Ron Bliss: Hometown Health helped save the day for Nevada exchange

The letters “HH” stand for Hometown Health. Earlier, this month however, the letters took on new meaning -- as in “Healthcare Heroes”.

Hometown Health had considered coming onto the exchange for 2018, but with the uncertainty caused by the actions of President Donald Trump that caused carriers like Anthem and Prominence to pull out of the exchange for next year, the company felt the timing was not right.

However, when Centene -- a healthcare company from Missouri -- expressed interest in filling the void in 14 “bare” counties in Nevada that had no one left on the exchange -- Hometown Health helped make it possible.

“They came to us and said they wanted to come into the state, but did not have a network set up,” said Jon Hager, Hometown Health’s Director of Planning and Performance at the Hometown Health Broker Summit at Edgewood Resort in Stateline on Friday. “That’s where we came in. We are partnering with them to let them use our network.”

That network is expanding. Hometown Health sold only in Washoe, Carson City and Douglas counties in Northern Nevada last year, but it bought OneHealth in Southern Nevada in 2015 and will use that for Clark and Nye counties this year and is contracting with doctors and facilities in the rural counties of Nevada in time for Open Enrollment, which will run from Nov. 1 through Dec. 15. Centene will be offering coverage as Silver Summit on the exchange.

“Governor (Brian) Sandoval was very pleased,” said Hometown Health Chief Executive Officer Ty Windfeldt on Friday at the Broker Summit. “He said we were like a white knight riding in on a horse.”

Centene is still working on a filing for rates, for Silver Summit, but specializes in insurance for lower-income individuals who use subsidies on the marketplace. One boost for Carson City residents is that Hometown Health is contracted with Carson Medical Group, which did not take any coverage from exchange plans Prominence and Anthem last year.

Hometown Health, meanwhile, has positioned itself to have a banner year on the off-exchange side during Open Enrollment. It already had the lowest off-the-exchange rates last year and this year has the lowest increase of any major plans in the state -- less than 16 percent between its HMOs and PPOs for individuals and families.

All rates are tentative for now, awaiting approval from the Nevada Division of Insurance -- which should come on Oct. 1.

Health Plan of Nevada, to include Sierra Health and Life, has filed for an average increase of about 25 percent and Anthem Blue Cross is going up an average of 61 percent and will offer only a catastrophic plan for individuals and families off the exchange.

The U.S. Senate is expected to take steps in September to stabilize the healthcare market, which saw premiums skyrocket with President Trump first saying the government may not enforce the individual mandate and later threatening to take away cost-sharing reductions from the marketplace.

Ron Bliss, an independent insurance agent in Carson City, is a former long-time sports writer who has sold health insurance on and off the exchange in both Nevada and California since 2011. In addition to major medical plans, he sells other ACA-compliant plans off the exchange, as well as Medicare supplements and Medicare Advantage. He also has dental and vision plans and supplemental health insurance plans, as well as a variety of life insurance plans. You can reach him at 775-224-7169.