Nevada moved a step closer on Wednesday to taking its health insurance exchange live.
The state Division of Insurance released the plan premiums that will take effect Oct. 1 both on and off the Silver State Health Insurance Exchange, and explained how consumers will be able to shop for coverage. The new plans and the exchange are part of federal changes under the Affordable Care Act, or Obamacare.
The rates shared Wednesday apply only to consumers who buy insurance themselves on the individual market, rather than through an employer. Individuals make up 15.4 percent of Nevada’s fully insured market.
Jon Hager, executive director of the Silver State Health Insurance Exchange, said state officials won’t offer average premium costs until after consumers begin to enroll in October.
But some specific rates differed from preliminary premiums the division released in July. The cheapest plan available in Clark County, for example, will be Altius Health Plans’ catastrophic coverage, which will cost $91.02 a month. That’s down from the $148 low proposed in July, though it’s still more expensive than the $29 low a 25-year-old would have paid for a catastrophic plan bought earlier in 2013, before new federal coverage mandates increased costs.
You have to be under 30 or experiencing financial hardship to buy a catastrophic plan.
Scott Kipper, commissioner of the Division of Insurance, said some plans are less expensive than initially proposed, while others are pricier. The division’s actuary and an independent consulting actuary pored through assumptions in insurers’ proposals, and asked carriers to justify statistics behind their rates. Some of the assumptions changed, and rates moved with them, Kipper said.
The division isn’t releasing plan designs until the exchange opens, so there’s still no way for individual buyers to know how big their insurer’s doctor or hospital network will be, or what costs they’ll share.
Just four carriers — Anthem, Health Plan of Nevada, Nevada Health CO-OP and Saint Mary’s — are selling 2014 plans on the exchange. Twelve carriers, including Cigna and Aetna, aren’t participating, though premiums for the same plan on or off the exchange must be equal.
Kipper said some insurers have made a business decision to sit out the exchange’s first year and evaluate how the system works. He said he believed more would participate in 2015 and 2016, once they’ve had a chance to see the process in action.
“Certainly, it’s in everybody’s best interest to have as many carriers as possible on the exchange,” Kipper said. “Competition does have a significant impact on rates. We would certainly encourage other carriers to put products on the exchange.”
Despite fewer insurers, Hager said he still expects strong participation in the exchange, because it’s the only way consumers can earn the advanced premium tax credit. If you’re single and earn less than $45,960 a year, or a family of four making less than $94,200, you qualify for help.
Hager said the exchange also has “transparencies” in its purchasing process that should appeal to buyers who don’t qualify for the tax credit.
Though you can’t buy coverage yet, you can visit www.nevadahealthlink.com to figure out whether you qualify for a tax credit. You can see premiums on and off the exchange, or search by carrier, at doi.nv.gov/rates.
Kipper said the state is also ramping up its program of navigators, or exchange enrollment facilitators, who will guide consumers through application and buying. Navigators will need several hours of continuing education, and they’ll have to pass a test and a background check. Kipper said grants have gone to six nonprofits to hire 110 to 120 facilitators. The state will certify another 300 to 400, and will station “quite a few” at Nevada hospitals, where they’ll help patients get coverage, Kipper said.
The Division of Insurance also expects about 1,200 brokers to sell coverage. To be licensed, brokers will need four hours of continuing education.