Eligibility
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.
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). Refer to chart for months eligible for health insurance by each semester teaching.
| Term | Month(s) |
|---|---|
| Spring | February - May |
| Summer Term 1 | June |
| Summer Term 2 | July |
| Summer Term 3 | August |
| Fall | September - December |
Monthly Premium Rates
| PPO - Consumer Driven High Deductible Plan | HMO Plan Health Plan of Nevada | |
|---|---|---|
| Employee Only | $30.95 | $137.47 |
| Employee + Spouse | $160.01 | $415.95 |
| Employee + Child(ren) | $82.97 | $275.84 |
| Employee + Family | $212.02 | $554.32 |
Medical Benefits Overview
| 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)
|
$20 copayment | |
| Cost for Specialist visit | $40 copayment | ||
| Urgent Care Visit | $50 copayment | ||
| Emergency Room Visit | $500 copayment | ||
| Hospital Inpatient | $350 copayment (Pre-Authorization Required) |
||
| General Laboratory Services | No charge | ||
Prescription Benefits Overview
| 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) |
$10 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 | 20% coinsurance |
Vision Benefits Overview
| 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 Benefits Overview
| 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 vs Health Reimbursement 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. |
|
Basic Life Insurance 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. | |
Open Enrollment
Annual Benefit Open Enrollment is held May 1-31 for an effective date of July 1 each year. Outside of the Benefit Open Enrollment, if a qualifying life event takes place (birth, adoption, marriage, divorce, or loss of medical coverage) participants are eligible to make changes to their plan within 60 days of the life event.