
Insurance
Contact Information
Teresa Foster, HRIS & Employee Wellness Specialist
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
Frequently Needed Websites
SASA /UNAFF
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
Office of Retirement Services - ORS
GLP Strategic Administrative Group 403b
ESOS/MESPA/SEA
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
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
Flexible Spending Account (FSA) Information
AMERIFLEX FSA INFORMATION EFFECTIVE SEPTEMBER 2017
Southfield Public Schools AMERIFLEX FSA in Brief
AMERIFLEX FSA Quick Reference Guide
AMERIFLEX FSA Online Account Instructions
AMERIFLEX FSA Adding A Family Member
BASIC FSA INFORMATION EFFECTIVE SEPTEMBER 2016 - AUGUST 2017
Southfield Public Schools BASIC FSA in Brief
BASIC FSA Medical Expense Summary List
BASIC FSA Summary Plan Description 2016-17
Patient Protection and Affordable Care Act (PPACA)
Medicare Creditable Coverage
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