By Louise Norris
April 9, 2014
Nevada Health Link is offering an enrollment extension to residents who begin their enrollment by March 31 but are unable to complete it because of technical problems with the website. Those applicants will have an additional 60 days to finish their enrollment and finalized their plan selections. The exchange is hopeful that it can complete enrollments for upwards of 50,000 people during the two month extension.
Nevada Health Link had enrolled 41,823 people by March 31 (28,000 had paid premiums by April 3, although many more have invoices that aren’t yet due). The exchange had originally set a goal of enrolling 118,000 people in private plans by March 31, but in February – amid ongoing technical problems – they reduced their goal to 50,000. But even that number will be a challenge for the state to meet, despite the fact that residents who begin their applications by March 31 will have additional time to complete them.
In addition to the private plan enrollments, Nevada Health Link had also enrolled 139,442 applicants in the state’s Medicaid program, which was expanded under the ACA.
Although Nevada Health Link is working better than it was in October, there are still problems with the site, including concerns that ID cards and bills are not being sent to insureds in a timely fashion. The state hired Xerox – with a $70 million contract – about $12 million of which had been paid by the end of January – to create and operate the exchange, and Governor Brian Sandoval was putting pressure on Xerox to get the site completely operational as soon as possible. In late March, Xerox presented their plan for fixing the problems with the site and ensuring that it will be working much better by the 2015 open enrollment that begins in November.
In early April, a class-action lawsuit was filed against Nevada Health Link, alleging gross negligence in the cases of residents who enrolled through the exchange, claim to have paid their premiums, and yet have applications that are still pending and no insurance coverage in force.
Nevada is the only state in the country where carriers selling plans outside of the exchange are required to make those policies available for purchase year-round. The carriers are allowed to impose a waiting period of up to 90 days before coverage become effective, a provision that was included in order to protect against adverse selection. Residents in Nevada are still required to comply with the individual mandate or face a tax penalty, but they are also allowed to shop for new coverage outside of the exchange year-round, with plans that will go into effect after 90 days.
Nevada’s Division of Insurance announced in late November that policies scheduled to end on December 31 could not be extended into 2014, and should instead be replaced with ACA compliant plans.
Four health insurance carriers are offering policies in Nevada’s exchange: Anthem, Health Plan of Nevada, Nevada Health CO-OP and Saint Mary’s Healthfirst. The lowest-cost bronze plan in Nevada’s exchange averages $227/month, which is lower than the national average of $249.
Nevada’s blueprint for its state-run health insurance exchange received federal approval on Dec. 3, 2012. Gov. Sandoval and the state legislature created the Silver State Health Insurance Exchange in 2011, and the state moved steadily to get the marketplace up and running.
Nevada’s exchange is overseen by a 10-member board, seven of which are voting members. Five of the voting members were appointed by the governor, and the other two were appointed by the state Senate majority leader. The three nonvoting members lead the state’s departments of Administration, Health & Human Services, and Insurance.
Nevada Health Link operates as a “free market facilitator,” meaning it allows all qualified health insurance companies to sell policies on the exchange. Insurers can participate in both the individual and small-business exchanges.
Nevada has received about $75 million in federal grants to establish its marketplace. Going forward, Nevada Health Link will be funded by a monthly fee charged to health insurance companies that operate on the exchange. Plans that include dental coverage will pay $5.31 per issued policy, while those without will pay $4.95 in 2014. The monthly fees will increase annually and are estimated to be about $8 per month for medical-only policies in 2017.
Nevada Health Link officials hope to reduce the state’s uninsured rate from the current 22 percent to 8 percent, according to a Kaiser Health News article.
Silver State Health Exchange
Information about exchange planning and start-up operations
State Exchange Profile: Nevada
The Henry J. Kaiser Family Foundation overview of Nevadaʼs progress toward creating a state health insurance exchange.
Nevada Governorʼs Office for Consumer Health Assistance
Serves all residents with health-related issues; benefits, denials, insured, uninsured, worker’s compensation, and hospital billing.
(702) 486-3587 / Toll-Free: 1-888-333-1597 (nationwide)