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FAQ

14 days ago

What is a dependent?

For all health benefit provisions with Lyon County School District (LCSD), a dependent is the employee's lawfulspouse, or lawful domestic partner (registered with the Nevada Office of the Secretary of State), or is a natural child, stepchild, or legally adopted child of either the member (employee), employee's spouse, or employee's domestic partner provided the child is under the age of 26.

  • A newborn will be eligible for coverage effective on date of birth.  The member must enroll newborn within 31 days or coverage will cease. Please contact the Benefits department after birth of newborn to complete the process.
  • A newly adopted child, or a child whom the employee has permanent legal guardianship, is eligible for coverage effective the date of adoption or permanent legal guardianship.  The member must enroll child within 31 days or coverage will cease. Please contact the Benefits department after adoption or permanent legal guardianship to complete the process.
  • Child is age 26 or older and is incapable of self-employment, self-care and is dependent on employee for support and maintenance due to a physical or mental disability and the condition originated prior to the child reaching age 26.
Is a domestic partner covered under benefits as a dependent?
Effective January 1, 2017, domestic partners, as identified by NRS 122A, will be able to be covered by employees as dependents under medical, dental, and/or vision.

When can I make changes to my benefits?
  • Open enrollment; occurs in November of current calendar year.  These changes would be effective January 1st.
  • During a qualifying event; see definition below.
When is open enrollment?
Open enrollment is held annually in November.  You will receive notification through your District email announcing dates and relevant information.

MEDICAL (Hometown Health) FAQ
(Hometown Health website

What is a "qualifying event"?
An event in your life, or your dependent's, such as birth, adoption or permanent legal guardianship of a child.  Marriage, or divorce is also a qualifying event which allows member to enroll or make appropriate changes to their health insurance coverage. Change in employment such as reduction of hours, increase of hours, termination or new employment that impacts eligibility or ineligibility of benefits or Medicare/Medicaid. If you have a “qualifying event”, or think you might have a qualifying event, you need to contact the Benefits person to open the IVEE portal for you to complete changes to your appropriate health insurance coverage(s).

What is a deductible?  How do I find out what is my deductible?
This is the amount paid by the member (insured) each calendar year before Hometown Health pays for certain covered services, other than preventive care. Please see your benefit summary plan located on the District website under Benefits. Please note there may be separate deductibles for medical, pharmacy, and other benefits. Also note, there are individual deductibles for those that have “Employee Only” coverage and family deductibles for those that have more than one person covered on their plan. To keep up to date on the amounts you have met for the year, please see your most current Explanation of Benefits (EOB).

What is a copay?  How do I find out what is my copay?
A specific amount that is due and payable by the member (insured) to a health care provider for certain covered services. A copay is due upon receipt of services. You can locate copays either on your card, reviewing on the appropriate website, or reviewing your benefit summary plan located on the District website under Benefits.

What is Out of Pocket maximum?  How do I find out what is my Out of Pocket maximum?
A specific amount that you the insured have paid towards medical costs which includes deductibles, copays and Prescription copays. Once the out of pocket maximum has been reached the insurance company will pay the medical expenses for the remainder of the calendar year (January 1 to December 31 is the calendar year). You can find this amount on your benefit summaries and you can check to see where you are at for the year on your Explanation of Benefits.

Where is my card? How do I get a copy of my medical card?
HOMETOWN HEALTH CONTACT INFORMATION:

Customer Service: 775.982.3232

Billing Inquiries: 775.982.3232

Complaints: 775.982.3232

You can also get your card by using the smartphone app or by registering at www.hometownhealth.com under My Benefits.

VISION (VSP) FAQ

Where is my card?  How do I get a copy of my VSP card?
VSP does not send out cards.  Your provider will verify your coverage by using your Social Security number.  Please note, services for dependents need to be identified by the dependent's social security number, not the insurer's number.

How do I know what my benefits are?  Where do I find a provider?
You can view your benefits and a list of providers by clicking on the website link directly to VSP: https://www.vsp.com/ To view your benefits, you will need to create a login by following the directions on the website.

 DENTAL (Guardian) FAQ

Where is my card?  How do I get a copy of my dental card?
Your insurance cards will be mailed to you within 7-10 business days of signing up for benefits.  If you should lose your card(s), you can log into Guardian Anytime and request a new card and/or print a temporary ID card. 

MEDICARE FAQ

When do I sign up for Medicare?  How can I get information?
Initial enrollment with Medicare is on the first of the month of your 65th birthday; unless you have other eligible requirements.  Please see the following link for information regarding Medicare: https://www.medicare.gov/

Is Medicare primary or secondary; how do i know?
For individuals who are working and have both District insurance and Medicare, the group health plan generally pays first.  It is important to ensure the group health plan carrier has a documentation of your Medicare information.  Please refer to the "Medicare & You" link: https://www.medicare.gov/medicare-and-you/medicare-and-you.html
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