FY2012 Premium Changes

The Public Employees Benefits Program (PEBP) Board met Thursday, February 24, for their regular Board meeting. The PEBP Board approved rate structure option B (comparisons shown below) and restored Long Term Disability Benefits to 60% from 40%.

OPEN ENROLLMENT

  • Open Enrollment will BEGIN on April 1 and END on May 31.
  • There will be two OPEN ENROLLMENT MEETINGS at NSC on Thursday, April 14, 2011 in the Great Hall in Dawson.
    • Meetings will be two hours long.
    • The first will be at 9:00 AM.
    • The second will be at 1:00 PM.
    • Vendors will be on site with information.
  • During Open Enrollment you will be able to .... add dependents, drop dependents, change from the HMO to PPO, change from the PPO to HMO, or decline coverage.
  • Everyone will be required to complete an Open Enrollment form regardless of whether or not you plan to make a change.
  • Information about Open Enrollment will be sent to directly to participants home addresses by the end March.
  • PEBP will be conducting Open Enrollment meetings in Carson City, Reno, and Las Vegas sometime in April. Human Resources will send out information regarding dates, times, and locations of these meetings as soon as they are available.
  • Participants planning on enrolling in the PPO Consumer Driven Health Plan will need to enroll in the Health Saving Account Plan in order to receive the seed money from PEBP. Additional information regarding the Health Savings Account will be available on PEBP's website sometime in early April.
  • Participants planning on enrolling in the HMO plan and wish to contribute pre-tax dollars into a Flexible Spending Account (FSA) plan will be eligible to do so during the NSHE's FSA Open Enrollment period which begins May 1.
  • One of NSHE's vendors, Western Insurance Services, will have a Guarantee Issue offering for the Supplemental Life Insurance product in September for those interested in purchasing additional term life insurance.

The information below includes a summary of the benefits available under each plan:

State Active Employee RATES:


Statewide Self-Funded PPO - Consumer Driven High Deductible Health Plan

Net Changes from PY11 to PY12

State Active Employees PY11 Premium PY12 Premium Net Change to Premium
Employee Only $43.73 $43.90 $0.17
Employee + Spouse $278.84 $198.40 ($80.44)
Employee + Child(ren) $81.53 $91.71 $10.18
Employee + Family $195.14 $246.23 $51.09

Statewide HMO - Hometown Health & HPN
Net Changes from PY11 to PY12

State Active Employees (South) PY11 Premium PY12 Premium Net Change to Premium
Employee Only $54.81 $116.57 $61.76
Employee + Spouse $172.52 $338.16 $165.64
Employee + Child(ren) $138.26 $225.25 $86.99
Employee + Family $255.07 $446.84 $191.77

  • Domestic Partner coverage will continue to be available, but the domestic partner's premiums will not be subsidized. Domestic Partner rates can be found in the PEBP Board Packet Appendix B page 3. A summary of the rate changes for Domestic Partners is below.

Domestic Partner RATES:


Statewide Self-Funded PPO - Consumer Driven High Deductible Health Plan
Net Changes from PY11 to PY12

State Active Employees
Domestic Partners
PY11 Premium PY11 Pre Tax Deduction PY11 Post Tax Deduction PY12 Premium PY12 Pre Tax Deduction PY12 Post Tax Deduction Net Change Premium Net Change Pre Tax Deduction Net Change Post Tax Deduction
Employee + DP $921.43 $43.73 $877.70 $611.91 $43.90 $568.01 ($309.52) $0.17 ($309.69)
Employee + DP's Child(ren) $184.84 $43.73 $141.11 $219.67 $43.90 $175.77 $34.83 $0.17 $34.66
Employee + Children of both $81.53 $81.53 0 $91.71 $91.71 0 $10.18 $10.18 0
Employee + DP + EE's Child(ren) $505.68 $81.53 $424.15 $659.81 $91.71 $568.10 $154.13 $10.18 $143.95
Employee + DP + DP's Child(ren) $608.99 $43.73 $565.26 $787.77 $43.90 $743.87 $178.78 $0.17 $178.61
Employee + DP + Children of both $505.68 $81.53 $424.15 $659.81 $91.71 $568.10 $154.13 $10.18 $143.95

Statewide HMO - Hometown Health & HPN
Net Changes from PY11 to PY12

State Active Employees (South) Domestic Partners PY11 Premium PY11 Pre Tax Deduction PY11 Post Tax Deduction PY12 Premium PY12 Pre Tax Deduction PY12 Post Tax Deduction Net Change Premium Net Change Pre Tax Deduction Net Change Post Tax Deduction
Employee + DP $411.50 $54.81 $356.69 $641.67 $116.57 $525.10 $230.17 $61.76 $168.41
Employee + DP's Child(ren) $307.68 $51.81 $255.87 $374.10 $116.57 $257.53 $66.42 $64.76 $1.66
Employee + Children of both $138.26 $138.26 0 $225.25 $225.25 0 $86.99 $86.99 0
Employee + DP + EE's Child(ren) $492.24 $138.26 $353.98 $750.35 $225.25 $525.10 $258.11 $86.99 $171.12
Employee + DP + DP's Child(ren) $661.66 $54.81 $606.85 $899.20 $116.57 $782.63 $237.54 $61.76 $175.78
Employee + DP + Children of both $492.24 $138.26 $353.98 $750.35 $225.25 $525.10 $258.11 $86.99 $171.12

PPO CONSUMER DRIVEN HEALTH PLAN:

  • $1900 individual deductible. If covering dependents, $3800 family deductible.
  • Employees must pay first dollar of every claim until they've met their deductible.
  • Prescriptions are now subject to the medical deductible.
  • Once the deductible is met, the plan covers 75%.
  • PEBP will establish a Health Savings Account for participants. Participants can use these funds to cover their out-of-pocket costs. Participants may opt to put in additional monies into this account on a tax deferred basis. PEBP will provide seed money into these accounts:
    • $700 for the participant.
    • $200 for each dependent.
    • Maximum for the family - $1300.
  • Maximum out of pocket cost of $3900 for individual coverage and $7800 if covering dependents.
  • Preventive care is still covered a 100%.
  • If you are participating the Live Well Be Well Prevention plan, you are eligible for a premium reduction based on your intervention score. Your intervention score as of May 31,2011 will determine the premium reduction.
    • Intervention score between 0 to 126 will result in $0.00 premium reduction.
    • Intervention score between 126 and 250 will result in $10.00 monthly premium reduction.
    • Intervention score between 251 and 375 will result in a $20.00 monthly premium reduction.
    • Intervention score between 376 and 500 will result in a $30 monthly premium reduction.
  • Annual vision exams are covered at 80%.

HMO PLAN:

  • No annual deductible.
  • Preventive care is covered at 100% and not subject to co-pays.
  • Participants will be responsible for co-pays for physician visits (range between $15 to $25).
  • Participants will be responsible for co-pays (range between $7 to $55).
  • Participants pay a co-pay for annual vision exams.
  • Lenses and frames are covered and subject to a co-pay.

DENTAL PLAN:

  • Regardless of whether you choose the PPO Consumer Driven Health Plan or the HMO, your dental benefits are still managed through PEBP.
  • Dental Benefits include:
    • A deductible of $100 for individual coverage and $300 for family.
    • Up to 4 cleanings per year.
    • Maximum dental benefit of $1000 per individual.
    • Basic Services are covered at 75%.
    • Major Services are covered at 50%.

OTHER BENEFITS:

  • If you elect coverage through PEBP, either in the PPO Consumer Driven Health Plan or the HMO, you will receive these benefits. If you decline coverage, you will not be eligible for these benefits:
    • Basic Life Insurance of $10,000 for the participant.
    • Long Term Disability that covers up to 60% of the participant's salary to a maximum monthly benefit of $7,500, if you are unable to work for more than 180 days.

If you have questions regarding the changes to the health insurance plans, please contact the Office if Human Resources at 992-2320.

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