District Forms

Accounts Payable
Amy Schehr at x8473

Mileage Reimbursement
Request for Check
Internal Account Request for Check

Cash Handling
Field Trip, Fundraiser, or Event Log

Benefits
Shelly Larsen at x8471

Open Enrollment
Instructions for Open Enrollment 2023
Benefits and Costs 2023
Benefits and Costs for 2023 - ACA Eligible
Waiver of Benefits Form
Supplemental Plans Overview
Supplemental Health Benefits
MESSA FSA-Dep Care Information 
HSA Plan Information
HSA Payroll Deduction Form
MESSA Online Benefits User Guide 
Voluntary Life Insurance Information 
MESSA ABC Plans (List of Preventative Medications)

Annual Notices
2022 Medicare Part D Credible Coverage Notice
Special Enrollment Rights
Annual CHIP Notice
Annual Meaningful 403(b) Notice

Forms
Madison National Life Insurance Beneficiary 
FSA Dependent Care Withdrawal Request
FSA Medical Withdrawal Request
Waiver of Group Benefits
Voluntary Life Insurance Enrollment
Voluntary Life Insurance Evidence of Insurability 
Vision Out-of-Network Reimbursement 

Summary Plan Descriptions
MESSA ABC Plan 1 - 0% Coinsurance with 3-Tier RX
MESSA ABC Plan 1 - 20% Coinsurance with 3-Tier RX
MESSA ABC Plan 2 - 20% Coinsurance with 3-Tier RX
MESSA Choices - 20% Coinsurance with 3-Tier RX
Essentials by MESSA PPO
Madison National Life
MESSA Dental Plan
MESSA Vision Plan

AFLAC
Link to Website
AFLAC Cancer Screen Wellness Benefit Claim

Maintenance and Operations Department
Fix It at [email protected]

Payroll Department
Donna Wertheimer at x8474

Office of Retirement Services
(800) 381-5111

Employee Portal
Link to Website
Employee Portal Quick Reference Guide
Employee Portal First Time Use
Instructions for Downloading Check Stubs

Forms
Direct Deposit
LSFEE Payroll Deduction Form
After School and Evening Assignment Request

Investments
403b Newsletter Introduction
403b Employee Newsletter
403b Salary Reduction Agreement
457 Agreement 
TSACG – Third Party Administrator for all 403b & 457 Plans

Payroll Schedule
2022-23 Payroll Schedule

Time Clock Information
Frontline Account
Absence Management Guide
Using the App to Clock In/Out
Mobile App Guide
Time Clock Kiosk Guide

Taxes
Federal W-4
State W-4

Employee Services
Jeanenne Cappo at x8491

Forms
Address/Phone Change
Advanced Degree (LSFT)  
Event Form (Background Checks)
Field Trip Request
FMLA Request Form 
Childcare
Leave Request (Contractual)
LSFT After School & Evening Assignment Form
LSFT Discretionary Teaching Supplies ($25)
Mileage Reimbursement
MISD SCECH Application
Name Change Form
Professional Development Request 
Request for Bus Transportation
Staff Requisition and Change Form (Administrators Only)
Tuition Reimbursement
Volunteer Background Check

Superintendent Office
Shannon Ketelhut at x8483

Forms
Grapevine

Technology Department
Help Desk at [email protected]

Forms
Hardware Request
Software Request
Acceptable Use Policy

Windows 10 Resources
Windows 10 Beginners Guide
Quick Steps to Setup Your Desktop for Windows 10
Keyboard Shortcuts for Windows 10
Quick Reference Sheet for Windows 10
Windows 10 Training

Windows 10 Resources
Dell Purchase Program
Journey Ed

Discovery Education
Schoology Course
BSGT-982T-WCQKJ

Phones
Mitel Phones
Retrieve Voicemails

Live Broadcasting 
Lake Shore Cable TV Channels
(Only accessible in-district, on a district device)
CBS
C-SPAN
Discover
FOX
History
NBC
PBS
The Weather Channel