Contact: Yeraldin
Deavila, Public Information Officer
Phone: (775)
687-0772
E-mail: ydeavila@doi.nv.gov
FOR IMMEDIATE RELEASE– August 26, 2015
The Nevada Division of Insurance Offers Guidance for Members Affected
by Nevada Health CO-OP’s Discontinuing Operations
Carson City – The Nevada Health CO-OP (NHC), a health insurer
formed under the provisions of the Affordable Care Act (ACA) as a non-profit health
maintenance organization, announced today that it will be voluntarily winding
down its operations at the end of 2015. NHC has informed the Nevada Division of
Insurance (DOI) that it is committed to honoring its in-force 2015 individual
and group policies, but will not offer health benefit plans for 2016. The NHC
has also informed the DOI that it plans to contact affected members, providers,
and brokers about the wind down.
“We appreciate the work done by
NHC over the past 3 years to develop and offer both individual and group health
insurance plans on and off the Exchange. Unfortunately, market conditions
ultimately proved more challenging for them than expected,” said Acting
Insurance Commissioner Amy Parks. “The decision to voluntarily wind down its
operations at this time is a reflection of NHC’s continued focus on doing what is
in the best interests of its members. The Division of Insurance will work with
NHC to continue that focus and to ensure a smooth wrap-up of its operations.”
The Division of Insurance offers the following guidance for NHC members:
If I have a policy with the NHC,
do I need to get a new policy right now?
Members can continue to see plan
providers and claims will be paid under the terms of the plan. Members will
need to continue to pay their premiums in accordance with plan rules for their 2015
coverage to remain in effect. Individual (non-employer sponsored) insurance
plan policies will end on December 31, 2015.
So, if you have an individual NHC
plan, you will need to enroll in a new plan from another carrier that will be
effective on January 1, 2016. The Open Enrollment period for health insurance
coverage for the 2016 calendar year runs November 1, 2015 through January 31,
2016. However, unlike with individual plans, employer groups can change
coverage at any time prior to the expiration date of their current plan. NHC has
offered to work with its members who wish to obtain alternative coverage prior
to the end of calendar year 2015.
Where can I get help finding a
new health insurance policy?
“Nevada enjoys a very competitive
health insurance market. Even with the exit of NHC, there will still be 13
carriers offering individual health benefit plans, and 14 carriers offering
small group plans. Consumers will also still be able to obtain both individual
and small group plans through Nevada Health Link,” said Acting Commissioner
Parks.
Consumers who originally
purchased coverage through Nevada’s Exchange can re-visit Nevada Health Link at
www.nevadahealthlink.com, go to
healthcare.gov, or call 1-800-318-2596. Any member who received a tax credit should
be aware that tax credits are only available if the new coverage is also
obtained through the Exchange.
If you purchased your coverage
through an insurance agent, your agent can assist you with selecting a new
plan.
To view all plans available “on
and “off” the Exchange, you can visit the DOI website at http://healthrates.doi.nv.gov/Wizard.aspx.
Can my doctor refuse to see me
because I have a 2015 NHC health insurance policy?
Providers (your doctors,
hospitals, pharmacies, etc.) are required by their contracts to continue
treating you under the terms of your 2015 NHC policy. If a provider in your
network refuses to honor their network agreements, please inform the NHC as
soon as you can or call the DOI Consumer Services Carson City office at (775)
687-0700, or the Las Vegas office at (702) 486-4009.
How can I contact NHC?
Members can contact NHC at (702)
823-2667, Monday through Friday from 8 a.m. to 6 p.m.
About the Nevada Division of
Insurance
The State of Nevada Division of
Insurance, a division of the Nevada Department of Business and Industry,
protects the rights of Nevada consumers and regulates Nevada’s $11.9 billion
insurance industry. The Division of Insurance has offices in Carson City and
Las Vegas. In 2014, the Division investigated more than 2,800 consumer
complaints and recovered nearly $4 million on behalf of consumers. For more
information about the Division of Insurance, visit DOI.NV.GOV or download the
Division’s smartphone app NDOI Connect today in the Apple App Store and Google
Play.
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