Insurance Documents

Sarpy County

(Insurance benefits available to employees classified as working 30+ hours per week or deemed eligible persuant to the Affordable Care Act)

Group Health Insurance Meeting: 10/25/2016 Audio File

Open Enrollment Insurance Meeting 11/14/2017: Audio File

Open Enrollment Calendar Year 2018: Paperwork Due November 22, 2017

Group Health Insurance:  Blue Cross/Blue Shield (1/1/18 - 12/31/18)

2018 Blue Cross premiums

Summary of Benefits and Coverage 1-1-18

Schedule of Benefits 1-1-18


Group Health Insurance: Blue Cross/Blue Shield (1/1/17-12/31/17)

Monthly Premium Costs
Schedule of Benefits
Summary of Benefits and Coverage (SBC)
Preventative Services
Retirement Health Insurance Benefits
Certificate of Coverage
Master Group Contract

Group Health Insurance: General Information and Documents Below

Tutorial: How to find an In-Network Provider
MY BLUE:Website for creating a subscriber account
Pre-Authorization List (link to website)

Naco Benefit: Term Life Insurance

Certificate of Coverage (must be enrolled in SARPY County BCBS Health Insurance)

In-Network Partial-Self Funding: Employee Benefits Systems (EBS) (1/1/17-12/31/17)

Claims Processing Illustration
Summary of Benefits and Coverage
Summary Plan Document


Flexible Spending Accounts: General Information and Documents Below

2018 Payflex 

Welcome to Payflex

Connected Claims Solutions

Keep Your Card Active


ASIFlex (link to website)
Mobile Access
Claim Form
Over-The-Counter (OTC) Overview
Explanation Presentation
Plan Document / Summary Plan Description


Group Dental Insurance:  MetLife effective 1/1/18

MetLife Summary of Benefits effective 1/1/18

Vision Discount Card

Group Dental Insurance: Reliance Standard (using Ameritas Network) ending 12/31/17

Highlights of Coverage
Certificate of Coverage
Provider Lookup Link (Plan Type: Classic PPO)
Vision Discount Program - available if enrolled in Dental Insurance


Group Term Life Insurance/Voluntary Supplemental Life Insurance: Reliance Standard

Certificate of Coverage: $30,000
Certificate of Coverage: $45,000
Cost sheet for Voluntary Supplemental Life Insurance
Certificate of Coverage: Voluntary Supplemental
Beneficiary Form 


Group Long-Term Disability Insurance: Reliance Standard

Certificate of Coverage: Less than $30,000 annual pay
Certificate of Coverage: $30,000 or more annual pay


CHI Health Employee Assistance Program (EAP): 402-398-5566

Summary of Benefits and Coverage 


Nebraska Public Employees Retirement System (NPERS)

Access to Full Website
Forms Link
County Handbook Link
Publications / Newsletter Link


Supplemental/Volunteer Benefit Providers

Link to contact list


Legal Documents/Notices

Notice of HIPAA Privacy Practices
Glossary of Health Coverage and Medical Terms
CHIP (Children's Health Insurance Program) Notice
Reliance Standard: Privacy Statement 


Mileage Rates



Chief Deputy Benefits (excludes Chief Deputy Sheriff)

Chief Deputy Benefits

Let us help you with any of your questions regarding Sarpy County Human Resources.

Contact Us Today!