Open enrollment for health insurance under the Affordable Care Act begins in just two weeks.
In Nevada, not only do consumers have more choices this year, Silver State Health Insurance Exchange Director Heather Korbulic says the process should be more transparent because Nevada is no longer working through the federal exchange at healthcare.gov. Nevada has transitioned to its own state-based exchange at nevadahealthlink.com.
The process of leaving the federal exchange began several years ago driven, in part, by the rising fees the federal system was demanding. She said those fees grew to the point where they were consuming almost all of the money Silver State needed to operate.
Going to the state-based exchange, Korbulic said, will save Nevada more than $4 million in the first year alone, “and that’s a conservative estimate.”
“As of Nov. 1, people will be able to go online, put things in their shopping bag and purchase them,” Korbulic said.
But until then, she said people can go online at nevadahealthlink.com and click on Window Shopping to find out what’s available, how much it will cost and what their subsidy might be to help pay that premium. They can also call the exchange at 800-547-2927
So far, she said the roll-out of the new system has gone very smoothly, in large part because Nevada selected a vendor that has done this in six other states.
“Every step of the way, we’ve had successful deliverables,” she said.
So all of the Nevada exchange’s current 83,000 customers have been moved to the state platform where those who selected automatic renewal will be re-enrolled in the same or most similar plan for 2020 unless they want to change coverage.
New customers have to go online and “claim” their account by signing up.
In Clark, Washoe and Nye counties, Korbulic said consumers can choose from 27 plans offered by three insurance carriers. In the rest of the counties including Carson City, there will be 17 plans offered by two insurance carriers.
Those plans are all Qualified Health Plans that meet the requirements of the Affordable Care Act. She said there are other plans outside of the exchange but that they may not provide all the benefits required to be a Qualified Health Plan.
So-called short term plans don’t have to cover all those areas including pre-existing conditions and other essential benefits.
She said Silver State now has 672 broker partners across the state compared to just 110 last year as well as ample navigators to help consumers through the process.
And she said Nevada is now offering six dental insurance carriers.
Korbulic said the money wasn’t the only benefit Nevada Health Link will get from moving to its own exchange. She said they will get much better access to data about their customers they couldn’t get from the federal exchange. There, all data from all participating states is basically put into one pile and she said it’s practically impossible to access figure out who their customers are. The result, they were spending money on marketing, “in a blanket fashion.”
“The data was never provided in a meaningful way,” she said.
On top of that, Korbulic said the federal exchange cut its marketing budget by 90 percent in each of the last three years.
In the last plan year, she said most state based exchanges saw increases in their enrollment while states using the federal exchange saw decreases.
“But now we know who we have. We can micro-target dollars to specific areas,” she said. “During open enrollment, we’ll know how many people are enrolling, how many completed applications and who is still pending.”
She said according to a study by the Guinn Center in Las Vegas, Nevada has the sixth highest uninsured rate in the nation, about 400,000 people. She said about 120,000 of them could be on the exchange and 77,000 could qualify for a subsidy. Much improved marketing, she said, should draw many of those people to the exchange.
“We’ve got the opportunity to find all these uninsured folks relatively stable and low priced plans”
Some of those people, she said, may be over-employed, holding several jobs but none of them full-time.
“I think some of them are eligible for subsidies,” she said.
Some 80 percent of Nevada Health Link’s current customers receive subsidies to help cover their premiums.
“I’m interested to see how competition impacts the market this year,” she said.
As for prices, Korbulic said statewide the premiums will only rise 1.6 percent for 2020. That may differ in different parts of the state.
But she said because the federal government changed the subsidy formula, out of pocket costs will rise slightly.
The final reason for going to a state based exchange, she said, is the flexibility to make policies specific to Nevada such as state specific enrollment periods.
She said, for instance, they can now enroll people in a dental plan without requiring they purchase a qualified health plan. She said that might appeal to people on Medicare for medical coverage but not dental coverage.