Benefits Forms Manager

  

Newly Married Employees
Please fill out, print and send the attached forms along with a copy of
your marriage license to the Benefits Department within 30 days of marriage.

Adding Benefit Coverage
Employees wanting to add benefit coverage due to qualifying events such as spouse's retirement, spouse's loss of coverage, divorce, death, etc.,
must complete the attached forms and return them to the benefits office.

Basic Flexible Spend Plan
The BASIC Flex Plan is available here and the reimbursement form.

Basic Health Flex

2013 Cafeteria Summary Plan Description
2013 Cafeteria Plan Document
2013 Cafeteria Plan Specifications

ACA Summary Benefits of Coverage
RX Saver Flyer
MESSA ABC 3 Plan
MESSA Choices ($10/$20 Drug Plan)
MESSA Choices (Saver RX)

Dental Benefits at a Glance

Vision Claim Form 
 

Address Change

Adding/Deleting A Dependent to your Insurance
Please fill out, print and send the attached forms along with the date of birth for your child within 30 days of birth.

Optional/Enhancement Benefits

90 Day Prescription Links with Blue Cross