The 2018 decision by Nevada legislators to split with the federal healthcare.gov insurance exchange in favor of a wholly state-based system will cause fall enrollees to see significant changes in the enrollment process and available insurance options when open enrollment begins Friday.
Las Vegas insurance broker Patrick Casale, managing partner with The Multicare Group, said the state-run system will likely give Nevada more control over the enrollment system and be better for buyers on the market who can take advantage of tax incentives offered under the Affordable Care Act.
“You only need the exchange if you’re getting tax credits,” Casale said, “if your income is over $50,000 for the individual, I would definitely go direct. I wouldn’t even deal with the exchange because you have more options.”
The switch to a state-run healthcare exchange, run by California based GetInsured, could save the Silver State Health Exchange money which could, in time, be passed along to consumers.
“Nevada Health Link will immediately realize at least $4 million in cost savings that would have otherwise been spent on healthcare.gov in the first year alone,” Silver State Health Exchange communications officer Janel Davis said, “The goal is to eventually reduce our premium fees for carriers who will then pass those savings along to consumers.
The federal government would have charged Nevada Health Link 3% on every premium to use their exchange services, according to a healthinsurance.org report, which Nevada Health Link passed along to consumers with a 3.15% premium fee.
The report said GetInsured will charge half of the government’s rate potentially saving insurance buyers money.
A Commonwealth Fund report found premiums in state run exchanges were typically 21% lower on average than exchanges using the federal exchange in 2018.
“It’s better for the consumer,” Casale said.
People opting into the exchange will have more coverage options this year as well.
Anthem has decided to rejoin the public exchange after a two year absence.
“Anthem being the new game in town is good for the consumer,” Casale said, “specifically in the rurals because in the rurals you only have the one option on the exchange. Now you’ll have two.”
Casale said one thing that is always important and hasn’t changed this year is that an enrollee report an accurate prediction of their next year’s income.
He said false reporting could lead to significant penalties from the Internal Revenue Service.
Silver State Health Insurance sent a letter or email to customers currently enrolled under healthcare.gov with a code allowing them to transfer service to the state system.
Open enrollment begins on Nov. 1.