Carson City, NV - August 27, 2015
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.