Fiscal & Utilization Reports
Laws and Regulations
Frequently Asked Questions
Notices From PEBP
National Defense Authorization Act
On January 28, 2008,
President Bush signed into law H.R. 4986, the National Defense
Authorization Act (NDAA). Section 585 of the NDAA amends the Family and
Medical Leave Act of 1993 (FMLA) to permit a “spouse/domestic partner,
son, daughter, parent, or next of kin” to take up to 26 workweeks of
leave to care for a “member of the Armed Forces, including a member of
the National Guard or Reserves, who is undergoing medical treatment,
recuperation, or therapy, is otherwise in outpatient status, or is
otherwise on the temporary disability retired list, for a serious injury
The NDAA also permits an employee to take FMLA
leave for “any qualifying exigency (as the Secretary [of Labor] shall,
by regulation, determine) arising out of the fact that the
spouse/domestic partner, or a son, daughter, or parent of the employee
is on active duty (or has been notified of an impending call or order to
active duty) in the Armed Forces in support of a contingency operation.”
You can read more about the National Defense Authorization Act by
visiting the US Department of Labor website
and typing NDAA in the Search Box.
|Heroes Earning Assistance and Relief Tax (HEART Act)
Heroes Earnings Assistance and Relief Tax Act of 2008 (HEART Act)
requires employers to provide certain retirement and welfare benefits
for returning military personnel and their beneficiaries. For more
information on the HEART Act (Heroes Earning Assistance and Relief Tax),
visit the IRS website at: www.irs.gov
and type HEART Act in the Search Box.
Uniformed Services Employment and
Reemployment Rights Act
The Uniformed Services Employment and
Reemployment Rights Act of 1994 (USERRA, 38 U.S.C. § 4301-4335 is a
federal law intended to ensure that persons who serve or have served in
the Armed Forces, Reserves, National Guard or other “uniformed
services:” (1) are not disadvantaged in their civilian careers because
of their services; (2) are promptly reemployed in their civilian jobs
upon their return from duty; and (3) are not discriminated against in
employment based on past, present, or future military service. For more
information about USERRA, please visit the US Department of Labor website.
The Americans with Disabilities Amendments Act
Effective January 1, 2009,
the Americans with Disabilities Act Amendments Act of 2008 (ADA
Amendments Act) changed the language regarding any
conditions that substantially limit and emphasizes that the definition
of disability should be construed in favor of broad coverage for
individuals to the maximum extent permitted by the terms of the ADA and
shall not require extensive analysis. The provisions of the ADA
Amendments Act were
designed to essentially overturn several Supreme Court decisions and
make it easier for an individual seeking protection under ADA to
establish that he or she has a disability within the meaning of the ADA. You can read more about the
ADA and the Amendments Act by visiting the US Equal Employment
|The Paul Wellstone and Pete Domenici Mental Health Parity
and Addiction Equity Act of 2008
requires that full parity be established between mental health/
substance abuse benefits and other surgical and medical benefits offered
under a healthcare plan. You can find more information on the Paul
Wellstone and Pete Domenici Mental Health Parity and Addiction Equity
Act of 2008 at the Centers for Medicare And Medicaid Services and
typing "MHPAEA" in the Search Box.
|Genetic Information Nondiscrimination Act of 2008
The Genetic Information Nondiscrimination Act of 2008 (GINA) was enacted May 21, 2008.
Title I (regarding genetic nondiscrimination in group health plans) was effective for plan years beginning after May 21, 2009.
Title II (regarding genetic nondiscrimination in employment) became effective November 21, 2009.
GINA amended the Employee Retirement Income Security Act of 1974 (ERISA), the Internal Revenue Code and the Public Health Service
Act to prevent group health plans and health insurance companies from basing enrollment decisions, premium costs or participant
contributions on genetic information. Group health plans and group insurers are prohibited from requiring that individuals undergo genetic testing.
Employers are also prevented from conditioning hiring or firing decisions on the basis of genetic information.
Lastly, GINA will extend medical privacy and confidentiality rules to the disclosure of genetic information.
Currently, neither the State of Nevada nor PEBP use genetic information for employment or benefits determination. Genetic testing excluded from coverage in the PEBP plan.
You can read more about GINA by visiting the
National Human Genome Research Institute
|Health Insurance Portability and Accountability Act (HIPAA) Privacy Practices
The HIPAA Privacy Rule provides federal protections for personal health information and gives
patients an array of rights with respect to that information. At the same time, the Privacy Rule is balanced so that it permits the
disclosure of personal health information needed for patient care and other purposes. For more information,
please visit US Department of Health and Human Services Offices for Civil Rights.
|Women’s Health and Cancer Rights Act
Your plan, as required by the Women’s Health and
Cancer Rights Act of 1998, provides benefits for mastectomy-related
services. This includes all stages of reconstruction and surgery to
achieve symmetry between the breasts, prosthesis, and complications
resulting from a mastectomy, including lymph edema.
If you have
questions about coverage of mastectomies and reconstructive surgery,
please call your plan administrator for additional information:
Consumer Driven PPO High Deductible Health Plan:
HealthScope Benefits at (877) 763-8232
Health Plan of Nevada: (702) 242-7300 or (800) 777-1840
Health Plan: (775) 982-3232 or (800) 336-0123
Newborns’ and Mothers’ Health
Protection Act of 1996
Group health plans and health
insurance issuers generally may not, under federal law, restrict
benefits for any hospital length of stay in connection with childbirth
for the mother or newborn child less than 48 hours following a vaginal
delivery, or less than 96 hours following a cesarean section. However,
federal law generally does not prohibit the mother’s or newborn’s
attending provider, after consulting with the mother, from discharging
the mother or her newborn earlier than 48 hours (or 96 hours, as
applicable). In any case, plans and issuers may not, under federal law,
require that a provider obtain authorization from the plan or the issuer
for prescribing a length of stay not in excess of 48 hours (or 96
hours). For more information, please visit the US Department of Labor and type Newborns' and Mothers' Health
Protection Act in the Search Box.
|Important Notice About
Your Plan Year 2011 Prescription Drug Coverage and Medicare