Board eyes health exchange grace period
March 20, 2014
Anyone who attempted to sign up for health insurance with Nevada's failed insurance exchange will have 60 more days to try to complete the sign-up process, a state board decided Thursday.
The action by the Silver State Health Insurance Exchange Board leaves the door open for tens if not hundreds of thousands of people to reapply after open enrollment ends March 31.
As many as 300,000 people may have tried to buy insurance coverage through the state's botched online portal, Nevada Health Link, but were thwarted by program errors in the system designed by Xerox, officials said.
But they also stressed that sum could represent duplicate enrollment attempts by people who became stuck during the process and started anew from scratch, hoping for a better outcome.
Only about 22,000 have successfully enrolled and paid for policies since the exchange went live Oct. 1, prompting the board to consider a special enrollment period for consumers who were trapped in the system and unable to complete their applications or make payment.
Given that dismal success rate, the potential volume of do-overs Xerox will be tasked to deal with in a two-month period far exceeds what it's been able to achieve in the past six months.
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Under the federal health care reform law, a special enrollment period can only be for 60 days and begins when a "triggering event" occurs. The law covers such things as the birth of a child or other life-changing event like the loss of a job. But it also includes "exceptional circumstances" in which people were unable to sign for insurance because of technical problems with the exchange.
Because of the 60-day time constraint, the board was tasked with trying to define when the clock would start ticking for someone who tried to enroll unsuccessfully. Scott Kipper, Nevada's insurance commissioner, noted that someone who gave up, say, in November, would be ineligible if the parameters were determined by when a last attempt was made.
A motion by board member Leslie Johnstone to limit the special enrollment to people who selected plans but didn't complete the payment process failed for lack of a second. Johnstone also questioned Xerox's ability to handle the volume of an all-encompassing pool.
But Marie Kerr, also on the board, opposed restricting the scope, saying it would have a "discriminatory" effect on minorities or others who are less educated or computer savvy and may have abolished their attempts earlier in the process.
"Whether or not Xerox has the capacity to undertake that kind of enrollment is not a consideration under the federal regulation," Kerr said.
Kerr's motion making anyone who attempts to sign up by March 31 eligible for the extension was approved on a 3-1 vote. Three board members were absent — Chairwoman Barbara Smith Campbell, Dr. Judith Ford and Dr. Florence Jameson.
Greg Vitiello, Xerox vice president, recommended limiting the special-enrollment pool to about 10,000 who have selected but not yet paid for coverage, or an estimated 78,000 who completed the application but stopped before picking a plan.
Vitiello said Xerox's 230 employees at a Henderson call center would work with consumer one-on-one to take them from start to finish.
The board told Xerox to come back next week with firm numbers on how many people the special period will encompass and the company's plan to deal with it.
Xerox was awarded a $75 million contract to develop Nevada's online health insurance exchange that was set up under President Barack Obama's signature health care reform law. But problems with program errors, billing, invoices and coverage verification persist and are largely to blame for the state's poor enrollment figures.
Under the contract, Xerox is being paid in phases as it meets performance standards. To date, the company has been paid $12 million, and it has not received any compensation for the project since December.
On Tuesday, a board chaired by Gov. Brian Sandoval approved a $1.5 million to hire Deloitte Consulting, a Xerox competitor, to evaluate Nevada's exchange and recommend fixes.