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.
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 Healthcare (a specialist in healthcare 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 www.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 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.
- 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.”
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 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