Employee Links and Forms
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
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
1-800-284-4885
PAYFLEX ELECTION FORM
Synergy Login
Forms in Alphabetical Order
2023 W-4 Federal Form - Please fill out form and return to Human Resources or Payroll (must also fill out W-4 Nebraska Form)
2023 W-4 Nebraska Form - Please fill out form and return to Human Resources or Payroll (must also fill out W-4 Federal Form)
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.
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)
Smart Find Express Leave Codes & Definitions
Time Sheet - Certificated - Complete and return to Payroll
Time Sheet - Classified/Hourly - Complete and return to Payroll
Time Sheet- Interpreter Complete and return to Jill Hilgendorf ()
