Medical Premium Surcharge
Tobacco users in Nevada are feeling the adverse side effects of their personal habits. Tobacco usage is not only hurting the health of many Nevadans but also their wallets. With new health care reform mandates, tobacco users will see an increase in their monthly medical premium surcharge.
Due to the Affordable Care Act, Americans are now subject to the new community rating style. This premium calculation factors in the applicant’s age, zip code, and tobacco usage status. Insurance carriers are no longer able to rate their members based on preexisting health conditions or gender.
Nevada’s state exchange, NV Health Link, defines tobacco usage as:
• Tobacco use means the use of tobacco on average four or more times per month within, no longer than, the past 6 months.
• This includes all tobacco products. Except those used for religious or ceremonial purposes.
• Tobacco status is based on self-attestation.
Member’s who enroll through NV Health Link may see a premium increase as high as 50%.
The tobacco premium increase, also known as a tobacco surcharge, can be waived under specific circumstances. Tobacco users can reduce the monthly surcharge by abstaining from tobacco use for 6 months. Members enrolled through NV Health Link will need to fill out the “Tobacco Surcharge Removal Request” form as provided by the state exchange. NV Health Link’s deadline for the surcharge removal request is the 20th of the month prior to the effective date of the change.
Nevada’s Division of Insurance will retroactively impose the tobacco surcharge for members who erroneously fill out their tobacco usage status. The retroactive billing surcharge will be imposed to the policy’s original effective date.
Some insurance carriers are enforcing minimal premium increases for their tobacco user members. Saint Mary’s and United Health Plans, two of the largest insurance carriers in Nevada, are applying reduced tobacco surcharges.
If you want more information on Nevada’s tobacco usage policies, please contact us for more information. Our dedicated staff of licensed brokers will help you find a health insurance policy tailored to your needs.
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