
Forms
Enrollment Form - Click Here
Evidence of Insurability Form - Click Here
Benefit Summary - Principals & Administrators
Benefit Summary - Superintendent
Benefit Summary - Teachers
Benefit Summary -Custodial & Food Service
Benefit Summary- All Other FT Employees
Benefit Summary- PT Employees
Voluntary Life and AD&D- Rate Sheet
Employee Assistance Program - Ability Assist
Empathy Overview - Employee
Empathy Overview - Beneficiary
Value Added Services
Travel Assistance / Identity Theft
Ability Assist Counseling Services
Beneficiary Assist Counseling Services
Phone: 855.329.0095
Email: healthaccountservices@myMidAmerica.com
Enroll Enrollment Form
Highlight Sheet - Critical Illness
Submit a Claim - Critical Illness Claim Form
Health Screening - Claim Form