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Consumer Alert: Small Group Health Plans Sold at Unapproved Rates by Sierra Health and Life

Contact: Jake Sunderland, Public Information Officer
Phone: (775) 687-0772
E-mail: jsunderland@doi.nv.gov
FOR IMMEDIATE RELEASE – December 8, 2014

CARSON CITY – The Nevada Division of Insurance (Division) has become aware that two small group PPO plans offered in Nevada by Sierra Health and Life were sold with rates that were not approved by the Division. It is estimated that at least 60 employers in Nevada may have been affected.

Plans sold at unapproved rates were sold under the names SHL Solutions PPO Silver 35/3000/70% and SHL Solutions PPO Silver 35/4500/70%. These plans were sold at unapproved rates in all Nevada counties with the exception of Clark and Nye counties.

In order to protect consumers state and federal law requires that all rates in Nevada be reviewed and approved by the Nevada Division of Insurance. It is illegal to sell an insurance plan at a rate that has not been approved.

Businesses who believe they may have purchased these plans should be aware that misquoted or unapproved health insurance rates are not permitted under any circumstances.

Businesses enrolled in these plans will be contacted by Sierra Health and Life notifying them of the actual approved rate of their plans. Sierra Life and Health will also require payment of the difference between the approved premium and any previously invoiced or paid premiums.

Business owners have the following options:
 

  • Cancel their coverage, request a refund of any premiums paid, and contact their licensed health insurance broker to find a plan that best fits their needs.
     
  • Cancel their coverage, receiving a refund of any premiums paid, and contact their previous health insurance carrier to re-enroll in coverage they may have previously canceled.
     
  • Pay the difference between previously invoiced premiums and approved premiums, and then continue their current enrollment with Sierra Health and Life paying the approved premium for the entire plan year.

Business owners with questions are encouraged to contact their licensed health insurance broker or Sierra Health and Life with any questions.

All rate and plan information in the small group market is available online by visiting doi.nv.gov. Click on “Health Insurance Rates” in the main navigation menu, from the “Health Insurance Rate Review” page click on “Search for Health Insurance Rates.”

Rates are displayed by age and county and are for non-smokers. Search results are displayed and then sortable by plan name, carrier name, metal tier, whether it’s on or off the Exchange and price.

Clicking on a plan name will take the user to the plan’s details, which includes rates, schedule of benefits, evidence of coverage and links to the plan’s provider network and drug formulary.

The Nevada Division of Insurance will continue to monitor the situation.

About the Nevada Division of Insurance
The State of Nevada Division of Insurance is a division of the Nevada Department of Business and Industry. It is the state agency that protects the rights of Nevada consumers and regulates Nevada’s $11.5 billion insurance industry. It has offices in Carson City and Las Vegas. In 2013, the Division investigated more than 2,300 consumer complaints and recovered nearly $4.4 million on behalf of consumers. Download the Division’s smartphone app NDOI Connect today in the Apple App Store and Google Play.

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