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PPO Self-Funded Health Plan

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PPO Plan Highlights

This is a traditional health plan with deductibles, co-payments, and co-insurance that is self-funded by the City of Henderson:

The majority of services pay at 95% co-insurance when received in-network
Out-of-Network: Plan pays 50% after deductible
Primary Care Provider: $15 co-payment per visit
Specialist Provider: $25 co-payment per visit
Preventive Services: Plan Pays 100%
Effective 06/01/2022 - $0 Cost Share on In-Network Mental Health and Substance Abuse Treatment for both in-patient and out-patient services.
Effective January 1, 2023 - Out-of-Network Mental Health and Substance Abuse Office Visits: Out-of-Network Deductible and Co-Insurance are Waived, and there is a maximum benefit of $150 per office visit

Provider Network (Medical, Dental and Behavioral Health): Sierra Healthcare Options / UHC Choice Plus (Outside Nevada)
Within Nevada
Outside Nevada

Claims Administrator:

UMR, Inc.
Customer Service Number: (800) 884-0793

Enroll on the UMR portal to access important insurance information such as coordination of benefits for your covered dependents, Explanation of Benefits (EOBs) after you or a dependent has been to the doctor or dentist, plan documents, and many other resources.

Please refer to your Summary Plan Description or call customer service for specific benefit details, limitations, and/or exclusions. Also check out our PPO Frequently Asked Questions.

2024 PPO Summary of Benefits and Coverage (SBC)

You may also request a paper copy of the SBC by contacting Benefits by e-mail at MyCOHBenefits @cityofhenderson.com or call (702) 267-1944.

Plan Administrator (UMR, Inc.) Portal Enrollment Instructions

Go to www.umr.com,
Select the "I Am a Member" drop-down option
Then click the "Create HealthSafe ID" option

Fill in your own First Name, Last Name, Date of Birth, Member ID (from your insurance card) or Last 6 digits of your Social Security number, and our Group Number (76415437). Then click continue. Simply follow the rest of the system prompts to set up a web account.

From the UMR portal, you can:

Print your temporary insurance card
Order additional insurance cards
View claims and provider information
Update other insurance information for your dependents
Respond to inquiries for accident or third party liability information

Prescription Benefit Summary

The City of Henderson Employee Health Care Plan provides a Prescription Drug Plan. The cardholder is responsible for the applicable co-payment when the card is presented at the pharmacy.

Express Scripts (Beginning January 1, 2024)
Customer Service Number: (800) 918-8309
Website: www.express-scripts.com
Drug Formulary: 2024 Express-Scripts National Formulary and Exclusions / Alternatives

CarelonRx (For Pharmacy Claims that Occurred in 2023)
Customer Service Number: (833) 464-0305
Website: www.carelonrx.com

WellTrac Services No Longer Available