Your Medical Plan Choices
Active employees have two medical plan choices:
PPO Plan (Anthem BlueCross BlueShield Network)
This plan is a preferred provider organization (PPO). It gives you the flexibility to see any medical provider. However, you save money when you use in-network providers. See the Summary Plan Description for details on this plan. This plan is self-funded, which means the Fund pays the claims, not Anthem or Zenith-American Solutions.
HMO Plan (Health Plan of Nevada)
This plan is a health maintenance organization (HMO). You must always see Health Plan of Nevada providers in order to receive coverage, except for life-threatening emergencies. See the Health Plan of Nevada folder in your enrollment packet for details on this plan. This plan is fully insured, which means Health Plan of Nevada pays the claims.
Medical Plan Comparison Chart
(Anthem BlueCross BlueShield Network)
(Health Plan of Nevada)
|Calendar year deductible
(the most you pay for covered expenses in a plan year before the plan begins to pay 100%)
(Includes prescription drugs)
|Preventive care services
||No cost to you
||No cost to you
||PCP: $10 copay
Specialist: $15 copay
|PCP: $35 copay
Physician Extender/Asst.:$25 copay
Specialist: $70 copay
|Hospital inpatient services
||$100 copay plus 10% coinsurance up to $5,000
||$500/day up to $1,500/admission
|Hospital outpatient services
|Routine diagnostic services
|Urgent care services
||$50 copay if life-threatening emergency
||$400/visit (waived if admitted)
||Generic: $5 copay
Preferred Brand: $20 copay or 20% coinsurance
Non-Preferred: $45 copay or 45% coinsurance
Specialty: $50 copay
(Mail order available)
|Low Cost: $25 copay
Midrange Cost: $50 copay
Highest Cost: $75 copay
(Mail order available)
* If your emergency isn’t life-threatening, the PPO Plan pays only $75 of emergency room charges and you pay the balance, which could be as much as $3,000 per visit, and the HMO Plan pays nothing.
Save Money on Medical Costs
Get Preventive Care
Teamsters Local 14 encourages all members to get preventive care services, which are covered by both plans at 100%. Spending a relatively small amount of time now can save you a lot of time, money and discomfort in the future. Early detection is often key to treatment of many diseases and conditions that cause serious illness or even death. For a list of covered preventive care services, for the PPO Plan see the Anthem Preventive Care Flyer; for the HMO Plan visit the Preventive Services page at www.myhpnonline.com.
- Be sure to use your Anthem ID card properly: For details, see About Your Anthem ID Card.
- Obtain pre-certification when needed: If you need surgery or other high-cost medical services, contact Innovative Care Management (ICM) at 1-800-862-3338 for pre-certification.
- Take advantage of Healthcare Bluebook: Healthcare Bluebook is an online tool you can use to shop for the most affordable care available in your area, from high quality providers. Plus, if you choose certain providers, you’ll receive a reward ranging from $25 to $100, depending on the service you receive. Just visit healthcarebluebook.com. Use your last name and the last four digits of your SSN to log in, then search for the service you need. For more information, watch this video.
- Save up to 65% on lifestyle medications for acne, weight loss, dietary supplements and more through the Personal Savings Program. Just show your EnvisionRx prescription card at the pharmacy counter. No forms to fill out or claims to send in!
- Register on Anthem.com, then check out discounts on a variety of fitness and nutrition services. Just select “Fitness and Health,” then “Discounts.”
Visit www.myhpnonline.com to learn about Health Plan of Nevada’s programs and resources:
- HPN Symptom Checker
- Telephone Advice Nurse Service
- NowClinic® 24/7 Online Care
- Health education and wellness programs and classes
- Online health education resources
- Health Management Program for chronic conditions