Member Resources

SET SEG Employee Benefit Services delivers affordable, innovative options to help employers take control of healthcare costs and build healthy futures for Michigan’s public education community. We offer a range of consultative, administrative, and compliance services to help school districts provide the best possible care options for their employees and navigate the complexities of benefits requirements.

Affordable Care Act Tracking and Reporting

ACATR Resource Center
[PDF] ACATR Benefits & Retirement Presentation Slides

COBRA Administration Service

Includes:

• Preparation and mailing of all notices — general and election
• Receiving and tracking enrollment and waiver forms
• Processing participant enrollments and terminations with carriers
• Invoicing and collection of premium payments from participants
• Remittance of COBRA premium payments to the district
• Substantiation of COBRA compliance upon request

Administrative Forms

[PDF] Application to Convert Group Life Insurance
[PDF] Beneficiary Form
[PDF] Change Form
[PDF] HIPAA Disclosure Authorization Form
[PDF] MEC Plan Subscriber Application
[PDF] Subscriber Application
[PDF] Waiver of Group Health Benefits

Claim Forms

[PDF] ADN Dental Claim Form
[PDF] ADN Vision Claim Form
Group Life Insurance Claim
[PDF] Hospital Indemnity Claim Report
[PDF] Long-Term Disability Claim Statement
[PDF] Reliance Standard Accelerated Benefit
[PDF] Reliance Standard Group Life & Accidental Death and Dismemberment
[PDF] Reliance Standard Long-Term Disability
[PDF] Reliance Standard Short-Term Disability
[PDF] Reliance Standard Voluntary Life Claim Form
[PDF] Short-Term Disability Claim Statement

Voluntary Products

[PDF] Voluntary Benefits