Plan Year 2019 Documents and Rates
If you are an active employee or retiree, please log on to your E-PEBP Portal for detailed information including Plan Year 2020 documents, new voluntary product information, to enroll/make changes, or to access your HealthScope or Express Scripts single sign on accounts.
—————————————————————————————————————————-
We encourage you to look over the commonly used health coverage and medical terms before you begin.
Plan Year 2019 Rates
Plan Year 2019 Plan Comparison
Active Employee Plan Documents
Below, you will find Plan Documents and Evidence of Coverage Certificates (EOC) that provide helpful information regarding the terms, conditions, and administration of your benefits. You should review the documents applicable to your plan to help you understand and make the best use of the protection provided to you and your family through the Public Employees' Benefits Program.
Consumer Driven Health Plan (CDHP)
- Master Plan Document for the Consumer Driven Health Plan (CDHP) for Medical, Vision, Prescription Drug, Health Savings Account (HSA), and Health Reimbursement Arrangement (HRA)
- Hometown Health Utilization and Case Management Services and Prior Authorization Form
- Summary of Benefits and Coverage - Individual
- Summary of Benefits and Coverage - Family
- Health and Welfare Benefits Plan Document
- Additional HSA/HRA Contribution FAQ
- Disease Management Programs FAQ
Flexible Spending Accounts
Premier Plan (EPO)
- Master Plan Document for the Premier Plan (EPO) for Medical, Vision, Prescription Drug
- Hometown Health Utilization and Case Management Services and Prior Authorization Form
- Health and Welfare Benefits Plan Document
- Summary of Benefits and Coverage - Individual and Family
Health Plan of Nevada (HMO)
- Evidence of Coverage Certificate (EOC) Document
- HMO - Summary of Benefits and Coverage
- Vision Plan Summary
- Preferred Drug List
- Timely access to care requirements
- Member Guide
Health and Welfare Plan Including the HIPAA Privacy Notice
Enrollment and Eligibility
PPO Dental Plan, Life Insurance and Long Term Disability Insurance
Basic Life, Long Term Disability, Voluntary Life and Short-Term Disability Insurance
Pre-Medicare Retiree Plan Documents
Below, you will find Plan Documents and Evidence of Coverage Certificates (EOC) that provide helpful information regarding the terms, conditions, and administration of your benefits. You should review the documents applicable to your plan to help you understand and make the best use of the protection provided to you and your family through the Public Employees' Benefits Program.
Consumer Driven Health Plan (CDHP)
- Master Plan Document for the Consumer Driven Health Plan (CDHP) for Medical, Vision, Prescription Drug, Health Savings Account (HSA), and Health Reimbursement Arrangement (HRA)
- Hometown Health Utilization and Case Management Services and Prior Authorization Form
- Summary of Benefits and Coverage - Individual
- Summary of Benefits and Coverage - Family
- Health and Welfare Benefits Plan Document
- Additional HSA/HRA Contribution FAQ
- Disease Management Programs FAQ
Premier Plan (EPO)
- Master Plan Document for the Premier Plan (EPO) for Medical, Vision, Prescription Drug
- Hometown Health Utilization and Case Management Services and Prior Authorization Form
- Health and Welfare Benefits Plan Document
- Summary of Benefits and Coverage - Individual and Family
Health Plan of Nevada (HMO)
- Evidence of Coverage Certificate (EOC) Document
- HMO - Summary of Benefits and Coverage
- Vision Plan Summary
- Preferred Drug List
- Timely access to care requirements
- Member Guide
Health and Welfare Plan Including the HIPAA Privacy Notice
Enrollment and Eligibility
- Enrollment and Eligibility Master Plan Document
- Benefit Guide
- Qualifying Life Events
- PEBP and Medicare Guide
PPO Dental Plan, Life Insurance and Long Term Disability Insurance
Basic Life Insurance Certificate for Eligible Retirees
Medicare Retiree Plan Documents
The Public Employees' Benefits Program offers a Voluntary PPO Dental Plan to Medicare retirees enrolled in a medical plan through the Medicare Exchange. Eligible retirees also receive a Health Reimbursement Arrangement (HRA) which may be used to reimburse the retiree for health care premiums, dental premiums, Medicare Part B premiums, and out-of-pocket health care expenses.
Below, you'll find documents that provide further detail on each of your benefit options. You should review the documents applicable to your benefits to help you understand and make the best use of the protection that's provided to you and your family through PEBP.
Retiree Resources
- Benefit Guide
- PEBP and Medicare Guide
- Qualifying Life Events Guide
- Enrollment and Eligibility Master Plan Document
