AFSCME Employee Benefits

The benefit information below is provided for AFSCME maintenance and custodial employee group:

AFSCME Benefit Information

• General Benefits Information Sheet (includes employee per pay amounts)
• Medical Insurance Enrollment Request Form
• SET SEG Optional Dental/Vision Enrollment Application

Medical Insurance

• MESSA $300/$600 Medical Summary
• MESSA $500/$1000 Medical Summary
• MESSA $1000/$2000 Medical Summary
• MESSA $1500/$3000 ABC 1 Medical Summary
• MESSA $1500/$3000 ABC 1-20% Medical Summary

Prescription Information

• MESSA Saver Rx Overview
• MESSA ABC with ABC Rx Overview
• MESSA ABC Free Preventative Prescriptions
• Mail Order Rx - Express Scripts

• Mail Order Rx - OptumRx (effective 1/1/22)

HSA Additional Information

• HSA Direct Deposit Form

Cash in Lieu of Medical Insurance

• Cash in Lieu Enrollment Form

Dental Insurance

• Dental Insurance Summary
• Dental Claim Form

Optional Vision Insurance

• Vision Summary
• Vision Claim Form

Health Equity Reimbursement Accounts

• Dependent Care Reimbursement Claim Form
• Medical Reimbursement Claim Form
• Orthodontia Payment Guidelines
• Card Use Checklist

Options

• SET SEG Options

Legal Shield

• Legal Shield Perks
• Mobile Apps Information
• Payroll Application
• Legal Shield Contact Information