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Human Resources

Payroll/Benefits

Forms

                          OPEN ENROLLMENT INFORMATION

ASI Flex 125 Information

VSP Vision Insurance Information

      Vision Enrollment Form

General Payroll Forms

• Direct Deposit
• 2010 W-4 Form
• I-9 Form
• VSP Out-of-Network Reimbursement Form

ASI Flex 125

• Claim Forms

Sun Life Insurance Company

• Enrollment Form
• Beneficiary Form

Blue Cross Blue Shield

• Claim Form: Non-Participating Provider
• Claim Form: Non-Participating Provider (Outside Nebraska)
• PrimMail Pharmacy Order Form

Bi-Weekly Payroll