View from the trenches: Insurance broker assesses status of ACA and Nevada Health Link

By Kyle Roerink

Thursday, Jan. 1, 2015 | 11:32 a.m.

Pat Casale isn’t a doctor, but he spends his days working with the sick and uninsured.

The Las Vegas health insurance broker was tireless in his efforts to aid Nevadans during last year’s disastrous rollout of Nevada Health Link, the online insurance marketplace selling health care plans offered under the Affordable Care Act. Casale worked with state officials in multiple agencies, as well as the governor’s office, to ensure his clients were covered. Consumers — some with life-threatening diseases — came to him to enroll for insurance but were thwarted by faulty enrollment software build by Xerox, the tech contractor for the health link. Others paid for insurance but didn’t receive coverage.

Casale went on TV. He appeared in newsprint. He screamed at bureaucrats and Xerox officials to get his clients coverage.

This open enrollment period — which started in mid-November and ends in February — things are different for Nevada Health Link and Casale. The state ditched Xerox and plugged into a new IT system run by the federal government. And Casale is signing up customers without suffering spikes in his blood pressure.

Casale spoke with the Las Vegas Sun about what insurance brokers do, the latest open enrollment period and not getting paid.

Compared to last year, what’s the biggest difference you’ve seen in open enrollment?

The computer system is working. I get people enrolled in less than 30 minutes. People are getting the plans I expect them to get.

The state didn’t put out an estimate for how many people would enroll in plans offered on the exchange. What’s your best guess?

All said and done, in the end of February between 40,000 and 44,000 on the high end. Thirty-two thousand to 36,000 on the medium end, and 30,000 on the low end.

Do brokers charge consumers for using their services to enroll for health care plans offered under the Affordable Care Act?

Not at all.

The average consumer may not know how an insurance broker can help them enroll for subsidized plans offered under the Affordable Care Act. What’s your main role?

My main role is to ensure the client buys the best plan for them and maximizes tax credits offered.

Because of the faulty Xerox software, insurance companies didn't pay you and other Nevada insurance brokers for your services during the first open enrollment. You’re in a class action suit to recoup damages. What’s the latest?

We are starting to get some of the money. Insurance companies are paying us going forward. But we lost time and money. For the first six months of the last enrollment, we didn’t get paid for a lot of services. I estimate that I lost at least $25,000 to $30,000. It’s the first time in my career that I didn’t get paid for work. If I wrote a life insurance policy and the commission is $1,000 when that policy gets issued, I get paid. With health insurance, you get paid at a month to month rate. This year that didn’t happen.

You’re originally from New York. What brought you to the desert to broker insurance?

The broker part wasn’t part of the plan. I came to Nevada because the state allows you to be able to own a home and offers a favorable tax system. The American dream was here.