Contact Information

Teresa Foster, HRIS & Employee Wellness Coordinator
Insurance Benefits & Leave of Absence (FMLA)
Phone: 248-746-8547
Fax:  248-746-8926
Email:  teresa.foster@southfieldk12.org

Benefit Information

SASA /UNAFF

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

 

ESOS/MESPA/SEA

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

Insurance Forms

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