Welcome all eligible employees to our on-line open enrollment site. We encourage you to utilize the forms and information on this page, to quickly sign up for City of Lincoln benefits.

For the new City plan year that begins November 1^st 2011 and goes through October 31^st 2012 we have on this web page all of the forms and information you will need for this years open enrollment. Also, PLEASE KEEP IN MIND THAT ALL OPEN ENROLLMENT INFORMATION MUST BE RECEIVED IN THE PERSONNEL DEPARTMENT BY SEPTEMBER 15, 2011.

This year: All eligible employees must complete an enrollment or waiver form for HEALTH insurance coverage. You DO NOT NEED TO COMPLETE a Dental or Vision form if you are not making any additions, deletions or other changes to your DENTAL or VISION insurance coverages. If you ARE making changes to these coverages you WILL HAVE TO COMPLETE A FORM BY printing it, completing it fully and then either mailing, or bringing this in to the Benefits area of the Personnel Department on the 3rd floor of the County City Building at 555 S. 10^th Street, Lincoln, NE 68508. Also we are completing our enrollment for PAY FLEX on-line just as we did last year.

Finally, should you have any questions for us in the Personnel Department, please don't hesitate to e-mail or call us as listed below.

Bill Thoreson Phone: 441-7883 Email: wthoreson@lincoln.ne.gov

Paula Lueders Phone: 441-7878 Email: plueders@lincoln.ne.gov

Bill Kostner Phone: 441-7671 Email: bkostner@lincoln.ne.gov

Send comments and/or suggestions to any of the above email's.

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All links are in PDF Format

City of Lincoln 2011 Open Enrollment Meeting: Schedule and General Information

City of Lincoln November 1, 2011 - October 31, 2012 Benefit Rates:

PAGE & X LCEA, E Fire
Police DSS, M ATU


Blue Cross / Blue Shield

Athorization for Release of Protected Health Information
Blue365 - Your resource for living healthier
Case Management Transition Form
Drug Formulary (April 2012)
Enrollment Form
Explanation of Benefits
Extension of Coverage Request for Extended Eligibility to Age 30
Health Care Reform Benefits for Preventive Services
International Claim Form
New Prescription Order Form
Notice of Privacy Practices
Online Member Services
Prescription Drug Claim Form
Preventive Guidelines
Schedule of Benefits Summary
Subscriber's Claim Form - Non-Participating Provider
Subscriber's Claim Form - Used when filing claims to another PCPS plan
Vision Claim Form
Customer Service number: 1-800-642-8980 or www.bcbsne.com


Ameritas - Dental

Group Enrollment/Change or Waiver Form
Plan Highlights
Customer Service number: 1-800-487-5553 or www.ameritasgroup.com


Ameritas - EyeMed

Enrollment/Change or Waiver Form
Vision Plan
Customer Service number: 1-866-289-0614 or www.eyemedvisioncare.com


PayFlex

Claim Form
Enrollment Form
Flexible Spending Account Flyer
Health Care Reform Act
Over the Counter Drugs and Medicines Information
Over the Counter Legislation Update
Payflex Card Flyer (Current Participants)
Payflex Card Flyer (New Participants)
Quick Reference Guide
Summary of Plan Description
Summary of Material Modifications
Customer Service number: 1-800-284-4885 or www.healthhub.com


PayFlex (Parking)

Change Form
Claim Form
On-Line Enrollment Form
Summary Program Description
Transportation Benefit Plan


Hartford Life

2011 Annual Enrollment Letter
Basic Life Coverage Booklet
Employee Travel Assistance Program
Hartford Personal Health Application
Life Conversations Brochure
New Hire Enrollment Form
Supplemental Life Brochure
Supplemental Life Insurance and Accidental Death & Dismemberment Benefit Highlight Sheet


Prudential - Long Term Care

Prudential Brochure
Contact number: 402-484-3826 or Email: Vera Schneider

Allstate Voluntary Benefits

Benefit Brochures and Videos
Accident and STD Claim Form - 651K
Allstate Corporate Information - 52K
Accident Insurance - 973K
Critical Illness Claim Form - 57K
Critical Illness Insurance - 454K
Critical Illness Wellness Claim Form - 36K
Enrollment Information - 34K
Voluntary Short Term Disability - 394K
Call Center: 877-282-0808; M-F; 7:00am - 4:00pm; or Email: Karen Keller