[{"_1":2,"_124":-5,"_125":-5},"loaderData",{"_3":4,"_26":27},"root",{"_5":6,"_17":10,"_18":19,"_20":21,"_22":10,"_23":-5,"_24":-5,"_25":10},"user",{"_7":8,"_9":10,"_11":10,"_12":-5,"_13":-5,"_14":15,"_16":-5},"roles",[],"isAuthenticated",false,"isPremium","planName","subscriptionStatus","featureFlags",{},"insightsBudget","isDevelopmentHost","userPreferences",{},"recaptchaSiteKey","6LcvOJcUAAAAAHsB-gPGfGktcRlKpH7OTIU_dMTD","isImpersonating","impersonation","affiliateStatus","isFreedomPortal","routes/v2/article/layout",{"_28":29,"_30":31},"notFound",true,"relatedArticles",[32,76,88,100,112],{"_33":34,"_35":36,"_37":38,"_39":40,"_41":42,"_43":44,"_45":46,"_47":48,"_49":50,"_51":52,"_53":54,"_55":56,"_57":58,"_59":60,"_61":62,"_63":64,"_65":66,"_67":68,"_69":70,"_71":72,"_73":74,"_75":74},"mediaId",6115208,"mediaKeyId","2739538-251d7820a001ffdc364ef81ef17abd55","parentId",2739538,"title","PEBB staff monitors several bills that could affect costs, rebates and provider payments","audioSeconds",574,"startMs",6252000,"endMs",6826000,"viewUrl","/Search/View?dp=1&key=2739538-251d7820a001ffdc364ef81ef17abd55&start=6252&end=6826","thumbnailUrl","https://assets.pipeline.soar.com/2739538-251d7820a001ffdc364ef81ef17abd55/thumbnail_6252000.jpg","articleUrl","/articles/6115208/Nevada/PEBB-staff-monitors-several-bills-that-could-affect-costs-rebates-and-provider-payments","mediaUrl","https://secure.pipeline.soar.com/6115208-50f8576ea36207e1ac0409eaac547178/orig.mp4?Expires=1776080476&Signature=lEt5s~I9906SspmllzLjILIjmrLyjZQxo-hucZLbc1Z2dFhcZmpuefPsI3Kws5GZZdY0eEK9QbArt0FzWZW04rESqv65DOe4EEcNY6~Iyn5zeBD4PZWA~Ov6hvjq-rAMCYiomDKNDbptAan9qyloQ39UOmZbTLl6YAlsaHpfLhFsFYyLWGl04UC5fyujQg9ee5v6JK9PS2kKJe45xz8WMCn8VFgSlbDLMVGfm254vv-9nw~wToJ5w6cnJrDCXiXokQ0QBvU0N8EZxTBKR-9ZrUE6pf7nAyw1sKtLjX9NMkVo2UcDAwutyGIgXAbF0CuurkHwMNBFTodN5s-k6YHHhw__&Key-Pair-Id=KUT5TJCACFTXG","author","Public Employees Benefits Program, NV","date","2025-03-21T06:34:27Z","article","PEBB staff reported to the board on March 25 that it is monitoring multiple 2025 legislative bills that could affect plan costs, rebate distribution or provider payments.

Celestina Glover highlighted a bill that would revise how hospitals and ambulatory surgical facilities are reimbursed (listed in materials as AB 349) and two Senate bills (SB 209 and SB 316) that would alter the application of pharmacy rebates. Glover said the hospital bill as currently written assumes direct contracting or a rate cap approach that PEBB does not use and that staff cannot yet compute a reliable fiscal impact without more detail about provider contracts. “We did not have the information, and we typically don't. We don't know what the various provider contracts say as far as their level of payments,” she said.

Glover explained the rebate bills would require rebates currently applied to overall plan costs to instead be applied to the individual member’s pharmacy costs. She warned that could reduce plan revenue and raise premiums for all members because the rebate dollars would no longer offset the plan’s gross costs. “However, what will happen is because we're losing those revenue streams, that would go into the expenditure side, which then would increase the rates across the board,” Glover said. Staff estimated the fiscal impact of the rebate proposals in materials at roughly $21–$23 million in the first biennium and up to about $46 million in future biennia, depending on how the bills are implemented.

Public comment and board members earlier also flagged other bills in public comment (AB 188, AB 169 and AB 349 were mentioned by public commenters as priorities). PEBB staff said it will continue to prepare fiscal analyses, work with vendors and testify as needed; staff indicated they typically testify in a neutral stance unless the board directs otherwise.

Why it matters: Proposals that change provider payment methods or redirect pharmacy rebates can shift costs between members and the plan and materially affect required state or employer contributions.

Next steps: Staff will continue analysis with Siegel and vendors (UMR, ESI) and return updates to the board as bills move through the legislature.","mediaType","Video","parentTitle","PEBP Board Meeting - March 20, 2025","oneSentenceSummary","PEBB staff briefed the board on several pending bills — including proposals affecting hospital payment caps and the distribution of pharmacy rebates — and said the agency is analyzing potential fiscal impacts.","taxTitle","Public Employees Benefits Program Board Meeting, Executive Agencies, Organizations, Executive, Nevada","taxId",26826,"location","Nevada","headline","","shortSummary",{"_33":77,"_35":36,"_37":38,"_39":78,"_41":79,"_43":80,"_45":81,"_47":82,"_49":83,"_51":84,"_53":85,"_55":56,"_57":58,"_59":86,"_61":62,"_63":64,"_65":87,"_67":68,"_69":70,"_71":72,"_73":74,"_75":74},6115213,"PEBB executive officer signals mid‑summer retirement; board tables recruitment pending legislative outcomes",725,5651000,6376000,"/Search/View?dp=1&key=2739538-251d7820a001ffdc364ef81ef17abd55&start=5651&end=6376","https://assets.pipeline.soar.com/2739538-251d7820a001ffdc364ef81ef17abd55/thumbnail_5651000.jpg","/articles/6115213/Nevada/PEBB-executive-officer-signals-midsummer-retirement-board-tables-recruitment-pending-legislative-outcomes","https://secure.pipeline.soar.com/6115213-b31c5a81e1c10cb35aa1cfac0cd302a2/orig.mp4?Expires=1776080476&Signature=h2f2PebwCmSnwid5wSbb~0qq8wQNwSOBxNx5JKVrgbwFbd-IrKGsIsoA6mh6T~0UpJLttJqgcUXLa2uRbhx2BR~qIPEGPMcf1CdM6v3QCaLMg8tZnfDca5xpyFY5HS1OLnk3VZUfI0KMpoO-f-NHmROmibI1tf1ub0kL9D5sp~emR8TOMMMAzSx2w~7-MhzB8u7OWjpl0hswIAd~hz~RFaJ1BUzg0hxctCh30ZsLc2PXdXZLdI4i7Gf3ur5RrMsi9m74Sr15P~mf0VYl9-c7UTA5-vboSWbgzzhfXHIp8jC5AlMFBCiXQcteAZWu4vCgVibRiKh574v-5YRBGGIYAA__&Key-Pair-Id=KUT5TJCACFTXG","Executive Officer Celestina Glover told the Public Employees Benefits Program Board on March 25 that she plans to retire in mid summer (between July 15 and August 15) and that the board should consider timing and format for recruiting her replacement.

Glover said she had not yet given formal notice and had not finalized a retirement date or met with Public Employees’ Retirement System staff. She advised the board to await clarity about pending legislation establishing the Nevada Health Authority and whether PEBB would fall under that new agency; the outcome could change the classification and recruitment profile for the position. “If that happens and PEBB is included, then you’re likely recruiting for an administrator level position versus a director level position, and that may change who you get applying for the position,” Glover said.

Board discussion and action: Board members expressed appreciation for Glover’s service and generally favored waiting to recruit until the legislative picture clarifies. Board member Michelle Kelly suggested considering an interim appointment from senior PEBB staff to preserve continuity while retaining the ability for an interim appointee to apply for the permanent role. Deputy Attorney General Radhika Kanal cautioned the board about agenda and personnel rules and recommended confirming personnel and human-resources processes before taking a recruitment step.

The board voted to table further action on the recruitment and to include the topic on a future agenda after staff gathers the necessary HR guidance and completes additional outreach. The motion to table was seconded by Theresa Carsten and passed by voice vote; no recorded opposition was noted.

Next steps: Glover said she will inform the board once she has set a final date and will meet with PERS as appropriate. Staff will bring the topic back to a future meeting after clarifying authority, position classification and timing for recruitment.","Executive Officer Celestina Glover told the PEBB Board she plans to retire mid‑summer; the board voted to table recruitment and return to the matter after clarifying the Nevada Health Authority legislation and personnel rules.",{"_33":89,"_35":36,"_37":38,"_39":90,"_41":91,"_43":92,"_45":93,"_47":94,"_49":95,"_51":96,"_53":97,"_55":56,"_57":58,"_59":98,"_61":62,"_63":64,"_65":99,"_67":68,"_69":70,"_71":72,"_73":74,"_75":74},6115215,"PEBB to analyze Carson Tahoe access for Medicare exchange members after public concerns",385,813000,1198000,"/Search/View?dp=1&key=2739538-251d7820a001ffdc364ef81ef17abd55&start=813&end=1198","https://assets.pipeline.soar.com/2739538-251d7820a001ffdc364ef81ef17abd55/thumbnail_813000.jpg","/articles/6115215/Nevada/PEBB-to-analyze-Carson-Tahoe-access-for-Medicare-exchange-members-after-public-concerns","https://secure.pipeline.soar.com/6115215-d4737c283270b272f629ba12aaf2cf51/orig.mp4?Expires=1776080476&Signature=Aku8S3KkpD0JGIkDbvxQtHOFvZ5w3HP85yWKS0ls6ApoLfACmhI~PxN-9qVq9bHKDq-4cYbeMKogtgrZO6iZ1Jrh8YP2gtIU0XFo7vUzZv5tlJ08uqaaJc97MnWAdZbzP9WVqlYftDadloMRFmk5Pp8Ke6fwkCaPrb2uqpdgRYTenDT2AVfosqHtQCd8TassnHqOXLuldavYQMSwTuMz6GhUDY1eSiaULBlmOkoZlKFVhu946wpJ1Ou8WELJ4a1xmnJMpzK9aW-ngv8eJA6ynZbRO6B6viRw6y8hRfZ~j5C2YlTnTjqx7bOCTKq2JUSGeXQGcoUAr8sfhefYEfSzVQ__&Key-Pair-Id=KUT5TJCACFTXG","Public comment and board questions at the March 25 PEBB meeting flagged concerns that some Medicare Advantage plans in the PEBB Medicare exchange may not include Carson Tahoe Medical Center (Carson City) as in‑network. Board members asked staff to analyze retiree access and report back.

During the consent agenda discussion, Board member Michelle Kelly asked staff to investigate which Medicare Advantage plans in the PEBB exchange accept Carson Tahoe after public commenters raised the issue. “I just wonder if miss Biddlestone ... could talk about if there's been any analysis done on our retirees in Medicare Advantage access to Carson Tahoe in Carson City and or through the Medicare Advantage program,” Kelly said.

Leslie Biddleston, PEBB quality control officer, said an analysis had not yet been done but staff could prepare one for the next board meeting. “No. We have not conducted such an analysis at this point, but more than willing to do so,” she said. Biddleston also referenced a prior, limited claims audit presented at a previous meeting.

Operations officer Nick Proper confirmed two Medicare Advantage plans would remain in network for Carson Tahoe: “We were confirmed that Prominence and Senior Care Plus will remain in network for Carson Tahoe,” Proper said. Kelly asked staff to follow up directly with a caller (identified in the transcript as Mr. Wagner) who had said he could not find Advantage plans accepting Carson Tahoe; Proper agreed to confirm availability and report back.

Why it matters: Retirees who rely on specific hospitals may be constrained by network changes; the board and members sought clarity about the Medicare exchange platform’s impact on retiree provider access. Board member Laura Rich also noted tradeoffs in channeling retirees into the PEBB Medicare exchange for administrative advantages versus allowing retirees to obtain coverage through other plans.

Board action: The board approved the underlying consent item (4.3.08) after the discussion. Michelle Kelly moved to accept item 4.3.08 and Jim Barnes seconded; the motion passed by voice vote. Staff committed to produce a network/access analysis and to follow up with the caller.","Public commenters and board members raised concerns about retired members’ access to Carson Tahoe Medical Center in Carson City under the PEBB Medicare exchange; staff committed to analyze in‑network availability and to follow up with callers.",{"_33":101,"_35":36,"_37":38,"_39":102,"_41":103,"_43":104,"_45":105,"_47":106,"_49":107,"_51":108,"_53":109,"_55":56,"_57":58,"_59":110,"_61":62,"_63":64,"_65":111,"_67":68,"_69":70,"_71":72,"_73":74,"_75":74},6115221,"PEBB staff updates master plan documents; board approves consolidations and clarifications",1468,4379000,5847000,"/Search/View?dp=1&key=2739538-251d7820a001ffdc364ef81ef17abd55&start=4379&end=5847","https://assets.pipeline.soar.com/2739538-251d7820a001ffdc364ef81ef17abd55/thumbnail_4379000.jpg","/articles/6115221/Nevada/PEBB-staff-updates-master-plan-documents-board-approves-consolidations-and-clarifications","https://secure.pipeline.soar.com/6115221-ff5c25028d0322920a69aa65a3bc97a6/orig.mp4?Expires=1776080476&Signature=U-~xeVLaoG6ww85J95qjGfl8cSaoPRefHjS0oLUxrJEhVmrCb2BGv8poAIwHiH~KWbNtnudtps~1yNWu4pSPdxG6xidCuZIlZqPixEigR9r3RWdMilNVuvxHmhFU58V3d4e0VcEeIqytCY7IuPnh~xlu-KBTpPAjsO9R5ISG0MDHP7B-LdWAP1HTDt4bmmOfzAqcaoegagtm5wm665lKye9gp2OmejY-NgAlyo74NH8SlnEBRADNwI8OzrMF7F7Uqh~zemEcCYaaTNjoH2Uuz5j~Xv4Wa70Y4U1tQDWBrS~h0VcXIgx5iRuzCNwDMYViNtF-8M3PikG4MguAR8MZlw__&Key-Pair-Id=KUT5TJCACFTXG","The Public Employees Benefits Program Board on March 25 approved staff recommendations to update and clarify the master plan documents (MPDs) that govern PEBB medical, pharmacy and related benefits for plan year 2026.

Quality Control Officer Leslie Biddleston reviewed a package of edits that included three explicit benefit enhancements, numerous clarifications to existing covered services, and broad clerical and formatting changes intended to reduce internal inconsistency across MPDs. “One of the things that we will be updating after this meeting, of course, is the rates that go along with the services because we just approved the rates just a minute ago,” Biddleston said.

Key changes: The packet lists three enhancements — addition of lofexidine as an FDA‑approved medication for substance use disorder treatment, added coverage for FDA‑approved drugs used for HIV prevention, and updates to mammography screening guidance (routine mammograms beginning at age 40 with earlier screening for higher‑risk individuals and genetic mutation carriers). Clarifications included removing an age limit for certain vision services for children under 19, adding a co‑pay structure for telehealth, clarifying coverage for pregnancy‑related testing and services, and harmonizing conflicting language about abortion coverage with the cited statute.

Organizational changes and timeline: Staff proposed consolidating multiple MPDs into fewer, larger documents (for example, combining the three medical plan MPDs into a single master medical MPD and consolidating HRA, FSA and Medicare HRA materials). Biddleston said a full MPD consolidation and cleanup is planned over the next two years to ensure consistent definitions and to reduce public-facing confusion.

Board action and next steps: The board voted to approve the proposed changes and to allow PEBB staff and vendors (UMR and ESI) to complete final formatting and technical adjustments prior to publication. Motion to approve was moved and seconded; the board voiced unanimous approval. Staff said redline versions of the MPDs will be posted and rates updated prior to open enrollment.

Why it matters: The MPD updates aim to align plan documents with federal guidance, FDA approvals, industry standards and recent compliance findings. The changes clarify member entitlements (for example, telehealth and emergency refill rules) and specify processes vendors must follow for overpayments and provider billing.

Votes at a glance: Motion to approve updates to master plan documents for plan year 2026 — approved unanimously. Motion: approve PEBB staff proposed changes as presented. Mover/second: not specified in the transcript. Outcome: approved.

Staff will publish updated benefit guides, plan comparison documents and the revised MPDs in advance of the 2026 open enrollment period.","PEBB staff proposed multiple clarifications, coverage enhancements and clerical cleanups to the master plan documents (MPDs) for plan year 2026; the board approved the changes and authorized final formatting and vendor review.",{"_33":113,"_35":36,"_37":38,"_39":114,"_41":115,"_43":116,"_45":117,"_47":118,"_49":119,"_51":120,"_53":121,"_55":56,"_57":58,"_59":122,"_61":62,"_63":64,"_65":123,"_67":68,"_69":70,"_71":72,"_73":74,"_75":74},6115226,"PEBB board approves more conservative 2026 rates, setting aside funds for 2027",3235,1364000,4599000,"/Search/View?dp=1&key=2739538-251d7820a001ffdc364ef81ef17abd55&start=1364&end=4599","https://assets.pipeline.soar.com/2739538-251d7820a001ffdc364ef81ef17abd55/thumbnail_1364000.jpg","/articles/6115226/Nevada/PEBB-board-approves-more-conservative-2026-rates-setting-aside-funds-for-2027","https://secure.pipeline.soar.com/6115226-614d7dc3fcf6dae676ebe548d9955839/orig.mp4?Expires=1776080476&Signature=fWdNl9Pw80bJnB6udVOdJhO4MHM7diO9v34jeWYruzx4nWjKE8n5KL-Ff7v8UL0nsCsW~7Y076tLA4AOfx47F87~VKGXSiaycFC69wSFpfA-8AwkAZW5Mg~6rGDqXGJEtuFbk44JbZqlopbrG~h8YOXiJD6Ffy0T9RUonaQuqfYCUSqpH35XfJUTlVJWVKv6iZWp0L1LOLaZs5~f2gqAISj1W7xWPJeaZZi0gpa0J-CkeN0hN7VZDXBcThVBieJ1HJYkK6RpmTEDbKSOMfjywQxS8S03mioTQLzoAbe6Cufeged4vQ5-8EOVE2ocn7~RKvI9QbSTkleHZoToNV1t0w__&Key-Pair-Id=KUT5TJCACFTXG","The Public Employees Benefits Program (PEBB) Board on March 25 approved plan-year 2026 premium rates under staff’s recommended scenario 2, a more conservative funding option intended to preserve reserves and reduce the risk of larger premium increases in the second year of the state biennium.

Board members said rising medical and pharmacy cost trends and uncertainty about second-year state contributions motivated the decision. Executive Officer Celestina Glover said PEBB will ask the Interim Finance Committee for $33,000,000 to cover an expected shortfall in claims for the current year. “We will be going to IFC on April 3, asking for $33,000,000 to bump up our claims category because that is the shortfall we’re projecting for now to the end of the year,” Glover said.

The board heard a technical presentation from Richard Ward of Siegel on cost trends and the methodology used to set rates. Ward noted persistent increases in medical and specialty pharmacy costs and explained the difference between gross pharmacy claims and net costs after rebates. “This pharmacy trend is just for claims. It doesn't consider the effect of rebates, which will show the effect of rebates on costs and trend here in a few slides,” Ward said, and added rebates materially reduce net pharmacy costs in some years.

Why it matters: Board members said using scenario 2 reallocates more state funding to the early part of the biennium and retains additional reserves to blunt a projected second-year funding drop. Board member Michelle Kelly, who made the motion to adopt staff’s recommendation, described the action as conservative fiduciary stewardship. “My motion is to approve staff’s recommendation scenario number 2,” Kelly said.

What the board approved: The motion to adopt scenario 2 passed; Laura Rich seconded. The recorded vote showed six in favor and one opposed. Board member Jim Barnes said he opposed the motion: “Yes. I’m voting against that,” he said during the roll call.

Board discussion and context: Siegel’s presentation showed multi-year increases in PEBB medical and pharmacy trends and highlighted drivers such as specialty drugs, rising provider contract costs, and higher utilization across several disease categories. Ward told the board that pharmacy claims trends have moderated recently but remain an important driver of overall cost. PEBB staff also noted that the state’s preliminary governor’s budget contains a higher funding assumption for the first year of the biennium, but the second-year AEGIS (state employer contribution) projection is lower and could create pressure in plan year 2027.

Next steps and fiscal notes: Glover said staff will proceed with the adopted rates and will take the IFC request on April 3. She also warned that other changes scheduled for the 2027 plan year — including how rebates and certain benefit-authority items are applied — could affect base rates starting in 2027.

Votes at a glance: Motion to adopt plan-year 2026 rates under scenario 2 — approved. Motion: approve staff’s recommendation (scenario 2). Mover: Michelle Kelly. Second: Laura Rich. Vote record (as captured during roll call): Grimmer — yes; Michelle Kelly — yes; Jim Barnes — no; Jennifer McClendon — yes; Janelle Woodward — yes; Theresa Karsten — yes; Laura Rich — yes. Betsy Strasberg — absent. Outcome: approved.

Funding detail excerpt: For plan year 2025 the AEGIS active-employee funding rate noted in materials was $780 per employee; preliminary governor’s budget showed an increase to roughly $1,022 in year one of the biennium with a possible decline in the second year to about $982, a change staff said could materially affect employee premiums if unaddressed.

The board adjourned from the item after adopting the rates and will pursue the IFC request and additional analysis of rebate and funding changes ahead of the 2027 plan-year decisions.","The Public Employees Benefits Program Board approved plan-year 2026 premiums under a more conservative funding scenario (scenario 2) to preserve reserves and reduce the risk of large premium spikes in year two of the biennium; the measure passed with one dissenting vote.","actionData","errors"]

Article not found

PEBB staff monitors several bills that could affect costs, rebates and provider payments

PEBB executive officer signals mid‑summer retirement; board tables recruitment pending legislative outcomes

PEBB to analyze Carson Tahoe access for Medicare exchange members after public concerns

PEBB staff updates master plan documents; board approves consolidations and clarifications

PEBB board approves more conservative 2026 rates, setting aside funds for 2027