Human Resources Benefits Information


Human Resources Department

Staff Calendars, Return to Work and Holiday Schedules

Return to Work and Holiday Schedules


2019 - 2020 Start and End Dates

2019 - 2020 Non Duty Days

Staff 2019-2020 Calendars and Pay Schedules

PHEA Calendar
PHEA Pay Dates Schedule


2020/2021 Non-Certified Staff Calendars

PPRO Calendar

Secretary 211 Calendar - Level I
Secretary 216 Calendar - Level II
Secretary 226 Calendar - Level III
Secretary 261 Calendar - Level IV

Custodian Calendar

Food Service Kitchen Assistant
Food Service Cooks / Manager
Food Service Managers - SPHR

NHS Calendar for Elementary
NHS Calendar for Middle and High School

Service Personnel - Hourly Employees

2020/2021 Pay Dates



Benefits Information

MESSA Insurance


The federal Affordable Care Act (ACA) mandates that a Summary of Benefits and Coverage (SBC) document is distributed to all employees for medical plans for which they are eligible at time of enrollment.
 

Summary of Benefits:
• Pak A
• Pak C
• Pak D
• Pak E
• SECR/PPRO Option 1
• SECR/PPRO Option 2
• SECR/PPRO Option 3

2019-20 Insurance Cost for Teachers with HSA 
2019-20 Insurance Cost for Teachers without HSA 

2019-20 Insurance Cost for Secretaries with HSA
2019-20 Insurance Cost for Secretaries without HSA

2019-20 Insurance Cost for Paraprofessionals with HSA
2019-20 Insurance Cost for Paraprofessionals without HSA

PPRO Vision & Dental Rates (with medical)

Teachers: MESSA ABC Plan Application
Paraprofessionals: MESSA ABC Plan Application
Secretaries: MESSA ABC Plan Application

Teachers: Beneficiary Designation Form
Paraprofessionals: Beneficiary Designation Form
Secretaries: Beneficiary Designation Form

PPRO & SECR Health Waiver
MESSA HSA Contribution Waiver

Life & Accident Insurance Certificate Booklet for Teachers, Counselors and Psychologists with Health Insurance
Life & Accident Insurance Certificate Booklet for Teachers, Counselors and Psychologists without Health Insurance

Long Term Disability Summary of Benefits for Teachers

Life Insurance Summary of Benefits (Optional)
Long Term Disability Summary of Benefits (Optional)
Short Term Disability Summary of Benefits (Optional)
MESSA Optional Insurance Rates

DELTA Dental Summary of Benefits
DELTA Dental 80% Non-Coordination of Benefits Highlights
DELTA Dental 50% Coordination of Benefits Highlights

VSP Vision Summary of Benefits
VSP Vision Plan Highlights


Blue Cross Blue Shield of Michigan / Blue Care Network
The federal Affordable Care Act (ACA) mandates that a Summary of Benefits and Coverage (SBC) document is distributed to all employees for medical plans for which they are eligible at time of enrollment. 

Summary of Benefits:
• BCBS Plan 1 A/B Summary
• New: BCBS ALT Plan 2 A/B Summary
 BCN Plan 3A Summary

2
019-20 BCBSM/BCN Insurance Cost (remaining 13 pays)

BCBS Member Application for Building Administrators & Central Office Staff 
(BAA, COA, CONF, SPSA, SPHR)

BCBS Member Application for Custodians (CUST)
BCBS Member Application for Food Service Employees (FSRV)

Beneficiary Designation Form (BAA, COA, CONF, SPSA)

Health Equity

Healthy Equity Website

HSA Advancement Request Form (SECR)

Health Savings Account Reimbursement Form

2020 HSA Payroll Deduction Authorization Form

Health Equity Reimbursement Request Form


Waiver of District Pre-Funded Contribution to Health Savings Account

Health Savings Account and Flexible Spending Account Information

IRS Publication 502 - Qualified Medical and Dental Expenses

IRS Publication 969 - Health Savings Accounts and Other Tax-Favored Health Plans

CIGNA Dental Insurance

CIGNA Dental Enrollment/Change Form

Building Administrators/Central Office/Confidential's/Hourly Service Personnel, Coordination of Benefits, Dental Summary of Plan Benefits

Building Administrators/Central Office/Confidential's/Hourly Service Personnel, Non-Coordination of Benefits, Dental Summary of Plan Benefits

Teamsters Dental Summary of Plan Benefits

Food Service Dental Summary of Plan Benefits

Paraprofessional Dental Summary of Plan Benefits

Secretary with Health Summary of Plan Benefits

Secretary without Health Summary of Plan Benefits

CIGNA Life Insurance

CIGNA Beneficiary Designation Form


EyeMed Vision Insurance

EyeMed Enrollment/Change Form

Eyemed Out of Network Claim Form


EyeMed Summary of Benefits (BAA, COA, CONF, SPSA/HR)

EyeMed Summary of Benefits (CUST, FSRV)

EyeMed Summary of Benefits (PPRO, SECR)


Family Medical Leave Act

Employee Rights under FMLA

FMLA Fact Sheets

Federal Mandates

Employee Assistance Program (EAP)
Company Code: PHASD

2020 Back to School Guide

New Directions Behavioral Health Website

Behavioral Health Poster

MyStrength Program

Free, Confidential Counseling 

403(B) & 457 Information

Locate Your Employer/Plan Sponsor

403(b) & 457(b) Plan Information for Employees & Advisors

Transaction Information Form

Salary Reduction Agreement - 403(b) Retirement Savings Plan

Salary Reduction Agreement - 457 Retirement Savings Plan


Notice of Universal Availability Eligibility to Contribute to 403 (b) / 457 Plans

Office of Retirement Services (ORS)

Office of Retirement Services Website
 

ORS Beneficiary Election Form

ORS Name and Address Change Form