The Center for Consumer Information & Insurance Oversight
Nevada Rate Review Grants Award List
Cycle I Grant Application Summary
Nevada Grantee: Nevada Division of Insurance
Award Date: August 16, 2010
Award Amount: $1,000,000
- Pursue Additional Legislative Authority: There are currently no rate filing requirements for small or large group preferred provider organization (PPO) products; Nevada has prior approval authority for individual and HMO rates. The State will propose legislation in the 2011 session to give it prior approval authority for health insurance premiums for group health benefit plans. The Department of Insurance is currently required to keep actuarial data in rate filings confidential; it will seek legislation to make rate filings publicly available when filed.
- Expand the Scope of the Review Process: Nevada will seek legislation to enable it to review small and large group health insurance premium filings.
- Improve the Review Process: Currently all individual rates in Nevada are reviewed. The State will use grant funds to seek greater review authority and hire staff to accommodate review of all major medical health insurance products.
- Increase Transparency and Accessibility: Presently, Nevada does not provide access to filing information. The State will create a new position of Consumer Advocate for Health Insurance Customers. This person will be able to seek hearings on health insurance premium filings requesting unreasonable increases and will represent the interests of consumers.
- Develop and Upgrade Technology: Nevada will collect data necessary to generate reports for the individual, small group and large group markets
Cycle II Grant Application Summary
Nevada Grantee: Nevada Division of Insurance
Award Date: September 20, 2011
Total Award: $3,959,972
Baseline Award: $3,000,000
Workload Award Amount: $359,972
Performance Award Amount: $600,000
- Expand scope of rate review: Nevada no longer exempts Group PPOs from filing requirements and Nevada will develop a plan to implement the necessary changes in policy and procedure to add small group rate filings to the rate review process.
- Improve rate filing requirements: Nevada will implement a "zero tolerance" policy as of July 1, 2011, requiring insurers to either resubmit an incorrect filing or correct minor errors through post-submission updates.
- Improve transparency and consumer interfaces: Nevada plans to host consumer outreach meetings across the State in late 2011. Nevada will post weekly updates of rate filings under consideration and review on its website within 5 days of receipt, and links to posted rate filings will remain valid for 3 years. Nevada will also post rate filings from 8/01/10 forward and public comments addressing proposed changes on its new website.
- Hire new staff: Nevada will create 3 new positions with this Cycle II grant funding.
- Improve IT: Nevada recently launched a website dedicated to the Divisions' rate review activities. The new site will serve as a primary consumer access point for health benefit plan rate filing information and posting of the Division's analysis summary upon disposition.
Cycle IV Grant Application Summary
Nevada Grantee: State of Nevada, Division of Insurance
Award Date: September 19, 2014
Total Award: $1,179,000
- Improve the Quality/Efficiency of Rate Review: Nevada plans to implement rate filing standardization procedures and plans to make the recommended rate template for 2015 mandatory in 2016.
- Expand Scope of Rate Review: Nevada plans to expand the scope of rate review into the small group market. Nevada will begin gathering data from carriers and conducting instructional webinars with small group market carriers.
- Improve Rate Review Transparency/IT and Other Technology Based Improvements: Nevada plans to implement "Rate Wizard," which will allow proposed rates to be simultaneously displayed during the rate analysis period, and approved rates to be simultaneously displayed 30 days before annual enrollment.
- November 5, 2019 FAQ: Quality Rating Information Bulletin’s (Quality Bulletin’s) Display Guidelines for Direct Enrollment (DE) Entities
- November 1, 2019 Enhanced Direct Enrollment Approved Partners (Updated)
- September 11, 2019 FAQ: Enhanced Direct Enrollment Participation Requirements for Non-Issuer of a Primary EDE Entity Environment
- August 15, 2019 Quality Rating Information Bulletin for Plan Year 2020 Health Insurance Exchanges Quality Rating System (QRS) for Plan Year (PY) 2019: Results at a Glance
- April 18, 2019 CMS-9926-F: Final HHS Notice of Benefit and Payment Parameters for 2020 Final 2020 Letter to Issuers on Federally-facilitated Exchanges Key Dates for Calendar Year 2019: QHP Certification in the FFEs; Rate Review; Risk Adjustment
- April 4, 2019 Guidance on Unified Rate Review Timeline: Timing of Submission of Rate Filing Justifications for the 2019 Filing Year for Single Risk Pool Coverage Effective on or after January 1, 2020
- March 19, 2019 2020 Final Actuarial Value Calculator 2020 Final Actuarial Value Calculator Methodology
- March 6, 2019 CMS-9921-NC: Request for Information Regarding the Sale of Individual Health Insurance Coverage Across State Lines Through Health Care Choice Compacts
- February 28, 2019 Section 1332 Pass-through Funding Tools and Resources