Cautious Optimism Pervades Launch of Nevada Health Link 2.0

We’re more than a month out from the Nov. 15 launch of Nevada Health Link 2.0. Still, given the first go-round’s disastrous results, it’s worth looking in now on how advance prep work is going for the new rollout.

If you recall our coverage this spring, you will remember that Nevada Health Link, the marketplace through which consumers can buy health coverage with federal tax credits, went live with big portions of its system incomplete and untested. The back end — where enrollment details got sent to insurers, premium invoices were created and people could switch coverage — wasn’t finished. And some test results on the original system weren’t even due until April, after the close of the first open enrollment period.

Some of those issues will go away Nov. 15, with the state’s borrowing of the federal infrastructure. Insurers will bill premiums directly to consumers without the exchange as a middleman, so that back-end element is gone from the website build and testing process.

Plus, early indications show more oversight — and more communication — this time around.

Exchange staff members said in a Sept. 11 report that they have partnered for guidance and technical help with more than a dozen groups, including the federal Centers for Medicare and Medicaid Services, Gov. Brian Sandoval’s office, Deloitte Consulting and carriers and insurance brokers. Participants meet several times a week, and as of September, they were sending status reports each Monday to Sandoval’s office and the Division of Welfare and Supportive Services, among other agencies.

And unlike the health link’s first iteration, when the state amended its contract with Xerox to extend some milestones and testing deadlines, the exchange said it was on track as of mid-September with its project milestones. Exchange staff members were set the week of Sept. 22 to begin testing the shopping process, starting with creating an application and continuing with the tax-credit eligibility process and actually signing up for coverage. They were also scheduled to begin visiting on-site with carriers Tuesday to watch and help out as insurers began enrollment testing.

Insurance Division officials say loading up plans onto the federal site has been pretty much glitch-free, and with the state exchange handling fewer functions, the process should improve.

“We’re confident the enrollment piece through will go smoother and faster,” Insurance Commissioner Scott Kipper told the Las Vegas Review-Journal on Sept. 16. “One thing that will help is direct enrollment by carriers. We shouldn’t have those hiccups we’ve had this year.”

That’s not to say officials are promising a trouble-free system come November.

Exchange Director Bruce Gilbert told the exchange’s board Sept. 11 that “no project of this size” is ever “flawless or perfect.”

“But we need to be able to see, from the first day of the enrollment period to the last, that we will not experience the same systemic failures that caused so many of our current problems,” Gilbert said.

So Gilbert said he’s scrutinized “every person and every hour of work” that could be redirected toward readying the exchange for its second chance. He also recommended canceling the search for another contractor to replace Xerox, which the board fired in May, and advised sticking instead with for the foreseeable future. That’s because ending the hunt for a new vendor would free additional resources for November’s launch. The board approved the idea Sept. 11.

Insurance brokers and information technology experts are also watching out for unknowns. Even if observers pretty much all agree’s shopping experience will be an improvement, there’s no precedent for what happens when you combine first-time enrollees with the crush of consumers trying to re-enroll.

The rollout will happen even as Xerox and exchange officials continue to work down a caseload of thousands of problem enrollments in which consumers have paid for a plan but seem to have no coverage in place. Xerox is scheduled to stay on hand through March to help with coverage kinks in 2014 plans.

An important publication note: We know you’ve got questions about health insurance. So we’ve got answers. Today’s edition of the Las Vegas Review-Journal features a comprehensive look at everything you need to know to begin weighing your coverage options when the state Insurance Division releases its official rates and plan designs midmonth. Do you have to buy coverage through the exchange? How do you get federal subsidies? We’ll help you sort it all out.

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