Brokers Maneuver Bureaucracy


RENO, NV - With less than 2 weeks, some Nevada residents are scrambling, trying to get health insurance through the state's health insurance exchange. Meantime others who already have insurance are trying to get back on to the exchange to remedy problems that have cropped up since their enrollment. Health insurance brokers are trying to help, but finding in some cases their expertise is for naught.

Last November, Reno resident Grey Martin went to a navigator to get health insurance for his wife through Nevada Health Link.

He says they were happy to get her the coverage she needed, and at the time, he says she had no major health concerns.

“I thought that it was excessively high. It was very high, but I wanted to make sure my wife had full coverage. We like the plan we selected, and we paid it and we continue to pay it,” says Martin.

Martin says the premiums have come out to 25% of his monthly income.

Then the unexpected: his wife had to have surgery in February.

While looking up his deductible and benefits a couple weeks later, Martin realized he had not only met his out-of-pocket; he was also paying too much on his premium and in fact he qualified for subsidies.

”For his particular application, they added an extra zero to his income,” says health insurance broker Alex Sampson.

Sampson has for at least a week tried to call and get help to adjust Martin's income.

All he is getting is recordings.

While he could just open up a new policy for Martin--Martin would have to start with out-of-pocket expenses all over again.

And no one can say just what will happen to the extra money he's forked out for the past several months.

“The money is cleared. It is out of my account, why should they get to keep it? For service...it is their mistake. We didn't do anything wrong here. So I want my money back, or I want it applied to my account at the very least. But I am not so certain that that is the acceptable choice. I think I'd rather have the money credited to my bank account,” says Martin.

According to C.J. Bawden with Nevada Health Link, extra zeroes or inverted numbers are not uncommon on health insurance applications prepared by navigators or by other individuals.

Bawden says in Martin's case can be resolved quickly; he can receive cost-sharing reductions on his premiums in the months to come.

If not, Bawden says Martin will get his money back through income taxes next year.


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