Open Enrollment Plan Year 2019 July 1, 2018 to June 30, 2019 Public Employees Benefits Program 901 S. Stewart Street, Suite 1001 Carson City, NV 89701 www.pebp.state.nv.us 775-684-7000. 1-800-326-5496
Today s Topics 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
Public Employees Benefits Program Public Employees Benefits Program 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
Plan Year 2019 July 1, 2018 June 30, 2019 X X
PY19 Active Employee Monthly Rates Rates Effective July 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 Retiree Monthly Rates PY19 Retirees Enrolled in the CDHP/EPO/HMO Plan Rates Effective July 1, 2018 June 30, 2019 Consumer Driven Health Plan (PPO) *Domestic Partner rates are deducted on a post-tax basis. Premier (EPO) Plan and Health Plan of Nevada (HMO) Retiree Only $199.56 $379.06 Retiree + Spouse/DP* Retiree + Child(ren) $470.33 $896.26 $309.96 $635.63 Retiree + Family $580.72 $1,152.83 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
Plan Year 2019 Monthly Premium Cost PY19 Medicare Exchange Monthly Dental Rates Plan Year 2019 Monthly 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 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
Open Enrollment: May 1 31, 2018 All 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
Allowable Changes Change health plan option 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.) 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
Changes that may be completed online 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 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
Plan Benefits and Enrollment Click Login to get to the E-PEBP Portal www.pebp.state.nv.us
123456789 051219606789 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, 1960 SSN 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
Required Supporting Documents if Adding Dependents Copies of documents due in the PEBP office by June 15, 2018 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 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
Northern Nevada Medical Plan Options 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
Plan Design Changes Consumer Driven Health Plan (CDHP)
CDHP Active Monthly Premium Cost Rates Effective July 1, 2018 June 30, 2019 Plan Year 2019 Plan Year 2018 Difference Employee Only $31.73 $41.91 ($10.18) Employee + Spouse/DP* Employee + Child(ren) Employee + Family *Domestic Partner rates are deducted on a post-tax basis. $156.04 $171.50 ($15.46) $82.41 $92.72 ($10.31) $206.72 $222.09 ($15.37)
CDHP Retiree Monthly Premium Cost Rates Effective July 1, 2018 June 30, 2019 Plan Year 2019 Plan Year 2018 Difference Retiree Only $199.56 $209.08 ($9.52) Retiree + Spouse/DP* Retiree + Child(ren) $470.33 $477.86 ($7.53) $309.96 $312.60 ($2.64) Retiree + Family $580.72 $582.78 ($2.06) *Domestic Partner rates are deducted on a post-tax basis.
Plan Year HSA/HRA 2019 HSA/HRA Contributions Contributions State/Non-State participant with coverage effective July 1, 2018 Base Contribution One-Time Additional Contribution Total Contribution for participant ONLY Participant Only Tier $700 Per Dependent (maximum 3 dependents) $200 per primary participant $200 N/A $900 after completion of Preventive Program $100 $100 One-Time Additional Contribution Complete 4 preventive requirements: 1. Annual wellness physical exam 2. Annual wellness lab work 3. Dental exam 4. Dental cleaning 1. Complete the Healthcare Blue Book Guided Tour AND 2. Complete the registration for Doctor on Demand
$49 $79 (25 min) Text PEBP to 68-398
Smart90 Pharmacy Network 3D Mammograms The PEBP Board approved 3D mammograms to be paid by the plan at 100% as a preventive/wellness service starting July 2018. If you currently take a 90- day supply medication, you could save money by ordering it through ESI mail order or switching to Smart90, which will be a new voluntary pharmacy network. Voluntary Vision Plan Coming Late 2018 PEBP will be 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 Design Consumer Driven Health Plan (CDHP)
How the CDHP Works The CDHP is coupled with a: Health Savings Account (HSA); or Health Reimbursement Arrangement (HRA) Member pays 100% until deductible* is met *Medical and Prescription Deductible are combined Member pays 20% until out of pocket max is met Plan pays 100% Individual Deductible: $1,500 Family Deductible: $3,000 In Network: Individual Max OOP: $3,900 Family Max OOP: $7,800 Out of Network: Individual Max OOP: $10,600 Family Max OOP: $21,200 CDHP medical, dental, and HSA/HRA claims are administered by HealthSCOPE Benefits (third-party administrator)
Consumer Driven Health Plan (CDHP) 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)
UNR Enhanced Primary Care Provider UNR Internal Medicine offers team-based primary care that focuses 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.
Consumer Driven Health Plan (CDHP) Benefit Category Amount You Pay In-Network Deductible Individual (employee only) Deductible Family (two or more covered on the plan) Annual Out-of-Pocket Maximum Primary Care Visit $1,500 Individual $3,000 Family $2,700 Individual Family Member Deductible $3,900 person $7,800 Family (per plan year) $6,850 for one person or $7,800 for the family Deductible, then 20% coinsurance Affordable Care Act Prevention Services* $0 (Covered at 100%) Telemedicine Visit (Doctor on Demand) Medical Visit Behavioral Health (psychologist) Specialist Visit $49 Copay per medical visit $79 Copay for 25 minutes or $119 for 50 minutes Deductible, then 20% coinsurance
Consumer Driven Health Plan (CDHP) Benefit Category Amount You Pay In-Network Urgent Care Visit Emergency Room Visit Hospital Inpatient Outpatient Hospital Deductible, then 20% coinsurance General Lab Services Chiropractic Services Annual Vision Screening Vision Hardware (frames, lenses and contacts) $25 copay - max benefit of $95 per annual exam One exam per year 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 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 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
Health Savings Account Tax-free contributions from PEBP. If you leave State Service, the money will stay with you. Optional employee contributions. Funds grow on a tax-deferred basis and remain tax-free. HSA There is an annual maximum contribution limit. Funds can be used on tax dependents. Not everyone is eligible.
Calendar Year 2018 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 for employees age 55 or older. $3,450 $6,850 INDIVIDUAL FAMILY NOTE: The HSA calendar year is from January to December.
Health Reimbursement Arrangement Tax-free contributions from PEBP. If you leave State Service, the money will revert back to The State. Participant cannot make contributions. HRA Regulated by the IRS. PEBP owned and funded. Funds can be used on tax dependents. For employees who are ineligible for the HSA.
Plan Design Premier (EPO) Plan
Premier (EPO) Plan Active Monthly Premium Cost Rates Effective July 1, 2018 June 30, 2019 Plan Year 2019 Plan Year 2018 Hometown Health HMO Difference Employee Only $142.43 $173.63 ($31.20) Employee + Spouse/DP* Employee + Child(ren) Employee + Family *Domestic Partner rates are deducted on a post-tax basis. $429.62 $485.90 ($56.28) $284.89 $319.89 ($35.00) $572.08 $637.15 ($65.07)
Premier (EPO) Plan Retiree Monthly Premium Cost Rates Effective July 1, 2018 June 30, 2019 Plan Year 2019 Plan Year 2018 Hometown Health HMO Difference Retiree Only $379.06 $397.99 ($18.93) Retiree + Spouse/DP* Retiree + Child(ren) $896.26 $942.40 ($46.14) $635.63 $657.53 ($21.90) Retiree + Family $1,152.83 $1,201.94 ($49.11) *Domestic Partner rates are deducted on a post-tax basis.
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
How the Premier (EPO) Plan Compares to the Hometown Health HMO 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
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.
Premier (EPO) Plan 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 Benefit Category Amount You Pay In-Network Deductible Individual/Family $0 Out-of-Pocket Maximum Primary Care Visit $7,150 Individual $14,300 Family $25 copay Affordable Care Act Prevention Services $0 (Covered at 100%) Urgent Care Visit Specialist Visit Telemedicine Visit (Doctor on Demand) Medical Visit Behavioral Health (psychologist) Ambulance CT/MRI $50 copay $45 copay (no referral required) $10 copay $25 copay (25 min)/$35 copay (50 min) Ground $150 copay Air/water $200 copay $250 copay 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.
Premier (EPO) Plan Benefit Category Emergency Room Visit Hospital Inpatient Outpatient Surgery 2D or 3D Mammogram Chiropractic/Acupuncture Services Annual Vision Screening Vision Hardware (frames, lenses, contacts) Amount You Pay In-Network $300 per visit $500 per admit $350 copay $0 (one per plan year) $45 copay $10 copay - max benefit of $100 per annual exam One exam per year $10 copay for eyeglasses Max benefit of $100 every 2 years Contact lenses in lieu of eyeglasses $100 every two years
Obesity Care Management Program Voluntary opt-in program offered to Premier (EPO) Plan participants, their covered spouses/domestic partners and children diagnosed as being overweight or obese. 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
$10 $25 (25 min) Text PEBP to 68-398
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
Flexible Spending Account (FSA) To participate in an FSA, active ssate 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 PEBPFSA@HealthSCOPEBenefits.com 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.
Dental Plan All PPO, EPO, and HMO Eligible Participants
Dental Plan PPO, EPO, and HMO Participants In-Network Plan Year Maximum Benefit $1,500 $1,500 Plan Year Deductible (applies to basic and major services only) Dental Plan $100 per person or $300 per family (3 or more) Out-of-Network* $100 per person or $300 per family (3 or more) Preventive Services Oral examination, teeth cleaning (4/plan year), 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 area, no deductible. Basic Services Full-mouth periodontal cleanings, fillings, extractions, root canals, full-mouth X-rays Major Services Bridges, crowns dentures, tooth implants 80% of allowable fee schedule, after deductible 50% of allowable fee schedule, after deductible 50% of the in network provider fee schedule for the Las Vegas area, after deductible. 50% of the in network provider fee schedule for the Las Vegas area, after deductible. *For services outside of Nevada, the Plan will reimburse at the U & C rates
Nevada Public Employees Benefits Program Plan Year: July, 2018 June, 2019 Prescription Drug Program Confidential and Proprietary Information 2011 Express Scripts, Inc. All Rights Reserved 51
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 Pharmacy SM 60,000+ retail pharmacies across the United States Specialty drug program through Accredo Confidential and Proprietary Information 2011 Express Scripts, Inc. All Rights Reserved 52
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 Confidential and Proprietary Information 2011 Express Scripts, Inc. All Rights Reserved 53
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. Confidential and Proprietary Information 2011 Express Scripts, Inc. All Rights Reserved 54
Consumer Driven Health Plan (CDHP) Your plan s drug coverage Confidential and Proprietary Information 2011 Express Scripts, Inc. All Rights Reserved 55
CDHP Prescription Costs Participating retail pharmacies Retail (30 or 90-day supply)* Express Scripts Home Delivery Mail Order (90-day supply) Deductible (medical and pharmacy combined) Out-of-Pocket Maximum (medical and pharmacy combined) Individual (self-only coverage): $1,500 Individual (family coverage): $2,700 Family: $3,000 Individual (self-only coverage): $3,900 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 Confidential and Proprietary Information 2011 Express Scripts, Inc. All Rights Reserved 56
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 Confidential and Proprietary Information 2011 Express Scripts, Inc. All Rights Reserved 57
90-Day Retail Benefit Locate a Smart90 Pharmacy Confidential and Proprietary Information 2011 Express Scripts, Inc. All Rights Reserved 58
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 Confidential and Proprietary Information 2011 Express Scripts, Inc. All Rights Reserved 59 at 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 Confidential and Proprietary Information 2011 Express Scripts, Inc. All Rights Reserved 60
Premier (EPO) Plan Your plan s drug coverage Confidential and Proprietary Information 2011 Express Scripts, Inc. All Rights Reserved 61
EPO Prescription Costs Participating retail pharmacies Retail (30-day supply)* Express Scripts Home Delivery Mail Order (90-day supply) Out-of-Pocket Maximum (medical and pharmacy combined) Individual (self-only coverage): $7,150 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 30% Accredo Specialty Pharmacy *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 Confidential and Proprietary Information 2011 Express Scripts, Inc. All Rights Reserved 62
Making the Best Use of Your Benefit Confidential and Proprietary Information 2011 Express Scripts, Inc. All Rights Reserved 63
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 Confidential and Proprietary Information 2011 Express Scripts, Inc. All Rights Reserved 64
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 Confidential and Proprietary Information 2011 Express Scripts, Inc. All Rights Reserved 65
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) Confidential and Proprietary Information 2011 Express Scripts, Inc. All Rights Reserved 66
Using Home Delivery Services from the Express Scripts Pharmacy SM 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 Pharmacy SM Go to www.expressscripts.com Review your Welcome Package Call Express Scripts Member Services 24 hours a day, 7 days a week Confidential and Proprietary Information 2011 Express Scripts, Inc. All Rights Reserved 67
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) Mail-order forms can be printed from www.express-scripts.com 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 Confidential and Proprietary Information 2011 Express Scripts, Inc. All Rights Reserved 68 Tip
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 To reach a pharmacist, call the Express Scripts Member Services number on your ID card 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 health Confidential and Proprietary Information 2011 Express Scripts, Inc. All Rights Reserved 69
Helpful Tools Available to You Confidential and Proprietary Information 2011 Express Scripts, Inc. All Rights Reserved 70
Open Enrollment Website www.express-scripts.com/nvpebp Confidential and Proprietary Information 2011 Express Scripts, Inc. All Rights Reserved 71
View preferred versus non-preferred status Non-Preferred Brand Generic equiv. available Confidential and Proprietary Information 2011 Express Scripts, Inc. All Rights Reserved 72
Manage Your Prescriptions at Express-Scripts.com 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. 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 Confidential and Proprietary Information 2011 Express Scripts, Inc. All Rights Reserved 73
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 Confidential and Proprietary Information 2011 Express Scripts, Inc. All Rights Reserved 74
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 Confidential and Proprietary Information 2011 Express Scripts, Inc. All Rights Reserved 75
An app for members on the go Convenience Easy-order refills and up-to-the-minute order status lets members avoid trips to their local pharmacy Simplicity One swipe of the finger is all it takes to stay on track with medications Peace of Mind Reminders and a drug interaction checker help keep members traveling on the road to good health Versatility Flexibility that fits members lives, delivering personalized prescription information whenever & wherever they need it Confidential and Proprietary Information 2011 Express Scripts, Inc. All Rights Reserved 76
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 Confidential and Proprietary Information 2011 Express Scripts, Inc. All Rights Reserved 77
Thank You Confidential and Proprietary Information 2011 Express Scripts, Inc. All Rights Reserved 78
State of Nevada Public Employees Benefits Program 2018 Annual Enrollment: Life and Disability Insurance
Northern Nevada PPO/CDHP Preferred Provider Organization In and Out-of-Network Coverage No Primary Care Physician Required Coinsurance High deductible HSA/HRA Lower monthly premiums $ (Pay as you go) EPO Exclusive Provider Organization In-Network Coverage only No Primary Care Physician Required Copayments No deductible No HSA/HRA Higher monthly premiums $$ (Pay up front)
Open Enrollment May 1st - May 31st Deadline to Submit Supporting Documents June 15, 2018 Deadline to Complete Changes May 31st Changes Become Effective July 1, 2018
Questions?? Thank you! 101
Public Employees Benefits Program 901 S. Stewart St. Suite 1001 Carson City, NV 89701 775-684-7000 or 1-800-326-5496 www.pebp.state.nv.us mservices@peb.state.nv.us Krystle Borgman, Education and Information Officer Amy Vanderlinden, Communications Specialist 102