Tuesday, February 07, 2012

Health Benefits

Medical / Dental / Vision / Pharmacy / Basic Life Insurance

Medical, dental, and vision insurance is available for a nominal fee through the State of Nevada's Health Plan. The health plan is administered by the Public Employees Benefits Program (PEBP).

Employees may choose between 2 medical options:

Consumer Driven High Deductible PPO Plan ($1,900 individual or $3,800 family)
HMO Plan

The following people are eligible to Participate in the State's Health Plan:

Full time classified staff (full-time means 80 hours of work per month or more)
Professional full-time employees of the College of Southern Nevada under annual contract
Professional part-time employees of the College of Southern Nevada who work more than 50% for over 90 days, but less than 1 year (Letter of Appointment with Benefits)
Retired employees of the Nevada System of Higher Education who worked for more than 5 years and are currently receiving a monthly benefit from one of the following retirement plans:
- Public Employees Retirement System (PERS)
- NSHE Retirement Plan Alternative (RPA)

Effective dates vary depending on the employee type:

Employee Type	Benefits Start	Benefits End
Classified Staff	1st day of the month following 90 days of full-time employment	Last day of the month in which your employment ends
Full time professional employees on annual contracts (includes postdoctoral fellow, academic and administrative faculty)	1st day of the month concurrent with or following the effective date of the annual contract	Last day of the month in which your employment ends
Part time employees on a letter of appointment with benefits (LOB) who are over 50% for 90 days	1st day of the month following 90 days of full-time employment. LOBs who return within 12 months of their term date may reinstate benefits on the 1st day of the month concurrent with or following the effective date of their contract.	Last day of the month in which your contract ends

Employees can make changes to their health plan during the Annual Open Enrollment Period which is normally held during May.

Dependent coverage changes can be made within 31 days of a qualified family status change. Qualified changes include marriage, birth/adoption, change of spouse's employment status, and involuntary loss of insurance coverage. Proofs of the qualified change along with marriage/birth certificates are required.

A newly hire or rehired employee may decline (opt-out-of) coverage offered during their new hire enrollment period. Employees who decline coverage lose the following benefits: medical, dental, pharmacy, vision, life, and long-term disability coverage.

MEDICAL

MONTHLY PREMIUM COMPARISON CHART - PLAN YEAR '11 to PLAN YEAR '12

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

RATING STRUCTURE OPTION B
	SELF FUNDED PLAN			HMO PLAN
	CURRENT PREMIUM	PREMIUM AS OF 7/1/11	AMOUNT CHANGE	CURRENT PREMIUM	PREMIUM AS OF 7/1/11	AMOUNT CHANGE
Participant Only	$43.73	$43.90	$0.17	$54.81	$116.57	$61.76
Participant + Spouse	$278.84	$198.40	($80.44)	$172.52	$338.16	$165.64
Participant + Child(ren)	$81.53	$91.71	$10.18	$138.26	$225.25	$86.99
Participant + Family	$195.14	$246.23	$51.09	$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 at the PEBP Board Packet Appendix B page 3. http://pebp.state.nv.us/stateactiverates.htm

Vision coverage is included with medical in both the PPO and the HMO plan.

DENTAL

Dental benefits are the same regardless of whether the employee chooses the PPO or the HMO plan. The dental plan is administered by Benefit Planners.

Benefit Category	In-Network	Out-of-Network
Plan year Maximum	$1,000 per person	$1,000 per person
Plan Year Deductible (applies to basic and major services only)	$100 per person or $300 per family (3 or more)	$100 per person or $300 per family (3 or more)
Preventive Services Four cleanings/plan year, exams, bitewing X-rays (2/plan year)	100% of allowable fee schedule, no deductible	80% of the in-network provider fee schedule for the Las Vegas service area. For services outside of Nevada, the plan will reimburse at the U & C
Basic Services Periodontal, fillings, extractions, root canals, full-mouth X-rays	75% of allowable fee schedule, after deductible	50% of the in-network provider fee schedule for the Las Vegas service area. For services outside of Nevada, the plan will reimburse at the U & C
Major Services Bridges, crowns, dentures, tooth implants	50% of allowable fee schedule, after deductible	50% of the in-network provider fee schedule for the Las Vegas service area. For services outside of Nevada, the plan will reimburse at the U & C
Family Deductible: Could be met by any combination of eligible dental expenses of three or more members of the same family coverage tier. No one single family member would be required to contribute more than the equivalent of the individual deductible toward the family deductible. Both in-network and out-of-network deductibles are combined to meet your deductible each plan year. Under no circumstances will the combination of PPO and Non-PPO benefit payments exceed the plan year maximum benefit $1,000

PRESCRIPTION DRUG BENEFIT

For Self-Funded PPO Plan Participants - Important Information Concerning Your Prescription Drug Benefit Program - CAT2011.pdf

Pharmacy Plan Comparison
Benefit Category	CD PPO HDHP	Health Plan of Nevada	Hometown Health Plan
Retail Pharmacy - 30 day supply
Preferred Generic (Tier 1)	25% after deductible	$7 copayment	$7 copayment
Preferred Brand (Tier 2)	25% after deductible	$35 copayment	$40 copayment
Non-Formulary (Tier 3)	100% of contracted price - does not apply to deductible or OOP	$55 copayment	Greater of $75 copayment per script or 40%
Specialty Drugs	25% after deductible - available in 30 day supply only through Walgreen pharmacies	Applicable retail pharmacy copayment will apply	30% coinsurance
Mail Order - 90 day supply
Preferred Generic (Tier 1)	25% after deductible	$14 copayment	$14 copayment
Preferred Brand (Tier 2)	25% after deductible	$70 copayment	$80 copayment
Non-formulary (Tier 3)	100% of contracted price - does not apply to deductible or OOP	Not available through mail order	Greater of $150 copayment per script or 40%
Specialty Drugs	25% after deductible, available in 30 day supply only through Walgreens mail order	Applicable retail pharmacy copayment applies	Not available through mail order

BASIC LIFE INSURANCE

Basic Life Insurance
Basic Life Insurance	$10,000 per eligible employee $5,000 per eligible retiree

If you have any questions or comments about any of the information contained on this or other Human Resources pages please e-mail HRCustomerService@csn.edu.

Human Resources information contained on the World Wide Web is in no way to be interpreted as a contract between the College of Southern Nevada and any of its employees. This information is provided as a service to the CSN community and will change as CSN changes. From time to time, CSN must modify its policies. Information is current as of the time of its presentation and may be subject to change or repeal at any time, with or without notice, at the discretion of CSN.