Nevada_Executive_Budget_2013-2015

SILVER STATE HEALTH INSURANCE EXCHANGE ADMIN
101-1400
PROGRAM DESCRIPTION
The Silver State Health Insurance Exchange was established pursuant to Senate Bill 440 (2011) and the Affordable Care Act. By the end of calendar year 2013, Nevada must establish an
Individual Health Insurance Exchange and a Small Business Health Options Program Exchange or cede that authority to the U.S. Department of Health and Human Services. The
marketplace must be operational by October 1, 2013 to facilitate open enrollment for health coverage that will take effect on January 1, 2014.
The establishment of a state based exchange allows Nevada to:
* Control costs and determine how the Exchange will be funded; the federal costs and funding methodology is unknown;
* Create an outreach program, tailored for Nevadans, that includes navigators and brokers;
* Ensure the participation requirements and products offered are as business friendly as possible;
* Determine health plan standards regarding accreditation, network adequacy, service areas, and transition of care;
* Keep jobs in Nevada;
* Influence the federal regulation-making process by providing thoughtful, constructive criticism thereby mitigating the risks that may be created by harmful regulations.
The U.S. Census Bureau estimates there were 557,000 uninsured individuals under the age of 65 in the State of Nevada in 2010 representing 23.9% of the total Nevada population under the
age of 65. It is estimated that approximately two-thirds of these individuals are, or will be, eligible for Medicaid. The remaining third will be eligible for coverage through the Exchange.
The Exchange expects enrollment will be approximately 118,000 in 2014 and 151,000 in 2015. To meet these goals, the Exchange will need to work with the Department of Health and
Human Services and the Division of Insurance to:
* Execute a comprehensive advertising campaign;
* Ensure Navigators and Brokers are available in sufficient numbers and properly trained and certified;
* Work with the Division of Insurance to ensure Qualified Health Plans include appropriate consumer protections and other certification requirements;
* Ensure a seamless customer service experience between Medicaid, Nevada Check Up and subsidized Exchange coverage;
* Provide enough value to attract small businesses and unsubsidized individuals to the Exchange.
BASE
This request continues funding for nine positions and associated operating costs. One-time expenses have been eliminated and any partial year costs have been annualized.
2012-2013 2013-2014 2013-2014 2014-2015 2014-2015
2011-2012 WORK AGENCY GOVERNOR AGENCY GOVERNOR
ACTUAL PROGRAM REQUEST RECOMMENDS REQUEST RECOMMENDS
RESOURCES:
BALANCE FORWARD FROM PREVIOUS YEAR 0 0 32,362,200 32,362,200 35,685,739 35,680,728
ADVANCES FROM GENERAL FUND 200,000 500,000 0 0 0 0
RETURN GENERAL FUND ADVANCE -200,000 0 0 0 0 0
PLANNING GRANT 695,180 0 0 5 0 5
SECOND LEVEL I ESTABLISHMENT GRANT 0 15,295,271 0 0 0 0
THIRD LEVEL I ESTABLISHMENT GRANT 0 4,397,926 0 0 0 0
FIRST LEVEL I ESTABLISHMENT GRANT 1,654,703 2,390,372 0 0 0 0
LEVEL 2 ESTABLISHMENT GRANT 0 50,016,011 2,035,027 5,434,960 218,527 1,634,746
FEES FROM QUALIFIED HEALTH PLANS (QHP) 0 0 3,274,010 0 2,295,512 1,056,683
FEES FROM DENTAL PLANS 0 0 26,100 0 59,040 0
FEES FROM VISION PLANS 0 0 4,350 0 9,840 0
FEES FROM ADVERTISING 0 0 18,750 0 25,000 0
SILVER STATE HEALTH INSURANCE EXCHANGE HEALTH INS EXCHANGE - 3
SILVER STATE HEALTH INSURANCE EXCHANGE