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Medical Benefits

Compare your options and choose the plan that’s right for you.

NV Energy offers Local 396 and Local 1245 employees two consumer-directed health (CDH) plans to choose from: the Health Reimbursement Arrangement (HRA) Plan and the Health Savings Account (HSA) Plan. The plans are described as consumer-directed plans because they allow you to be more involved with how and when you spend your health care dollars. In both options, NV Energy contributes money to help you pay out-of-pocket health care expenses.

NV Energy offers non-represented employees a consumer-directed plan and a simplicity based insurance design to choose from: the Health Savings Account (HSA) and the Copay Plan. With the new Copay Plan you pay a copay for medical services. Your copay will vary based on the the medical service.

These plans strengthen the shared responsibility between you and NV Energy by protecting you and your family while encouraging you to be more actively involved in your health care decisions. When you anticipate, manage and avoid unnecessary health care costs, both you and NV Energy spend less — and that’s good for all of us.

NV Energy will continue contributing toward your out-of-pocket expenses in both the HRA and HSA medical options.

NV Energy participates in health care coalitions with other employers in northern and southern Nevada for in-network hospital coverage. These coalitions negotiate with hospitals to determine who will be considered part of the plan’s network. To find in-network hospitals, visit aetna.com/docfind/custom/nvenergy.

Under the plan, NV Energy sets up a fund for you to pay qualified medical expenses. Any money left in the fund at the end of the year will be rolled over to the next year. The company owns the HRA fund, so if you leave the company, change to the HSA Plan, or drop your medical coverage, you forfeit the money in the fund. Generally, out-of-pocket expenses for eligible health care services will be paid first from the HRA fund, as long as there is enough money available.

How the HRA Plan Works

January – December NV Energy pays 100% of preventive care all year long
  STEP 1: STEP 2: STEP 3: STEP 4:
HRA NV Energy contributes to your HRA each year (added to whatever’s left from previous year). Use the money in your HRA to help cover your deductible and coinsurance. Once your HRA runs out, you must pay out of pocket. After you meet your deductible, you pay coinsurance until you reach the out-of-pocket maximum. When you reach your out-of-pocket maximum, NV Energy pays 100% until end of year.

NV Energy’s contributions to your account are available starting January 1, so you will have access to the entire company contribution at the start of the calendar year.

Qualified Medical Expenses

HRA and HSA money can be used only to pay for qualified medical expenses, which include, but are not limited to, doctors’ fees, prescribed drugs, chiropractors’ fees, and hospital expenses not reimbursed by a medical plan. For more information, go to irs.gov and search for Publication 969.

The HRA Deductible

The HRA deductible is a traditional-style deductible, meaning the individual deductible is included within the family deductible. Once a covered family member meets the individual deductible in the family tier, coinsurance will apply for that family member. Charges for all covered family members will continue to count toward the family deductible until it is met.

Example: Under the HRA Plan, John’s annual family deductible is $2,000 and the individual deductible is $1,000. If John meets the individual deductible ($1,000), he won’t be required to pay any more toward the deductible, and any additional expenses he incurs will count toward the out-of-pocket maximum. John’s family members will need to meet the family deductible amount. In this example, no one member of the family needs to meet more than $1,000 toward the family deductible.

This plan allows you to set aside pretax dollars in a Health Savings Account (HSA) to pay for current qualified medical expenses or to save for future expenses. NV Energy contributes a lump sum amount to your HSA. The HSA is your account and goes where you go, even if you leave the company or retire, and you can invest funds over $1,000.

How the HSA Plan Works

January – December NV Energy pays 100% of preventive care all year long
  STEP 1: STEP 2: STEP 3: STEP 4:
HSA NV Energy contributes to your HSA (added to whatever’s left from previous year). You can also contribute. You decide whether to use HSA money or pay out of pocket to cover your deductible and/or coinsurance. Depending on your HSA balance, it may cover the deductible and coinsurance, or you may have to make up the difference out of pocket. After you meet your deductible, you pay coinsurance until you reach the out-of-pocket maximum. Once you reach your out-of-pocket maximum, NV Energy pays 100% until end of year.

NV Energy’s contribution to your account is available starting January 1, so you will have access to the entire company contribution at the start of the calendar year. Money you contribute to the account will be available as soon as your account is credited.

The IRS has increased the maximum total amount (your contributions plus the company’s contributions) that can be contributed to your HSA. For 2022, the contribution limits are $3,650 for "employee only" coverage and $7,300 for all other coverage levels.

Catch-Up Contributions

If you will be at least age 55 in 2022 and not enrolled in Medicare, you can make a “catch-up contribution” to your HSA. The maximum catch-up amount for 2022 is $1,000.

About Your HSA Account

  • Your contributions reduce your taxable income, and eligible withdrawals are tax-free.
  • Interest is earned tax-free. You control how to save and spend money in your account.
  • The money in your account rolls over each year. Therefore, some employees may opt to build up their account — and have money available for when they need it in the future.

The HSA Plan Deductible

The HSA Plan deductible is a true family-style deductible because there are no individual deductibles within the family plan. This means the entire deductible must be met before coinsurance applies, regardless of whether one person reaches the “employee only” deductible limit. It could be possible that one member of the family meets the entire HSA deductible alone, or that several family members collectively meet the HSA deductible.

Instant Access to Your Money With the PayFlex Card

The PayFlex Card is a debit card that gives you a simple way to spend the money in your HSA account. It electronically accesses the money in your account when used to pay for eligible expenses. Generally, all you need to do is select your eligible item, swipe your card and save your receipt!

As a requirement of the USA Patriot Act, PayFlex verifies your demographic (name, SSN, date of birth or home address) information before setting up your HSA account. If you receive a letter from PayFlex, please respond in a timely manner as any delay will delay the availability and use of your HSA funds.

With this plan you will not have a deductible to pay before the medical plan (NV Energy) begins paying for services. Instead, you pay a copay for in-network medical services. The copay amount will vary by the medical service. The medical plan will pay the difference between your copay and the cost of the service. The copay will be applied to your out-of-pocket maximum (OOPM). Once you reach your out-of-pocket maximum, the medical plan pays 100% until the end of the calendar year.

How the Copay Plan Works

January – December NV Energy pays 100% of preventive care all year long
  STEP 1: STEP 2: STEP 3: STEP 4:
Copay Pay your copay for medical services or prescription drugs. NV Energy will pay the difference between your copay and the cost of service. The copay amount is applied to your out-of-pocket maximum Once you reach your out-of-pocket maximum, NV Energy pays 100% until end of year.
    Non-rep Employees
  Represented Employees  
  HRA Plan HSA Plan Copay Plan
Does NV Energy contribute money to my account to help pay medical and prescription drug expenses? Yes Yes Participants do not have an account
Do I have to meet an annual deductible before the plan begins to pay? Yes Yes Deductible does not apply
When the deductible is reached, does the plan pay a percentage of eligible expenses (coinsurance) until the out-of-pocket maximum is met? Yes Yes Deductible does not apply
Once the out-of-pocket maximum is reached for the year, does the plan pay 100% of eligible expenses? Yes Yes Yes
Are prescription drugs not on the preventive medication list subject to the deductible and coinsurance? Yes Yes Deductible does not apply. Co-insurance applies to out-of-network only
Are in-network preventive care and generic drugs on the preventive medication list covered at 100%? Yes Yes Yes
If the contributions/funds in my account are not used, do they rollover over to the following year? Yes Yes Participants do not have an account

In-Network

It’s always better to use in-network services, because out-of-network services provide less benefits.

  1. Show your Aetna ID card when you see a provider.
  2. The provider bills Aetna.
  3. Aetna reviews the claim and determines what you owe.
  4. If you are enrolled in an HRA plan, Aetna pays the provider directly from your HRA funds until your HRA funds are depleted,
    OR
    If you are enrolled in an HSA plan, you decide how you want to pay your claim; use your HSA funds, or pay out of pocket.
    OR
    If you are enrolled in a Copay plan, you pay the predetermined copay amount at the time of service.

Out-of-Network

If you go out-of-network and a provider does not file a claim on your behalf, you may need to pay the provider up front and file a claim with Aetna. You can download a claim form at aetna.com.