Human Resources

Benefits - Medical Insurance

  • How do I add and/or delete a dependent?

    You must log onto ESS and submit a Life and Work Event request to add or remove a dependent.  

    Please see the “Eligibility Quick Reference” on the Human Resources website for more information on adding or deleting dependents: Eligibility Quick Reference 

    Under the new Health Care Reform Bill, you may cover your child/children up to age 26.  They do not have to be a full-time student, living with you, and/or dependent upon your financial support. 

    If you are adding a domestic partner, you must do so within 31 days of filing the declaration of domestic partnership, or during the annual Open Enrollment period. 

    You may add your new baby within 31 days of the birth by submitting a Life and Work Event request through ESS and providing a copy of the live birth confirmation to Human Resources.

  • Where is the Benefits Office? How do I contact them?

    Washoe County Employee Benefits is located within the Human Resources Department at the County Administration Complex, 1001 East Ninth Street, Building A, Room A220, and the contact information for the benefits team is as follows:          

  • How do I change health insurance plans?

    You may change your choice of health plan for any reason during the annual Open Enrollment period by logging on to ESS and completing the online enrollment process. 
  • How much does the County contribute toward premiums for me and my dependents?

    Washoe County pays 100% of the employee premium. Through collective bargaining, the County has also agreed to pay 50% of the enrolled dependent’s premium.  Employees are responsible for the remaining premium for their enrolled dependents.
  • My dependent child just turned 19. Is he/she still covered?

    As a result of the Health Care Reform Act, dependent children may now continue on your health insurance until age 26.
  • How can I find out how much it will cost to carry my dependents on my insurance?

    Current insurance rates are posted on the Washoe County Human Resources public website and can be found under the Benefits section (Washoe County Employee Benefits).
  • Do the Washoe County health plans include prescription drug coverage?

    Yes.  By visiting one of the websites below, you can identify which drugs are available on your specific plan, how much they cost, and the applicable co-payment:

    • Self-funded PPO:  www.maxorplus.com (or call 1-800-687-0707)

    • Signature HMO:  www.hometownhealth.com (or call 844-373-0970)

  • What is the GAP Plan?

    The GAP Plan was first introduced in FY 10/11 and is available in conjunction with the Hometown Health HMO Plan only.  Washoe County pays the cost of the GAP plan for all employees enrolled in the HMO; however, it is an elective coverage for dependents and employees are responsible for those premiums.  Provided by American Fidelity, the GAP Plan is designed to reimburse the following out-of-pocket expenses up to:

    • $1,000 per inpatient hospital confinement

    • $200 for certain outpatient services

    • $25 for non-routine doctors visits (limit of $125 per family per year)

    For more information about the GAP Plan, or to enroll or delete a dependent, you must contact American Fidelity directly at 775-829-1313. 

  • When do my health insurance benefits go into effect?

    Coverage becomes effective on the 91st day of continuous full-time or permanent part-time employment.  You must log onto Employee Self Service (ESS) and select your health plan network within 30 days of your effective date.  If enrollment is not completed on a timely basis, you will be enrolled with employee-only coverage in the High Deductible Health Plan with Saint Mary's Network as of your effective date.
  • What hospitals are associated with each plan?

     Self-funded PPO Plan

    1. CDS Group Health: Saint Mary’s, Northern Nevada Medical Center and Carson-Tahoe
    2. Hometown Health: Renown, Northern Nevada Medical Center and Carson-Tahoe

     High Deductible Health Plan:

    1. CDS Group Health:  Saint Mary’s, Northern Nevada Medical Center and Carson-Tahoe
    2. Hometown Health: Renown, Northern Nevada Medical Center and Carson-Tahoe

    HMO Plan

    1.  Saint Mary's Regional Medical Center
  • I lost my insurance card. How can I obtain a new one?

    Contact information for the following plans:

    •  Self-funded PPO with the Universal Health Network, contact CDS Group Health at 775-352-6900.
    •  Self-funded PPO with the Hometown Health Network, contact Hometown Health at 775-982-3232.
    •  Prominence HMO, contact Prominence at 800-863-7515.
    •  High Deductible Health Plan with the Hometown Health Network, contact Hometown Health at 775-982-  3232.
    •  High Deductible Health Plan with the Universal Health Network, contact CDS Group Health at 775-352-6900.
  • What is the Medicare Advantage Plan?

    The HMO Medicare Advantage Plan was added to the Washoe County Retiree Health Benefits Program in FY 10/11.  The coverage is provided through Senior Care Plus, and is available only to those retirees and their dependents with both Medicare parts A and B.  This plan is a great option for those retirees who are receiving only a partial premium benefit from Washoe County and/or who are covering dependents. Please note that enrollment occurs only on the first of each month.
  • How do I find out more information about the Medicare Advantage Plan?

    You may contact the Enrollment Specialist at Senior Care Plus at 775-982-3134.
  • What is the “Open Enrollment” period?

    Every year, mid-October through mid-November, the County holds an Open Enrollment period during which time you can make any changes to your health insurance plan without qualifying event restrictions.  This is the perfect opportunity to review all your health insurance options to make sure you and your family are appropriately covered.

  • What if I do not want to make any changes during Open Enrollment?

    With the introduction of online open enrollment in FY 12/13, you must now review and certify your existing benefits via ESS even if you are not making any changes. You are strongly encouraged to attend one of the annual Open Enrollment meetings or review the Open Enrollment data posted on the website to be sure you understand any changes occurring at the beginning of the calendar year (January 1).
  • How do I find out more about the plans offered through the Health Benefits Program?

    We strongly encourage all employees to attend Open Enrollment meetings which are scheduled each year mid-October through mid-November.  If for some reason you cannot attend one of these informative meetings, you may contact a Benefits Specialist:  Kristie Harmon at 775 328-2079 or Vicki Scott at 775 328-2099 to set up an appointment.

  • How do I find out if my doctor is a provider on my plan?

    If you are on the Self-funded Plan with the Universal Health Network, go to www.uhnppo.com. Enter your provider’s name and click search.  Or you may contact Universal Health Care  at 775-356-1159.

    If you are on the Self-funded Plan with the Hometown Health Network, go to hometownhealth.com. Click on the provider directory and select Self-funded Plan. Or you may contact Hometown Health at 775-982-3232.

    If you are on the Prominence HMO Plan, go to www.Prominencehealthplan.com.  Click on provider directory, choose Hometown Premier HMO Plan, enter the provider’s name and click search.  Or you may contact Hometown Health Customer Service at 800-863-7515.

    If you are on the High Deductible Health Plan with the Universal Health Network, go to www.uhnppo.com.  Enter your provider’s name and click search.  Or you may contact Universal Health Care directly at 775-356-1159.

    If you are on the High Deductible Health Plan with the Hometown Health Network, go to www.hometownhealth.com.  Click on provider directory, choose Self-funded Plan, enter the provider's name and click search.  Or you may contact Hometown Health Customer Service at 775-982-3232.

  • I see preventative and routine medical care is now covered at 100%. What exactly does this include?

    For a full description of what services meet the definition of preventative and routine medical care, please refer to your plan summary or contact your plan administrator directly:

    • Self-funded PPO with the Universal Health Network, participants may contact CDS Customer Service at 775-352-6900.

    • Self-funded PPO with the Hometown Health Network, participants may contact Hometown Health Customer Service at 775-982-3232.

    • HMO participants may contact Prominence Customer Service at 800-863-7515.

    • High Deductible Health Plan participants with the Universal Health Network may contact CDS Group Health Customer Service at 775-352-6900.

    • High Deductible Health Plan participants with the Hometown Health Network may contact Hometown Health Customer Service at 775-982-5425.

  • My spouse/partner lost his/her job. Can I add them to my insurance?

    Yes, this is considered a “qualifying event” and they must be added within 31 days of the loss of coverage.  You must submit a Life and Work Event request through ESS along with documentation from the previous insurance company that indicates their last day of coverage.
  • My spouse/partner has a new job and insurance is being offered. Can I remove them from my insurance?

    Yes, this is considered a “qualifying event” and they must be removed within 31 days of the effective date of the new insurance.  You must also submit a Life and Work Event request through ESS along with documentation from your spouse’s new employer that indicates the effective date of his/her coverage.

  • Am I required to receive care only from contracted providers?

    Participants on the HMO Plan are required to receive care from physicians, hospitals and other health care providers that are contracted to provide services for Prominence Health Plan. 

    If you are on the Self-funded PPO, you will receive a better rate if you use contracted providers, but you do have flexibility. 

    If you are on the High Deductible Health Plan, you will receive a better rate if you use contracted providers, but you do have flexibility. 

Call 311 to find resources, ask questions, and utilize Washoe County services. Learn More »
Call 311 to find resources, ask questions, and utilize Washoe County services. Learn More »