AdministrativeServices
Employee Wellness and Benefits

Active Employee Benefit Plans Options

• Enrollment Guide
• Health Care Premiums (cost for coverage)
• Health Care Plans Comparison
• Waiver Statement

BlueCross BlueShield of Nebraska

• BlueCross BlueShield Customer Service or 1-800-642-3022

Go to BlueCross BlueShield, then click "Find a Doctor" to search for doctors and hospitals in your plan.

• Affidavit of Dependency

Summary Plan Descriptions

• BlueChoice
• HDHP PPO
• Regular PPO
• Wellness PPO

Highlights

• BlueChoice
• HDHP PPO
• Regular PPO
• Wellness PPO

Other Information

• AccessBlue
• Authorization for Release of Public Health Information form
• BluePreferred Hospitals, Doctors and Other Health Care Professionals
• Enrollment form
• Extended Eligibility to Age 30 information
• Extension of Coverage Request for Extended Eligibility to Age 30 (LB 551)
• Health Care Reform/Preventive Services
• Mental Health Parity Update, effective 7/1/10
• The BlueCard Program (in English)
• The BlueCard Program (in Spanish)

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Express Scripts

• Home Page
• Prescription Mail Order form
• Prescription Drug Claim form
• PA, Step Therapy and Quantity Limit Drugs
• Tablet Splitting Program
• Specialty Drug List by Disease

  What is a Specialty Pharmacy?

  A specialty pharmacy provides injectable, oral and infused medications. These complex and costly medications usually require special storage and handling and may not be readily available at your local drug store. Sometimes these medications have side effects that require monitoring by a trained pharmacist or nurse. CuraScript focuses on providing these medications, while offering excellent clinical services and support to you and your caregivers. Once you choose CuraScript, you will receive personalized medication management, insurance coordination, educational materials and social support services at no additional cost to you or your doctor.

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Ameritas, Dental

Certificates of Coverage

• Basic Dental Plan
• Premium Dental Plan

Other Information

• Home Page
• Enrollment form

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EyeMed, Vision

• Enrollment form

• Member Home Page
• Out of Network claim form

Certificates of Coverage

• Basic Plan
• Premium Plan

Overview

• Basic Plan
• Premium Plan

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ASI, Flexible Spending Accounts

• Home Page
• Enrollment form
• Flexible Spending Accounts Change of Election form
• Summary Plan Description

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Mutual of Omaha, Income Protection, Basic & Supplemental Life, and AD&D

• Plan Member Home Page
• Conversion form
• Enrollment form
• Life Insurance Waiver form
• Life Insurance rates
• Proof of Death Claim form

Eligible Department of Labor Employees

• Certificate Book
• Summary of Coverage

Other Employees

• Certificate Book
• Summary of Coverage

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MetLife, Income Protection, LTD (for injury claims on or after January 1, 2008)

• Home Page
• Welcome Letter
• Certificate Book
• Enrollment Form
• Rates (Excel spreadsheet)
• Summary of Benefits
• Phone number: 800-858-6506

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BestCare, Employee Assistance Program

• Home Page




Training seminars available through EAP (various subjects):

• Open Training - Lincoln
• Webinars - available to employees outside the Lincoln and Omaha areas

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