State’s health insurance exchange defers decision on fix for ailing website

The state’s health insurance exchange on Wednesday put off a decision on a fix for its struggling Nevada Health Link website even as state officials urged a fast decision.

The board of the Silver State Health Insurance Exchange said it needs more information before it can decide whether to stick with health link contractor Xerox, or fire the company and adopt another state’s website platform or throw in with the federal exchange.

The exchange board retained Deloitte Consulting for $1.5 million in March to evaluate Nevada Health Link and give guidance on how to fix its myriad technical issues, which have held paid enrollments to about a quarter of the targeted goal of 118,000.

The glitches culminated in a class-action lawsuit filed on April 1 by plaintiffs who said they paid for coverage but never received a plan.

In the analysis Deloitte delivered to the board, company officials said they found problems ranging from frequent sub­contractor turnover to flaws that ask parents whether their 3-year-old daughters are pregnant.

Deloitte, which has also built exchanges in Connecticut, Kentucky, Rhode Island and Washington, drew up pros and cons of keeping the system, or dumping it and either using another state’s platform or transitioning to the federal exchange.

Deloitte did not recommend any specific exchange platform for the board to adopt, but it did say any choice the board made might require more federal grant money on top of the $84 million the exchange already received. The exchange will also need approval from the Centers for Medicare and Medicaid Services to make the switch.

Board members asked exchange staff to put together reports looking at the cost of any changes, available funding and which option is most feasible.

TIME CALLED KEY

But it could be weeks before any reports are available: It’s been 11 weeks since the board decided to look at alternatives, and it took five weeks for Deloitte to deliver its report. That’s a problem, state officials say, because the system needs to begin gearing up for the next open-enrollment session that starts on Nov. 15.

“Time is of the essence. We’re already working on product (policy) and rate review and approvals,” Nevada Insurance Commissioner Scott Kipper said. “If you change to go with (another state exchange) or become a partner with the federally facilitated marketplace, we need to make that decision post-haste.”

Despite the decision to get more information, board members expressed continued frustration with Xerox.

“There are so many issues and problems in every category, and I just don’t hear anything different (from Xerox) than we’ve been hearing over the last few months: ‘We’re working really hard, we really want to do this, we want to make improvements,’ ” Vice Chair Lynn Etkins said.

“I’m not blind to enrollment numbers getting better, but this report seems overwhelming to me, and I’m really not hearing anything that all of these issues are going to be resolved well before open enrollment. The number of issues are so vast, and now we’re at five months from open enrollment. Can this be done?”

But board members also asked Xerox to come back in two weeks with reports on how it could improve the system.

“The report showed me there are fundamental flaws in the (operating) system,” Chairwoman Barbara Smith Campbell said. “It showed me the system Xerox has is now fairly fragmented, and the project management side is fairly immature. I would like to see if you see weak links in the management system, and what you are going to do to change that and get a stronger management system in to make this work.”

It was the latest back-and-forth in a troubled, two-year relationship.

The exchange board approved Xerox’s $72 million contract to build the Nevada Health Link website and call center in June 2012.

DISMAL BEGINNING

But Xerox’s website was a failure from the start. The company missed multiple deadlines on the build, and by March — five months after the Oct. 1 launch — the company still hadn’t completed the part of the system where premium invoices are created, enrollment details get sent to insurers and consumers can move into new plans.

The website was so incomplete that the exchange had paid Xerox just $10 million of its contract by March. And just 25,899 people out of a forecasted 118,000 bought and paid for plans by the close of open enrollment on March 31. Consumers reported lost payments, incorrect effective dates and missing coverage.

Enrollments have jumped about 10,000, to more than 34,000, in a special enrollment period that ends May 30.

Still, the system continues to struggle.

Brent Leavitt, an insurance broker with Nevada Benefits in Las Vegas, said in late April that the website wiped out his clients’ automatic electronic payments on March 15, and again on April 15.

And broker Pat Casale said Tuesday that he still has clients going without coverage that was supposed to take effect Jan. 1.

He said most of the insurance community wants Xerox gone.

“The carriers want this, the navigators want this, and so do the brokers,” he said.

The board will meet again for a regularly scheduled monthly meeting on May 8.

Contact reporter Jennifer Robison at jrobison@reviewjournal.com or 702-380-4512. Follow @J_Robison1 on Twitter.