1.5 - Enrollment Summary 202107~2.xlsx

XLSX spreadsheet 35 KB Posted Aug 4, 2021

Attached to: Telemedicine for PEBP
Solicitation number: 95PEBP-S1671
Issued by: Churchill County, Nevada

About this file

Written by GovTribe AI · Apr 2, 2024

The document is a government file related to a state and local contract opportunity for Telemedicine services issued by the State of Nevada Purchasing Division on behalf of the Public Employees' Benefits Program (PEBP). The solicitation seeks proposals from qualified vendors to provide Telemedicine services. The contract will be applicable to the jurisdictions of Carson City, Nevada. No additional details are provided regarding item quantities, response dates, due dates, site visits, bidder's meetings and conferences, award dates, or the term of the contract including any renewal options.

The file does not contain any information regarding pricing terms, set asides, incumbents, current environment, funding requirements and sources, amounts and sources, or any other salient details. The document appears to be focused on providing enrollment summaries for various health plan options available to state and non-state employees and retirees.

View the file

Other files

File	Type	Posted
1.1 - RFP Information~3.docx	DOCX document	Aug 4, 2021
1.6 - DrOnDemand - UtilizationReport.pdf	PDF	Aug 4, 2021
1.2 - Standard Form Contract~3.docx	DOCX document	Aug 4, 2021
1.3 - Insurance Schedule~3.docx	DOCX document	Aug 4, 2021
Quote Instructions.pdf	PDF	Aug 4, 2021
2.3 - Telemedicine RFP - References - CONFIDENTIAL.xlsx	XLSX spreadsheet	Aug 4, 2021
1.4 - Sample Business Associate Agreement~3.docx	DOCX document	Aug 4, 2021
2.1 - Intent to bid - Telemedicine.pdf	PDF	Aug 4, 2021
2.2 - Telemedicine RFP - Template.xlsx	XLSX spreadsheet	Aug 4, 2021
95PEBP-S1671 Letter of Intent 2021-10-11.pdf	PDF	Aug 4, 2021

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Enrollment by Tier

	Consumer Driven Health Plan w/H.S.A. In-State	Consumer Driven Health Plan w/H.S.A. Out-of-State	Total CDHP with HSA	Consumer Driven Health Plan w/H.R.A. In-State	Consumer Driven Health Plan w/H.R.A. Out-of-State	Total CDHP with HRA	Total CDHP	Low Deductible PPO In-State	Low Deductible PPO Out-of-State	Total Low Deductible PPO	PEBP Premier Plan	HPN - Health Plan of Nevada	Exchange Plan - PEBP Dental	Exchange Plan - No Dental	Tri-Care - PEBP Dental	Tri-Care Medical	Total Exchange/Tricare - PEBP Dental	Total Exchange/Tricare - No Dental
STATE EMPLOYEE
Participant	6,222	127	6,349	2,912	76	2,988	9,337	1,276	34	1,310	1,846	1,937	0	0	0	0	0	0
Participant + Spouse	966	21	987	314	9	323	1,310	332	9	341	321	270	0	0	0	0	0	0
Participant + Children	2,517	17	2,534	582	13	595	3,129	779	14	793	954	818	0	0	0	0	0	0
Participant + Family	1,778	39	1,817	321	6	327	2,144	561	14	575	400	318	0	0	0	0	0	0
	11,483	204	11,687	4,129	104	4,233	15,920	2,948	71	3,019	3,521	3,343	0	0	0	0	0	0	25,803
STATE RETIREE
Participant	0	0	0	1,613	318	1,931	1,931	156	25	181	421	230	4,423	1,838	118	62	4,541	1,900
Participant + Spouse	0	0	0	480	112	592	592	55	16	71	72	21	914	342	22	3	936	345
Participant + Children	0	0	0	218	39	257	257	32	4	36	49	24	1	0	0	0	1	0
Participant + Family	0	0	0	162	40	202	202	21	6	27	18	13	0	0	0	0	0	0
Surviving Spouse	0	0	0	28	4	32	32	0	1	1	4	3	160	41	2	0	162	41
Survivor + Children	0	0	0	5	2	7	7	0	0	0	0	0	0	0	0	0	0	0
	0	0	0	2,506	515	3,021	3,021	264	52	316	564	291	5,498	2,221	142	65	5,640	2,286	12,118

Consumer Driven Health Plan w/H.S.A. In-State Consumer Driven Health Plan w/H.S.A. Out-of-State Total CDHP with HSA Consumer Driven Health Plan w/H.R.A. In-State Consumer Driven Health Plan w/H.R.A. Out-of-State Total CDHP with HRA Total CDHP Low Deductible PPO In-State Low Deductible PPO Out-of-State Total Low Deductible PPO PEBP Premier Plan HPN - Health Plan of Nevada Exchange Plan - PEBP Dental Exchange Plan - No Dental Tri-Care - PEBP Dental Tri-Care Medical Total Exchange/Tricare - PEBP Dental Total Exchange/Tricare - No Dental

NON STATE EMPLOYEE
Participant	1	0	1	0	0	0	1	0	0	0	4	0	0	0	0	0	0	0
Participant + Spouse	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0
Participant + Children	1	1	2	0	0	0	2	0	0	0	0	0	0	0	0	0	0	0
Participant + Family	1	0	1	0	0	0	1	0	0	0	0	0	0	0	0	0	0	0
	3	1	4	0	0	0	4	0	0	0	4	0	0	0	0	0	0	0	8

NON STATE RETIREE
Participant	0	0	0	301	86	387	387	7	3	10	70	149	3,027	1,345	19	7	3,046	1,352
Participant + Spouse	0	0	0	49	14	63	63	7	2	9	19	28	368	175	3	0	371	175
Participant + Children	0	0	0	4	2	6	6	0	0	0	6	6	2	0	0	0	2	0
Participant + Family	0	0	0	5	2	7	7	0	0	0	1	3	0	0	0	0	0	0
Surviving Spouse	0	0	0	0	2	2	2	0	0	0	0	2	51	17	1	0	52	17
Survivor + Children	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0
	0	0	0	359	106	465	465	14	5	19	96	188	3,448	1,537	23	7	3,471	1,544	5,783
																			43,712

HeadCounts

	Enrollment as of
July 1, 2021	Consumer Driven Health Plan w/H.S.A.			Consumer Driven Health Plan w/H.R.A.			Total Consumer Driven Health Plan			Low Deductible PPO Plan			PEBP Premier Plan	HPN - Health Plan of Nevada	Exchange Plan - PEBP Dental	Exchange Plan - No Dental	Total Exchange	TriCare - PEPB Dental	TriCare - Medical	TriCare Total	Total
		In-State	Out-Of-State	Total	In-State	Out-Of-State	Total	In-State	Out-Of-State	Total	In-State	Out-Of-State	Total
	State
	ACTIVE	11,483	204	11,687	4,129	104	4,233	15,612	308	15,920	2,948	71	3,019	3,521	3,343	0	0	0	0	0	0	25,803
	Retiree - Non Medicare	0	0	0	2,012	412	2,424	2,012	412	2,424	247	45	292	491	244	0	0	0	0	0	0	3,451
	Retiree - Part A	0	0	0	236	60	296	236	60	296	11	4	15	35	22	5,498	2,221	7,719	142	65	207	8,294
	Retiree - Part B Only	0	0	0	258	43	301	258	43	301	6	3	9	38	25	0	0	0	0	0	0	373
	RETIREE	0	0	0	2,506	515	3,021	2,506	515	3,021	264	52	316	564	291	5,498	2,221	7,719	142	65	207	12,118
	Total	11,483	204	11,687	6,635	619	7,254	18,118	823	18,941	3,212	123	3,335	4,085	3,634	5,498	2,221	7,719	142	65	207	37,921
	Non State
	ACTIVE	3	1	4	0	0	0	3	1	4	0	0	0	4	0	0	0	0	0	0	0	8
	Retiree - Non Medicare	0	0	0	140	65	205	140	65	205	7	3	10	46	87	0	0	0	0	0	0	348
	Retiree - Part A	0	0	0	32	5	37	32	5	37	3	0	3	16	18	3,448	1,537	4,985	23	7	30	5,089
	Retiree - Part B Only	0	0	0	187	36	223	187	36	223	4	2	6	34	83	0	0	0	0	0	0	346
	RETIREE	0	0	0	359	106	465	359	106	465	14	5	19	96	188	3,448	1,537	4,985	23	7	30	5,783
	Total	3	1	4	359	106	465	362	107	469	14	5	19	100	188	3,448	1,537	4,985	23	7	30	5,791
	Total
	ACTIVE	11,486	205	11,691	4,129	104	4,233	15,615	309	15,924	2,948	71	3,019	3,525	3,343	0	0	0	0	0	0	25,811
	Retiree - Non Medicare	0	0	0	2,152	477	2,629	2,152	477	2,629	254	48	302	537	331	0	0	0	0	0	0	3,799
	Retiree - Part A	0	0	0	268	65	333	268	65	333	14	4	18	51	40	8,946	3,758	12,704	165	72	237	13,383
	Retiree - Part B Only	0	0	0	445	79	524	445	79	524	10	5	15	72	108	0	0	0	0	0	0	719
	RETIREE	0	0	0	2,865	621	3,486	2,865	621	3,486	278	57	335	660	479	8,946	3,758	12,704	165	72	237	17,901
	Total	11,486	205	11,691	6,994	725	7,719	18,480	930	19,410	3,226	128	3,354	4,185	3,822	8,946	3,758	12,704	165	72	237	43,712

RDS Eligibile
Retiree Part D	0	0	0	5	1	6	5	1	6	0	0	0	2	0	0	0	0	6	5	11	19
Spouse Part D	0	0	0	2	0	2	2	0	2	0	0	0	0	0	0	0	0	0	0	0	2
Total	0	0	0	7	1	8	7	1	8	0	0	0	2	0	0	0	0	6	5	11	21
Retiree No Part D	0	0	0	708	143	851	708	143	851	24	9	33	121	148	0	0	0	159	67	226	1,379
Spouse No Part D	0	0	0	81	13	94	81	13	94	1	1	2	10	5	0	0	0	24	3	27	138
Total	0	0	0	789	156	945	789	156	945	25	10	35	131	153	0	0	0	183	70	253	1,517

Dental		COBRA		Active Dependents		Life Insurance Eligible		Reinstated Retirees
Consumer Driven	19,410	State Active	101	CHSA	11012	CDHP State Active	15,920	State Exchange	69
LD-PPO	3,354	State Retiree	0	CHRA	3930	CDHP State Retiree	3,015	State CDHP	6
EPO	4,185	Non State Active	0	LD-PPO	3742	CDHP Non State Active	4	State LD-PPO	1
HMO	3,822	Non State Retiree	0	EPO	3542	CDHP Non State Retiree	372	State EPO	0
Exchange w/ Dental	8,946	Total COBRA	101	HPN	2915	LD-PPO State Active	3,019	State HMO	0
TriCare w/ Dental	165	Non - COBRA	43,712	EH	519	LD-PPO State Retiree	315	State Other Coverage	0
Dental Only	17,118	Total Enrollment	43,813	EHD	1287	LD-PPO Non-State Active	0	State Total	76
Total w/ Dental	39,882			TCD	25	LD-PPO Non-State Retiree	18
Exchange w/o Dental	3,758	TOTAL DECLINES		TC	3	EPO State Active	3,521	Non State Exchange	1559
TriCare w/o Dental	72	State Active	1,975	Total Enrollment	26975	EPO State Retiree	564	Non State CDHP	93
Total Enrollment	43,712	State Retiree	0			EPO Non State Active	4	Non-State LD-PPO	1
		Non State Active	16	CDHP Total Lives	34,352	EPO Non State Retiree	73	Non State EPO	23
		Non State Retiree	0	LD-PPO Lives	7,096	HMO State Active	3,343	Non State HMO	47
				EPO Lives	7,727	HMO State Retiree	291	Non State Other Coverage	0
		TOTAL NOT ELIGIBLE		HMO Lives	6,737	HMO Non State Active	0	Non State Total	1723
		State Active	42	Med Exchange Total Lives	14,510	HMO Non State Retiree	141
		State Retiree	7	Tricare Total Lives	265	State Medicare Retiree	7,857
		Non State Active	0	PEBP Total Lives	70,687	Non State Medi Retiree	3,456
		Non State Retiree	0			Totals	41,913

DOMESTIC PARTNERS								PARTICIPANTS BY TIER
	CDHP	LD-PPO	EPO	HMO	Exch	TriCare	Total		Primary	+SPS/DP'	+Child'	Family	Total
State ACTIVE	123	30	31	20	0	0	204	DP	1	137	6	85	229
State RETIREE	16	2	2	1	3	0	24	PRIMARY	28,652	4,807	6,077	3,624	43,160
Non State ACTIVE	0	0	0	0	0	0	0	SURVIVOR	316	0	7	0	323
Non State RETIREE	1	0	0	0	0	0	1	Total	28,969	4,944	6,090	3,709	43,712
Total	140	32	33	21	3	0	229

File details come from the government source that posted it. Updated Apr 2, 2024.