Changes Coming To State Health Insurance Enrollment Program

Cropped Photo: MGN Photo / Creative Commons Attribution 2.0 Generic

RENO, Nev (KOLO) - If you were around three years ago when health care enrollment got underway in Nevada or better yet, tried to enroll, you know the problems that persisted for more than a year. At that time Nevada had contracted Xerox to run the system and it was a disaster.

Now the state is faced with finding another entity to perform the task, and officials here say they are determined to not make the same mistakes.

Claudia Lamb had trouble two years ago while trying to get insurance.
For months, the Zephyr Cove resident tried to get coverage for her and her husband.

“Our applications kept being denied,” said Claudia at the time.

The reason? The exchange said it would not insure the couple because her husband Richard was incarcerated. He was sitting at the table next to us during the interview. It took four months, but Claudia eventually got her coverage, and she was just one of thousands caught in a system run by Xerox that lost information, misplaced payments, or didn't get the coverage information to the facilities that needed it.

A lawsuit was filed on behalf of one man who had insurance, subsequently had a heart attack, and was told he had no coverage.

“I incurred $475,000 worth of health care costs,” Larry Basich testified during a Silver State Health Insurance Exchange Board meeting.

The board dropped Xerox and went with the federal system to enroll residents in fall of 2014. But now comes word the feds want to charge our state for using their system.

“They want to charge us 3% above the cost now; that could translate into $9,000,000,” says Bruce Gilbert, Executive Director of the Silver State Health Insurance Exchange..

Gilbert says the board is looking at options. One would be to join with another state that has a successful track record to run the enrollment program.

“I am really scared,” says Alex Sampson, a broker with Health Benefits Associates.

Sampson says he’s worried about the switch and what it will mean to him and his clients. The program worked well this year. And he wonders if the 3% increase should really be enough to scare off Nevada's health insurance exchange.

“When we had to actually switch everybody over to healthcare.gov from Nevada health link we had huge attrition that year. I had to meet with every client I've ever sold an individual policy to and re-enroll them into healthcare.gov instead of Nevada Healthlink,” says Sampson.

“We are not talking about building something from scratch. We are talking to other states that have a state-based market place that are successful,” says Gilbert.

Gilbert says nothing is set in stone yet. They don’t know what the actual price the feds will be charging to use their program.

When that does happen, Gilbert says, the board will seriously be looking at other options and bids to run the state’s health insurance enrollment plan.