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Employee Links and Forms

 
 
Sub Finder link

blue cross blue shield nebraska
Educators Health Alliance logo


BCBS ENROLLMENT FORM (Health/Dental Insurance)
BCBS Overview of EHA Healthcare, Prescription Drug, and Dental Benefits
https://members.nebraskablue.com/

BCBS TeleHealth flyer
myBlue flyer

myBlue Logo


VSP logo
VSP VISION INSURANCE ENROLLMENT FORM
VSP Vision Insurance Benefit Summary


formerly I-VISIONS Employee Self-Service (ESS) Portal

Nebraska Retirement System (NPERS)  
1-800-245-5712

ehawellness

payflex
1-800-284-4885
PAYFLEX ELECTION FORM


Synergy logo
 
 
 

Synergy Login



esu9

Forms in Alphabetical Order
 
Instructions to update tax forms online in Employee Access portal.
2024 W-4 Federal Form - Print, fill out form and return to Human Resources or Payroll
2024 W-4 Nebraska Form - Print, fill out form and return to Human Resources or Payroll
 
Annuity (403B) Form-Must be filled out online.Directions to navigate the site. Please direct questions to Payroll: 402-461-7564 or email Melissa Clark ()

Beneficiary Form for Retirement- (PDF) - Complete and get notarized and then forward to Human Resources. 
 
 
rev. 07/2022

Course Approval Form - Complete and forward to the Director of Human Resources
 
Direct Deposit Form - for security purposes, if you wish to change your direct deposit information please contact Human Resources Office
 
 
 
Mileage Claim Form you can fill this out and download it, then Send to Jill Hilgendorf () if for Special Education or Nurse. Send to Melanie Davis () if it is for anything else.


 
 
Sick Leave Bank Application (Certificated & Classified)
 
Time Sheet - Classified/Hourly - Complete and return to Payroll
 
Time Sheet- Interpreter Complete and return to Jill Hilgendorf ()