Nevada's state-based public exchange will give consumers more time to sign up for individual health coverage.
Members of the Silver State Health Insurance Exchange Board, the body that governs the Nevada Health Link exchange, voted Thursday to add a 60-day special enrollment period.
The special enrollment period would start March 31, at the end of the ordinary open enrollment period for individual "qualified health plan" coverage, and it would be open to anyone who tried to apply for QHP coverage before March 31 and gave up before selecting and paying for coverage.
Carriers have enrolled 22,000 consumers in individual health coverage through the Nevada exchange. Exchange managers said as many as 300,000 people may have started the application process and given up before choosing QHPs. Another 10,000 have chosen QHPs but have not yet paid the premiums.
Representatives from Xerox, the company running the exchange web and call center enrollment systems, recommended reducing enrollment system capacity strain by limiting access to the special enrollment period to consumers who have selected QHPs and have not yet paid for coverage.
Marie Martin Kerr, a lawyer who sits on the board, said that limiting access in the way would hurt consumers who had a harder time getting through the QHP selection process because they are less familiar with insurance or less comfortable using computers. She said the exchange should come up with the capacity to extend the enrollment period for anyone who struggled with enrollment system glitches.
"If Xerox is unable to provide that capacity, perhaps we should be looking at other alternatives," Kerr said.
Federal and state officials who set up the new Patient Protection and Affordable Care Act public exchange system added the open enrollment calendar rules to try to keep consumers from waiting until they get sick to buy individual QHP coverage.
The open enrollment system started Oct. 1 and is set to end March 31.
Consumers can sign up for Medicaid after March 31, and public exchanges can sell group coverage after that date.
Individual consumers can still buy individual 2014 coverage after March 31 if they can show that they have gone through a major life change or qualify for a hardship exemption.
PPACA also lets exchange managers create a 60-day general special enrollment period to cope with unusual circumstances.
At the meeting, Nevada exchange members said the enrollment system problems have been serious enough to justify adding a general special enrollment period.
The Nevada Association of Health Plans said overall QHP user satisfaction has been severely affected by exchange premium collection and billing problems. The association is asking the exchange to let its members enroll and bill enrollees directly in 2015.
Kevin Sampson, a broker, submitted a written comment with the title, "Sorry - we are experiencing technical difficulties." He said one problem is that Xerox has recommended that enrollees make minor changes in applications and coverage by creating new applications, rather than changing previously filed applications or existing coverage.
"This is all well and good," Sampson said, "except that people that have already had medical claims find themselves facing a new deductible on the new effective date."
Another problem is that the exchange tells callers to talk to the QHP issuers to resolve problems, and the QHP issuers bounce callers back to exchange, Sampson said.
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