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City of Omaha - Nebraska

City of Omaha Human ResourcesOmaha, Nebraska

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http://hr-staging.cityofomaha.org/benefits/benefits-forms

Print off Health Dental Application form.

This email address is being protected from spambots. You need JavaScript enabled to view it.402-444-5314 or scan and email it back to This email address is being protected from spambots. You need JavaScript enabled to view it.

For marriage, please provide a certified copy of marriage certificate.  For birth of child, please provide copy of certified birth certificate.

Must submit required forms within 31 days of qualifying event.  

Please contact Benefits at 402-444-5320 for additional assistance.  

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