Getting Ready for Q4: The Latest Nevada Carrier Updates

Q4 Carrier Updates Nevada

At Word & Brown, we want to work with you to help you maximize your sales opportunities – and address more of your Nevada clients’ diverse needs – during fourth quarter.

Our recently concluded 2021 Carrier Con webinar series included presentations by 20+ of our carrier and administrator partners, where each highlighted important information about what’s new for Q4 and what to expect in 2022.

Below are highlights from our Nevada presenters for those of you who were unable to take part in Carrier Con. You can also link here to listen to the recorded Nevada presenters. (A summary of the California presentations appeared last month in our blog; link here to read it.)


Nevada Carrier Con Presenters, August 26, 2021:

(List is in order of presenting carriers/administrators)


-Aetna Funding Advantage level-funded product is available for groups of up to 50+ employees

-Minimum 10 enrolled (50 eligible)

-No majority required for NV employees for multi-state groups (only one W-2 employee in NV is required)

-60+ Open Access plans; no Primary Care Physician; no referrals required for a Specialist

-Up to four plan designs per group; deductible range from $0 to $8,150

-All plans include prescription drug coverage

-Access to MinuteClinic® services at CVS® at no cost to members

-Effective 9/1, access to Teladoc® with $0 copay for general medicine and dermatology telemedicine

-Standard Plans (in- and out-of-network benefits) or Essential Plan (EPO) options (offering only emergency services out of network)

-Individual Medical Questionnaires for 10-24 enrolled or groups without current coverage

-Member level census required for 25-50 enrolled

-Admin Fee Credit and Guaranteed Surplus (based on group size) promotions through 12/1/2021

-Attain by Aetna® wellness offers free Apple® Watch (employee, spouse, and 18+ dependents)

-Employee Assistance Program (EAP) included at no cost

-Peerfit® app (fitness program)

-Stop Loss and Surplus options for middle market

Anthem Blue Cross Blue Shield

-User-friendly, personalized portals for brokers and employers

-Sydney Health mobile app for members

-Differentiators: online enrollment; Simplified Excel spreadsheet for enrollments and waivers; two-tier composite rates and age-rated available; groups can offer as many plans as they want

-Carve-outs available for management or location

-1099 employees are okay if less than 50% of group (minimum two W-2 employees)

-Virgin groups okay with no wage and tax or payroll required; submit W-4s for each employee

-Partnerships, Corporations okay – W-2 employees not needed if on articles of incorporation

-Owner only groups okay if not husband and wife

-Out-of-state employees okay if at least 25% of group is Nevada residents or in one of 14 states where Anthem does business

-Guided Access HMO in rating areas 1 and 2; offers 33%-47% savings vs. Full PPO depending on tier

-Specialty products (Dental, Vision, Life/AD&D, Disability) available; discounts for 10+ enrolled


-Solutions for employers with fewer than 500 employees

-Engagement Consultant available to improve workforce health

-Behavioral health resources available through Talkspace and Ginger

-Multiple funding options: Fully Insured, Full Insured Plus, Level FundingSM, and Graded FundingSM

-Comprehensive reporting (financial and utilization review, employee engagement, etc.)

-Nevada portfolio includes PPO, EPO, HSA, and HRA products – no HMO filing in NV

-Open Access Plus or LocalPlus networks

-LocalPlus offers 16% savings; new additions to Nevada provider network

-Dedicated team; 10+ average years of experience of client management team

-Dental available, too – bundled or standalone; Nevada networks include DPPO and DHMO dentists

-Accident, Hospital, and Critical Illness products available, too

E.D.I.S. (Employer Driven Insurance Services)

-Third party administrator established in 1996

-HRA/MERP administration: ID cards, debit cards, EOB retrieval, ICHRA (individual coverage HRA)

-Level-funded Stop Loss: administration for Applicable Large Employers (ALEs); Stop Loss as low as $10,000 (Group level and member level); multiple network options; COBRA administration; 24/7 telemedicine; 100% of unused claims funds back to employer; no Health Risk Assessments for 25-150 employee groups; 50 or fewer requires 75% participation (minimum 26 enrolling); 51 or more requires 60% participation; coverage available alongside Kaiser Permanente or union HMO plans; customizable agent commission

-Minimum Essential Coverage (MEC) plans: 100% ACA compliant; level-funded with Stop Loss; minimum of 30 employees required

-Broker Bonus of up to $4,000 per case, based on group size and products offered ($500, $1,500, $2,500, $4,000)

-High customer retention (90%+)

-Mobile-friendly web portal

-Comprehensive analysis/reporting

-Ask about client results and testimonials from current customers

Allstate Benefits (formerly National General)

-Level-funded product

-Focus is on groups of 2-50; write up to 500 employees

-Multiple national networks

-Multiple plan choices based on enrolling employee count: groups of 3-15 can have two plans, groups of 16-24 can have three plans, and groups of 25+ can up to four plans

-Carve-outs possible (e.g., managers, owners, out-of-state employees)

-No industry exclusions

-Multi-state coverage possible (except Hawaii)

-HSA and HRA plans available

Prominence Health Plan

-Multiple product lines: Small Group (2-50), Large Group (51+) Association Health Plans (2-50), and Administrative Services Only/Self-Funded (100+)

-Small Group: rating reduction in 3rd/4th quarters; 100+ plan offerings; Open Access network (no referrals); HMO, PPO, POS, and National HMO Open Access Plan

-UHS Network updates Elite Medical in Southern Nevada, St. Mary’s Hospital in Northern Nevada; Northern Nevada Sierra Hospital coming in March 2022

-Association Health Plans (2-50, composite rates): 10 associations/groups across the state

-What’s new? Underwriting change to up to 50% of employees out of Prominence service area; wellPORTAL exclusive network of advanced primary care providers serving Southern Nevada; Large Group broker bonus

Have Questions or Want to Learn More?

To find out how Word & Brown can help you maximize your Nevada sales opportunities in Q4 – and all year long – contact your Nevada Word & Brown team: Ken LaRovere, Regional Sales Manager, and Mona Hannah, Inside Sales Representative. Both can be reached at (800) 606-4996. Or, visit our Nevada regional office contact page on our website.





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