1.6 - Enrollment Summary 202104.xlsx

XLSX spreadsheet 32 KB Posted

Attached to
Third Party Administrator (TPA) for the Public Employees' Benefits Program (PEBP) State and local contract opportunity
Solicitation number
95PEBP-S1579
Issued by
Churchill County, Nevada

About this file

Written by GovTribe AI ·

This document appears to be an Enrollment Summary for the Public Employees' Benefits Program (PEBP) in the state of Nevada. It provides detailed headcount information for state and non-state employees and retirees enrolled in various health plan options, including Consumer Driven Health Plans, PEBP Premier Plan, HMO plans, and TriCare. The summary covers enrollment as of April 1, 2021 across in-state and out-of-state participants.

The related state and local contract opportunity is for a Third Party Administrator (TPA) for the PEBP, which covers the jurisdiction of Carson City, Nevada. The contract details are not provided, but this document suggests the PEBP is a significant program with over 44,000 total participants enrolled across various health plan options.

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1.1 - RFP Information.docx DOCX document
1.2 - Standard Form Contract.docx DOCX document
1.4 - Sample Business Associate Agreement.docx DOCX document
1.7 - Discount Instructions.pdf PDF
95PEBP-S1579 Letter of Intent.pdf PDF
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Enrollment by Tier

Consumer Driven Health Plan w/H.S.A. In-StateConsumer Driven Health Plan w/H.S.A. Out-of-StateConsumer Driven Health Plan w/H.R.A. In-StateConsumer Driven Health Plan w/H.R.A. Out-of-StatePEBP Premier PlanHPN - Health Plan of NevadaExchange Plan - PEBP DentalExchange Plan - No DentalTri-Care - PEBP DentalTri-Care Medical
STATE EMPLOYEE
Participant7,2521553,400912,0621,9870000
Participant + Spouse1,22327409103562670000
Participant + Children3,19928687161,0297900000
Participant + Family2,3475239264373170000
14,0212624,8881233,8843,361000026,539
STATE RETIREE
Participant001,7233464322234,4101,77211555
Participant + Spouse005161267426921337233
Participant + Children002464548241000
Participant + Family001774519100000
Surviving Spouse00265431584410
Survivor + Children0072000000
002,6955695772865,4902,1531395811,967

Consumer Driven Health Plan w/H.S.A. In-State Consumer Driven Health Plan w/H.S.A. Out-of-State Consumer Driven Health Plan w/H.R.A. In-State Consumer Driven Health Plan w/H.R.A. Out-of-State PEBP Premier Plan HPN - Health Plan of Nevada Exchange Plan - PEBP Dental Exchange Plan - No Dental Tri-Care - PEBP Dental Tri-Care Medical

NON STATE EMPLOYEE
Participant1010400000
Participant + Spouse0000000000
Participant + Children0100000000
Participant + Family1000000000
21104000008
NON STATE RETIREE
Participant0032396851573,0571,360197
Participant + Spouse005015222937518030
Participant + Children0042662000
Participant + Family0062140000
Surviving Spouse000112512100
Survivor + Children0000000000
003831161151983,4851,5612275,887
44,401

HeadCounts

Enrollment as of
April 1, 2021Consumer Driven Health Plan w/H.S.A.Consumer Driven Health Plan w/H.R.A.Total Consumer Driven Health PlanPEBP Premier PlanHPN - Health Plan of NevadaExchange Plan - PEBP DentalExchange Plan - No DentalTotal ExchangeTriCare - PEPB DentalTriCare - MedicalTriCare TotalTotal
In-StateOut-Of-StateTotalIn-StateOut-Of-StateTotalIn-StateOut-Of-StateTotal
State
ACTIVE14,02126214,2834,8881235,01118,90938519,2943,8843,36100000026,539
Retiree - Non Medicare0002,2054622,6672,2054622,6674992400000003,406
Retiree - Part A000229642932296429336215,4902,1537,643139581978,190
Retiree - Part B Only00026143304261433044225000000371
RETIREE0002,6955693,2642,6955693,2645772865,4902,1537,6431395819711,967
Total14,02126214,2837,5836928,27521,60495422,5584,4613,6475,4902,1537,6431395819738,506
Non State
ACTIVE213101314400000008
Retiree - Non Medicare00016572237165722376398000000398
Retiree - Part A000305353053519193,4851,5615,046227295,148
Retiree - Part B Only00018839227188392273381000000341
RETIREE0003831164993831164991151983,4851,5615,046227295,887
Total2133841165003861175031191983,4851,5615,046227295,895
Total
ACTIVE14,02326314,2864,8891235,01218,91238619,2983,8883,36100000026,547
Retiree - Non Medicare0002,3705342,9042,3705342,9045623380000003,804
Retiree - Part A000259693282596932855408,9753,71412,6891616522613,338
Retiree - Part B Only000449825314498253175106000000712
RETIREE0003,0786853,7633,0786853,7636924848,9753,71412,6891616522617,854
Total14,02326314,2867,9678088,77521,9901,07123,0614,5803,8458,9753,71412,6891616522644,401
RDS Eligibile
Retiree Part D00061761720000641019
Spouse Part D000202202000000002
Total00081981920000641021
Retiree No Part D000702150852702150852128146000155612161,342
Spouse No Part D00075138875138810500025328131
Total000777163940777163940138151000180642441,473
DentalCOBRAActive DependentsLife Insurance EligibleDOMESTIC PARTNERS
Consumer Driven23,061State Active76CHSA14272CDHP State Active19,294CDHPEPOHMOExchTriCareTotal
EPO4,580State Retiree0CHRA4584CDHP State Retiree3,258State ACTIVE156331900208
HMO3,845Non State Active0EPO3866CDHP Non State Active4State RETIREE18302023
Exchange w/ Dental8,975Non State Retiree0HPN2859CDHP Non State Retiree402Non State ACTIVE100001
TriCare w/ Dental161Total COBRA76EH519EPO State Active3,884Non State RETIREE000000
Dental Only17,561Non - COBRA44,401EHD1301EPO State Retiree576Total175361920232
Total w/ Dental40,622Total Enrollment44,477TCD26EPO Non State Active4
Exchange w/o Dental3,714TC3EPO Non State Retiree90PARTICIPANTS BY TIER
TriCare w/o Dental65TOTAL DECLINESTotal Enrollment27430HMO State Active3,361Primary+SPS/DP'+Child'FamilyTotal
Total Enrollment44,401State Active2,056HMO State Retiree286DP1138786232
State Retiree0CDHP Total Lives41,917HMO Non State Active0PRIMARY29,1324,8546,1273,73043,843
Non State Active16EPO Lives8,446HMO Non State Retiree151SURVIVOR317090326
Non State Retiree0HMO Lives6,704State Medicare Retiree7,771Total29,4504,9926,1433,81644,401
Med Exchange Total Lives14,509Non State Medi Retiree3,497
TOTAL NOT ELIGIBLETricare Total Lives255Totals42,578
State Active30PEBP Total Lives71,831
State Retiree2Reinstated Retirees
Non State Active0State Exchange69
Non State Retiree0State CDHP6
State EPO1
State HMO0
State Other Coverage0
State Total76
Non State Exchange1578
Non State CDHP97
Non State EPO25
Non State HMO47
Non State Other Coverage0
Non State Total1747

File details come from the government source that posted it. Updated .