Eligibility
Employees eligible for health insurance coverage include:
- Academic and Administrative Faculty at least 50% Full Time Employment (FTE).
- Classified Staff (working at least 80 hours per month)
- Post-Doctoral Scholars
- Letter of Appointment at least 50% FTE
- Part Time Instructors (benefit eligibility depends on number of credits teaching per semester)
Coverage for benefit eligible positions begins on the first day of the month concurrent with, or following, the effective date of your date of hire. If your position begins after the first day of the month, your coverage will not begin until the first day of the following month.
Coverage ends the last day of the month in which your employment ends.
Open Enrollment
May 1, 2019 to May 31, 2019 – NSHE Open Enrollment - FSA and Legal Plan
May 20, 2019 to June 7, 2019 – Open Enrollment for PEBP Health Insurance & Voluntary Benefits
PEBP will be conducting an Open Enrollment meeting May 8th, 2019 at the UNLV campus. The meeting will be held in the Student Union Ballroom at 10 a.m. Representatives from Public Employees Benefits Program will be available to answer questions. In addition, PEBP and University vendors will be available immediately following the presentation from 12 p.m. to 3 p.m.
Rates
| PPO - Consumer Driven High Deductible Plan | HMO PLAN Health Plan of Nevada |
|
|---|---|---|
| Employee Only | $31.73 | $142.43 |
| Employee + Spouse | $156.04 | $429.62 |
| Employee + Child(ren) | $82.41 | $284.89 |
| Employee + Family | $206.72 | $572.08 |
Medical
| Benefit Category | PPO - Consumer Driven Health Plan (CDHP) -- PPO | Health Maintenance Organization (HMO) | |
|---|---|---|---|
| Annual Deductible | In Network | Out-of-Network |
No Deductible Note: You must select a primary care physician. |
| These deductibles calculate separately. | |||
|
$1,500 individual $3,000 family ($2,600 individual family member deductible) |
$,1500 individual $3,000 family |
||
| Maximum Out of Pocket |
$3,900 individual $7,800 family $6,850 individual family member out of pocket maximum (per plan year) |
$10,600 individual $21,200 family |
$7,150 per person, per calendar year $14,300 Family (per calendar year) |
| Lifetime Maximum | Unlimited | Unlimited | Unlimited |
| Co-Insurance | 80% | 50% | No Co-insurance |
| Cost for Primary Care Visit |
20% Co-Insurance after deductible has been met (In-Network) 50% Co-Insurance after deductible has been met (Out-of-Network)
|
$25 copayment | |
| Cost for Specialist visit | $25 (with a referral) $45 (without a referral) |
||
| Urgent Care Visit | $30 copayment | ||
| Emergency Room Visit | $300 copayment | ||
| Hospital Inpatient | $500 copayment per admission | ||
| General Laboratory Services | No charge | ||
Pharmacy
| PPO - Consumer Driven High Deductible Plan | HMO PLAN Health Plan of Nevada |
|
|---|---|---|
| Preventive Drug List (New)* | 20% Co-insurance not subject to deductible (In-Network only) | N/A |
| Tier 1 - Preferred Generic |
20% Co-insurance after deductible has been met (In-Network) 50% Co-insurance after deductible has been met (Out-of-Network) |
$7 copayment |
| Tier 2 -Preferred Brand |
20% Co-insurance after deductible has been met (In-Network) 50% Co-insurance after deductible has been met (Out-of-Network) |
$40 copayment |
| Tier 3 - Non-formulary |
20% Co-insurance after deductible has been met (In-Network) 50% Co-insurance after deductible has been met (Out-of-Network) |
$75 copayment |
| Tier 4 - Specialty | N/A | 30% |
Vision
| PPO - Consumer Driven High Deductible Plan | HMO PLAN Health Plan of Nevada |
|
|---|---|---|
| Vision Exam | $25 copayment | $10 copayment every 12 months |
| Eyeglasses, Frames, or Contact Lenses | Not covered | $10 copayment/lenses & frames $100 allowance, contacts in lieu of glasses $115 allowance |
Dental
| CDHP - PPO and HMO | |
|---|---|
| Deductible | $100 individual deductible $300 family deductible |
| Preventive Care |
4 cleanings/plan year |
| Basic Services | Plan pays 80% (In-Network) Plan pays 50% (Out-of-Network) Subject to deductible |
| Major Services | Plan pays 50% (In-Network) Plan pays 50% (Out-of-Network) Subject to deductible |
| Maximum Benefit | $1,500 per participant (per plan year) |
Health Savings Account
Only available when selecting PPO - Consumer Driven Health Plan.
| Health Savings Account | Health Reimbursement Account | |
|---|---|---|
| Description | Owned by employee and portable | PEBP owned and funded |
| Employee Contributions (optional) | Limit $3,500 for individual coverage or $7,000 for family coverage (2 or more), additional $1,000 for catch up for 55 years or older | Not Permitted |
| Base Contribution |
Prorated if hired during plan year. |
|
| Per Dependent (maximum 3) |
Prorated if hired during plan year. |
|
| Supplemental Wellness Contribution (Employee Only) |
$100 for signing up for Doctor on Demand and Healthcare Bluebook |
|
Requirement for Preventive Services $100 Wellness Contribution
- Annual preventive exam
- Annual preventive lab work
- Annual Dental exam
- One dental cleaning
Note: Wellness benefit items must be completed during Plan Year (July 1 to June 30)
Life and Long Term Disability Insurance
| CDHP - PPO and HMO | |
|---|---|
| Basic Life Insurance | $25,000/ Employee |
| Long Term Disability | 60% pre-disability earnings capped at $7500/month |
| Whether you choose the CDHP or the HMO Plan, you receive these benefits. If you decline coverage, you will not be eligible for these benefits. | |