SEA/ESOS/MESPA

VSP-3 - Vision for SEA/ESOS/MESPA

Basic Flexible Spending Account FSA effective 2016 - August 2017

AMERIFLEX Flexible Spending Account FSA effective after September 2017

HealthEquity Health Savings Account for MESSA Pak C  or D ABC Plan 1 or 2

Colonial Life Optional Plans

Office of Retirement Services - ORS

GLP Strategic Administrative Group 403b

MESSA Member Application for All Members
Used to re-instate recalled employees and to switch from Pak A (full coverage) to Pak B (no medical).

MESSA Member Change Form for All Members 
Used to add/remove dependents/optional benefits or name/address changes.

MESSA COBRA Application for All Members 
Used to elect employee paid group health coverage upon separation from the District.

MESSA CIGNA Life Insurance Beneficiary Designation Form for All Members

MESSA CIGNA Life Insurance Beneficiary Address Form for All Members

SASA/UNAFF (ONLY) MUTUAL OF OMAHA Beneficiary Designation Form

Employee Notice 09/2013 for MESPA/SASA/SEA/Unaffiliates

Employee Notice 09/2013 for ESOS

COBRA Notice 10/2013

MESSA Medicare Creditable Prescription Coverage Letter to Eligible Employees  2017

MESSA Medicare Creditable Prescription Coverage Letter to Eligible Employees 2018

MESSA Medicare Creditable Prescription Coverage Letter to Eligible Employees 2019

MESSA Medicare Creditable Prescription Coverage Letter to Eligible Employees 2020

Southfield Public Schools AMERIFLEX FSA in Brief

AMERIFLEX FSA Quick Reference Guide

AMERIFLEX FSA Enrollment Form

AMERIFLEX FSA Claim Form

AMERIFLEX FSA Online Account Instructions

AMERIFLEX FSA Adding A Family Member

FSA versus HSA

Southfield Public Schools BASIC FSA in Brief

BASIC FSA Medical Expense Summary List

BASIC FSA Claim Form

BASIC FSA Summary Plan Description 2016-17