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Plan Year 2015 Benefits

The following contains an overview of each medical plan option and voluntary benefits. To view more detail regarding each plan, select from the links below:

  • Consumer Driven Health Plan (CDHP) Medical, Vision and Prescription Drug Master Plan Document

  • Master Plan Document for Dental, Life and Long Term Disability

  • CDHP Wellness Benefits Summary Document

  • CDHP Summary of Benefits and Coverage - Individual

  • CDHP Summary of Benefits and Coverage - Family

  • Hometown Health Plan

  • Hometown Health Plan Summary of Benefits

  • Health Plan of Nevada

  •   
    Link to Benefits Overview of Benefits
    Consumer Driven Health Plan with a Health Savings Account (HSA)


    A health insurance plan plus a
    tax-advantaged HSA - all in one!
    For eligible active employees.

    Learn About the CDHP Prevention Programs:

    NVision Health & Wellness Program

    Diabetes Care Management Program


    Search for a Provider:

    Statewide PPO Network


    First Health Network

    Consumer Driven Health Plan - Health Savings Account

    • Preventive Care (medical and dental) covered 100% when using participating providers
    • Individual and Family Deductible
    • Statewide PPO Network - preferred provider network in Nevada.
    • First Health Network - national preferred provider network.
    • Health Savings Account (HSA)
      • PEBP contributes funds
      • Subject to annual contribution limits determined by the Internal Revenue Service, you can add funds to your HSA throughout the year with automatic monthly pre-tax "employee" contributions which may be increased, decreased, started or stopped any time throughout the year
      • You save by using the HSA to pay for qualified health expenses tax free, including vision and dental.
      • You can access your HSA with a NO-FEE debit card.
      • You can save funds in your HSA for future expenses and it can grow tax free with available interest-bearing and investment options. Funds carry over from year to year
      • There is no limit on the amount of funds that can be carried over from year to year
      • HSAs are portable; employees retain the HSA during a change of employment status, e.g., termination, retirement, etc.
      • You can designate a beneficiary to receive your HSA in the event of your death
    • Annual Vision Screening Exam (not subject to deductible or coinsurance)
    • Prescription drugs: 90-day supply of maintenance drugs available retail and mail order (subject to deductible)
    • Diabetic Sense Program – Enroll to receive an annual glucose monitor and/or a 90 day supply of test strips, Lancets, and Insulin Syringes - $50 copayment applies to each 90-day supply item. If the actual cost is less, you pay the actual cost. There is no cost for for the blood glucose monitor (out-of-network subject to deductible and co-insurance)
    • NVision Health & Wellness Program - a  personalized, confidential wellness program to get healthy and feel better…with a variety of tools and personal attention throughout the year. It is designed based on the best medical research.
    • Diabetes Care Management Program - for primary participants and spouses/domestic partners who have diabetes or who receive a diagnosis during the year. RN Care Managers work closely with you and your doctors to provide extra support and education to help you manage your diabetes.


    Consumer Driven Health Plan with a Health Reimbursement Arrangement (HRA)


    A health insurance plan plus a tax-exempt HRA - all in one!

    For retirees enrolled in the CDHP.


    Search for a Provider:

    Statewide PPO Network


    First Health Network

    Consumer Driven Health Plan -Health Reimbursement Arrangement (HRA)
    • Preventive Care (medical and dental) covered 100% when using participating providers
    • Individual and Family Deductible
    • Statewide PPO Network - preferred provider network in Nevada.
    • First Health Network - national preferred provider network.
    • Health Reimbursement Arrangement (HRA)
      • PEBP contributes funds
      • You save by using the HRA to pay for qualified health expenses tax free, including vision and dental
      • You can access your HRA with a NO-FEE debit card
      • You can save funds in your HRA for future expenses.
      • HRAs are not portable; funds revert to PEBP during a change of employment status, e.g., termination, retirement, etc.
    • Annual Vision Exam (not subject to deductible or coinsurance)
    • Prescription drugs: 90-day supply of maintenance drugs available retail and mail order (subject to deductible)
    • Diabetic Sense Program - Enroll to receive an annual glucose monitor and/or a 90 day supply of test strips, Lancets, and Insulin Syringes - $50 copayment applies to each 90-day supply item. If the actual cost is less, you pay the actual cost. There is no cost for for the blood glucose monitor (out-of-network subject to deductible and co-insurance)
    • NVision Health & Wellness Program - a personalized, confidential wellness program to get healthy and feel better...with a variety of tools and personal attention throughout the year
    • Diabetes Care Management Program - for primary participants and spouses/domestic partners who have diabetes or who receive a diagnosis during the year. RN Care Managers work closely with you and your doctors to provide extra support and education to help you manage your diabetes

    HMO Plan

    Health Plan of Nevada (HPN)

    Search for an HPN Provider
















    Hometown Health Plan Search for an HHP Provider
    Health Plan of Nevada
    • Health Plan of Nevada (HPN)
    • Low, fixed out of pocket costs
    • No Annual Deductibles
    • No Coinsurance
    • No Claim Forms
    • No pre-existing condition exclusions or limitations
    • Primary Care Physician coordinates and monitors your care
    • 100% Preventive Care Benefit
    • NVision Health & Wellness Program
    • Urgent Care and Emergency Care Services covered nationally and worldwide
    • Large Pharmacy network including Mail Order Prescription Program
    • Local Member Services and Claims Operations
    • Increased convenience and Access to Care:
    • Fast Cares and Retail Storefront Locations with same or next-day appointments
    • Online Web Portal
    • Online Appointment Scheduling at Southwest Medical Associates
    • Express Check-In at Southwest Medical Associates
    • Online access to medical and prescription records

    Hometown Health Plan

    • Open Access- gives you the ability to see select contracted specialist without seeing your PCP first.
    • World-wide coverage for ER and Urgent Care
    • No annual deductibles
    • No co-insurance
    • No pre-existing condition exclusions or limitations
    • Primary Care Physician selection required
    • 100% Preventative Care Benefits
    • Free Health and Wellness Educational Programs
    • NVision Health & Wellness Program
    • Health Management offers Diabetes, Heart, Lung and Nutrition/ Weight Management programs free of charge
    • Healthy Tracks
    • Community Flu Shots Clinics
    • Health Hotline- 24 X 7 nurse triage service
    • Centralized scheduling for 60 medical providers
    • 15 locations including Urgent Care Clinics, Emergency, and Pediatric Emergency Services
    • Local Customer Service
    Dental Plan

    Search for a Diversified Dental Provider or a Principal Dental Provider using the following link:

    Diversified Dental Services Network

    Dental Plan

    • $1,500 benefit maximum per plan year for Basic and Major services per covered individual.
    • $100 Individual Deductible/$300 Family Deductible (3 or more family members)
    • Preventive benefits (4 teeth cleanings, bitewing x-rays, and fluoride/dental sealants (children under age 18) paid 100% when using PPO dental network providers (not subject to deductible or annual benefit maximum.)
    • Basic services such as fillings and root canals are paid at 80% after deductible
    • Major Services such as crowns, bridges and dentures paid at 50% after deductible
    • Provider network for State of Nevada participants: Diversified Dental Services, Inc.
    • Provider network for all other states: Principal Dental Provider Network


    Basic Life and Long-term Disability Insurance

    Active Employee Basic Life and Long-term Disability Insurance

    • If you participate in a PEBP medical plan, your benefits include $25,000 Basic Life insurance coverage and Long-Term Disability (LTD).  LTD is designed to protect you against a loss of income in the event you become disabled and are unable to work for an extended period of time.
    Retiree Basic Life Insurance
    • If you participate in a PEBP medical plan, the State provides eligible retirees a Basic Life insurance benefit of $12,500.

    Voluntary Life, AD & D, and
    Short-Term Disability Insurance

    Employees

    • May purchase voluntary Life, AD & D, Dependent Life and Short-term Disability Insurance at group rates.
    Retirees
    • May purchase Voluntary Life Insurance at group rates.





     

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     Updated October 13, 2014



     


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