Salary Reduction Agreement
Tax Sheltered Annuity Vendors 
Universal Notice 

2023 Health Insurance Rates
HSA Summary of Benefits
Value Plan Summary of Benefits
Mayo Network Complete Health Information
HSA Plan ONLY - Preventative Drug List 
Enrollment/Change/Cancellation Form
2023 Health Insurance Presentation with Mark Beltz

Medica CompleteHealth
Medica Choice Passport

Dental Benefit Plan
Dental Summary Plan
Dental Enrollment Form
Coordination of Benefits Form
Claim Reimbursement Form
Direct Deposit Transfer Form
Calendar Year Dental Plan Document
Quickstart Guide

The Family and Medical Leave Act (FMLA) provides certain employees with up to 12 weeks of unpaid, job-protected leave per year. It also requires that their group health benefits be maintained during the leave. 

FMLA is designed to help employees balance their work and family responsiblities by allowing them to take reasonable unpaid leave for certain family and medical reasons. It also seeks to accomodate the legitimate interests of employers and promote equal employment opportunity for men and women. 

Please reach out to your Site Principal and/or Human Resource Specialist for further information and help on starting on the FMLA process. 

FMLA Compliance Poster
FMLA Facts
FMLA Frequently Asked QuestionsFMLA Employee Guide
FMLA Application 

FSA (Medical and Dependent) Enrollment Form

Reimbursement/Claim Form

2023 Max Limit Contributions: 

Medical - $3,050.00
Dependent Care - $5,000.00

*FSA works as a "use it or lose it" account, meaning any funds that are not spent by the end of the calendar year will be lost.
*Anyone can participate in the FSA plan, even if not covered under a school-sponsored insurance plan.
*If you have both an HSA and FSA Medical account, you may only use your FSA account for Dental and Vision.
*Contribuatinos are made tax-free!

HSA Enrollment Form

Reimbursement/Claim Form

2023 Max Limit Contributions: 

Single - $3,850.00
Family - $7,750.00
55+ Catch Up - $1,000.00

*There is no limit to when you can use your funds. Unspent funds are transferred year to year. 
*Must be enrolled in a HDHP (High Deductible Health Plan), such as the Medica HSA.
*Contributions are made tax-free! 

Admin/Director Certificate
Non-Certified Certificate
Teacher Certificate
LTD Enrollment Form

Life Enrollment Form
Evidence of Insurability 
Certificate - All Other Eligible
Certificate - FT Admin
Life Amendment 1
Life Amendment 2
Life Amendment 3

PERA is a public pension fund that serves over 450,000 current and former public employees from over 3,500 local units of government throughout the state of Minnesota. 

PERA Pension Plan Video 

General Plan Handbook

TRA is a defined-benefit ("DB") pension plan that's more similiar to Social Security than to a 401(k) or 403(b) defined-contribution ("DC") plan. 

TRA Pension Video

COBRA Notice 

Employee Exchange Notice