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On agenda:
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9/21/2021
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Final action:
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Title:
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Approve and authorize the Chair to sign an amendment to the Self-Funded Group Medical and Dental Benefits Preferred Provider Organization (PPO) Plan among Clark County, the Clark County Water Reclamation District, the University Medical Center of Southern Nevada, the Las Vegas Convention and Visitors Authority, the Las Vegas Valley Water District, the Clark County Regional Flood Control District, the Regional Transportation Commission of Southern Nevada, the Southern Nevada Health District, the Henderson District Public Libraries, the Mount Charleston Fire Protection District, the Las Vegas Metropolitan Police Department and the Moapa Valley Fire Protection District adopting an amended Self-Funded Group Medical and Dental Benefits PPO Plan, effective January 1, 2022. (Also sitting as the Clark County Water Reclamation District Board of Trustees, the University Medical Center of Southern Nevada Board of Hospital Trustees, the Mount Charleston Fire Protection District Board of Fire Commissioners and the Moapa Valley Fire Protection District Board of Fire Commissioners) (For possible action)
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CLARK COUNTY BOARD OF COMMISSIONERS
AGENDA ITEM
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Petitioner: |
Les Lee Shell, Chief Administrative Officer Jessica L. Colvin, Chief Financial Officer |
Recommendation:
title
Approve and authorize the Chair to sign an amendment to the Self-Funded Group Medical and Dental Benefits Preferred Provider Organization (PPO) Plan among Clark County, the Clark County Water Reclamation District, the University Medical Center of Southern Nevada, the Las Vegas Convention and Visitors Authority, the Las Vegas Valley Water District, the Clark County Regional Flood Control District, the Regional Transportation Commission of Southern Nevada, the Southern Nevada Health District, the Henderson District Public Libraries, the Mount Charleston Fire Protection District, the Las Vegas Metropolitan Police Department and the Moapa Valley Fire Protection District adopting an amended Self-Funded Group Medical and Dental Benefits PPO Plan, effective January 1, 2022. (Also sitting as the Clark County Water Reclamation District Board of Trustees, the University Medical Center of Southern Nevada Board of Hospital Trustees, the Mount Charleston Fire Protection District Board of Fire Commissioners and the Moapa Valley Fire Protection District Board of Fire Commissioners) (For possible action)
body
FISCAL IMPACT:
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Fund #: |
6520 |
Fund Name: |
Self-Funded Group Insurance |
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Fund Center: |
1020520000 |
Funded PGM/Grant: |
N/A |
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Amount: |
No Estimated Cost |
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Description: |
Self-Funded Group Medical and Dental Benefits PPO Plan Changes |
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Additional Comments: |
N/A |
BACKGROUND:
The Self-Funded Group Medical and Dental Benefits PPO Plan (the Plan) was established in 1984 to provide group medical and dental benefits to the employees of Clark County and affiliated entities. Annually, the Plan is put before the Board of County Commissioners for approval.
Following are the proposed modifications for the upcoming Plan Year, effective January 1, 2022:
• Clarification that copayments for inpatient mental health and substance abuse partial hospitalization are due daily.
• Updating the eligibility age for colorectal preventative services from 50 years to 45 years as recommended by
the United States Preventative Services Task Force.
• Changes to the annual wellness benefit, including:
1. Removing minor outpatient surgical procedures from the list of reimbursable items.
2. Adding language that claims must be submitted within 12 months from the date of service.
• Updating the timeline for the Plan Administrator to make a determination on first level appeals from 30 days to 20 days.
The above noted changes have been discussed with represented members, as required by governing bargaining agreements.
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