Eligibility
If you reside in southern Nevada, coverage is administered by the Health Plan of Nevada (HMO) and is only available to participants residing in the following counties: Clark, Esmeralda and Nye Counties. If you reside in northern Nevada, coverage is administered by the Premier (EPO) Plan and is only available to participants residing in the following fourteen northern Nevada counties: Carson City, Churchill, Douglas, Elko, Eureka, Humboldt, Lander, Lincoln, Lyon, Mineral, Pershing, Storey, Washoe and White Pine. If you are no longer an eligible individual, you can still receive tax-free distributions to pay or reimburse your qualified medical expenses, however, you can no longer contribute money to your HSA. In general, you must be a United States citizen, green card holder, or a United States resident to participate. An HSA cannot be opened without a verifiable United States residential address and a valid United States Social Security Number. Yes. If you do not qualify for premium-free Medicare Part A you will be able to maintain your PEBP CDHP, EPO or HMO plan. You will need to submit verification from the Social Security Administration that you’re ineligible for premium-free Part A. You will also be required to purchase Part B Medicare at age 65 if you are retired. You do not need to purchase Part B if you are an active employee who is age 65 and you can wait until retirement to enroll in Medicare. To be eligible to establish and contribute to an HSA on a pre-tax basis, the employee must meet the following criteria: Employees with an initial hire date on or after January 1, 2012 may enroll in retiree coverage but will not qualify for a retiree premium subsidy or Exchange HRA contribution. EPO and HMO participants who move outside of their designated plan’s coverage area must select a new medical plan to coincide with their new coverage area within 30 days. Contact PEBP Members Services to notify them and discuss your options. A spouse or domestic partner who is eligible for other employer group coverage is not eligible for coverage as a dependent under this plan. Exceptions may apply if the employer group coverage is determined to be significantly inferior. “Significantly inferior” refers to a plan that offers limited benefits, such as a mini-med plan or a catastrophic plan with a $5,000 or greater individual deductible and the plan is not coupled with an HSA or HRA. Newborn dependent child(ren) will automatically be covered under PEBP from the date of birth to 31 days following the date of birth. To continue coverage beyond the initial coverage period, enrollment must be completed within 60 days of the newborn’s date of birth. If a child (age 26 or younger) is enrolled as a dependent of a PEBP participant and becomes eligible for their own PEBP coverage as a primary participant, the child has the option to remain as a dependent OR enroll on their own as a primary participant. If the child enrolls as a primary participant, they must be removed as a dependent from their parent’s coverage. Employees hired on the first day of the month are eligible for benefits on their date of hire. Employees hired on the second day through the last day of the month are eligible for benefits on the first day of the month following their date of hire. For example, if you were hired on June 1, your benefit eligibility would begin that day. If you were hired on June 2, your benefit eligibility would begin July 1. You will not have to wait until open enrollment to add your spouse/domestic partner. The loss of employer-sponsored group coverage is a qualified family status event. However, you must submit a request within 60-days of the date your spouse/domestic partner’s other coverage ended. A dependent loses coverage event requires a certificate of credible coverage letter with the dependent’s name and date of termination of coverage, and a copy of your certified marriage certificate or certificate of domestic partnership to complete the event. No, PEBP does not require active employees aged 65 or older to enroll in Medicare until they retire. The covered dependents of a deceased active employee who had 10 or more years of service credit may continue coverage by re-joining the program as a survivor within 60 days of the employee’s death.
Unsubsidized Dependents Covered under a PEBP Plan
Unsubsidized Dependents Covered under the Medicare Exchange