Employer Sponsored Health Care Plans

Employee Benefits

PDF DocumentPA 106
PDF DocumentDirections on how to set up a 403b or 457
PDF DocumentApproved 403b/457 Vendor List

PDF DocumentMESSA Choices Plan Highlights $1,000 $2,000 Annual Deductible
PDF DocumentMESSA Choices Plan Highlights $2,000 $4,000 Annual Deductible
PDF DocumentMESSA ABC 1 Plan Highlights
PDF DocumentMESSA Essentials Plan Highlights
PDF DocumentSummary of Benefits and Coverage MESSA Choices II $1,000 $2,000
PDF DocumentSummary of Benefits and Coverage MESSA Choices II $2,000 $4,000
PDF DocumentSummary of Benefits and Coverage MESSA ABC Plan 1
PDF DocumentSummary of Benefits and Coverage MESSA Essentials
PDF DocumentMESSA Prescription Drug Coverage
PDF DocumentUnderstanding MESSA Choices Deductible
PDF DocumentHow to Find MESSA Dedictible

PDF DocumentWhere do I go, Who do I see first?

PDF DocumentMESSA 24 7 Online Doctor   

PDF DocumentOmada - Weight Loss

PDF DocumentLivongo - Diabetes Management
PDF DocumentMESSA Nurseline
PDF DocumentNotification of COBRA Rights
PDF DocumentPlanSource - 2019 Flexible Spending Account Booklet

PDF DocumentHealth Insurance Marketplace Coverage

Shared Time Teachers - Full Time - Benefits

PDF DocumentMESSA Prescription Drug Coverage
PDF Document ADN Benefit Summary
PDF Document NVA Benefit Summary

Non-Affiliated Technicians - Benefits

PDF DocumentMESSA Prescription Drug Coverage
PDF DocumentNVA Benefit Summary
PDF DocumentADN Benefit Summary 
PDF DocumentLife and AD&D Non Affiliated Technicians w health coverage
PDF DocumentLife and AD&D - Non Affiliated Technicians w/o health coverage
PDF DocumentLong Term Disability - Non Affiliated Technicians

Teachers (BEA) Benefits

PDF DocumentADN Benefit Summary
PDF DocumentMESSA Prescription Drug Coverage
PDF DocumentNVA Benefit Summary
PDF DocumentLife Insurance with Medical
PDF DocumentLife Insurance without Medical
PDF DocumentLong Term Disability

Paraeducators (BEAP) Benefits


PDF DocumentMESSA Prescription Drug Coveraqe
PDF DocumentADN Benefit Summary
PDF DocumentMESSA Vision VSP 
PDF DocumentLife Insurance - BEAP working less than 20 hours per week
PDF DocumentLife Insurance - BEAP working over 20 hours per week w/o medical coverage
PDF DocumentLife Insurance - BEAP working over 30 hours per week w medical coverage

Secretaries (BESA) Benefits

PDF DocumentADN Benefit Summary
PDF DocumentPrescription Drug Coverage 
PDF DocumentNVA Benefit Summary
PDF DocumentBESA Life Insurance w Health Coverage
PDF DocumentBESA Life Insurance wo Health Care Coverage
PDF DocumentBESA Long Term Disability Coverage

Administrators (ABA) Benefits

PDF DocumentPrescription Drug Coverage
PDF DocumentNVA Benefit Summary
PDF DocumentADN Benefit Summary

Non-Affiliated Employee Benefits

PDF DocumentADN Benefit Summary
PDF DocumentPrescription Drug Coverage
PDF DocumentNVA Benefit Summary
PDF DocumentLife Insuarance and AD&D Insurance - Supervisor without health coverage
PDF DocumentLife Insurance and AD&D Insurance - Supervisor with health coverage
PDF DocumentLong Term Disability Coverage - Supervisor

Custodial & Maintenance (AFSCME) Benefits

PDF DocumentMESSA Prescription Drug Coverage
PDF DocumentNVA Benefit Summary
PDF DocumentADN Benefit Summary
PDF DocumentAFSCME Life and AD&D Insurance for members with medical coverage
PDF DocumentAFSCME Life and AD&D Insurance for members w/o medical coverage
PDF DocumentAFSCME Long Term Disability Insurance

Enrollment Forms

PDF DocumentMESSA Enrollment Form
PDF DocumentMESSA Online Enrollment Website - Employee User Guide
PDF DocumentCertificate of HSA Eligibility
PDF DocumentHealth Equity Payroll Form
PDF DocumentADN Dental Enrollment Form
PDF DocumentNational Vision Administrators (NVA) Enrollment Form
PDF DocumentDesignation of Beneficiary Form - Reliance Standard
PDF DocumentDesignation of Beneficiary Form - MESSA/CIGNA page 1
PDF DocumentDesignation of Beneficiary Form - MESSA/CIGNA page 2
PDF DocumentPlanSource - Flexible Spending Account Enrollment Form
PDF DocumentWaiver Form - Cash in Lieu of insurance
PDF DocumentThe OMNI Group 403(b) Salary Reduction Agreement Form

PDF DocumentThe OMNI Group 457 Salary Reduction Agreement Form

If participating in the 403b/457 plan, see instructions under subsection heading Employee Benefits on how to set up a 403b account (above).  Otherwise, if not participating, please print out The Omni Group 403(b) Salary Reduction Agreement Form and complete Parts 1,2,3, and 5.

Useful Links

External LinkMESSA
External LinkADN DENTAL
External LinkNational Vision Administrators (NVA) - Vision
External LinkPlanSource - Flexible Spending Account Administrator
External LinkThe Omni Group (Third Party 403b/457 Administrator)
External LinkOffice of Retirement Services