Benefits
Legal and Annual Notices
Priority Health - Medical Benefits
Plan Year July 1st through June 30th
Priority Health POS Summary of Benefits
Priority Health PPO Summary of Benefits
Priority Health HMO Summary of Benefits
Priority Health PPO/HSA Summary of Benefits
ADN Dental - Dental Benefits
Plan Year July 1st through June 30th
ADN Dental Summary of Benefits
NVA Vision - Vision Benefits
Plan Year July 1st through June 30th
NVA Vision Summary of Benefits
Reliance Standard Life and Accidental Death and Dismemberment Coverage
Reliance Standard Beneficiary Form
Non Teacher Life Insurance
Administrators
Administrative Assistants - Non Union
AFSCME
Paraprofessionals - AFT
Teamster
Retired Administrators
Retired Teamster
Non Teacher Long Term Disability
Administrators
Administrative Assistants - Non Union
AFSCME
Paraprofessional - AFT
Teamster
MESSA - Teacher Benefits
Plan Year Medical January 1st through December 31st
**NEW Plan Year 2022 Dental & Vision January 1st through December 31st
MESSA Choices Plan Benefits - PAK A
MESSA ABC Plan 1 Benefits - PAK C
MESSA ABC Plan 1 with 20% Co-Insurance - PAK D
MESSA ABC Plan 2 with 20% Co-Insurance - PAK E
MESSA Delta Dental Benefits - PAK A ,C,D & E
MESSA Delta Dental Benefits - PAK B
MESSA VSP Gold Vision Coverage -All PAKS
MESSA Life & Accidental Death Benefits - PAK A, C, D, & E
MESSA Life & Accidental Death Benefit - PAK B
MESSA Long Term Disability Coverage - All PAKS
MESSA Basic Term Life - PAK A, C, D, & E
Group Resources Flexible Spending (FSA) and Dependent Care (DC)
Plan Year July 1st through June 30th
FSA/Dependent Care Enrollment Form 2023-2024
FSA/ Dependent Care Direct Deposit Reimbursement Form
FSA Claim Form
Dependent Care FSA Claim Form
Summit Online Access Instructions
Debit Card Information 2023-2024
Health Equity - Health Savings Account (HSA)
* An updated form is required each calendar year
MESSA 2023 HSA Payroll Deduction Authorization
Priority Health 2023 HSA Payroll Deduction Authorization