Health/Medical Insurance

Web Portal Access Form

Employee Enrollment Form

Change Request Form – NSHEB-6005 (1-14)

Services Requiring Coverage – PPO 2015 BCNEPA

NEB Admin Guide – 4/8/15

Employee Assistance Program

Experian Identity Protection Services


Traditional – Summary of Coverage and Benefits

Workers’ Compensation Program: Designated Health Care Providers

PPO E – Summary of Coverage and Benefits

PPO G – Summary of Coverage and Benefits

Traditional – Outline of Services

PPO E – Outline of Services

PPO G – Outline of Services

Summary of Coverage and Benefits Glossary

Henry Dunn Contact Information

Preventative Schedule

Preventative Schedule Addendum – Women’s Health

Prescription Home Delivery

Tier Zero Prescriptions

Urgent Care Centers Information

2012 Women’s Health and Cancer Rights Act Notice

2013 Medicare Part D Creditable Coverage Notice

2014 HIPAA Notice of Privacy Practice

BCNEPA July 2014 Benefit Changes


Dental Insurance

Outline of Dental Coverage


125 Flexible Spending Account (FSA)

Vendor (CBiZ) Contact Information

FSA Agreement for Direct Deposi

FSA Debit Card Detail

FSA Debit Card FAQs

FSA Reimburseable OTC Medicines

FSA Reimbursement Form



403(b) Plan Summary

403(b) Salary Reduction Agreement

403(b) Disclosure Form

403(b) Information