The Center for Consumer Information & Insurance Oversight
Nevada Health Insurance Marketplace Grants Awards List
Nevada has received seven grant awards to build its Health Insurance Marketplace - Opens in a new window . This includes a Planning Grant, five Level One Establishment Grants, and a Level Two Establishment Grant.
Summaries of Nevada's applications for each grant are provided below:
Establishment Grant Level Two Application Summary
Administrator: Silver State Health Insurance Exchange
Award Amount: $50,016,012
Award Date: August 23, 2012
Application Due Date: June 29, 2012
Supplement Amount: $10,227,300 (July 10, 2014)
Level of Funding: Level Two
Administrative Supplement Award Amount: $10,227,300 (July 10, 2014)
Summary: Nevada's Exchange is receiving a Level Two Establishment grant to accomplish the activities necessary to meet certification requirements in January 2013, provide coverage to enrollees by January 1, 2014, and self-sustainability by January 2015. Nevada established the Exchange during the 2011 legislative session by passage of Senate Bill 440. This funding will allow Nevada to: (1) provide the same customer experience to all individuals seeking coverage, regardless of source or amount of subsidy for which they may qualify, or the door through which they enter; (2) permit real-time eligibility determination, routing, and enrollment, whenever feasible; (3) provide a timely and responsive resolution process for all individuals; (4) extract the business rules out of an aging eligibility system in a central repository that is more dynamic and flexible; (5) implement a common system complemented with a high level of integration to avoid duplication of costs, processes, data, and effort on the part of the State and beneficiaries; and (6) leverage the federal approach to verification from federal agencies, such as the Internal Revenue Service, the Department of Health and Human Services, and the Department of Homeland Security, to avoid the independent establishment of those interfaces and connections at the State level.
Administrative Supplement Award Amount: $10,227,300 (July 10, 2014)
Summary: Nevada will use the supplement funds address business needs related to the implementation of a State-Based Exchange. This includes funding for a Project Management Office, a full time Deputy Attorney General; Marketing and Outreach, and provides funding for Enrollment Assisters. Additionally, this includes Health Care Reform Eligibility Engine project for CMS-mandated system changes to Verify Lawful Presence and security consulting services.
Establishment Grant Level One Application Summary
Administrator: Nevada Department of Health and Human Services (DHHS)
Award Amount: $4,045,076; $15,295,271; $4,397,926, $9,020,798; $6,998,685.
Award Date: August 12, 2011; February 22, 2012; May 16, 2012; July 9, 2013; January 22, 2014.
Application Due Date: June 30, 2011; December 30, 2011; March 30, 2012; May 15, 2013; November 15, 2013.
Level of Funding: Level One
Summary: Nevada will use funding to: develop a rules-based eligibility engine that will serve as the single, streamlined eligibility process for all medical assistance programs, including Medicaid, Nevada Check Up (the state's CHIP program) and the Exchange; prepare business and IT systems requirements for non-eligibility-related functions of the Exchange, and develop an operational plan; create a financial management and sustainability model; enhance Nevada's consumer assistance; engage stakeholders and consult with Nevada's Native American Tribal community; prepare statutory and regulatory changes for commercial health insurance, as required by the Patient Protection and Affordable Care Act; assess the impact to the commercial health insurance market from regulatory changes, the essential health benefits requirements, and the introduction of an Exchange as a purchasing platform in the individual and small group markets; and, review existing programs to identify opportunities to leverage services, functions and resources that may be applicable to the Exchange, as well as opportunities to modify existing programs in light of the coverage expansions that will take effect in 2014.
Nevada will use its second Level One Establishment Grant for funding the development of a rules-based eligibility engine, business and IT systems requirements for non-eligibility-related functions of the Exchange, the development of an operational plan, and the review of existing programs to identify opportunities to leverage services, functions and resources that may be applicable to the Exchange, as well as opportunities to modify existing programs in light of the coverage expansions that will take effect in 2014.
Nevada will use additional Level One funding to build on the Planning Grant and previously-awarded Level One Establishment grants. Funds will be used to establish Nevada's Silver State Health Insurance Exchange. The establishment of the Silver State Health Insurance Exchange will significantly affect health insurance delivery, and will improve access to affordable health insurance for Nevada residents.
The Nevada Silver State Health Insurance Exchange’s additional Level One request will be used to support information technology security requirements and to augment needed technical staffing and training. Funds will also be used to support a system for managing hearings and appeals, and to develop a Virtual Assistant to allow the Exchange to provide one-on-one consumer support and training for the Exchange’s Marketing and Consumer Exchange Enrollment Facilitator program, the State’s non-Navigator assistance program. The budget also supports a Southern Nevada area of operations office.
Nevada’s Marketplace, “The Silver State Health Insurance Exchange,” will use its fifth Level One award funding to support Informational Technology (IT) requirements for eligibility and enrollment and security as well as additional outreach and education through Public Service Announcements. IT improvements include design, development and implementation changes that will allow the state to securely accept credit card payments among other enhancements.
State Planning Grant
Awarded September 30, 2010
Administrator: Nevada Department of Health and Human Services
Amount Awarded: $1,000,000
- Assemble information, identify priorities, assess resource needs, and lay the foundation for the development of a fully functioning health insurance Exchange that best meets the needs of Nevadans.
- Conduct background research to better quantify the populations covered by existing and future health insurance programs and to better understand the potential impact on the market with introduction of the Exchange.
- Establish a streamlined eligibility process to serve all applicants for all medical assistance programs.
- Define a governance structure and administrator for the Exchange.
- Catalogue existing resources that may be used to support an Exchange.
- Identify services that will need to be developed and contracted to operate the Exchange.
- March 5, 2020 Information Related to COVID–19 Individual and Small Group Market Insurance Coverage
- March 12, 2020 FAQs on Essential Health Benefits Coverage and the Coronavirus (COVID-19)
- March 18, 2020 FAQs on Catastrophic Plan Coverage and the Coronavirus Disease 2019 (COVID-19)
- March 24, 2020 FAQs on Availability and Usage of Telehealth Services through Private Health Insurance Coverage in Response to Coronavirus Disease 2019 (COVID-19)
- March 24, 2020 Payment and Grace Period Flexibilities Associated with the COVID-19 National Emergency
- March 24, 2020 FAQs on Prescription Drugs and the Coronavirus Disease 2019 (COVID-19) for Issuers Offering Health Insurance Coverage in the Individual and Small Group Markets
- April 11, 2020 FAQs about Families First Coronavirus Response Act and the Coronavirus Aid, Relief, and Economic Security Act Implementation
*This document was updated on April 15, 2020, to correct an error in footnote 10 regarding the current end date of the public health emergency related to COVID 19.
- April 13, 2020 Postponement of 2019 Benefit Year HHS-operated Risk Adjustment Data Validation (HHS-RADV)