The executive director at Nevada's health insurance exchange is stepping down amid poor enrollment and website glitches, with the board now mulling a switch to the federal marketplace.
Jon Hager, the former CFO of the Nevada Public Employees' Benefits Program, took the helm of Nevada Health Link in January 2012, and announced recently that he'll be stepping down effective March 14. He is the fifth state exchange director to resign, following those in Hawaii, Maryland, Minnesota and Oregon.
Hager and lead contractor Xerox have faced mounting pressure from the exchange board in recent months, with the exchange's website struggling to function as intended for consumers and brokers, and the consumer hotline often being overloaded.
At a Feb. 13 board meeting, Hager outlined three goals: "Fix the website. Fix the call center. Enroll 50,000 people by the end of open enrollment."
That 50,000 enrollment target is less than half of the 118,000 previously projected.
By the end of the meeting, exchange board chair Barbara Smith-Campbell, a consultant, chair of the state tax commission and finance director for Mandalay Development, suggested drafting a "disaster recovery plan" and exploring the possibility of finding a new vendor or just deferring to the federal exchange, Healthcare.gov.
For his part, Hager was never found vacationing in the height of open enrollment, like other now-former directors of troubled insurance exchanges in Maryland and Minnesota, who respectively were criticized for November 2013 trips to the Caymans and Costa Rica.
But so acute are the problems with Nevada Health Link that Hager called the revised 50,000 enrollment target "still a challenge."
While "corrections and improvements to the website over the past month should go a long way to allowing the public unfettered access," he wrote in his Feb. 13 update, there is "still a lot of work that needs to be completed."
Enrollments are being transmitted to insurers digitally, he said, but there are still ongoing issues with that and related functions for both consumers and carriers.
Testifying at the last board meeting was Nevadan Claudia Lamb, who described her experience trying to enroll in a Nevada Health CO-OP plan as "appalling."
With a policy expiring at the end of 2013, she and her husband got to work selecting a plan last October, only to find herself uninsured for the first time in a decade this past January and covering medication costs out-of-pocket.
"We have had two applications accepted and then rescinded without notice or communication from Xerox. I've spent at least 120 hours on the phone and several hundred more waiting for calls from (Nevada Health Link) that never came," Lamb said.
"Finally, on Jan. 15, 2014 we found out why: All this time, Xerox had classified my squeaky clean, never-been arrested husband as an incarcerated felon."
And then it wasn't until just about a month later that that problem was resolved by the exchange -- only after a Las Vegas television news program told her story, she said.
Similar problems could be plaguing other consumers, in a state with some 600,000 estimated uninsured, Lamb warned.
For its part, Xerox told the exchange board in its most recent update that it has 182 current defects that will resolve by March 14. "Our top priority areas," the company said in its presentation, are eligibility, tax credits and cost sharing functions, benefit plans and enrollment, payment, and automating data flow to insurers.