How long do I have to submit an eligible receipt for reimbursement from my HRA?

Requests for reimbursement must be submitted within one year (12 months) from the date the service(s) where incurred.

Categories: CDHP with HSA or HRA, Medicare & Retirees

How may I use a Flexible Spending Account (FSA) to offset costs for orthodontic services?

A flexible spending account is a financial account you put money into that you can use to pay certain out-of-pocket healthcare and dependent care costs. You don’t pay taxes on this money. With an FSA, you can set aside up to $3,050 in pre-tax wages during PY24 for out-of-pocket medical expenses. The amount limits are subject to change annually. Depending on your tax bracket the tax savings could cover from 18 to 35 percent of the cost. What many people don’t know is that your FSA funds can help offset the high cost of orthodontic services as well.

Single Year Savings Comparison

Without an FSA:
$212.50 Monthly budget for orthodontic expenses
– $46.75 Taxes deducted on $212.50 (federal tax rate of 22%)
$165.75 Amount left for out-of-pocket orthodontic expenses

With an FSA:
$212.50 Monthly FSA deposit for orthodontic expenses
– $0.00 Taxes deducted on $212.50
$212.50 Amount left for out-of-pocket orthodontic expenses

Annual Savings (Example):
$46.75 x 12 = $561
Use $561 towards orthodontic expenses from income tax savings using a flexible spending account.

Categories: CDHP with HSA or HRA, EPO, Flexible Spending Account (FSA), HMO & LD FAQs

What are the coverage areas for the HMO and EPO plans?

Southern Nevada

If you reside in southern Nevada, coverage is administered by the Health Plan of Nevada (HMO) and is only available to participants residing in the following counties: Clark, Esmeralda and Nye Counties.

Northern Nevada

If you reside in northern Nevada, coverage is administered by the Exclusive Provider Organization (EPO) Plan and is only available to participants residing in the following fourteen northern Nevada counties: Carson City, Churchill, Douglas, Elko, Eureka, Humboldt, Lander, Lincoln, Lyon, Mineral, Pershing, Storey, Washoe and White Pine.

Categories: EPO & HMO FAQs

What are the risks of participating in a health care or dependent care FSA?

FSA dollars are “use-it-or-lose-it” funds. For PY24, account balances greater than $610 cannot be carried over into the following plan year for Health Care and Limited Purpose FSAs. For dependent care FSAs, $0 can be carried over to the next plan year, so it is important to only contribute what you know you will use. If you have any unused funds exceeding the limit at the end of the plan year (end of grace period), those funds will be forfeited per IRS requirements.

Categories: CDHP with HSA or HRA, EPO, Flexible Spending Account (FSA), HMO & LD FAQs

Is there a cost to participate in the FSA?

You pay a small administration fee of $3.15 per month to participate in either one or both (medical and/or dependent care) flexible spending accounts.

Categories: CDHP with HSA or HRA, EPO, Flexible Spending Account (FSA), HMO & LD

What is a Dependent Care Flexible Spending Account (Dependent Care FSA)?

A dependent care FSA provides a way to pay dependent care expenses and lower your taxable income. You direct part of your before-tax pay into a special account to pay work-related dependent care costs. You can use your account throughout the year to help pay for eligible expenses. Your expense must be for the purpose of allowing you and, if married, your spouse to be employed. Members can enroll in an FSA during a new hire event, open enrollment, or during a qualifying life event. For more information, contact UMR at 1-888-763-8232.

Categories: CDHP with HSA or HRA, EPO, Flexible Spending Account (FSA), HMO, LD

What is a Limited Purpose Flexible Spending Account (Limited Purpose FSA)?

The Limited Purpose FSA is a tax-advantaged account that allows employees to set aside a portion of earnings to pay for out-of-pocket dental and vision expenses. Employees who contribute to an HSA may also elect the Limited Purpose FSA. For more information, contact UMR at 1-888-763-8232.

Categories: CDHP with HSA or HRA, EPO, Flexible Spending Account (FSA), HMO, & LD

What is a Medical Flexible Spending Account (Medical FSA)?

The Medical FSA is a tax-advantaged account that allows employees to set aside a portion of earnings to pay for qualified health care expenses that are not paid by insurance (i.e. copayments, deductibles, and coinsurance). An FSA may also be used to pay for things like prescription eyeglasses and Lasik surgery. Generally, allowable items are the same as those allowed for the medical tax deduction.

Categories: CDHP with HSA or HRA, EPO, Flexible Spending Account (FSA), HMO, & LD

What is the FSA? Does it have anything to do with the HSA or HRA?

Non-state and NSHE employees are ineligible for the PEBP sponsored FSA but may be eligible through a similar program offered by their employer. The HealthCare FSA is a tax-free account that allows a person to pay for essential health care expenses that are not covered or are partially covered by your medical, pharmacy, dental and vision plans. The FSA plan year is July 1 through June 30 of the following year. Flexible Spending Account open enrollment is usually held in May each year. To participate in an FSA, you must enroll during open enrollment each year for the upcoming plan year, within 60 days of your hire date, or during certain qualifying life events. For more information regarding FSAs contact UMR at 1-888-763-8232.

The FSA is a use it or lose it account and the HSA/HRA rolls over from year to year, month to month. The FSA allows for a limited amount of funds to roll over from year to year.

An HSA is a Health Savings Account that also receives tax-free contributions from PEBP but also allows the participant to make voluntarily contributions to their HSA through pre-tax payroll deductions. If you leave State service, the money will stay with you until it is spent by you. Not everyone is eligible for an HSA.

An HRA is a Health Reimbursement Arrangement with only PEBP contributions. You are not eligible to make your own contributions to this account. If you leave State service, this money will revert to the State. Everyone enrolled in the CDHP PPO plan is eligible for an HRA.

Categories: CDHP with HSA or HRA, EPO, Flexible Spending Account (FSA), Health Reimbursement Arrangement (HRA), Health Savings Account (HSA), HMO, LD

What happens to my HSA funds when I retire?

HSA funds are portable. At retirement, you will retain any funds in your HSA. You may also continue to use HSA money to pay for out-of-pocket health care expenses.

Categories: Health Savings Account (HSA), Retirees

I am covered under the EPO plan in Northern Nevada. However, I am moving to Las Vegas. May I keep my Northern Nevada EPO Plan?

EPO and HMO participants who move outside of their designated plan’s coverage area must select a new medical plan to coincide with their new coverage area within 30 days. Contact PEBP Members Services to notify them and discuss your options. 

Member Services at 775-684-7000, 702-486-3100 or long distance at 1-800-326-5496.

Categories: Eligibility, EPO, & HMO 

Is there a cost difference between using an outpatient lab at a hospital versus a free-standing lab such as LabCorp or Quest?

Generally, hospitals charge substantially more for these services than stand alone laboratories. Some physicians may refer a patient to the hospital for lab testing; however, to reduce out-of-pocket costs the member should request a referral to a stand alone laboratory. Most hospital based lab services except for pre-admission testing, urgent care, and emergency lab room services are not covered. Laboratory outpatient services at a free standing, in-network facility such as Lab Corp or Quest are subject to the deductible and/or co-insurance/co-payment.

Categories: CDHP with HSA or HRA, EPO, HMO, & LD