Employee Enrollment

Manage new hires, conduct open enrollment, and make benefit changes easily online with BluesEnroll ^SM. BluesEnroll is a comprehensive electronic benefit administration and enrollment solution. 

Don't yet have a BluesEnroll account for your group?

Please contact your BCBSNE Account Representative to get set up.

To add a login for your group or request a change, call the BluesEnroll helpline at 866-513-5474.

Employee Enrollment Forms

• BluePride Employee Enrollment Form (1-50 employees)
• BlueFreedom Employee Enrollment Form (51-150 employees)
• Coverage Termination Notice
• Nebraska Uniform Group Health Application
• Election to Continue Coverage - Involuntary Termination
• Election to Continue Coverage - Death of Employee
• Request for Waiver of Probation Period
• Group Health Enrollment Form (Self-funded and Premier Blue)
• Group Health Enrollment Form (Self-funded and Premier Blue) Spanish
• Group Health and Dental Enrollment Form (Self-funded and Premier Blue)
• Group Health and Dental Enrollment Form-Multiple Options (Self-funded and Premier Blue)

BluesEnroll is provided by Benefitfocus. Benefitfocus is an independent company that has contracted with Blue Cross and Blue Shield of Nebraska to provide electronic health plan enrollment services.