All forms for Benefits and Wellness can be found here

Services (5)

Contact Us

This form is used to contact Human Resources Benefits and Wellness office

Health Savings Account (HSA) Certification

Health Savings Account (HSA) Certification

Health Savings Account (HSA) Enrollment / Change

Health Savings Account (HSA)
Enrollment / Change Form

MESSA Open Enrollment Elections

Complete this form if you would like to change your 2024 MESSA plan election and/or add or remove a dependent(s). This form must be submitted by Friday, October 27, 2023, at 5:00pm (EST).

Other Eligible Individual (OEI) Eligibility

Form for designating an Other Eligible Individual (OEI)