Changes in the 2021-2022 Payroll & Benefits Information
- W-4 (Federal) and W-4N (State) You can change these forms at any time during the year. Fill one out, print it off and return it to the payroll department.
- Direct Deposit Form You can change this form at any time during the year. You may have up to ten checking or savings accounts. Fill the form out, print it off and return to payroll.
- 2021-2022 Paid Holidays
- 2021-2022 Payroll Cut-Off Dates
- Exception Sheet-Classified
- Compensatory Time Form-Classified
- Staff Absence Form-Classified
Benefit & Insurance Information
Open Enrollment/Records Instructions
Health Insurance
- Heath & Dental Enrollment and Declination of Coverage Form
- My Blue Flyer-Mobile App, Card Access & More
- Benefit Summary for $1,050 Deductible Plan
- Benefit Summary for $3,600 Deductible Plan
- Rates for Administrators, Certified Staff and Salaried Classified
- Rates for Hourly Classified Employees
- Blue Cross All Clear ID Brochure
- Blue Cross HSA Brochure
- Blue Cross Telehealth Brochure
PayFlex Section 125 Plan
- PayFlex Health/Dependent Care Enrollment Form
- PayFlex Limited Purpose Flexible Spending Account
- PayFlex Flexible Spending Account
- PayFlex Health/Dependent Claim Form
Vision Insurance
Cancer Insurance
- Colonial Life Cancer Plan
- Colonial Life Cancer Enrollment Form
- Colonial Life Cancer Service Guide
- Colonial Life Cancer Rider
- Colonial Wellness Benefits
Life Insurance
- Life Insurance-Teachers (Certificate of Insurance)
- Life Insurance-Administrators (Certificate of Insurance)
- Life Insurance-All Other Employees (Certificate of Insurance)
- Life Insurance-Evidence of Insurability Form
Disability
- Disability Policy-Teachers & Administrators (Certificate of Insurance)
- Disability Policy-All Other Employees (Certificate of Insurance)
- Employee Assistance Program Brochure
403(b)
- 403(b) Enrollment Form
- 403(b) Salary Reduction Form
- 403(b) Personal Information Change Form
- 403(b) Consultants Presentation
- 403(b) Summary Plan Description
Retirement
- Beneficiary Designation Form
- Nebraska School Employee Retirement Handbook
- Employee Early Retirement Inducement Form
Helpful Links
www.paycheckcity.com Fill in your exemptions and deductions and find out how much your paycheck will be
http://npers.ne.gov Create a personal account and you can verify the amount in your retirement account, calculate the amount you will receive at retirement, find out when you are eligible for retirement, etc.
www.payflex.com A Flexible Spending Account (FSA) provides a tax-advantaged way to pay for eligible out-of-pocket healthcare expenses and work-related dependent day care expenses. Authorized by Internal Revenue Code Section 125, an FSA allows you to pay for eligible expenses with "pre-tax" dollars, thereby lowering your taxable income. Employers have the option of offering a healthcare spending account, a dependent day care account or both.
