Nevada Division of Insurance Seeking Public Input on Essential Health Benefits

CARSON CITY, NEVADA – The Nevada Division of Insurance (Division) is seeking public input on revisions to Nevada’s essential health benefits (EHB) plan. The EHB benchmark plan establishes the required set of healthcare services that all individual and small group health insurance plans must cover in the state. Since 2017, Nevada’s EHB benchmark plan has been the Health Plan of Nevada’s HPN Solutions HMO Platinum small group plan.

Beginning in 2020, the Centers for Medicare and Medicaid Services (CMS) provided states with three options for defining their EHB benchmark plan:

• Option 1: Select another state’s entire EHB benchmark.
• Option 2: Replace a category of benefits in the current benchmark with the same category of benefits from another state’s EHB plan.
• Option 3: Select a set of benefits to become Nevada’s new EHB plan.

Under federal law, states seeking to update their EHB benchmark plan must conduct actuarial analysis, solicit public comments on proposed changes, and submit an application to CMS.

Nevada is considering updating its EHB benchmark plan under Option 3 to better reflect changes in the insurance market and is seeking public comment on the following proposed revisions:

• Add all FDA-approved drugs to treat opioid use disorder.
• Add all FDA-approved drugs for testing, treating, and preventing human immunodeficiency virus (HIV).
• Add all FDA-approved drugs for testing, treating, and preventing hepatitis B and C.

“Ensuring that Nevada’s essential health benefits align with the evolving needs of consumers is a top priority,” said Insurance Commissioner Scott Kipper. “Public participation in this process is crucial, and we encourage all stakeholders to share their insights so we can make informed decisions that promote access to necessary healthcare services.”

Public comment has historically played a key role in refining health benefit requirements in Nevada, ensuring access to comprehensive and necessary care. The Division urges consumers, healthcare providers, insurers, and other stakeholders to participate in this opportunity to help shape the future of Nevada’s health insurance landscape.

Public Meetings for Consumer and Industry Feedback

The Nevada Division of Insurance will be hosting in-person and virtual public meetings to receive comments, answer questions, and share information on Wednesday, February 26, from 10:00 AM to 11:00 AM. These meetings will provide an opportunity for consumers, insurers, and other stakeholders to engage with the Division and discuss key insurance matters.

Meeting Locations:

Las Vegas:

3300 W. Sahara Ave., Suite 275

Las Vegas, NV 89102

Carson City:

1818 E. College Pkwy., Suite 103

Carson City, NV 89706

Virtual Participation Options:

Join from the meeting link:

https://doinv.webex.com/doinv/j.php?MTID=m8f694255ef45b619d32c2ce95f61bbdd

Join by meeting number:

Access code: 2865 088 8463

Meeting password: txJfjtKE343

Join by phone:

Toll-Free (U.S.): 1-844-621-3956

Toll (U.S.): +1-415-655-0001

Or dial 173.243.2.68 and enter the meeting number

Submitting Public Comments

Public comments can be submitted directly through the Division’s website (https://doi.nv.gov/Healthcare-Reform/Individuals-Families/Essential-Health-Benefits/)

 or in writing to the Commissioner of Insurance at 1818 E. College Pkwy., Suite 103, Carson City, NV 89706, by fax at (775) 687-0788, or by email to Adam Plain at aplain@doi.nv.gov.

All public comments must be received by March 19, 2025, at 5 p.m.