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City of Lincoln
City of Lincoln
Human Resources Department
Risk Management Division

City Benefit Information for plan year 11/01/2013 - 10/31/2014



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 1st 2013 and goes through October 31st 2014 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 Human Resources Department by September 13, 2013.

This year: All coverages will continue as they have except for Payflex. You do not need to complete a Health, Dental or Vision form if you are not making any additions, deletions or other changes to your 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 Human Resources Department, County City Building at 555 S. 10th Street, Room 302 Lincoln, NE 68508. Also we are completing our enrollment for PAY FLEX on-line just as we did last year, yet the total amount you may put aside for unreimbursed medical has been reduced to $2,500.

Finally, should you have any questions for us in the Human Resources 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


All links are in PDF Format

City of Lincoln 2013 Open Enrollment Meeting Schedule

City of Lincoln November 1, 2013 - October 31, 2014 Benefit Rates:

ATU DSS & M Fire LCEA & E PAGE Police X


Blue Cross / Blue Shield

Athorization for Release of Protected Health Information
Blue365 - Your resource for living healthier
Breastfeeding Support, Supplies and Counseling
Case Management Transition Form
Contraceptive Drugs and Methods Pharmacy List
Contraceptive Methods and Counseling
Deciding Where To GoNew
Drug Formulary (November 2012)
Enrollment Form New
Explanation of Benefits
Extension of Coverage Request for Extended Eligibility to Age 30
Health Care Reform Benefits for Preventive Services
International Claim Form
Nebraska Urgent Care & Retail Health Locations New
New Prescription Order Form
Notice of Privacy Practices
Online Member Services
Prescription Drug Claim Form
Preventive Guidelines
Prime Therapeutics Specialty Pharmacy
Schedule of Benefits Summary ($300-$400)
Schedule of Benefits Summary ($400)
Schedule of Benefits Summary (IAFF)
Schedule of Benefits Summary (PAGE)
Schedule of Benefits Summary(ATU/LPU/LCEA/E/DSS/X/M)
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.nebraskablue.com


Ameritas - Dental

Group Enrollment/Change or Waiver Form
Plan Highlights
Summary Plan Description (2013)
Customer Service number: 1-800-487-5553 or www.ameritasgroup.com


Ameritas - EyeMed

Enrollment/Change or Waiver Form
Vision Plan
Summary Plan Description (2013)
Customer Service number: 1-866-289-0614 or www.eyemedvisioncare.com


PayFlex

On-Line Enrollment Form
Claim Form
Enrollment Form
Flexible Benefit Plan
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)
Payflex Mobile Flyer
Pay Them Flyer
Summary Plan Description
Quick Reference Guide
Substantiation
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

2014 Annual Enrollment Letter
Basic Life Coverage Booklet
Beneficiary Assist Program
City of Lincoln Benefits Enrollment Form
Estate Guidance Will Services
Funeral Planning and Concierge Services
Group Life and/or Accidental Death & Dismemberment Claim Forms for Employee or Dependent
Group Life Portability Outline
Life and Accidental Death and Dismemberment Insurance
Personal Health Application
Supplemental Life Brochure
Supplemental Life Insurance and Accidental Death & Dismemberment Benefit Highlight Sheet
Travel Assistance Program


Allstate Voluntary Benefits

Benefit Brochures and Videos
Accident and STD Claim Form
Allstate Corporate Information
Accident Insurance
Critical Illness Claim Form
Critical Illness Insurance
Critical Illness Wellness Claim Form
Enrollment Information
Voluntary Short Term Disability
Call Center: 877-282-0808; M-F; 7:00am - 4:00pm; or Email: Karen Keeler


Human Resources Homepage Risk Management