Nevada health insurance marketplace: history and news of the state’s exchange

 

Richard

But they were still eligible for a special enrollment period , through March 1, during which they can pick a different option for the remainder of But they remained in the Nevada market , both on and off-exchange they only continued to participate in three exchanges: In addition to the various Chamber of Commerce plans, the Nevada Contractors and Nevada Builders Alliance associations, and the Builders Association of Northern Nevada are offering association health plans to their members.

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Legal notices Aetna is the brand name used for products and services provided by one or more of the Aetna group of subsidiary companies, including Aetna Life Insurance Company and its affiliates Aetna. As with private insurance or healthcare coverage purchased through your employer, plans bought via the health insurance exchange or general Marketplace will vary in coverage options and premium prices.

Plus, some families will be eligible for subsidies and tax credits that lower the monthly premiums even more. In this section, we'll give you a couple of examples of the types of premiums available to help you make a more informed decision about Obamacare. Keep in mind that the following information is just a guide and could vary significantly depending on your individual situation. In an effort to help people become familiar with the cost of premiums available on the Marketplace, we have created a subsidy calculator that can also help you understand the cost of healthcare premiums.

Let's start with a family of four that earns above the federal poverty threshold percentage; in other words, this family would not receive any subsidies on the Marketplace because they earn enough to pay for insurance without assistance. You can buy four types of plans on the Marketplace: Bronze, Silver, Gold and Platinum. There's also a "Catastrophic" plan available, but this plan is generally reserved for healthy individuals under the age of 30, who want basic coverage for emergency situations only or people that are experiencing a hardship..

As you can see with the example above, the Clarks will pay higher premiums for more coverage; Platinum plans cover 90 percent of medical costs but require significantly higher premiums. Now, let's see how much the Clarks would pay if they didn't have children. As mentioned in an earlier section, some families will pay more in healthcare costs than they would pay in penalty fees. In this scenario, the Clarks are relatively young and healthy, and they have no kids. The Clarks may choose to forgo insurance and pay the fine instead until they reach an age when they need more medical care.

You may have noticed that we made a point to mention the Clarks' tobacco use. Under the Affordable Care Act, tobacco users will pay more for health insurance.

The goal of Obamacare is to provide more affordable coverage for more Americans while increasing public awareness for better healthcare management. This means that those who smoke will pay more. If the Clarks were to take up smoking, they could expect an increase in their yearly premium via a "tobacco surcharge" assessed by the government.

They might also pay more due to the out-of-pocket costs associated with prolonged tobacco use. In the examples listed above, the Clarks earned well above the federal poverty line with and without kids.

Unfortunately, millions of Americans live and work well under the poverty line and still need the same healthcare coverage as their more affluent neighbors.

Obamacare was designed to help low-to-middle-income families get the coverage they need. Through subsidies and a Tax Credit , thousands of lower income families in the United States have access to unprecedented coverage and healthcare options.

In this section, we'll discuss how Obamacare can help offset the cost of monthly premiums and work to your advantage if you fall beneath the poverty threshold. The amounts for are different so check out our Federal Poverty Level chart for updated information. Under the Affordable Care Act, families that earn between one and four times the federal poverty line are eligible for subsidies and tax credits that help make insurance more affordable by reducing the monthly premiums.

Let's take a look at the Granger family as an example. How do the Grangers get such a great deal when the Clarks had to pay full price for their premiums?

The Clarks earn almost twice as much as the Grangers do with one less child to support. Obamacare works on the premise that those who can afford insurance should contribute more to the shared responsibility pool. Lower income families will benefit from the new healthcare law in a way that many affluent families were already enjoying.

By being able to purchase subsidized healthcare through Idaho's marketplace, the Grangers will enjoy the same access to healthcare that the Clarks probably already had prior to the ACA. If you live without a spouse or any dependents, then you may be wondering about cost assistant for single taxpayers.

Can individuals receive cost assistance? The answer to this question depends on where you live, your age, your income level and several other factors, but the short answer is that even single people can apply for cost assistance if they meet the right parameters.

For an example, let's take a look at Cassidy Jones. Because Cassidy probably won't make as many trips to the doctor as her older relatives, she may choose to purchase a Bronze plan instead of a more expensive metal plan on the Marketplace. If she were a few years younger, Cassidy might instead choose a "Catastrophic" plan to cover emergencies only.

Keep in mind that regardless of the plan you choose on the Marketplace or off, you can expect preventative care and select other benefits to be included in your coverage. If you qualify for Medicaid or the Children's Health Insurance Program, then you don't need to worry about the individual mandate or the health insurance coverage requirement because you meet the minimum essential coverage requirement by enrolling in Medicaid or CHIP. These government systems still exist and still are available to lower income families regardless of the new law.

In fact, several states have approved the expansion of Medicaid as set forth by the Affordable Care Act, which means that you may now qualify for Medicaid even if you didn't in the past.

Check out the government's health insurance exchange site for more information on your state's participation in Medicaid expansion. The examples in this article featured relatively young and healthy people who most likely would not need a lot of medical care throughout the year.

Some very young people may even get away with paying the penalty fee for non-compliance rather than spending money on health insurance they feel they don't need. However, the cost of insurance rises for everyone if people refuse to participate in Obamacare. And just because you pay the fine doesn't mean that you have coverage in case of an emergency. In fact, if you need medical treatment but lack insurance then you will be liable for percent of the cost out-of-pocket. Did you know that a significant portion of debt in the America comes from unpaid medical bills?

In fact, unpaid medical bills are the leading cause of bankruptcy in the United States as of Even people with insurance can sometimes struggle to pay high deductibles and out-of-pocket expenses, so imagine what people without insurance will pay when they need emergency appendectomies or life-saving vaccines. With so many billions of dollars on the line, it's important to consider the whole cost of healthcare rather than the upfront cost of increased premiums.

If it works correctly, then Obamacare may lower the cost of healthcare in indirect ways as well. For example, one of the ten essential benefits mandated by the Affordable Care Act is free preventative care. This includes access to yearly screenings for high blood pressure, high cholesterol, breast cancer and colon cancer.

If more people have access to these valuable preventative services, then people will stay healthier and reduce the burden on the healthcare industry as a whole. Over time, these costs add up to real savings and better, more affordable healthcare for everyone. There were five carriers that offered individual plans in the Nevada exchange in That dropped to three in , but existing carriers expanded their offerings. The CO-OP closed at the end of , and Assurant Time announced earlier in that they would be exiting the individual market nationwide, and would not participate in the open enrollment.

Both the CO-OP and Assurant had requested double-digit rate increases for , but their members ended up having to select a plan from a different carrier for In addition, Prominence expanded their plan offerings into Southern Nevada. Humana also joined the exchange for , but only in the small-group market. For , the individual market carrier options within the exchange — and their average approved rate increase for , if applicable — were:.

At ACAsignups, Charles Gaba calculated the overall weighted average rate increase for the entire individual market in Nevada including the carriers that only offer plans outside the exchange , at 9.

For the remaining enrollees, the average premium increase within the exchange was 8. During the open enrollment period, although Healthcare. As a result, Nevada Health Link opted not to run the walk-in centers during the open enrollment period. But in-person assistance is still available from brokers and navigators across the state, and the exchange held enrollment events throughout open enrollment.

As of February 22 — at the end of the open enrollment period — 73, people in Nevada had enrolled in private plans for This was more than double the number of people who had enrolled by the end of the open enrollment period — when the exchange was using its own technologically-flawed enrollment platform.

By the end of March, 62, had in-force private plan coverage through the Nevada exchange, and by the end of June, effectuated enrollment had dropped to 60, people; In addition to the private plan enrollments, there were 28, Nevada exchange enrollees who qualified for Medicaid during the second open enrollment period.

Medicaid enrollment continues year-round, but tends to increase during general open enrollment due to the additional consumer outreach conducted by the exchanges, carriers, and HHS. Since Nevada switched to Healthcare. Thus the enrollment report showed that percent of the enrollees were new to the exchange as opposed to plans renewed from At its peak in the summer of , total enrollment in private plans was about 38,, and it had declined to under 33, by fall.

Things went much better for Nevada Health Link during the second open enrollment period, since they were using Healthcare. On May 20, , the exchange board unanimously voted to drop Xerox the company that had been responsible for building the state-run exchange website and switch to Healthcare.

The state has retained some responsibilities — certifying private plans and determining Medicaid eligibility — and is still legally be classified as a state-run exchange. But HHS is handling enrollment; applicants are redirected to Healthcare. This type of set-up is known as a federally-supported state-based exchange. Because Nevada switched to Healthcare. People who did not complete the re-enrollment process were automatically re-enrolled in their plan, but without premium subsidies.

In order to continue to receive subsidies, people who enrolled through Nevada Health Link for needed to make sure that they re-enrolled for In order to have had uninterrupted subsidies in January , enrollees needed to complete their re-enrollment by December 15, If they missed that deadline, they were able to re-enroll anytime until February 15 February 22 with the extension that was added , but in that case, they needed to pay their full premium up front in January.

In October , Nevada Health Link began an aggressive outreach campaign to alert enrollees of the need to re-enroll, and they continued the outreach into December. Oregon was the only other state to switch from running their own enrollment to utilizing Healthcare.

In Oregon, exchange plans terminated on December 31, and enrollees had no choice but to re-enroll. Carriers in Nevada were required to file their rates by early September. Final approved rates were released by the Division of Insurance in mid-October.

The average premium increase was 6. But Las Vegas was one of the 16 metropolitan areas analyzed in a September Kaiser Family Foundation report that examined proposed rates for benchmark second lowest cost silver plans. According to the report, the benchmark silver plan — upon which subsidies are based — was proposed to rise by a very modest 1. With Nevada Health Link relying on the now very-functional Healthcare.

The state launched their new and improved Nevada Health Link website on November 3, In addition to using Healthcare. As a result of these changes, Nevada Health Link had far fewer technological headaches during the open enrollment and throughout the year. Nevada Health Link debuted a pre-screener tool for the open enrollment period; consumers answer six simple questions and are then routed to the appropriate section of the website.

The exchange also put a lot of emphasis on in-person assistance during the open enrollment period. They upgraded the portion of their site that helps consumers find local navigators, brokers and assisters. You can search by zip code and the results are displayed on a map so you can easily pinpoint the nearest in-person help. Nevada Health Link also has a community events calendar on its website so that people can easily see when and where enrollment events are taking place.

Nevada Health Link extended their open enrollment period to May 30 for people who experienced technical difficulties during the regular enrollment period. By the end of May, the exchange had enrolled about 35, people — short of their goal of 50, which had been modified in early , down from an original goal of , Enrollment had climbed to about 38, by mid-summer, but had dropped to about 34, by early September, and to 32, by mid-October. Medicaid enrollment continues year-round, but tends to spike during open enrollment, due to outreach.

However, Xerox continued to work with Nevada Health Link until April , running call centers and enrolling applicants who qualified for a special open enrollment period during the latter part of Applicants signing up during the general open enrollment — that started on November 15, — were directed to the federal call center for Healthcare.

There was some confusion in the transition, but officials decided this approach would be less expensive than completely revamping the existing state-run exchange. Xerox and Nevada Health Link are settling their contract privately , without litigation.

But 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.

If you were unable to obtain coverage in because of the technological problems with Nevada Health Link and you need to file an amended return for , you can resubmit form to the IRS with the correct exemption code. In addition, many enrollees received incorrect data regarding coverage dates on their A forms that were mailed out in early To handle the problem and correct the errors , Xerox kept its Nevada Health Link call center open until April 15 — two weeks later than originally scheduled.

Errors on A forms was certainly not unique to Nevada — they happened in other state-run exchanges and also with Healthcare. During the August board meeting for Nevada Health Link, it was noted that they were still dealing with a small backlog of A errors, but they expected to have them all fixed by the end of August. Thus there was also no renewal available for pre plans heading into , and all non-grandfathered plans in the individual market in Arizona are now ACA-compliant.

Sandoval and the state legislature created the Silver State Health Insurance Exchange in , and the state moved steadily to get the marketplace up and running. Five of the voting members are appointed by the governor, and the other two are appointed by the state Senate majority leader. In May , AB86 was signed into law, allowing insurance agents and insurance carrier representatives to serve on the board of directors for the exchange.

Insurers can participate in both the individual and small-business exchanges. Silver State Health Exchange Information about exchange planning and start-up operations. Nevada The Henry J. Step 1 of 2. About our health insurance quote forms and phone lines We do not sell insurance products, but this form will connect you with partners of healthinsurance. If you have questions or comments on this service, please contact us. Latest Nevada exchange updates Open enrollment for coverage in Nevada ended on December 15, but people losing Anthem grandfathered plans have extra time to enroll.

Outside the exchange, enrollment continues year-round in Nevada with a waiting period Enrollment in the exchange is still open for Nevadans with qualifying events. Association health plans available to some chamber of commerce members in Nevada Short-term health plans are available in Nevada with initial plan terms up to days.

For plans, Nevada exchange premiums had a 0. Nevada plans to switch back to fully state-run exchange by Average approved rates Silver Summit joined the Nevada exchange for , and is continuing to offer statewide coverage in