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Nevada insurance law and regulation
The state insurance department can be reached by telephone at (702) 486-4009 or by mail at 2501 East Sahara Avenue, Suite 302, Las Vegas, Nevada 89104. The state children’s health insurance plan (CHIP) Web site is Nevada Check Up.
News that affects your health insurance and planning
June 2, 2019 – Status of alternative non-ACA health plans: Nevada does not require individuals to maintain adequate health coverage. The state provides no premium or cost-sharing subsidies for individual market coverage, permits insurers to sell non-compliant transitional policies in the individual market. Nevada limits the sale of short-term coverage more strictly than the federal government. A maximum policy of 185 days and a maximum under multiple policies of 15 days per year is allowed.
March 23, 2019 – The Nevada Office for Consumer Health Assistance reminds consumers that it handles complaints from health plan members who have difficulty finding in-network medical providers. If a patient has tried to reach the insurance company through the patient line provided on the back of their insurance card then the state would connect consumers to the right office.
The history of health care planning in Nevada (Information is outdated and links may be expired)
10/20/2015 Nevada Health CO-OP will not offer coverage for 2016. Participants will be covered through the end of 2015 but are asked to choose another insurance provider when open enrollment period beings on the insurance exchange in November.
3/30/2015 Nevada has a shortage of physicians as a result of the Affordable Care Act expanding coverage for so many residents. Nevada ranks 45th in the nation in the number of physicians per 100,000 in population.
12/21/2014 Nevada residents living near the border with California need to be aware of the sharp differences in health insurance and health care between the two. Don’t assume that what works in one state applies to the other.
12/10/2014 – Nevada Health Link reports that 10,000 Nevada residents have enrolled already for 2015 health insurance. Consumers have until December 15 for coverage to start January 1, 2015.
2/11/2014 Professional support for any health care reform issue is available free of charge through an arrangement with OnlineNavigator. All online inquiries are handled personally by Tony Novak, CPA. Online support is available through a number of popular social media channels including Facebook and Google+ as well as e-mail. Telephone support for insurance enrollment is available through Members Insurance Exchange at (800) 609-0683.
10/9/2013 Nevada confirms that its state online insurance exchange is working properly for Medicaid-eligible individuals to allow enrollment id free or subsidized health insurance.
7/26/2013 Affordable Smart Term Life Insurance is now available to most Nevada residents from age 20 through 60 directly online with no physical exam, agent appointment or telephone verification. Most policies are issued on the same day with coverage amounts of $25,000 up to $350,000. The level premium life insurance is available for terms of 10, 15, 20 and 30 years. Sample rates for $150,000 coverage for a preferred risk male age 30, non-tobacco $30.85 per month; tobacco user $49.55 per month. A preferred risk female age 30 non-tobacco user would be $26.49 per month and a tobacco user would be $40.96 per month. Rates are higher for older applicants and lower health risks as described online. Pricing is based on input you provide about your medical history but, unlike most other life insurers, does not consider family medical history. Coverage is issued by innovative National Life Group, rated “A” by A.M. Best Company for 2013.
3/11/2013 This page was updated to include a link to the insurance plan that will be used to determine specific “essential health benefits” for insurance that qualified for 2014 federal tax purposes. Also, a link to additional covered benefits required by state law. Non-qualified insurance is likely to continue to be available at a lower cost that does not include these benefits nor qualify for federal tax purposes.
12/14/2012 Nevada is one of a minority of states that will run a health insurance exchange for individuals and small businesses that is not managed by the federal government. Consumer advocates who once viewed a state-run exchange as a positive are growing concerned that the state may not be fully committed to implementing all of the funding and features expected to be part of the federal health insurance exchanges that are expected to open in the fall of 2013.
2/1/2012 The Center for Consumer Information and Insurance Oversight, a division of the Center for Medicare and Medicaid Services (CMS)reported that as of June 30, 2011 Anthem BCBS and Health Plan of Nevada are the state’s largest health insurance providers and as such, earn the right to set the benchmark for the development of the state’s essential benefit plans to debut in 2014 under health reform law.
1/12/2012 Value Access Guarantee is no longer available in Nevada.
6/20/2011 The Silver State Exchange was created by law to offer health insurance to Nevada residents. Initially the exchange board will be run by the Director of the Nevada Department of Health and Human Services. A strategic operating plan has not yet been developed and many of the specific functions and operational standards are unresolved, including how to pay for the exchange past the formation stage. The exchange board is required to adopt an implementation and operational plan for submission to the Nevada state legislature before the end of the year.
2/7/2011 The state’s pre-existing condition insurance plan (PCIP) monthly premium rates (per person):
PCIP will cover a broad range of health benefits, including primary and specialty care, hospital care, and prescription drugs. All covered benefits are available for you, beginning on your coverage effective date, even if it’s to treat a pre-existing condition – there are no waiting periods. PCIP applicants who are approved to participate in PCIP can choose from three plan options, with different levels of premiums, calendar year deductibles, prescription deductibles and prescription copays. The HSA Option provides an opportunity to open a Health Savings Account, a tax-exempt account where you can deposit funds for eligible medical expenses. Each of the three PCIP plan options provides preventive care (paid at 100%, with no deductible) when you see an in-network doctor and the doctor indicates preventive diagnosis. Included are annual physicals, flu shots, routine mammograms and cancer screenings. For other care, you will pay a deductible before PCIP pays for your health care and prescriptions. After you pay the deductible, you will pay 20% of medical costs in-network. The maximum you will pay out-of-pocket for covered services in a calendar year is $5,950 in-network/$7,000 out-of-network. There is no lifetime maximum or cap on the amount the plan pays for your care. If you apply for PCIP coverage on the government Web site, you will be billed for the premium once your application is approved. You will need to send in your payment in order for your coverage to be effective. Please do not send in the premium before you are billed. Note that your premium may increase if you age into a higher rate tier, or if PCIP adjusts its premiums to any changes in the commercial market.
12/16/2010 Nevada Department of Health and Human Services officials met representatives of 44 other states and numerous employees of the federal Health and Human Services Department in Washington DC this week for a two-day working meeting to discuss the next steps in establish a government-run health insurance exchange under the American Health Benefit Exchange Model Act. Their attendance at this meeting was paid for by a $1 million federal grant awarded by HHS in September to the state for research how to set up an insurance exchange. Two states (Alaska and Minnesota) declined to participate, saying that it was a waste of taxpayer money. Four other states (not identified in press reports) that received federal grants did not send representatives to the meeting. Attendees included representatives of 16 states that are suing the federal government in an attempt to overturn the federal health reform law; specifically the requirement that forces individuals to buy health insurance on the insurance exchange or pay a hefty tax fine.
In its initial federal grant request for the insurance exchange project, the Nevada Department of Health and Human Services said that it would: 1) Assemble information, identify priorities, assess resource needs, and lay the foundation for the development of a fully functioning health insurance Exchange that best meets the needs of Nevadans, 2) Conduct background research to better quantify the populations covered by existing and future health insurance programs and to better understand the potential impact on the market with introduction of the Exchange, 3) Establish a streamlined eligibility process to serve all applicants for all medical assistance programs, 4) Define a governance structure and administrator for the Exchange, 5) Catalogue existing resources that may be used to support an Exchange, and 6) Identify services that will need to be developed and contracted to operate the Exchange.
The meeting reportedly did not address the role of the commercial health insurance exchanges on the implementation of new competing government systems. The model act does not address inter-state insurance exchange proposals nor insurance sales across state lines. Federal officials admitted that they may not be able to provide further guidance until 2012. Meanwhile, most states are motivated to continue to meet requirements to obtain additional funding promised by the federal government for the establishment of insurance exchange by 2014. Freedom Benefits has previously voiced the opinion that the huge amount of money being spent to set up alternate insurance sales system technologies could be better used providing health benefits to the public. We proposed on the Universal Health Insurance blog that adequate commercial insurance sales systems are already in place that could be modified in a public/private partnership to make health insurance more affordable.
5/14/2010 Diabetes Coverage: A new resource to help find health insurance for diabetics in Nevada is now available at Freedom Benefits.