The Affordable Care Act (ACA) was signed into law on March 23, 2010. The law’s purpose is to have health insurance be available to more Americans and to improve people’s health. The law requires many changes to Medicare and Medicaid as well as companies that sell health insurance. Although some of the changes went into effect in 2010, the majority of changes occurred on January 1, 2014.

A health insurance CO-OP is a Consumer-Operated and -Oriented Plan. It is a not-for-profit insurance company directed by its members for their mutual benefit. Created by the Affordable Care Act (ACA), the CO-OP initiative was designed to help create member-controlled health insurance plans that offer ACA-compliant policies in the individual and small business markets.  A CO-OP uses profits for the benefit of its members and is designed to offer individuals, families and businesses of all sizes, the opportunity to have high-quality, ACA-compliant health insurance options. CO-OPs may operate locally, statewide or in multiple states. CO-OPs must be licensed as issuers in each U.S. state in which they operate and are subject to state laws and regulations that apply to all similarly-situated issuers. To ensure that all the needs of the members are served, the majority of the CO-OP’s Board of Directors must be actual members of the CO-OP and must serve on the board no later than two years after the organization becomes operational.

The Nevada Health CO-OP is one of many national CO-OPs funded on May 18, 2012 as a result of the Affordable Care Act. With a loan from the Department of Health and Human Services, the Nevada Health CO-OP was established as a Consumer-Operated and -Oriented (CO-OP) health insurance company for the citizens of Nevada. Today we are focused on providing affordable health insurance plans throughout the state. As a local CO-OP, we are a member-controlled and -operated organization. Open enrollment for our plans begin on November 1, 2015 and coverage starts on January 1, 2016.

It depends, but the main difference between the two plans are the eligibility requirements for subsidies associated with the plans. The Nevada Health CO-OP offers plans on-exchange through healthcare.gov and off-exchange through nevadahealthcoop.org.

On-Exchange plans: If you are eligible for an Advanced Premium Tax Credit (APTC) subsidy, open enrollment for all Nevada Health CO-OP plans begins November 1, 2015 and ends January 31, 2016. During that time, individuals and families can purchase our plans on-Exchange through healthcare.gov or Nevada Health Link.

Off-Exchange plans: If you are not eligible for an APTC, you can purchase any of our plans year round through the nevadahealthcoop.org or by calling our CO-OP Care Crew at 702-823-2667 or toll-free at 855-606-2667. Individuals, families, small and large groups can purchase any of our plans year round.

SHOP plans: The Affordable Care Act (ACA) created the Small business Health Options Program (SHOP) for small businesses who may have trouble affording health insurance for their employees. Through this program, businesses can qualify to receive up to 50% credit towards their employer contribution for up to two years. Government-subsidized SHOP plans can be purchased anytime on healthcare.gov.

For more information or to see if you are eligible, click here.

We have good news for you! Under the Affordable Care Act, health insurance plans can no longer take a person’s health into account. Which means that pre-existing condition limits won’t prevent you from purchasing health insurance with the Nevada Health CO-OP.

Adult children can stay on their parent’s plan until he/she reaches the age of 26. On his/her 26th birthday, he/she must have their own health insurance.

During the open enrollment season, you may qualify for a tax credit or subsidy to help pay for your health insurance premiums. How much money you receive depends on your income, family size, and age.

Use our Subsidy Calculator to see if you qualify for a tax credit or subsidy.

Yes, only if you are eligible for a qualifying life event. A qualifying life event is when certain events such as job loss, changes in your marital status and other occurrences in your personal life will allow you to purchase health insurance after the open enrollment period has passed. Please contact the CO-OP Care Crew at 702-823-2667 or toll-free at 855-606-2667 for more information and find out if you qualify.

You can call the CO-OP Care Crew at 702-823-2667 or toll-free at 855-606-2667 for any benefit questions you may have. You can also visit our plan benefits page for more information:

Individual Benefits
Group Benefits

*For On-Exchange members only

Your 1095-A tax form shows what healthcare.gov/Nevada Health Link paid to the Nevada Health CO-OP to help you with the cost of your health coverage. The amount paid was based on the income information and household size you provided when you applied for health insurance. If your income changed during the year associated with the tax form, you may have paid too much or too little for your health insurance coverage. You will need to save this form for the upcoming tax season.

For the tax year of 2014, you can obtain a copy of this form by calling Nevada Health Link at 855-768-5465.

For the tax year of 2015, you can obtain a copy of this form by calling Healthcare.gov at 800-318-2596 / TTY: 855-889-4325.

You can call the CO-OP Care Crew at 702-823-2667 or toll-free at 855-606-2667 to request a new ID card.

Our walk-in center is open Monday through Friday from 8am to 6pm PST excluding federal holidays.

You can use the following ways below to make a payment:

We accept personal checks, Visa or MasterCard payments by phone. You can also make a payment with our online payment portal (American Express is not accepted at this time).

For on-exchange members: You must call healthcare.gov at 800-318-2596 / TTY: 855-889-4325 to make any changes to your address.

For off-exchange members: You can call the CO-OP Care Crew at 702-823-2667 or toll-free at 855-606-2667 to make any changes to your address.

In-network is any provider or healthcare facilities that are contracted with the Nevada Health CO-OP. You will pay lower co-pays for using an in-network provider. For a full listing of CO-OP contracted providers, please visit the ‘Find a Provider’ page located near the right section of our homepage or by clicking here.

Out-of-network is any provider or healthcare facility which is not contracted with the Nevada Health CO-OP. You will likely pay higher out-of-pocket costs for using an out-of-network provider. Always check with our CO-OP Care Crew at 702-823-2667 or toll-free at 855-606-2667 (TTY at 711) and/or your plan benefits before visiting an out-of-network provider.

It is important to use an in-network provider because using an in-network provider saves you out-of-pocket costs for your healthcare services depending on the NHC plan you chose. Using an out-of-network provider will cost you more out-of-pocket costs and some services may not be covered with the CO-OP.

Always check with our CO-OP Care Crew at 702-823-2667 or toll-free at 855-606-2667 (TTY at 711) and/or your plan benefits before visiting an out-of-network provider.

If you are a member of the Nevada Health CO-OP, finding a doctor or specialist is quick and easy. From the homepage, locate the ‘Find a Provider’ button near the top right section of the homepage. Click the button and fill out the information on the page. This information is used to help find a doctor or specialist near you. You can also access our ‘Find a Provider’ page by clicking here.

You can also call our CO-OP Care Crew at 702-823-2667 or toll-free at 855-606-2667 (TTY at 711) Monday through Friday, 8 am to 6 pm PST

Call our CO-OP Care Crew at 702-823-2667 or toll-free at 855-606-2667 (TTY at 711) Monday through Friday, 8 a.m. to 6 p.m. PST. They will gladly help find a doctor or specialist near you.

You can call Harmony Healthcare at 855-371-5758 for further assistance with behavioral health providers.

You can call the CO-OP Care Crew at 702-823-2667 or toll-free at 855-606-2667 to add an authorized representative to your account.

The Nevada Health CO-OP has three plans, each with two tiers – Southern Star, Union Star and VIP. The main difference between the tiers are:

Tier 1 – has a smaller network of providers with lower co-pays.
Tier 2 – has a broader network of providers, but with higher co-pays.

The tiers are set up so you can have more options under the plan you choose. Please refer to your plan design/Schedule of Benefits or give us a call at 702-823-2667 or toll-free at 855-606-2667 for more details.

An HSA, or health savings account helps you save money for health expenses, tax-free. You don’t pay taxes on the money you put in, the money you take out, or any money you earn on the account. The IRS determines what qualifies as a health expense, which includes your out-of-pocket costs (co-pays, deductibles, and coinsurance) along with certain services that are not covered by a health plan, such as LASIK surgery.