The State Exchanges are Here Now What?

By: Robert Pusateri, Capstone Brokerage Benefits Consultant, June 2014

Here in Nevada we had a rough start with the state exchange. The company Xerox that was hired and since been fired to create the software for Nevada’s exchange failed miserably. Many users reported slow website speeds and thousands experienced glitches forcing the state to extend sign up deadlines due to error codes. A lot has changed since nevadahealthlink.com first kicked off.

For 2015 Nevada has decided to use the federal exchange and create a new state-run infrastructure for 2016. Although this may further confusion for Nevadans, switching to a federal state exchange won’t be immediate. The transition may cause more headaches for consumers in the short term but the goal is to have a fully operational state exchange ready for 2016 enrollments.

Many Insurance companies held back from joining state exchanges for the first year. In fact in Nevada only 3 insurance companies offer policies through the state exchange; Health Plan of Nevada, Anthem Blue Cross Blue Shield and Nevada Co-op. That could change here in the not so distant future. Many Insurance companies were reluctant to offer policies on the state exchanges because they simply didn’t know how they would pan out.

Many companies are now seeing there is good business opportunity on federal and state exchanges. For example, it is expected that enrollment will increase in the coming year. Proving it may be the right time for many insurance companies to begin or expand their coverage on state and federal exchanges. More options for consumers will be a great benefit. In the coming weeks Companies must decide whether they want to participate in the online exchanges run by the federal government. So we may know very soon what and who will be offering plans.

What most consumers seem to be interested in may not be the companies that offer insurance on exchanges but rather the cost. The great debate of what insurers want to charge in 2015 and what regulators will allow them to charge — will not be settled for months. The situation is so unique because insurers do not have enough experience to know if 2014 premiums will cover medical cost. The prices they set for 2014 may or may not cover the medical costs of the people enrolled in their plans and they may not know that until it is too late. As a result, some insurers expressing interest now may back out later, and regulators could refuse to license a new entrant.

Here in Nevada there hasn’t been any word of new insurance companies expressing interest in joining the state exchange but there is still time. Nevada was hit hard with obstacles but proves to be overcoming many hurdles. John Hager the Executive Director of Nevada Health Link also stepped down earlier this year and his replacement Steve Fisher seems to be making headway. Perhaps the most important change was the firing of the company Xerox that managed the software that left Nevadans struggling to meet the open enrollment deadline.