Getting to Know Your Plan

Appointments are available only on Thursdays. To schedule an appointment please call Member Services at 775-684-7000 or 702-486-3100. Please note that our office is located in Carson City.

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We encourage you to look over the commonly used health coverage and medical terms before you begin.

PLAN YEAR 2023 (July 1, 2022 – June 30, 2023)

To review plan options, dependent eligibility, years of service subsidy and premium cost under the Consumer Driven Health Plan (CDHP PPO), Low Deductible PPO Plan (LD PPO), Premier (EPO) Plan, or Health Plan of Nevada (HMO), view the Benefit Guide.

View the Plan Comparison
View the Rates

View the Qualifying Life Events Guide

Effective July 1, 2022, the Consumer Driven Health Plan (CDHP), Premier Plan (EPO), and Low Deductible PPO (LD PPO) networks (Aetna Signature Administrators) are being replaced with UnitedHealthcare Choice Plus (northern Nevada and out-of-state) and Sierra Health-Care Options (southern Nevada). To find in-network providers for PY23 please visit the Find a Provider tool on PEBPs homepage. PPO and EPO members are encouraged to confirm the network status of provider(s) before receiving health care services beginning July 1, 2022. 

Plan Year 2023 Master Plan Documents

Consumer Driven Health Plan (CDHP-PPO) MPD
Low Deductible (LD-PPO) MPD
Premier Plan (EPO) MPD
Enrollment and Eligibility MPD
Flexible Spending Accounts MPD
Health and Welfare Wrap Plan- Actives
Health and Welfare Wrap Plan - Retirees
Section 125 Health and Welfare Benefits
Medicare Exchange Health Reimbursement Arrangement Summary
Dental Plan and Summary of Benefits for Life Insurance

Health Plan of Nevada (HMO)

Employee Enrollment Booklet
HPN Member Kit
Benefit Schedule
Pharmacy Rx Rider
Drug Benefit Guide
Vision Care Rider
HPN Website - https://www.myhpnstateofnevada.com/

Summary of Benefits and Coverage

Consumer Driven Health Plan - Individual
Consumer Driven Health Plan - Family
PEBP Premier Plan - Individual and Family
Low Deductible Plan - Individual
Low Deductible Plan - Family
Health Plan of Nevada - Individual and Family

Voluntary Products

Please click here to learn more about voluntary benefits and vendor information.
Or view the Voluntary Products FAQs

Express Scripts Price Your Medications

Express Scripts administers pharmacy benefits for the Consumer Driven Health Plan (CDHP PPO), Low Deductible Plan (LD PPO), and Premier Plan (EPO). Just like your medical plan covers visits to your doctor, your Express Scripts prescription plan covers the medication your doctor prescribes. Use the Price Your Medication and Find a Provider Tool.

PY22 CDHP Pharmacy Benefit Summary
PY22 EPO Pharmacy Benefit Summary
PY22 LD PPO Pharmacy Benefit Summary

Via Benefits Medicare Exchange Retirees

Retirees and their eligible spouses/domestic partners enrolled in a medical plan through Via Benefits may newly enroll in or opt-out of their current PEBP dental coverage during open enrollment. To make changes online, log on to your E-PEBP Portal.

View Dental Rates and Monthly HRA Contributions
View PEBP and Medicare Guide

Information for Retiree Late Enrollment

Retiree Late Enrollment is the time when retired state employees and retired employees from a PEBP participating local government (or the surviving spouse or domestic partner of such retirees) can reinstate PEBP retiree coverage one time. To learn about Retiree benefits and eligibility view the Benefit Guide.

PEBP provides a comprehensive benefit package to eligible full-time employees and retirees which includes medical, prescription drug, dental, vision, and basic life insurance. Additional voluntary products are also available to purchase.

Log on to your E-PEBP Portal for additional information on each plan, voluntary product details, or to complete enrollment.

PEBP offers three medical plan options for Northern Nevada and three medical plan options for Southern Nevada. Those residing out of the state of Nevada have two plan options to choose from.

Northern Nevada:

Consumer Driven Health Plan (PPO) with an HSA or HRA
Low-Deductible Plan (LD-PPO)
Premier Plan (EPO)

Southern Nevada:

Consumer Driven Health Plan (PPO) with an HSA or HRA
Low-Deductible Plan (LD-PPO)
Health Plan of Nevada (HMO)

Out-of-State:

Consumer Driven Health Plan (PPO) with an HSA or HRA
Low-Deductible Plan (LD-PPO)

View plan option details here.

Plan Year

Benefits are based on a fiscal year, rather than a calendar year. The plan year starts July 1st and ends June 30th. The benefits you select at initial enrollment will remain in effect through June 30th, unless you experience a qualifying life event that allows you to make changes to your coverage.

New Hire Enrollment

Medical Plan Enrollment

Employees working in a full-time position with a state agency, participating non-state agency, or the Nevada System of Higher Education (NSHE) are eligible for benefits on:

  • The first day of full-time employment or the date of the contract, if that date is the first day of the month; or
  • The first day of the month immediately following the first day of full-time employment or contract date if the first day of employment/contract date is on or after the second day of the month.

Completing Enrollment

As a new benefits-eligible employee you must enroll or decline coverage online through your E-PEBP Portal and upload any required supporting documents (if adding dependents) no later than the last day of the month your coverage is scheduled to become effective.

Default Enrollment

Failure to enroll or decline coverage within the specified timeframe will result in coverage being defaulted to the Consumer Driven Health Plan (CDHP) with a Health Reimbursement Arrangement (HRA) and self-only coverage. Employees enrolled in the CDHP will pay a monthly premium for that coverage.

Voluntary Products

New benefits-eligible employees who wish to participate in any voluntary products may find additional information, including enrollment timeframes, in their E-PEBP Portal.

Open Enrollment

During open enrollment, PEBP participants have the opportunity to make changes to their coverage. Changes that may be made during open enrollment include changing medical plan options, adding or deleting dependents, and declining all benefits. Medicare Exchange retirees may elect or decline PEBP dental benefits.

Open Enrollment is normally held between May 1st - May 31st each year with any changes becoming effective on July 1st.

Supporting Documents - Participants who are adding dependents to their coverage during the open enrollment period must upload any required supporting documents into their E-PEBP Portal (e.g., copy of marriage certificate, birth certificate, etc.) by June 15th.

Qualifying Life Events

Qualifying life events include the birth of a child, marriage, divorce, etc. You must complete an online event through the E-PEBP Portal as well as upload any supporting documents within 60 days of the qualifying life event in order for changes to your coverage to take place.

To view the Qualifying Life Events Quick Reference Guide click here.
For detailed information, view the Enrollment and Eligibility Plan Document.

Enrolling in Retiree Coverage

Once PEBP receives a termination notice from your Agency due to retirement, we will mail you retiree forms you will need to complete in order to continue your health insurance coverage once you retire. You can also access these forms from the Retiring Before and After Age 65 sections of this website. You will need to complete these forms within 60 days after your retirement date. Retirement coverage starts on the first day of the month concurrent with or following your date of retirement. Failure to enroll within 60 days will result in termination of coverage.

Medicare Enrollment

Active employees and their covered dependents are not required to enroll in Medicare Part A or B prior to retirement.

Retirees and their covered dependents who are turning 65 must enroll in premium-free Medicare Part A (if eligible) and purchase Part B coverage. Retirees should contact the Social Security Administration (SSA) 60-90 days prior to their 65th birthday to determine if they qualify for premium-free Medicare Part A coverage.

Retirees with Medicare Parts A and B will be required to enroll in a medical plan through Via Benefits unless they cover a non-Medicare dependent on their plan or have TRICARE for Life.

Portability of Voluntary Life Insurance Coverage

Terminating employees may be eligible to port or convert their voluntary group life insurance under the "Portability and/or Right to Convert" provisions of their Standard life insurance policies. To apply, complete the Group Conversion packet or the Group Life Portability Insurance application within 31 days after your employment terminates. Details regarding these options are available in the policy certificates on The Standard's website. For specific information, contact The Standard at 1-888-288-1270.