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May 2, 2007
Open Enrollment is your one chance during the plan year to make changes to your Health Insurance Plan offered by the State of Nevada Public Employees' Benefits Program (PEBP). The Open Enrollment period is May 1 through May 31 and changes you make will become effective July 1.
All benefits eligible employees should receive a PEBP Open Enrollment Packet in the U.S. Mail If you have not received an Open Enrollment Packet by Monday May 7, you should call PEBP at (775) 684-7000 or (800) 326-5496 and request that they send you a replacement.
Alternatively, you can access an electronic copy of the Employee Open Enrollment Guide, by going to the HR Benefits Site.
During Open Enrollment you may make the following changes to your Health Insurance:
You may elect to enroll yourself and your eligible dependents in one of the health plans offered; AND/OR
You may add or delete eligible dependents to your health insurance coverage; AND/OR
You may change medical plan options.
INFORMATION AFFECTING ALL EMPLOYEES FOR PLAN YEAR 2008
Health Assessment Questionnaire (HAQ).
All employees should consider completing the HAQ , those that do will receive the following incentives:
PPO Members (High & Low Deductible) The annual deductible will be reduced by 50 percent if a Health Assessment is completed by you and your covered spouse by May 31.
Self-funded PPO Dental Plan maximum benefit increases to $2,000 for each covered person. This increased dental benefit applies to all enrolled employees in the self funded PPO plan or in Anthem HMO or Health Plan of Nevada since this is the only dental plan available to all participants.
THE HEALTH ASSESSMENT QUESTIONNAIRE (HAQ) MUST BE COMPLETED BY MAY 31, 2007 IN ORDER TO RECEIVE THE INCENTIVES LISTED ABOVE.
For instructions on completing the Health Assessment Questionnaire refer to page 13 of the Employee Open Enrollment Guide, or at HR Benefits Site .
Note: Participants 75 years and older are not required to complete the Health Assessment to receive the reduced deductible and in-network dental maximum.
Premium Holiday for July 2007. Due to lower than expected claims costs last year, the premium for all participants will be waived for the month of July. The new premiums for Plan Year 2008 will take effect in the month of August.
Rates have changed for Plan Year 2008. Please refer to the Employee Open Enrollment Guide for the new rates for your tier. These new rates will take effect August, 2007.
CHANGES TO THE SELF-FUNDED PPO DENTAL PLAN FOR PLAN YEAR 2008
Effective July 1, eligible dental services provided by out-of-network dental providers will be paid using the same cost percentile as in-network dental providers, subject to the Usual, Customary and Reasonable provision. This change will only affect those who choose to use out-of-network providers.
CHANGES TO THE SELF FUNDED MEDICAL PPO PLAN FOR 2008
No Annual Deductible for Generic Drugs.
Beginning July 1, 2007 the plan year $50 prescription deductible will be waived for all generic drugs. The deductible waiver is being introduced to encourage participants to utilize generic drugs.
Benefit for Specific Over-the-Counter Drugs.
Drugs available at your local pharmacy can be divided into two categories: Those that require written prescriptions from your doctor to purchase, and those that can be purchased right off the shelf. Medicines you buy off the shelf are called over-the-counter (OTC) drugs.
For Plan Year 2008, the PPO prescription drug program will provide a benefit for two OTC drugs. In order to receive the benefit, a physician's prescription and your PPO medical ID card must be presented to the pharmacist. The OTC copay will be $5 and is not subject to the $50 plan year prescription deductible. At this time, the OTC benefit applies ONLY to the following drugs:
Limited Genetic Testing. The Self-funded PPO Plan will include limited and very specific types of genetic testing. You should refer to the Master Plan Document for more information.
Coordination of Benefits.
PEBP has changed the way they will coordinate benefits when the Self-funded PPO is not the primary insurance plan. The new method, effective July 1, 2008, is the Standard Coordination of Benefits.
This would apply if a participant is covered under a separate, primary insurance plan. Under this method, PEBP coordinates benefits after the primary insurer has considered their portion of the claim. The combined amount paid by all plans will never exceed the total allowable charges.
For more information on the above highlights and to view the 2008 contribution rates, please refer to the Employee Open Enrollment Guide .
PEBP OPEN ENROLLMENT MEETINGS
Public Employees' Benefits Program (PEBP) will be conducting an open enrollment meeting at the Reno campus on Monday, May 21 at 3 p.m. in the JTSU Alumni Room.
PEBP staff will be on hand to explain plan changes effective July 1. There will be an opportunity to ask questions at the presentation. Plan to arrive early to visit the PEBP vendors and secure a seat for the meeting. This meeting is for active employees of NSHE only.
PEBP will also be conducting an open enrollment meeting at TMCC on Monday May 14 at 12:30 p.m. for retirees and 3 p.m. for active employees, in the Sierra Building, Room 108.
Note: The Governor's Office has approved two hours of release time for state employees to attend an Open Enrollment Meeting.