OPEN ENROLLMENT SOUTHERN NEVADA - JULY 1, 2020 - JUNE 30, 2021 - Public Employees' Benefits
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OPEN ENROLLMENT SOUTHERN NEVADA PLAN YEAR 2021 775-684-7000 JULY 1, 2020 – JUNE 30, 2021 or 1-800-326-5496 www.pebp.state.nv.us
Today’s Topics What is the Public Employees’ Benefits Program (PEBP)? Overview of Open Enrollment Who is Eligible Enrollment Process Medical Plan Options Dental Plan Express Scripts Contact Information
Public Employees’ Benefits Program Administers PEBP insures healthcare benefits approximately 73,000 for State employees, total lives approved non-state 45,000 Primary Participants agencies and retirees 28,000 Covered Dependents Accessing Information: Overseen by a Board of • E-PEBP Portal Directors appointed • Newsletters through the Governor • Member Services
Plan Year 2021 July 1, 2020 – June 30, 2021 X XX The information in this presentation contains general plan benefits and may not include additional provisions or exclusions. For more in-depth plan benefits, please refer to each Master Plan Document.
Open Enrollment: May 15 – 31, 2020 Complete all changes online through the E-PEBP Portal All changes made during Open Enrollment will be effective July 1, 2020 Participants are NOT required to do Options during Open Enrollment anything if they wish to remain on the • Decline coverage • Change health plan option same plan and coverage tier: • Add or delete dependent(s) • Participant Only • Switch from HRA to HSA or vise versa • Participant + Spouse or DP • Modify HSA Contributions • Participant + Child(ren) • Designate HSA or basic life beneficiaries • Participant + Family • Enroll or decline voluntary benefits
Who is Eligible for Coverage? Legal Spouse or Children/Step Children Disabled Children under Domestic Partner (Birth to Age 26) Dependent Child Legal Guardianship If not eligible for May be covered A child of any age • Children under permanent legal group coverage from birth through with a disability guardianship to age 19 through their own the last day of the incapable of • To continue coverage employer* month the child self-support after 19 (to age 26), the reaches age 26 child must be: o Unmarried o Reside with participant o Full-time student *Significantly Inferior exception may apply o Claimed on tax return
Required Supporting Documents Upload required documents into your E-PEBP Portal by June 15th, 2020 Spouse • Copy of certified marriage certificate • Social Security Number Domestic Partner • Copy of Certified Domestic Partner Certification • Social Security Number Children • Copy of certified birth certificate and SSN and as applicable: o Stepchild: Copy of marriage certificate/domestic partner certificate o Disabled child over age 26: Certification of Disabled Dependent Child and verification child has had continuous health insurance since age 26 o Permanent legal guardianship: Copy of legal guardianship papers signed by a judge
Completing Enrollment You must enroll or decline coverage online
Click Login to get to the E-PEBP Portal www.pebp.state.nv.us
• Review Current Benefits • Complete Qualifying Life Events • Enroll in Voluntary Products
E-PEBP Portal Features Send a Secure Message Elect Beneficiaries Compare Health Plans Upload Documents Enroll in Voluntary Products
Send a Secure Message NAME Due to COVID-19 there has been a reduction in call center staff. To avoid a longer than normal hold time, please send a secure message through your E-PEBP portal or view Open Enrollment information online. Have a question regarding billing, eligibility, password reset, plan benefits, address change or any inquires regarding your PEBP benefits please send a secure message through your E-PEBP portal.
Interactive Guides
Medical Plan Options and Rates
Medical Plan Options Consumer Driven Health Plan Preferred Provider Organization (CDHP-PPO) • Available Nationwide • Comes with a: o Health Savings Account (HSA); or o Health Reimbursement Arrangement (HRA) Health Plan of Nevada Health Maintenance Organization (Southern Nevada HMO) • Available in Clark, Esmeralda, and Nye counties
Medical $25,000 Basic Life Dental Insurance Policy Long-term PEBP Disability Insurance Benefits Vision Package Life Prescription Service Drugs Toolkit Travel Assistance If you decline coverage, you are not eligible for any of these benefits
Monthly Premium Cost Rates Effective Consumer Driven Health Plan of Nevada (HMO) July 1, 2020 – June 30, 2021 Health Plan (PPO) Employee Only $43.94 $171.05 Employee + Spouse/DP $227.16 $517.57 Employee + Child(ren) $117.80 $343.23 *Domestic Partner rates are deducted on a post-tax basis. Employee + Family $301.01 $689.74
Retiree Monthly Premium Cost Retiree Coverage for Use subsidy charts to Employees Initially Hired calculate monthly premium Before January 1, 2010 Retirees initial hire date will Retiree Coverage for Must have at least 15 years Employees Initially Hired On determine January 1, 2010 – of service or retire under a their eligibility long term-disability plan December 31, 2011 for benefits. Retiree Coverage for May participate but will not Employees Initially Hired On be qualify for a subsidy or January 1, 2012 or After Exchange HRA Please view PY21 State and Non-State Retiree rates for unsubsidized rates https://pebp.state.nv.us/wp-content/uploads/2020/04/PY21_All-Rates.pdf
Retiree Monthly Premium Cost Subsidy for Retirees Enrolled in the Rates Effective Consumer Driven Health Plan of CDHP/HMO Plan July 1, 2020 – June 30, 2021 Health Plan (PPO) Nevada (HMO) Years of Service Subsidy 5 +358.61 Retiree Only $233.59 $419.79 6 +322.75 7 +286.89 8 +251.03 Retiree + Spouse/DP $553.84 $994.97 9 +215.17 10 +179.31 11 +143.45 Retiree + Child(ren) $362.66 $705.57 12 +107.58 13 +71.72 14 +35.86 Retiree + Family $682.91 $1,280.76 15 (base) - 16 -35.86 17 -71.72 18 -107.58 19 -143.45 20 -179.31
Plan Design Consumer Driven Health Plan (PPO)
How the CDHP Works Choose from a Health Savings Account (HSA) or Health Reimbursement Arrangement (HRA) Member pays 100% until the Member pays Plan pays deductible* is met 20% until out of 100%* pocket max is met Individual Deductible: $1,500 In Network: *of eligible medical expenses Family Deductible: $3,000 Individual Max OOP: $3,900 Ind. Family Deductible: $2,800 Family Max OOP: $7,800 Out of Network: Individual Max OOP: $10,600 *Medical and Prescription Deductibles are combined Family Max OOP: $21,200
Consumer Driven Health Plan (PPO) PY21 Plan Design Benefits Benefit Category Amount You Pay In-Network $1,500 Individual Deductible $3,000 Family • $2,800 Individual Family Member Deductible $3,900 Individual Annual Out-of-Pocket Maximum $7,800 Family • $6,850 Individual Family Member OOP Max Primary Care Visit Deductible, then 20% coinsurance Affordable Care Act Prevention Services $0 (Covered at 100%) Telemedicine Visit (Doctor on Demand) • Medical Visit $49 copay per medical visit • Behavioral Health (psychologist) $79 copay for 25 minutes or $119 for 50 minutes Specialist Visit Deductible, then 20% coinsurance
Consumer Driven Health Plan (PPO) PY21 Plan Design Benefits Benefit Category Amount You Pay In-Network Urgent Care Visit Emergency Room Visit Hospital Inpatient/Outpatient Deductible, then 20% coinsurance Imaging (CT, MRI, X-rays) General Lab Services Chiropractic/Acupuncture Services $25 copay - max benefit of $95 per annual exam Annual Vision Screening One exam per year Vision Hardware No benefit* (frames, lenses and contacts) *Prescription glasses and contact lenses are qualified health care expenses which may be purchased using HSA and HRA funds, but will not count towards your deductible
Not everyone is eligible If you terminate Optional Health Savings coverage*, the employee money will Account stay with you contributions Tax-free contributions from PEBP There is an Funds grow on annual a tax-deferred maximum basis and remain contribution tax-free limit Funds can be used on tax dependents *Terminating coverage includes leaving the CDHP (by declining coverage or switching plans) or by leaving state service.
HSA Eligibility To be eligible to establish and contribute to an HSA on a pre-tax basis, employees must meet the following criteria: ❑ You are an active employee covered under the Consumer Driven Health Plan (CDHP) ❑ You cannot have other coverage (Medicare, TRICARE, Tribal, HMO, COBRA, etc.) unless the coverage is also an IRS qualified high deductible health plan ❑ You or your spouse cannot be enrolled in a Medical Flexible Spending Account or HRA ❑ You cannot be claimed on someone else's tax return (excludes joint returns) $ $
2020 HSA Contribution Limits • PEBP + Employee contribution limit • Family is defined as two or more covered individuals on your plan • $1,000 Catch-up contribution limit $3,550 $7,100 for employees age 55 or older INDIVIDUAL FAMILY • Funds are regulated by the IRS NOTE: The HSA calendar year is from January to December
For employees who are ineligible for the HSA If you terminate coverage*, the Participant Health money will cannot make Reimbursement revert back to contributions the State Arrangement Tax-free contributions from PEBP Regulated by PEBP owned the IRS. Must and funded keep receipts Funds can be used on tax dependents *Terminating coverage includes leaving the CDHP (by declining coverage or switching plans) or by leaving state service
HSA/HRA Contributions Base Contribution One-Time Additional State/Non-State participant Effective July 1, 2020 Contributions No additional one-time HSA/HRA Participant Only Tier $700 contributions have been approved for this plan year Per Dependent $200 N/A (maximum 3 dependents)
Hand-picked doctors Some of the conditions that from top medical can be treated: schools with 15 years average experience. • Cold & Flu • Asthma & Allergies • Bronchitis & Sinus Issues • Rashes & Skin Issues • Eye Issues 18/20 ER cases can be Medical Visit treated using Doctor $49 copay on Demand. Behavioral Visit $79 copay for 25 minutes Prescriptions* sent $119 for 50 minutes directly to your pharmacy of choice. *Excluding narcotics
• Compares quality and costs of medical services • Provides incentives for selecting high quality low cost in-network providers • App available on smartphone, tablet, or computer • Call customer service for questions or to register Available on both the CDHP and EPO! 1-800-341-0504 Company Code: PEBP
PEBP Dental Plan All PPO and HMO Participants
PEBP Dental Plan PPO and HMO Participants In-Network Out-of-Network** Plan Year Maximum Benefit $1,500 $1,500 Plan Year Deductible $100 per person or $100 per person or (applies to basic and major services only) $300 per family (3 or more) $300 per family (3 or more) Preventive Services* • Covered 100% • Covered at 80% Teeth cleaning (4/plan year) • Not subject to deductible • Not subject to deductible Oral examination (2/plan year) Bitewing X-rays (2/plan year) • Does not apply towards plan • Does not apply towards plan year max benefit year max benefit Basic Services* You pay 20% coinsurance You pay 50% coinsurance Full-mouth periodontal cleanings, fillings, after deductible is met after deductible is met extractions, root canals, full-mouth X-rays Major Services* You pay 50% coinsurance You pay 50% coinsurance Bridges, crowns dentures, tooth implants after deductible is met after deductible is met *Allowable fee schedule applies **For services outside of Nevada, the plan will reimburse at the U&C rates
Nevada Public Employees’ Benefits Program Plan Year: July, 2020 – June, 2021 Prescription Drug Program 34 © 2020 Express Scripts Holding Company. All Rights Reserved.
About Express Scripts • Express Scripts is Nevada Public Employees’ chosen partner for administering your prescription plan • We are a leading pharmacy benefit manager that puts medicine in reach for tens of millions of people • As an Express Scripts member, you have access to: • 60k+ retail pharmacies located across the United States • Convenient home delivery services • Express-Scripts.com and our mobile app for ordering and managing your prescriptions • Accredo specialty pharmacy for medications that treat complex and chronic health conditions • Specialized pharmacists, nurses and other clinicians in 20+ condition-specific Therapeutic Resource Centers 35 © 2020 Express Scripts Holding Company. All Rights Reserved.
Prescription Drug Plans Your prescription drug benefit is based upon the core benefit package selected: 1. Consumer Driven Health Plan (CDHP) 36 © 2020 Express Scripts Holding Company. All Rights Reserved.
Your Plan’s Drug Coverage Your plan covers a broad range of medications that fall into three categories • Generic medications (Tier 1) May cost you less than plan-preferred medications • Plan-preferred medications (Tier 2) A broad list that includes more than 1,800 brand-name drugs • Non-preferred medications (Tier 3) Brand-name drugs that are not included on the plan-preferred list (CDHP participants will pay 100% of the preferred contracted rate for these drugs.) Your plan encourages you to choose plan-preferred generic and brand medications. 37 © 2020 Express Scripts Holding Company. All Rights Reserved.
Consumer Driven Health Plan (CDHP) Your plan’s drug coverage 38 © 2020 Express Scripts Holding Company. All Rights Reserved.
CDHP Participating Express Scripts Home Delivery Prescription Costs retail pharmacies Retail (30 or 90-day supply)* Mail Order (90-day supply) Deductible Individual (self-only coverage): $1,500 (medical and pharmacy Individual (family coverage): $2,800 combined) Family: $3,000 Out-of-Pocket Maximum Individual (self-only coverage): $3,900 (medical and pharmacy Individual (family coverage): $6,850 combined) Family: $7,800 Preferred Generic & Brand 20% coinsurance 20% coinsurance Preventive Maintenance 20% (bypass deductible) 20% (bypass deductible) Non-Preferred Generic & Brand 100% coinsurance *90-Day Retail Program on maintenance medications at participating retail pharmacies *Specialty drugs are only available through Accredo Specialty Pharmacy (30-day supply) *Prescription drugs purchased out-of-network are not covered 39 © 2020 Express Scripts Holding Company. All Rights Reserved.
CDHP Retail 90-day supply “Smart90 Network” • Your benefit requires all long-term (maintenance) medications to be filled for a 90-day supply through either home delivery via the Express Scripts Pharmacy or from a participating “Smart90” retail pharmacy • To locate the nearest participating retail pharmacy: • Prior to July 1: Visit www.express- scripts.com/NVPEBP • Starting July 1: Log in or register at www.express-scripts.com/90day select “Prescriptions”, and click “Find a Pharmacy” 40 © 2020 Express Scripts Holding Company. All Rights Reserved.
90-Day Retail Benefit “Find a Pharmacy” on Express-Scripts.com 41 © 2020 Express Scripts Holding Company. All Rights Reserved.
CDHP Preventive Medication Benefit • In addition to eligible medications covered under the plan’s wellness benefit (at $0 member cost in accordance with the Affordable Care Act), your plan is offering a number of additional preventive medications for just a coinsurance payment • 20% coinsurance, bypass plan deductible • Excluded: Brand drugs with generic equivalents, diabetes medications • Example: Asthma/COPD, Diuretics, High Blood Pressure, Cholesterol Lowering • To locate a list of commonly prescribed preventive medications: • Prior to July 1: Visit www.express-scripts.com/NVPEBP • Starting July 1: Log in at www.express-scripts.com (link located on bottom of home page under “Benefit and account notifications”) or visit PEBP’s website at www.pebp.state.nv.us 42 © 2020 Express Scripts Holding Company. All Rights Reserved.
CDHP Disease Management • Members can enroll in the Diabetes Care Management and/or Obesity and Overweight Care Management program by contacting PEBP’s claims administrator listed in the Participant Contact Guide • Plan preferred medications follow program-specific copayment structure • Not subject to the plan year deductible. Applies to the annual out-of-pocket maximum. • Express Scripts home delivery pharmacy or participating retail pharmacies • Retail fills greater than 30-day supply will charge 3x program 30-day supply copayment • Diabetic Supplies (ex: test strips, syringes, alcohol pads, lancets) • Mail order service through Express Scripts pharmacy only (up to 90-day supply) • $50 maximum copay applies to each diabetic supply item. If cost is less than $50, patient will pay the cost of the supply. • Diabetes Participants are eligible for one blood glucose monitor/meter per year at $0 copayment. Insulin pump supplies only covered under medical plan. 43 © 2020 Express Scripts Holding Company. All Rights Reserved.
Making the Best Use of Your Benefit 44 © 2020 Express Scripts Holding Company. All Rights Reserved.
Accredo Specialty Pharmacy • Specialty medications are infused, injectable or oral medications which: • Are used to treat chronic and life-threatening conditions • Are difficult to administer • May cause adverse reactions • Require temperature control or other special handling • These medications must be filled through Accredo Specialty pharmacy • 30-day supply • Contact Express Scripts members’ services for more information or to connect with a pharmacist 45 © 2020 Express Scripts Holding Company. All Rights Reserved.
Your Plan’s Prescription Drug Coverage • Your plan covers a broad range of medications. Some medications may not be covered by your plan unless you receive approval through a coverage review (prior authorization) • This review helps ensure a particular drug is being prescribed appropriately and in accordance with your plan’s coverage • The review uses plan rules that are based on FDA-approved prescribing and safety information, clinical guidelines, and uses that are considered reasonable, safe, and effective • Some covered medications may also have limits (for example, only for a certain amount or for certain uses) unless you receive approval through a review To learn more about your plan’s drug coverage, log on to Express-Scripts.com or call Member Services 46 © 2020 Express Scripts Holding Company. All Rights Reserved.
Using Your Member ID Card at a Participating Retail Pharmacy • Access to more than 60,000 pharmacies nationwide • A retail pharmacy is a perfect choice for medications to treat an acute or temporary condition, such as antibiotics for an infection • 90-Day Retail Program also available to receive maintenance medications at select retail pharmacies • To locate a participating retail pharmacy • NEW MEMBERS (prior to July 1): Select “Locate a Pharmacy” under your plan option at www.express-scripts.com/NVPEBP • CURRENT MEMBERS: Log in to Express-Scripts.com, select “Prescriptions” and click “Find a Pharmacy” • Or call Express Scripts Member Services (24 hours a day, 7 days a week) 47 © 2020 Express Scripts Holding Company. All Rights Reserved.
Using Home Delivery Services from the Express Scripts PharmacySM • A convenient and safe way to have certain medications delivered right to you • The perfect choice for medications you take on an ongoing basis, such as those used to treat • Asthma • High cholesterol • Diabetes • To learn more about how to use Home Delivery Services from the Express Scripts PharmacySM • Go to www.express-scripts.com • Review your Welcome Package • Call Express Scripts Member Services 24 hours a day, 7 days a week 48 © 2020 Express Scripts Holding Company. All Rights Reserved.
Getting Started With Home Delivery From the Express Scripts Pharmacy Ask your doctor to write up to a 90-day prescription, with refills for up to one year as appropriate • Option 1: Ask your doctor to send your prescription to Express Scripts via electronic-prescribing or fax • Prescriptions are processed and delivered within 5 to 8 calendar days (after receipt of your prescription) • Option 2: Mail in your prescription • Print a mail-order form • Mail prescription and completed order form to the Express Scripts Pharmacy • First-time orders will usually be delivered within 8 to 11 calendar days after we receive your order Tip Mail-order forms can be printed from www.express-scripts.com 49 © 2020 Express Scripts Holding Company. All Rights Reserved.
Have a Question About a Medication? Ask a pharmacist You can contact one of Each Specialist our pharmacists for Pharmacist has had You can contact general counseling — or specialized training in the a Specialist Pharmacist a Specialist Pharmacist medications used to treat 24/7 to ask for complex concerns. a specific condition, questions about: such as: ▪ High cholesterol ▪ Drug interactions ▪ High blood pressure ▪ Side effects ▪ Depression ▪ Risks and benefits of ▪ Diabetes your medication ▪ Asthma ▪ The challenges of ▪ Osteoporosis taking your medication ▪ Cancer as prescribed — one of the best ways to help To reach a pharmacist, call the Express Scripts maintain or improve Member Services number on your ID card your health 50 © 2020 Express Scripts Holding Company. All Rights Reserved.
Helpful Tools Available to You 51 © 2020 Express Scripts Holding Company. All Rights Reserved.
Open Enrollment Website www.express-scripts.com/NVPEBP 52 © 2020 Express Scripts Holding Company. All Rights Reserved.
Open Enrollment Website www.express-scripts.com/NVPEBP • Access your Benefits Overview • Review a listing of the most commonly prescribed drugs, representing an abbreviated version of your plan’s preferred drug list (formulary) • Price a Medication to receive an approximate cost under your plan selection • CDHP participants may choose to view copayment results “before” or “after” plan deductible is satisfied • Locate a participating retail pharmacy If you have questions about your prescription plan while using this website, call Member Services at 855.889.7708 53 © 2020 Express Scripts Holding Company. All Rights Reserved.
Manage Your Prescriptions at Express-Scripts.com • Review your plan benefits and coverage • Look up drug information • Learn about opportunities to save • Order refills • Check on shipments • Review your prescription history • Look up health and wellness information •. Locate retail pharmacies in your network At Express-Scripts.com you can log in and complete the one-time registration. You are then routed to the member website for a personalized, plan-specific experience 54 © 2020 Express Scripts Holding Company. All Rights Reserved.
Member Website Homepage • Provides a one-stop shopping experience • Services patients can expect: • Order status with tracking • Refilling a prescription • Enrolling in automatic refills • Visibility to home delivery savings • Transferring a prescription to home delivery • Navigating to anywhere in the site 55 © 2020 Express Scripts Holding Company. All Rights Reserved.
Price a Medication • Compare home delivery and retail pharmacy costs • Compare with a generic equivalent, if available • View coverage notes and formulary alternatives • View coverage alerts, if applicable. • Members whose plans have accumulators including CDH plans can add drugs to a list for “market basket” pricing 56 © 2020 Express Scripts Holding Company. All Rights Reserved.
Mobile App • Convenience & simplicity • Quick access to popular actions and easy access to the full menu © 2019 Express Scripts. All Rights Reserved. 57 © 2020 Express Scripts Holding Company. All Rights Reserved.
We’re Here to Help Answer Your Questions and Address Your Concerns • New Members- visit the Express Scripts Open Enrollment Website • www.express-scripts.com/NVPEBP • Current Members- visit Express-Scripts.com • Information you will need to complete registration can be found on your Member ID card • Call the Member Services number at 855-889-7708 • Member services is available 24/7 58 © 2020 Express Scripts Holding Company. All Rights Reserved.
Thank you 59 © 2016 Express Scripts Holding Company. All Rights Reserved.
Health Plan of Nevada (HPN) HMO Benefit Overview for Southern Nevada PEBP Participants Plan Year 2021 (July 1, 2020 – June 30, 2021)
Medical and Vision Snapshot 61
Medical Benefit Snapshot Service HPN HMO Plan Primary Care Provider Visit $20 Specialist Visit $25 (with a referral) $40 (without a referral) Urgent Care Visit $30 NowClinic® Virtual Visit $0 Emergency Room Visit $500 per visit waived if admitted Hospital Admission $500 per admission Outpatient Hospital Facility Services $50 per surgery Diagnostic X-ray and Lab $0 Pharmacy Tiers 1-4 $10/$40/$75/20% Form Nos. 17H_KN_SOL_HMO_5_SON, 17H_KN_SOL_HMO_25_DA_SON, 17H_KA_4T_RX74075_40SP_2_5X, 17H_KA_4T_RX255075_40SP_2_5X. These Plans include additional benefits, exclusions and limitations which are shown in the Health Plan of Nevada Evidence of Coverage, Attachment A Benefit Schedule, any other applicable Riders and the Summary of Benefits and Coverage. Copies of these documents are available upon request. Plan documents govern in resolving any benefit questions or payments. Proprietary information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Medical Student and Travel Coverage Care While at School or Traveling: Student Coverage is available for eligible dependents enrolled in an accredited college, university or vocational school anywhere in the United States. Travel coverage is available for members and their dependents for certain covered services while traveling for business or pleasure in the United States. Proprietary information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Vision Benefit Snapshot Vision Plan Plan Benefits Examination $10 (one during 12 consecutive months) Lenses $10 (one pair during 12 consecutive months) Frames $100 (one pair during any 24 consecutive months) maximum allowance Medically Necessary Contact Lenses $250 (one pair during any 12 consecutive months, in maximum allowance lieu of lenses and frames) Elective Contact Lenses $115 (one pair during any 12 consecutive months, in maximum allowance lieu of lenses and frames) Proprietary information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Service Highlights Resources, Programs and Updates 65
Member ID Card Type of plan Member Services Member ID 24-Hour and Group Advice Number Nurse Outside Copay benefits What’s Important! Copays and costs on the front of the ID card -- have it on you at all times! Symptoms, Questions About Care, Help 24/7 - Call 24 hour advice nurse Benefits and Claims Questions – Call Member Services Proprietary information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
24/7 Advice Nurse The Advice Nurse team is available 24/7. Day or night, peace of mind is a phone call away. This team is available to help you decide the best place to seek medical care based on your symptoms. Those options may Call (800) 288-2264 include: (This number is listed on the back of your ID card) Virtual Visits Urgent Care Emergency room Schedule future Advice on how appointments to treat your with your symptoms at provider home Proprietary information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Real Appeal Follow simple steps to help you transform and get the tools you need to make it happen. Real Appeal® is an online weight loss program customized to what works for you. Enroll at myhpnstateofnevada.com/Real-Appeal Get your free success kit with food and weight scales, recipes, workout DVDs and more – shipped to your door Schedule weekly online group sessions with your transformation coach. Download the Real Appeal app and track your progress. Proprietary information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
NowClinic® Virtual Visits See a provider online. Anytime, from anywhere. Go to NowClinic.com or get the NowClinic® app and sign up Choose a provider. The average wait time is 5 – 7 minutes. Get care! Virtual visits are good for... ▪ Allergies ▪ Pink eye ▪ Bladder infection ▪ Sinus infections ▪ Bronchitis ▪ Viral illnesses Behavioral health therapy is available by appointment only. Call Behavioral Healthcare Options at 702-364-1484 or toll-free 1-800-873-2246, TTY 711, to arrange a convenient time. NowClinic providers do not replace your primary care physician. The services are not covered by Medicare and may not be covered by your private health plan or Medicaid, so check with them prior to using the services. If not covered, the consumer is responsible for paying the fees at the time of service. If covered, Proprietary copays andof information deductibles may apply. UnitedHealth NowClinic Group. Do notproviders do not distribute orprescribe reproduce controlled substances without expressand reserve theof permission right to refuse to prescribe UnitedHealth Group.other drugs that are restricted by state law or may be harmful or non-therapeutic. Providers may also decline an individual as a patient if the medical problem presented is not appropriate for NowClinic care or for misuse of services. All trademarks are the property of their respective owners.
HPN Provider Network Highlights and updates 70
Southwest Medical Over 450+ providers that deliver care across southern Nevada and growing in 45 locations – 6 new primary care locations added in 2019! Innovative On 2 Ambulatory 17 Specialty State of the Art Demand Care Surgery Centers Departments Cancer Center 6 urgent care Surgery services Allergy, Endocrinology, 55,000 square foot locations - one is 24- include: Hospice, Orthopedics, Cancer Center hour with a close Gastroenterology, Pharmacy and Home located in Las observation unit and Cardiology, Pain Medical Equip, Vegas Medical infusion center Management, Rheumatology, Breast District with 7 Orthopedics, Care, satellite locations 7 convenient care Podiatry, General Gastroenterology, locations Neurology, Pain Surgery, Dental Management, Podiatry, Surgery, Ear, Nose Urology, Cardiology, NowClinic and Throat, General Home Health, Telemedicine virtual Eye, Gynecology, Oncology, Palliative visits E-visit etc. Care, Pulmonology. Proprietary information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Network/Plan Highlights HCA Healthcare Sunrise Health System facilities added to HPN network effective 1/1/2020: • 17 CareNow urgent care facilities • Sunrise Hospital and Medical Center, Sunrise Children’s Hospital, MountainView Hospital, and Southern Hills Hospital and Medical Center • Four surgery centers On-demand healthcare at home -- Dispatch Health available to HPN members New HPN App available – Search for MyHPN in your app store Proprietary information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Dispatch Health Leaving the hospital can be overwhelming. We collaborate with DispatchHealth to provide in-home medical services. A DispatchHealth medical team will visit you in your home to: ▪ Check symptoms and make sure you are feeling better. ▪ Review and clarify the medications you’re taking, and prescribe or refill medications if needed. ▪ Answer questions and keep you informed about your medical condition. ▪ Provide advanced treatment in the home if required (IV fluids, lab tests, sutures, and much more). Call the 24/7 advice nurse at Available 7 days a week 8 702-242-7330, to set up your a.m. – 10 p.m. DispatchHealth appointment. Proprietary information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
HPN App Easily manage your health plan information on the go. Search for MyHPN in your app store and download the app. Sign in with your Optum ID. First-time users will need to create an account. Save your password with Touch ID or Face ID, if desired. Use the MyHPN app to: • Find out who is on record as your primary care provider (PCP). • Talk with an advice nurse. Available 24/7. • Video chat with a provider 24/7. No appointment needed. • Search for a doctor, specialist, facility or lab. • View, download and email your health plan ID card. • Save your health plan ID card to your Apple Wallet™. • See your copay, deductible, and out-of-pocket expenses, if applicable. • Check the status of a claim, prior authorization or referral. • Access your health records.* • Update your contact information and address. • Select communication preferences. Proprietary information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Health Education and Wellness We’ve got you covered. Our Health Education and Disease Management teams provide support and resources to help you stay well. Nutrition Fitness and exercise Weight loss Diabetes Asthma Stop smoking Classroom education Online education Telephonic education Registered nurses Registered dietitians 1:1 consultations Proprietary information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Questions? Questions? Telephone Number: 1-877-545-7378, TYY 711 Website: www.myhpnstateofnevada.com Proprietary information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Voluntary Benefits Visit https://pebp.state.nv.us/voluntary-benefits/ for more information
Voluntary Benefits Visit https://pebp.state.nv.us/voluntary-benefits/ for more information
Voluntary Benefits Visit https://pebp.state.nv.us/voluntary-benefits/ for more information
Voluntary Benefits Visit https://pebp.state.nv.us/voluntary-benefits/ for more information
Voluntary Benefits Visit https://pebp.state.nv.us/voluntary-benefits/ for more information
Voluntary Benefits Visit https://pebp.state.nv.us/voluntary-benefits/ for more information
Dates and Deadlines Plan Year 2021 Deadline to Upload Open Enrollment Supporting Documents May 15th - May 31st June 15, 2020 ⏳ Deadline to Changes Complete Changes Become Effective May 31st July 1, 2020 This presentation is available on the Open Enrollment section of the PEBP website
Questions? Nicole Pluta, Education and Information Officer Amy Vanderlinden, Communications Specialist84
Public Employees’ Benefits Program 901 S. Stewart St. Suite 1001 Carson City, NV 89701 www.pebp.state.nv.us memberservices@peb.nv.gov 775-684-7000 or 1-800-326-5496 Log on to your E-PEBP Portal to contact us! Thank You FOR JOINING US!
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