PEBP board keeps HMO/EPO options for 2026 after weeks of public outcry; authorizes HMO contract talks

The Public Employees Benefits Program (PEBP) board voted Jan. 23 to continue offering the HMO/EPO option through plan year 2026 and authorized Executive Officer Celestina Glover to negotiate and sign a contract with the recommended HMO vendor for southern Nevada.

The board’s action followed more than two hours of public comment by state employees, faculty and retirees who said eliminating the HMO or converting the low-deductible PPO to a higher-deductible PPO would disrupt care, raise out-of-pocket costs and risk patients losing long-term providers. Many callers also described billing and prior-authorization problems they said they experienced under the current third-party administrator, UMR, and urged the board to replace or rein in that vendor and to preserve the HMO option.

Why it matters: The HMO and EPO plans have lower member cost-sharing for many services and are widely used by state university and other public employees in southern Nevada. Board staff and consultant materials showed the HMO/EPO are the most expensive options by premium, and staff had presented data and an RFP process intended to secure network continuity; the board’s decision preserves choice for members while staff negotiates a replacement HMO contract for the South.

Board and staff rationale Executive Officer Celestina Glover told the board PEBP had analyzed utilization, premium and network data and had released an RFP to create a secondary network that would include Carson Tahoe Health. “We are looking at trying to make the transition, should the board approve it, as smooth as possible, and we are taking into consideration the concerns that our members have,” she said, adding the current HMO contract expires June 30, 2025 and that the RFP results for the HMO vendor must be discussed in closed session before any award.

Consultant Richard Ward of Segal (presentation…