Forms

Below you will find the necessary employee forms.  Click on the link and the form will open.  You can then save the form, fill it in, and e-mail it or put it in the mailbox of the intended recipient.

Expense Reimbursement Form

Leave Request

Purchase Order

Nebraska Public Employees Retirement Systems

You may access your NPERS account online at https://npers.ne.gov.  You will need to create an account if you have not used the online system and you will need your retirement account number to do this.  There is a Benefit Estimator you can use as well as beneficiary designation forms and lots of other good information.  If you don’t know who your beneficiary is, your beneficiary has gotten married and the name is changed or you’ve decided to change your beneficiary, please submit a new form.

If you have moved

Please make sure to give me your new address so I can update your records here, with NPERS, and with BCBS if applicable.  Completing a new W-4 is simple way to do this.  http://www.irs.gov/   The link is on the top left.

New Flex Plan Form

Flexible Spending forms with receipts are due in the office by the 10th of the month to receive payment on payday.  Click on the link below:

Flex Plan Form 

Flex Spending Handbook

BlueCross BlueShield

BlueCross BlueShield has a newly redesigned health and wellness Web site, www.BlueHealthAdvantageNE.com .  This site has a great individual section that ALL employees are eligible to use.

Features include:

• Personal Health Risk Assessment – learn how to enhance your health status
• Daily Health News courtesy of WebMD
• Weekly Polling Question
• Use Facebook, LinkedIn, Twitter and more to share with friends
• Blog with experts about health and wellness

We encourage you to visit this Website and take advantage of the exciting new features.