Open Enrollment - pebp.state.nv.us · 04.04.2018 · Complete Open Enrollment Form ... Complete...

Open EnrollmentPlan Year 2019

Public Employees’ Benefits Program901 S. Stewart Street, Suite 1001

Carson City, NV 89701www.pebp.state.nv.us

775-684-7000 . 1-800-326-5496

July 1, 2018 to June 30, 2019

• What is the Public Employees’ Benefits Program (PEBP)

• Overview of Open Enrollment

• New Rates

• Consumer Driven Health Plan (PPO)

• Premier Plan (EPO)

• Express Scripts Inc.

• Dental Plan

• Unum

• The Standard

Today’s Topics

• Administers healthcare benefits for State employees, approved non-state agencies and retirees

• Insures over 42,000 primary participants‐ +26,000 covered dependents

• Governed by a Board of Directors appointed through the Governor

• Accessing information:‐ Website

‐ Newsletter

‐ Member Services

Public Employees’ Benefits ProgramPublic Employees’ Benefits Program

Plan Year 2019July 1, 2018 – June 30, 2019

X

X

Rates EffectiveJuly 1, 2018 – June 30, 2019

Consumer Driven Health Plan (PPO)

Premier Plan(EPO)

Employee Only $31.73 $142.43

Employee + Spouse/DP* $156.04 $429.62

Employee + Child(ren) $82.41 $284.89

Employee + Family $206.72 $572.08

*Domestic Partner rates are deducted on a post-tax basis.

PY19 Active Employee Monthly Rates


Rates EffectiveJuly 1, 2018 –June 30, 2019

Consumer Driven Health Plan (PPO)

Premier (EPO) Plan and Health Plan of Nevada

(HMO)

Retiree Only $199.56 $379.06

Retiree + Spouse/DP*

$470.33 $896.26

Retiree + Child(ren)

$309.96 $635.63

Retiree + Family $580.72 $1,152.83

PY19 Retirees Enrolled in the CDHP/EPO/HMO Plan

Years of Service Subsidy

5 +338.42

6 +304.58

7 +270.74

8 +236.90

9 +203.05

10 +169.21

11 +135.37

12 +101.53

13 +67.68

14 +33.84

15 (base) —

16 -33.84

17 -67.68

18 -101.53

19 -135.37

20 -169.21

PY19 Retiree Monthly Rates

Plan Year 2019 Monthly Premium CostPY19 Medicare Exchange Monthly Dental Rates

Plan Year 2019 Dental Premium State Retiree Non-State Retiree

Retiree Only $40.63 $41.06

Retiree + Spouse/DP $81.26 $82.13

Surviving/Unsubsidized Spouse/DP

$40.63 $41.06

Plan Year 2019Monthly and One-Time HRA Contributions for Medicare Retirees Enrolled in a MEDICAL Plan through Via Benefits (formerly OneExchange)

Years of Service

Monthly Contribution

One-Time Contribution

5 $60 $120

6 $72 $144

7 $84 $168

8 $96 $192

9 $108 $216

10 $120 $240

11 $132 $264

12 $144 $288

13 $156 $312

14 $168 $336

15 (Base) $180 $360

16 $192 $384

17 $204 $408

18 $216 $432

19 $228 $456

20 $240 $480

Open Enrollment: May 1 – 31, 2018All changes will be effective July 1, 2018

Complete changes:

• Online Portal at www.pebp.state.nv.us

OR

• Complete Open Enrollment Form

‐ Call PEBP at 775-684-7000 or

1-800-326-5496 to request a form

Form submissions must be postmarked by May 31, 2018

• Change health plan option

• Add or delete dependent(s)

• Decline coverage

• Medicare exchange retirees may newly enroll or decline PEBP dental coverage. (CDHP, EPO and HMO members are unable to opt out of dental)

• Switch from HRA to HSA or vice versa (if eligible)

10

Participants are NOT required to do anything if they wish to remain on the same plan and

coverage tier (Participant Only, Participant + Spouse/DP, etc.)

Allowable Changes

• Changing Health Plans

• Adding or deleting dependent(s)

• Designating initial beneficiaries

• Modifying HSA contributions

• Establishing an HSA or HRA (if changing coverage from HMO to CDHP or are ineligible for an HSA)

• Updating address/contact info

Changes that may be completed online Changes that may not be completed online

• Enrolling in flexible spending

• Enrolling in a voluntary product; i.e. Voluntary Life Insurance

• Cancelling a voluntary product

• Initial enrollment in retiree coverage

• Completing a name change

www.pebp.state.nv.us

Click Login to get to the E-PEBP Portal

Plan Benefits and Enrollment

• Login using full SSN no dashes or slashes

• Password: The first time you log in, your password will be your birthdate in this format (mmddyyyy), followed by the last four digits of your SSN (mmddyyyyssss)

Example

May 12, 1960SSN is 123-45-6789

051219606789

Instructions are on the screen to guide you through the login process. Problems? Call 775-684-7000 or

1-800-326-5496

123456789051219606789

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 25: 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

Spouse• Copy of certified marriage certificate • Social Security Number

Domestic Partner• Copy of Certified Domestic Partner Certification • Social Security Number

Copies of documents due in the PEBP office by June 15, 2018

Required Supporting Documents if Adding Dependents

Consumer Driven Health Plan (PPO) with a:

• Health Savings Account (HSA); or

• Health Reimbursement Arrangement (HRA)

Premier (EPO) Plan • Available to participants in Washoe, Carson, Douglas, Storey, Lyon,

Churchill, Pershing, Humboldt, Mineral, Lander, Eureka, White Pine, Lincoln, Elko counties

Northern Nevada Medical Plan Options

Plan Design ChangesConsumer Driven Health Plan (CDHP)



Plan Year 2019 Plan Year 2018 Difference

Employee Only $31.73 $41.91 ($10.18)

Employee + Spouse/DP*

$156.04 $171.50 ($15.46)

Employee + Child(ren)

$82.41 $92.72 ($10.31)

Employee + Family

$206.72 $222.09 ($15.37)

CDHP Active Monthly Premium Cost



Plan Year 2019 Plan Year 2018 Difference

Retiree Only $199.56 $209.08 ($9.52)


$470.33 $477.86 ($7.53)


$309.96 $312.60 ($2.64)

Retiree + Family $580.72 $582.78 ($2.06)

CDHP Retiree Monthly Premium Cost

HSA/HRA ContributionsState/Non State participant

with coverage effectiveJuly 1, 2018

Base ContributionOne-Time Additional

Contribution

Total Contribution for participant ONLY

Participant Only Tier $700$200 per primary

participant$900 after

completion of Preventive Program

Per Dependent(maximum 3 dependents) $200 N/A

Plan Year 2019 HSA/HRA Contributions

Complete 4 preventive requirements:1. Annual wellness physical exam2. Annual wellness lab work3. Dental exam4. Dental cleaning

1. Complete the Healthcare Blue Book Guided Tour AND

2. Complete the registration for Doctor on Demand

$100

$100

One-Time Additional Contribution

$49 $79

Text PEBP to 68-398

(25 min)

3D Mammograms

The PEBP Board approved3D mammograms to be paidby the plan at 100% as apreventive/wellness servicestarting July 2018.

Smart90 Pharmacy Network

If you currently take a 90-day supply medication, you could save money if you order it through ESI mail order or switch to Smart90, which will be a new voluntary pharmacy network.

Voluntary Vision PlanComing Late 2018

PEBP is implementing a voluntary vision plan that may cover vision exams, lenses, frames, contact lenses, as well as laser surgery discounts.

This benefit will be offered in late 2018 to all members, regardless of their plan choice.

Plan DesignConsumer Driven Health Plan (CDHP)

The CDHP is coupled with a:

Health Savings Account (HSA); or

Health Reimbursement Arrangement (HRA)

Member pays 100% until

deductible*is met

Member pays 20% until out of

pocket maxis met

Plan pays 100%

Individual Deductible: $1,500Family Deductible: $3,000

In Network:Individual Max OOP: $3,900Family Max OOP: $7,800

Out of Network:Individual Max OOP: $10,600Family Max OOP: $21,200

*Medical and Prescription Deductible are combined

CDHP medical, dental, and HSA/HRA claims are administered by HealthSCOPE Benefits (third-party administrator)

How the CDHP Works

PEBP Statewide PPO Network

• To find Statewide PPO Network Providers call 1-888-763-8232 or visit www.pebp.state.nv.us

Aetna Signature Administrators

• For CDHP Participants who reside outside of Nevada or who live in Nevada but choose to seek health care outside of Nevada call 1-888-763-8232 or visit www.pebp.state.nv.us

All CDHP medical, dental, and HSA/HRA claims are administered by HealthSCOPE Benefits (third-party administrator)

Consumer Driven Health Plan (CDHP)

UNR Enhanced Primary Care Provider

UNR Internal Medicine offers team-based primary care thatfocuses on spending additional time with each patient.

• In-Depth Health Evaluations• 80 minute Personalized Perspective Health

Assessment (PPHA)• Same-Day Appointments• After Hour Access• MyChart Online Health Tool• Chronic Disease Coordination• Comprehensive Adult Care

• Prevention, diagnosis, and treatment of diseases

*The resident doctors are under the supervision by the internal medicine faculty.

Benefit Category Amount You Pay In-Network

Deductible – Individual(employee only)

$1,500 Individual

Deductible – Family (two or more covered on the plan)

$3,000 Family$2,700 Individual Family Member Deductible

Annual Out-of-Pocket Maximum

$3,900 person $7,800 Family (per plan year)

• $6,850 for one person or $7,800 for the family

Primary Care Visit Deductible, then 20% coinsurance

Affordable Care Act Prevention Services* $0 (Covered at 100%)

Telemedicine Visit (Doctor on Demand)• Medical Visit• Behavioral Health (psychologist)

$49 Copay per medical visit $79 Copay for 25 minutes or $119 for 50 minutes

Specialist Visit Deductible, then 20% coinsurance



Urgent Care Visit

Deductible, then 20% coinsurance

Emergency Room Visit

Hospital Inpatient

Outpatient Hospital

General Lab Services

Chiropractic Services

Annual Vision Screening $25 copay - max benefit of $95 per annual examOne exam per year

Vision Hardware(frames, lenses and contacts)

No benefit*

*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.


HSA EligibilityTo 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 by an IRS qualified high deductible health plan, such as the Consumer Driven Health Plan (CDHP)

You are NOT covered by a non-IRS qualified health plan, such as a spouse’s PPO or HMO

You or your spouse cannot be enrolled in a Medical Flexible Spending Account or HRA

You are NOT enrolled in Tribal coverage

You are NOT enrolled in TRICARE or TRICARE for Life

You are NOT enrolled in Medicare

You are NOT retired

Tax-free contributions

from PEBP.

Optional employee

contributions.

There is an annual maximum

contribution limit.

Not everyone is eligible.

Funds can be used on tax dependents.

Funds grow on a tax-deferred basis and remain tax-

free.

If you leave State Service, the

money will stay with you.

HSA

He

alth

Sav

ings

Acc

ou

nt

• PEBP + Employee contribution limit

• Family is defined as two or more covered individuals on your plan

• $1,000 Catch-up contribution limit for employees age 55 or older.

NOTE: The HSA calendar year is from January to December.

Calendar Year 2018 HSA Contribution Limits

$3,450 $6,850INDIVIDUAL FAMILY

Tax-free contributions

from PEBP.

Participant cannot make contributions.

PEBP owned and funded.

For employees who are

ineligible for the HSA.

Funds can be used on tax dependents.

Regulated by the IRS.

If you leave State Service,

the money will revert back to

The State.

HRA

He

alth

Re

imb

urs

em

en

t A

rran

gem

en

t

Plan DesignPremier (EPO) Plan



Plan Year 2019Plan Year 2018

Hometown Health HMO

Difference

Employee Only $142.43 $173.63 ($31.20)

Employee + Spouse/DP*

$429.62 $485.90 ($56.28)

Employee + Child(ren)

$284.89 $319.89 ($35.00)

Employee + Family

$572.08 $637.15 ($65.07)

Premier (EPO) Plan Active Monthly Premium Cost



Plan Year 2019Plan Year 2018

Hometown Health HMO

Difference

Retiree Only $379.06 $397.99 ($18.93)


$896.26 $942.40 ($46.14)


$635.63 $657.53 ($21.90)

Retiree + Family $1,152.83 $1,201.94 ($49.11)

Premier (EPO) Plan Retiree Monthly Premium Cost

How the Premier (EPO) Plan Compares to the Hometown Health HMO

• Banner Churchill Community Hospital will no longer be included as an in-network provider

• Specialty drug coinsurance will improve from 40% coinsurance to 30% coinsurance

• The Pharmacy Benefit Manager will change to Express Scripts Inc. for prescription drugs and to Accredo for specialty prescription drugs

• Hip and Knee replacement surgeries must be performed at an exclusive facility

• Lab tests must be performed at a contracted free-standing laboratory facility

• Vision benefits will include one vision exam per plan year with a $10 copay up to $100 and a maximum $100 benefit for prescription eyeglasses or contact lenses every 24 months with a $10 copay

• Travel reimbursement will be offered for specific medical procedures

• Members may be balance billed if an out-of-network provider is used for emergent or urgent care services

• Added benefits include: • Obesity Care Management Program

• Doctor on Demand Telemedicine

• Healthcare Bluebook shop and compare tool

How the Premier (EPO) Plan Compares to the Hometown Health HMO

What if I am currently on the Hometown Health HMO Plan?

During Open Enrollment, if you make no new plan selections, you will automatically be enrolled into the

Premier (EPO) Plan for Plan Year 2019.

Hometown Health Network

• To find In-Network Providers call 1-888-763-8232 or visit www.pebp.state.nv.us

All Premier Plan medical and dental claims are administered by HealthSCOPE Benefits (third-party administrator)

Premier (EPO) Plan


Deductible – Individual/Family $0

Out-of-Pocket Maximum$7,150 Individual$14,300 Family

Primary Care Visit $25 copay

Affordable Care Act Prevention Services $0 (Covered at 100%)

Urgent Care Visit $50 copay

Specialist Visit $45 copay (no referral required)

Telemedicine Visit (Doctor on Demand)• Medical Visit• Behavioral Health (psychologist)

$10 copay$25 copay (25 min)/$35 copay (50 min)

AmbulanceGround $150 copayAir/water $200 copay

CT/MRI $250 copay

Premier (EPO) Plan

Note: This information contain general plan benefits and may not include additional provisions or exclusions. For more in-depth plan benefits, please refer to the Premier Plan Master Plan Document.


Emergency Room Visit $300 per visit

Hospital Inpatient $500 per admit

Outpatient Surgery $350 copay

2D or 3D Mammogram $0 (one per plan year)

Chiropractic/Acupuncture Services $45 copay

Annual Vision Screening $10 copay - max benefit of $100 per annual examOne exam per year

Vision Hardware(frames, lenses, contacts)

$10 copay for eyeglasses Max benefit of $100 every 2 years

Contact lenses in lieu of eyeglasses $100 every two years

Premier (EPO) Plan

Participants in the program receive benefits for:

• Medically supervised weight loss program

• Nutritional counseling

• Weight-loss medications available for a flat

copayment

• Meal replacement therapy with certain

restrictions

Voluntary “opt-in” program offered to Premier (EPO) Plan participants, their covered spouses/domestic partners and children diagnosed as being overweight or obese.

Obesity Care Management Program

$10 $25

Text PEBP to 68-398

(25 min)

Starting July 1, 2018

• App available on smartphone, tablet, or computer

• Call customer service

• Compares quality and costs of medical services

• Provides incentives for selecting high quality low cost in-network providers

To participate in an FSA, State Active employees must submit a NEW election each plan year.

• PEBP offers three types of flexible spending accounts:

‒ Health Care FSA

‒ Limited Purpose FSA (for dental and vision only)

‒ Dependent Care FSA

• Forms are available for download at www.pebp.state.nv.us

• Completed forms may be faxed to HealthSCOPE Benefits at 1-877-240-0135 or emailed to [email protected] by May 31, 2018.

You will pay a small administration fee of $3.25 per month to participate in one or both (medical and/or dependent care) FSAs.

Flexible Spending Account (FSA)

http://www.pebp.state.nv.us/

mailto:[email protected]

Dental Plan

All PPO, EPO, and HMO Eligible Participants

Dental PlanPPO, EPO, and HMO Participants

In-Network Out-of-Network*

Plan Year Maximum Benefit $1,500 $1,500

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 ServicesOral examination, teeth cleaning (4/plan year), bitewing X-rays, (2/plan year)

100% of allowable fee scheduleNo deductible

80% of the in network provider fee schedule for the Las Vegas area, no deductible.

Basic ServicesFull-mouth periodontal cleanings, fillings, extractions, root canals, full-mouth X-rays

80% of allowable fee schedule, after deductible

50% of the in network provider fee schedule for the Las Vegas area, after deductible.

Major ServicesBridges, crowns dentures, tooth implants

50% of allowable fee schedule, after deductible

50% of the in network provider fee schedule for the Las Vegas area, after deductible.

Dental Plan

*For services outside of Nevada, the Plan will reimburse at the U & C rates

Confidential and Proprietary Information© 2011 Express Scripts, Inc. All Rights Reserved 51

Nevada Public Employees’

Benefits Program

Plan Year: July, 2018–June, 2019

Prescription Drug Program


About Express Scripts,

Your Pharmacy Benefit Administrator

Express Scripts is a leading pharmacy benefit manager

(PBM) and administers Nevada Public Employees’

prescription drug benefit program

As an Express Scripts member you have access to

Home Delivery Services from the Express Scripts PharmacySM

60,000+ retail pharmacies across the United States

Specialty drug program through Accredo


Prescription Drug Plans

Your prescription drug benefit is based upon the core benefit

package selected:

1. Consumer Driven Health Plan (CDHP)

2. Premier (EPO) Plan


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.



Your plan’s drug coverage


CDHP

Prescription Costs

Participating

retail pharmacies

Express Scripts Home Delivery

Retail (30 or 90-day supply)* Mail Order (90-day supply)

Deductible(medical and pharmacy combined)

Individual (self-only coverage): $1,500

Individual (family coverage): $2,700

Family: $3,000

Out-of-Pocket Maximum (medical and pharmacy combined)


Individual (family coverage): $6,850

Family: $7,800

Preferred Generic & Brand 20% 20%

Preventive Maintenance 20% (bypass deductible) 20% (bypass deductible)

Non-Preferred Generic & Brand 100%

*90-Day Retail Program available on maintenance medications at participating retail pharmacies

*Specialty drugs are only available through Accredo Specialty Pharmacy

*Prescription drugs purchased out-of-network are not covered


CDHP 90-Day Retail Benefit

Your benefit allows you to receive up to a 90-day supply of long-term

(maintenance) medications through home delivery from 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/3month, select

“Prescriptions”, and click “Find a Pharmacy”

http://www.express-scripts.com/NVPEBP

http://www.express-scripts.com/3month


90-Day Retail Benefit “Locate a Smart90 Pharmacy”


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


http://www.express-scripts.com/

http://www.pebp.state.nv.us/


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


Premier (EPO) Plan

Your plan’s drug coverage


EPO

Prescription Costs

Participating

retail pharmacies

Express Scripts Home Delivery

Retail (30-day supply)* Mail Order (90-day supply)

Out-of-Pocket Maximum(medical and pharmacy combined)


Family coverage: $14,300

Preferred Generic $7 copay $14 copay

Preferred Brand $40 copay $80 copay

Non-Preferred Brand* $75 copay $150 copay

Specialty Drugs- through

Accredo Specialty Pharmacy 30%

*90-Day Retail: A copayment for a 90-day supply filled at a participating retail pharmacy is available for 3x the

copayment of a 30-day supply

*If you fill a prescription for a multi-source non-preferred brand-name drug when a generic equivalent is

available, you will pay the difference in cost between the brand and the generic. The difference in cost will not

apply to your out-of-pocket maximum and you will be responsible for this fee after your out-of-pocket maximum

is satisfied.

*Prescription drugs purchased out-of-network are not covered


Making the Best Use of Your Benefit


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


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 reviewTo learn more about your plan’s

drug coverage, log on to

Express-Scripts.com or call

Member Services


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 “Find a local participating pharmacy”

at www.express-scripts.com/NVPEBP

CURRENT MEMBERS: Go 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)



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


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

Mail-order forms can be printed

from www.express-scripts.com

Tip

Getting Started With Home Delivery From the

Express Scripts Pharmacy


Have a Question About a Medication? Ask a pharmacist

You can contact one of our pharmacists for

general counseling — or a Specialist Pharmacist for

complex concerns.

Each Specialist Pharmacist has had specialized

training in the medications used to treat

a specific condition, such as:

You can contact a Specialist Pharmacist

24/7 to ask questions about:

High cholesterol

High blood pressure

Depression

Diabetes

Asthma

Osteoporosis

Cancer

Drug interactions

Side effects

Risks and benefits of

your medication

The challenges of

taking your medication

as prescribed — one of

the best ways to help

maintain or improve

your healthTo reach a pharmacist, call the Express Scripts Member

Services number on your ID card


Helpful Tools Available to You


Open Enrollment Website www.express-scripts.com/NVPEBP



View preferred versus non-preferred status

Non-Preferred BrandGeneric equiv. available


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.


Member Website

Homepage

• Provides a one-stop shopping experience

• Offers the services patients expect right

up front…• 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


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


An app for members on the go

Peace of Mind

• Reminders and a drug interaction checker help keep members traveling on the road to good health

Simplicity

• One swipe of the finger is all it takes to stay on track with medications

Versatility

• Flexibility that fits members’ lives, delivering personalized prescription information – whenever & wherever they need it

Convenience

• Easy-order refills and up-to-the-minute order status lets members avoid trips to their local pharmacy


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



Thank YouThank You

State of Nevada Public Employees’ Benefits Program

2018 Annual Enrollment: Life and Disability Insurance

PPO/CDHPPreferred Provider Organization

In and Out-of-Network CoverageNo Primary Care Physician Required

Coinsurance

High deductible

HSA/HRA

Lower monthly premiums $(Pay as you go)

EPOExclusive Provider Organization

In-Network Coverage onlyNo Primary Care Physician Required

Copayments

No deductible

No HSA/HRA

Higher monthly premiums $$(Pay up front)

Overview

Open Enrollment

May 1st - May 31st

Deadline to Complete Changes

May 31st

Deadline to Submit Supporting Documents

June 15, 2018

Changes Become Effective

July 1, 2018

Questions?

101

?

Thank you!

102

Public Employees’ Benefits Program901 S. Stewart St. Suite 1001

Carson City, NV 89701 775-684-7000 or 1-800-326-5496

www.pebp.state.nv.us [email protected]

Krystle Borgman, Education and Information Officer

Amy Vanderlinden, Communications Specialist

Open Enrollment - pebp.state.nv.us · 04.04.2018 · Complete Open Enrollment Form ... Complete...

Documents

Transcript of Open Enrollment - pebp.state.nv.us · 04.04.2018 · Complete Open Enrollment Form ... Complete...