Medical

Your Medical Plan Choices

Active employees have two medical plan choices:

PPO Plan (Anthem Blue Cross Blue Shield 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. This plan is self-funded, which means the Fund—not Anthem or Zenith American Solutions—pays the claims.

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. This plan is fully insured, which means Health Plan of Nevada pays the claims.

Medical Plan Comparison Chart

Swipe to see full table.

 
PPO Plan
(Anthem Blue Cross Blue Shield Network)
In-Network Coverage
HMO Plan
(Health Plan of Nevada)
In-Network Required
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
Single: $6,250
Family: $12,500
Includes prescription drugs

Preventive care services No cost to you No cost to you
Physician services 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 per day up to $1,500 per admission
Hospital outpatient services $50 copay $400 per admission
Routine diagnostic services X-ray: $15 per visit
Lab: $5 per service
X-ray: $25 per service
Lab: $15 per service
Urgent care services $15 copay $40 copay
Emergency services*  $50 copay if life-threatening emergency $400 per visit (waived if admitted)
Prescription drugs Generic: $5 copay
Preferred brand: $20 copay or 20% coinsurance
Non-preferred: $45 copay or 45% coinsurance
Specialty: $50 copay
Mail order available for all tiers
Low cost: $25 copay
Midrange cost: $50 copay
Highest cost: $75 copay
Mail order available for all tiers

* 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.

Teamsters Local 14 Family Wellness Centers

The Teamsters Local 14 Family Wellness Centers offer plan members FREE:

  • High-quality, confidential medical care and preventive care
  • Access to certain prescription drugs
  • Lab work

PPO plan members and their covered dependents can visit the centers at no out-of-pocket cost! HMO plan members can also take advantage of the centers.

Same services as a primary care physician (PCP) visit. Local 14 partnered with Activate Health Care (a specialist in health care clinics) to open two centers. You can receive the same services as those provided by a board-certified PCP. When needed, center providers will refer you to cost-effective, high-quality specialists and outside services.

If desired, make the center your PCP. You can make the Family Wellness Center your PCP or continue visiting your current provider. Physician visits outside of the centers will continue to be subject to deductibles and copays.

Appointments required. You must make an appointment before visiting the Family Wellness Center for your medical needs. However, same-day appointments are generally available. Contact the Family Wellness Center closest to you to schedule your appointment.

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 myhpnonline.com.
 

  • Visit a Family Wellness Center for no-cost medical care. You’ll have access to an experienced medical team, including a full-time PCP. Your covered dependents can visit for free too!
  • Be sure to use your Anthem ID card properly. For details, see About Your Anthem ID Card.
  • Obtain precertification when needed. If you need surgery or other high-cost medical services, contact Innovative Care Management (ICM) at 800-862-3338 for precertification.
  • 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 at anthem.com, then check out discounts on a variety of fitness and nutrition services. Just select “Fitness and Health,” then “Discounts.”

You can visit a Family Wellness Center for no-cost medical care. You’ll have access to an experienced medical team, including a full-time PCP.

Visit myhpnonline.com to learn about Health Plan of Nevada’s programs and resources:

  • HPN symptom checker
  • 24/7 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

Teamsters Local 14 Family Wellness Centers

Visit a Family Wellness Center for convenient, no-cost primary/acute health care, preventive care, and medications.

  • Open to PPO plan members and covered dependents
  • Open to HMO plan members

How to Find a Medical Plan Provider

PPO Plan (Anthem Blue Cross Blue Shield Network)

  • Hospitals: Choose Health Services Coalition providers from the list at lvhsc.org/coalition.
  • Mental health/substance abuse treatment: Call the Harmony Healthcare EAP at 702-251-8000 or visit harmonyhc.com/eap/accounts/teamsters-14 for an online provider directory.
  • Prescription drugs: Access the EnvisionRx Pharmacy Locator at envisionrx.com or call 800-361-4542.
  • All other providers: Visit anthem.com and click “Find a Doctor” at the top right of the screen. Scroll down to “Search using your ID Number or Alpha Prefix” and enter “JTF.” Complete the requested information and click “Search.”

HMO Plan (Health Plan of Nevada)

Visit myhpnonline.com for a provider directory.

How to Find an In-Network Laboratory

For in-network coverage of laboratory tests, use any of these LabCorp facilities: 

Las Vegas

Clark City

Reno

For more information, visit labcorp.com/wps/portal/findalab.

How to Get an ID Card

If you are enrolled in the PPO plan and have not received your ID card and sleeve in the mail, contact Zenith American Solutions at 702-851-8286 to request them. If you are enrolled in the HMO plan and have not received an ID card in the mail, contact Zenith American Solutions or Health Plan of Nevada at 800-777-1840.

Looking for an Urgent Care Center?

Try any of these resources to find an urgent care center covered by your plan:

PPO Plan

  • See the PPO plan urgent care pamphlet and urgent care providers list.
  • Visit livehealthonline.com for 24/7 advice, treatment, and prescriptions from a board-certified doctor via live, two-way video on your computer or mobile device.
  • Use DispatchHealth to request on-demand and on­-location urgent care services provided by board-­certified physicians, nurse practitioners, and physician assistants. Visit dispatchhealth.com, call 702-848-4443, or download the DispatchHealth app.

HMO Plan

  • Use the HPN symptom checker at myhpnonline.com.
  • Download the HPN symptom checker mobile app, tap “Seek Help” at the bottom of the home screen, then tap “Find Nearby Urgent Care.”
  • Call the 24/7 nurse advice line at 800-288-2264.
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