New Faculty Benefit Information & Enrollment Forms

Below are the links for the benefit information and enrollment forms. Please print and complete the forms before your scheduled orientation (for orientation dates and times, click here). All forms are in PDF format.

Please note: This information is for reference only and is not a contract. For detailed information concerning coverages, premiums and University contributions, please refer to the website or contact our office.

Benefit  Name

(Provides the name of the benefit)

Overview of Benefit

(Provides general information regarding the benefit and employee costs, if applicable)

Enrollment Form(s) or Additional Info

(Provide links to the actual enrollment forms for the listed benefit)

New Faculty Checklist Provides a checklist for new employees New Faculty Orientation Checklist‌ (32kB)
Flexible Benefit Enrollment and Election Form* This summarizes your benefit elections Flexible Benefit Enrollment and Election Form‌ (179kB)

Health Insurance*

MESSA Super Care I

MESSA Choices II

MESSA Comparison Chart‌ (1kB)

2010-2011 MESSA Rates‌ (1kB)

MESSA Enrollment Form‌ (99kB)

Dental Insurance*

Blue Cross Blue Shield

Vision Insurance*

Blue Cross Blue Shield

Dental Benefits Overview‌ (884kB)

Dental Monthly Premium Rates‌ (1kB)

Vision Benefits Overview‌ (772kB)

Vision Monthly Premium Rates‌ (1kB)

Dental and Vision Enrollment Form‌ (1kB)

(If you are electing different coverage levels for dental and vision, you must complete two separate forms.  For example: Single dental and family vision.)

Basic & Optional Group Life Insurance* Basic and Supplemental Life Overview‌ (159kB)

 Supplemental Life Insurance Enrollment and Change Form (192kB)


Long Term Disability Insurance
LTD Overview‌ (293kB) LTD Enrollment Form
*Retirement Plan (403(b)) & Supplemental Plan (403(b) and 457) (TIAA-CREF) The TIAA-CREF website has an overview of the retirement plans available to SVSU employees. (for enrollment forms) (Click here for directions on how to electronically enroll in TIAA-CREF.)

403(b) Compensation Plan Agreement Form (205kB)

457(b) Salary Reduction Form (SVSU Form)‌ (171kB)

Faculty Association Membership and Dues Agreement Per Faculty Contract, see Article A 12.4‌ (9,861kB) Faculty Association Membership and Dues Agreement Form‌ (102kB)
Release of Official Transcript This allows the University to receive an official transcript for your personnel file. Release of Official Transcript Form‌ (92kB)
Reserved Parking Permit Parking Services Website Reserved Parking Permit Application Form
Tuition Waiver Tuitition Waiver Policy Tuition Waiver Enrollment Form (76kB)
Direct Deposit Direct Deposit Overview Direct Deposit Application‌ (1kB)
Flexible Spending Account FlexibleSpending2011FSA_Overview (196kB) Web Page Flexible Spending Account Reimbursement Form‌ (40kB)
Family Medical Leave Act (FMLA) FMLA Policy FMLA Contact for Forms and Information
Sick Leave Units See Faculty Contract - link at right Faculty Contract - Article M 5‌ (9,861kB)
Personal Leave See Faculty Contract - link at right Faculty Contract - Article M 8‌ (9,861kB)
Jury Duty See Faculty Contract - link at right Faculty Contract - Article M 11 (9,861kB)
Sexual Harassment Sexual Harassment Policy Sexual Harassment Policy Receipt‌ (11kB)
Drug-Free Workplace Drug-Free Workplace Policy Drug Free Workplace Policy Receipt‌ (11kB)
Travel See website for overview TravelPolicy (420kB)(Operations
LifeWorks (EAP) SVSU's Employee Assistance Program (EAP) Provider.  User name and password are located on the employee perks page under Ceridian.
New Employee Forms Forms all new employees must complete New Employee Forms
All Employee Benefit Perks Benefits available to all employees All Employee Perks

* - This is a required form and must be completed prior to and brought to your scheduled orientation.