Nevada insurance exchange gets off to bumpy start

CARSON CITY, Nev. (AP) -- Nevada's health insurance exchange was late getting out of the starting gate and limped through the opening hours Tuesday, with users encountering "unresolvable" errors when they tried to create an account to check on available policies.

Officials with Nevada Health Link, the state's online insurance marketplace, said consumers will need to be patient as bugs are worked out.

"To be clear it's not all roses," Jon Hager, executive director of Silver State Health Insurance Exchange, told reporters early Tuesday as the website made its debut. "There will be hiccups."

One big hiccup was trying to create an account to get access to the site. After trying to create a username and password, the system displayed a message saying, "You have encountered an unresolvable error."

Elicia Torres, a program coordinator at Great Basin Primary Care Association said navigators and assistors were scheduling appointments for people who wanted help because of the delays.

"There are a lot of components right now that are not functioning properly," Torres said. The association was one of about a half dozen statewide to receive grant funding to assist enrolling people.

The rollout in Nevada was about 20 minutes late from its targeted startup time of 8 a.m. because insurance policy plans had to be reloaded.

Later in the day, a notice appeared on the Nevada Health Link website: "We are currently experiencing technical difficulties with account creation at this time. Please check back with this site at a later time to create an exchange account and apply for health coverage."

Despite the glitches, by midafternoon, more than 3,000 accounts had been created on the exchange and workers at a call center handled about 1,400 telephone queries, officials said.

Hager said problems are to be expected given the enormity of the task that has been two years in the making.

"It has been an incredible undertaking," he said. "Nothing like this has ever been done before."

Gov. Brian Sandoval agreed.

"The creation of the exchange has been a difficult and complicated first-of-a-kind endeavor," Sandoval said in a statement. "As such, we knew the rollout wouldn't be perfect, and technical issues were expected."

Sandoval, the first Republican governor in the nation to accept Medicaid expansion under the law, praised those who invested their time and energy into the project.

Hager said developing the website and computer program involved tens of thousands of man hours. Nevada's system, developed by Xerox State Healthcare LLC, was paid for by $75.4 million in federal grants. Complicating the project was thousands of pages of federal regulations, many of which kept changing or were issued as the deadline for implementation neared.

Insurance carriers were still verifying that information on the website is accurate, Hager said Tuesday, a process that could take a few days.

"Rates in the system are correct and accurate," he said, and benefits "are just about correct."

"Insurance carriers continue to review the plans. They are still working through the process," he said.

Additionally, an online calculator to determine out-of-pocket costs is not yet functioning and a Spanish language portal won't be ready until November.

Tuesday was opening day for online insurance exchanges around the country. They are part of President Barack Obama's signature health care reform law that requires everyone to have insurance by 2014.

"We are in the midst of the largest mobilization of IT resources in the country," Hager said.

The law also forbids insurance companies from denying coverage because of pre-existing conditions and is designed to make insurance more affordable for people who don't get it through an employer. People making up to 400 percent of the federal poverty level are eligible for subsidies to reduce monthly premiums. That income threshold is $45,960 annually for a single adult; $94,200 for a family of four.

The online exchange is integrated with federal data hubs that will verify a person's citizenship and income. It also is linked to the state's system for signing up people eligible for Medicaid or other services for the poor, such as Nevada Checkup, an insurance program for low-income children.

About 1,600 "navigators" have been or are completing training to assist people with the application process.

Four companies are offering policies on the exchange for 2014. Coverage areas are broken into four regions — Clark and Nye counties; Washoe County; Carson City, Douglas, Lyon and Storey counties; and the rural areas encompassing Nevada's 10 remaining counties.

Only two carriers, Nevada Health Co-op and Anthem, are offering plans through the exchange in all four regions. The other carries, Saint Mary's and Health Plan of Nevada, exclude rural coverage.

Determining how much coverage will cost depends on where you live, how old you are and annual income.