New for 2026! The Engaged Care Plan will go into effect January 1, 2026, and will replace the HMO Plan (Health Plan of Nevada). To continue medical plan coverage in 2026, all members currently enrolled in the HMO Plan must decide whether to enroll in the PPO Plan or the new Engaged Care Plan. If you do not make an election during open enrollment for 2026, you will automatically be enrolled in the Engaged Care Plan.
And that’s not all. Teamsters 14 participants who do enroll in the Engaged Care Plan for 2026 will automatically be entered into a raffle for a chance to win two tickets to either a Golden Knights or Raiders game during the 2025–2026 season. Up to 20 winners will be chosen and contacted by Zenith American Solutions after the enrollment season ends. Don’t miss out on your chance to win big!
The Engaged Care Plan provides medical and prescription drug coverage for all active participants and their dependents.
The Engaged Care Plan is a self-insured plan, which means the claims are paid by the Fund rather than an insurance company. The plan promotes the Fund’s Family Wellness Centers, provided in partnership with Marathon Health, as your first stop and primary source for health care services. By using the Fund’s wellness centers when you need care, your out-of-pocket expenses will be lower compared with seeing providers outside the wellness centers.
The wellness centers offer high-quality medical and preventive care, a board-certified primary care physician (PCP), access to prescription drugs, telemedicine visits, and lab work at no cost to you. Due to popular demand, the wellness centers have expanded their staff and in 2026 will offer new services such as physical therapy and access to a registered dietitian/health coach. Whenever you need care, whether it be primary care, specialty care, or urgent care, the Fund’s Family Wellness Centers are there to support you first.
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Swipe to see full table. |
PPO Plan (Anthem BCBS) |
Engaged Care Plan (Anthem BCBS) |
|---|---|---|
| Calendar-year deductible | Single: $500 Family: $1,500 |
None |
| Out-of-pocket maximum The most you pay for covered expenses in a plan year (includes in-network copayments, coinsurance, and deductibles) before the plan begins to pay 100% |
Medical: Single: $5,600 Family: $11,200 Prescription drugs: Single: $1,000 Family: $2,000 |
Medical: Single: $4,000 Family: $8,000 Prescription drugs: Single: $500 Family: $1,000 |
| Family Wellness Centers | No cost | No cost |
| Preventive care services | No cost | No cost |
| Physician services | PCP: $10 copay Specialist: $15 copay |
PCP: $5 copay (with wellness center referral/visit) or $75 copay (without wellness center referral/visit) Specialist: $5 copay (with wellness center referral/visit) or $100 copay (without wellness center referral/visit) |
| Routine diagnostic services | X-ray: $15 per visit Lab: $5 per service Imaging: $50 per test |
X-ray: $10 copay (with wellness center referral/visit) or $25 copay (without wellness center referral/visit) Lab: $5 copay (with wellness center referral/visit) or $15 copay (without wellness center referral/visit) Imaging: $45 copay (with wellness center referral/visit) or $100 copay (without wellness center referral/visit) |
| Hospital inpatient services | $100 copay plus 10% coinsurance up to $5,000 | $500 per day up to $1,500 per admission |
| Hospital outpatient services | $50 copay per visit | $250 per visit |
| Urgent care services | $15 copay | $10 copay (with wellness center referral/visit) or $40 copay (without wellness center referral/visit) |
| Emergency services | $50 copay if life-threatening emergency | $400 per visit (waived if admitted) |
| Prescription drugs (Managed by MedImpact) Note: Mail order available for all tiers |
Generic: $5 copay Preferred brand: Greater of 20% coinsurance or $20 copay Non-preferred: Greater of 45% coinsurance or $45 copay Specialty: $50 copay |
Generic: $5 copay Preferred brand: Greater of 20% coinsurance or $20 copay Non-preferred: Greater of 45% coinsurance or $45 copay Specialty: $50 copay |
The Engaged Care Plan encourages and promotes the use of the Family Wellness Centers as your first stop whenever you need to seek health and wellness care. In circumstances when you are unable to seek care at a Family Wellness Center (e.g., needing care after hours, in cases of emergency or medical urgency, or to seek out a specialist), the plan does provide access to the Anthem Blue Cross Blue Shield PPO national network. However, if you seek care outside the PPO network, services will not be covered (except in the case of an emergency or if referred by a Family Wellness Center).
Here are the guidelines you need to follow under the plan:
Note: You do not need a referral to receive OB-GYN, pediatric, or mental health care as long as you stay within the Anthem Blue Cross Blue Shield PPO network (or Harmony network for mental health care). For more details on the PPO coverage you receive when you visit a Family Wellness Center, visit the Where to Go for Medical Care page.
If you enroll in the Engaged Care Plan, keep a lookout in your mailbox later this year for new ID cards from Anthem Blue Cross Blue Shield and MedImpact for you and your covered dependents.
Visit the 2026 Open Enrollment page for detailed instructions on how to enroll in the Engaged Care Plan for coverage for you and your dependents in the coming year.
For any questions or concerns, contact Zenith American Solutions at 702-851-8286 or visit edge.zenith-american.com.