Health coverage enrollment gets good early reviews

So far, so good.

That was the word from insurance brokers and enrollment navigators on Monday, following the first weekend of open enrollment in Affordable Care Act health coverage through state and federal marketplaces.

Industry professionals praised the new system’s efficiency and performance, giving it high marks, especially when measured against 2013’s glitch-riddled platform. The board of the Nevada Health Link exchange fired original contractor Xerox in May and opted to borrow the federal healthcare.gov platform for sign-ups this fall.

“The system is working really, really well. It’s night and day compared to last year,” said Pat Casale, a broker with Pat Casale & Associates in Las Vegas. “I give it an A-minus to B-plus. If the carriers do their billing correctly and everything is smooth between now and Dec. 15, it’ll be a home run, and we’ll go from there.”

Added Lou Cila, a local broker with Best Nevada Insurance Agency: “Compared to what I dealt with all those months last year, this is a walk in the park. It looks like a 70 (on a scale of 100). Last year was like a minus-50.”

Consumers also seemed to have few early complaints.

Las Vegan Phillip Olivas, who also bought through Nevada Health Link a year ago, said on Saturday that he was able to get online, enroll in a 2015 plan, keep his provider network and lower his premium.

“There were no glitches and I was able to compare to other plan options and pay for the premium all with one visit,” Olivas said, adding that he was “happy” with the system both last year and this year.

A FEW HICCUPS

But the positive reviews don’t mean everything went perfectly. Brokers said hiccups included a temporarily dysfunctional carrier portal through which consumers should have been able to sign up directly through insurers, and occasional access issues because of high traffic. Also, some of the questions and language used online were confusing, said Chris Carothers of Carothers Insurance Agency, who reported that it took more than two hours to enroll his first client Saturday.

What’s more, consumers must have an email address to sign up — a problem for a system designed for moderate- to low-income people, said Cila, who found himself setting up email accounts to get some clients into the system.

Plus, re-enrollment of customers, key to boosting sign-ups in Year Two, proved difficult and time-consuming, Cila said. The system asked several multiple-choice security questions, so “you can’t re-enroll someone without them being here,” he said.

Brokers said they’re also eyeing a few potential problems down the road.

Start with enrollment numbers. The Nevada Health Link exchange had 32,000 enrollees as of last week — a number that was already down more than 15 percent from a peak of about 38,000 in the summer, and a drop Cila blamed on the relatively low incomes of enrollees. Health Link officials had initially set a first-year target of 118,000 enrollees; they haven’t publicly released a sign-up goal for the current session, which runs through Feb. 15.

Cila said he’s not optimistic the exchange will see a big membership surge.

“They need 35,000 to 50,000 more people to keep the state exchange. It’s not that people don’t care about signing up; it’s that they don’t have the money,” he said.

A Saturday sign-up fair at the Rio drew about 5,000 people, said organizer Andres Ramirez of The Ramirez Group, the state’s largest enrollment-navigator firm. Ramirez said several hundred consumers enrolled in private plans at the event.

But Cila, who attended to look for clients, said 70 percent of the crowd left after an announcement that consumers couldn’t enroll in Medicaid at the fair. Medicaid expansion in Nevada has drawn 182,000 new enrollees in the publicly funded program for low-income earners. That imbalance between enrollees in public aid versus private coverage may not be good for the exchange’s survival in the long run, Cila said.

The federal government said Monday that 100,000 people enrolled over the weekend, but officials didn’t break down sign-ups by state. Nevada Health Link spokesman Tyler Klimas said it may be a few weeks before the agency can report state statistics.

Carriers didn’t disclose enrollment numbers Monday, either, although officials with Anthem said the system was more effective than 2013’s version.

“Anthem is prepared and excited to be a resource for all Nevadans across the state who want to enroll for health insurance.

“We believe the Nevada exchange is set up in a much more effective way than last year,” the company said in a statement.

DOUBLE PAYMENTS A WORRY

Beyond enrollment numbers, there are also concerns about how double premium payments in December will affect new and returning enrollees who already have insurance.

People with coverage must make a premium payment on or around Dec. 1 for their plan. But the exchange also requires a payment by Dec. 15 for a 2015 plan set to take effect Jan. 1. That’s not how insurance normally works, Casale said. Off the exchange, carriers won’t require January’s payment until sometime in the first week of January.

“Who can make two payments in one month? We’re dealing with lower-income people,” Casale said. “People need to go Christmas shopping in December, and you’re asking them to spend more money on insurance. One of my clients told me, ‘Christmas isn’t coming this year.’”

Carothers said the double premiums were a problem for some of his clients, as well.

The only solution he’s found, he said, is to cancel the premium draft for December on the existing plan, triggering a grace period on the current plan, and then paying the premium on the new plan.

Finally, Casale said he’s wary of possible website bottlenecks Dec. 12 to Dec. 15, the last day people can enroll in a plan that takes effect Jan. 1.

“Everyone is going to wait until the last second, and I anticipate those few days becoming a nightmare,” he said. “If people wait until then, the computers will get bogged down.”

Still, those issues couldn’t dampen enthusiasm over the weekend’s launch.

“I’m ecstatic,” Casale said.

Contact Jennifer Robison at jrobison@reviewjournal.com. Find her on Twitter: @J_Robison1