Page 4 - Microsoft Word - CNLV Benefits Booklet Draft Revised 10.31.19 NON RETIREE.docx

MEDICAL BENEFITS

City of North Las Vegas medical, dental and vision plan options provide comprehensive coverage for you and your family.
The next few pages will detail the medical benefit plans offered. (1) HMO plan and (2) PPO plan options are available.

For a complete listing of coverage and exclusions, please refer to the Summary of Benefits and Coverage (SBC) which is
available upon request.

H H H HMO vs. PPO?MO vs. PPO?
MO vs. PPO?MO vs. PPO?
HMO:HMO:
HMO:MO: PPO:PPO:
P
PPO:PO:
H
Covers services performed solely by in-network Has a network of providers, but also allows for the
providers. Tends to be a lower cost system, but is use of providers outside the plan’s network. It is
more restrictive than a PPO plan. more flexible than an HMO, but is usually more
expensive

YOUR MONTHLY COST

Base Planase Plan E Premium Plan remium Plan
Economy Savings Plan conomy Savings Plan
B
P
Base PlanBase Plan
Economy Savings Plan Economy Savings Plan
Premium Plan Premium Plan
MRMR Choice Plus Choice Plus PPOPPO
HPN HPN HMOHMO 2525 U UU UMRMR Choice Plus Choice Plus PPOPPO U UU UMRMR Choice Plus Choice Plus PPOPPO
MRMR Choice Plus Choice Plus PPOPPO
HPN HPN HMOHMO 2525
Employees’ Contribution Per MonthEmployees’ Contribution Per Month for Medical, Dental & Visionfor Medical, Dental & Vision
Employees’ Contribution Per Monthmployees’ Contribution Per Month for Medical, Dental & Visionfor Medical, Dental & Vision
E
Employee Only $0.00 $53.71 $83.50
Employee + One $0.00 $118.15 $183.70
Employee + Family $0.00 $171.86 $267.21

Please note that Medical, Dental & Vision is a packaged benefit. You must be enrolled in all 3 lines of coverage.

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