Benefits

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

EBC Dedepent Care Claim Form 21-22
EBC Direct Deposit ACH Form 21-22
EBC Flexible Spending Claim Form 21-22
EBC Flex Benefit Debit Card Information
EBC Flex Benefit Debit Card FAQ
EBC Limited Purpose FSA FAQ 21-22
EBC Flexible Spending Eligible Expenses 21-22
EBC MyFlex Mobile App Information 21-22
EBC MyFlexOnline Website Information 21-22

 

Health Equity - Health Savings Account (HSA)

* An updated form is required each calendar year


MESSA 2021 HSA Payroll Deduction Authorization
MESSA 2022 HSA Payroll Deduction Authorization

Priority Health 2021 HSA Payroll Deduction Authorization
Priority Health 2022 HSA Payroll Deduction Authorization