Human Resources

Forms & Web Resources

Medical, Vision, and Dental Insurance Benefits

• Blue Cross Blue Shield of Michigan
• Blue Care Network
• MESSA (Adjuncts)


• Aetna Dental Form (Staff)
• Aetna
• Delta Dental of Michigan


• Meritain Health Vision Form (Staff)
• Meritain
• Vision Service Plan


• BCBSM Medco by Mail Order Form
• Medco Mail Order


• BASIC
• IIAS

Flexible Spending Account (FSA)

• FSA BASIC Presentation
• FSA Guidelines
• FSA Enrollment Form
• IRS Eligible Expenses
• FSA Child Care Plan
• Fifth Third Bank

Family Medical Leave Act (FMLA)

• FMLA Guidelines & Physician statement

Michigan Public School Employees Retirement System (MPSERS)

• Name & Address Change Form
• Beneficiary Change Form
• MPSERS – Office of Retirement Services

Payroll

• Time Card & Leave Time Adjustment Form
• Direct Deposit Form
• Visa® Debit Payroll Card Enrollment Form
• Election of Pay Schedule (Full-Time Faculty)
• W-4 Federal
• W-4 State