As an HMO there are a few extra hoops to jump though to get care that hold the costs down for everyone. The key to the kingdom is getting a good primary care physician. Once you do that you will have no problems with your Healthcare. Lets fact it, all insurance companies are a pain in the butt but I honestly never felt anything but genuine concern when I spoke to their various agents who also followed up with me after a hospital stay to make sure everything was OK. Their online presence and mobile phone apps are excellent as well. I have nothing bad to say about them. When it came time to approve my care, doctor visits, and specialty referrals they stepped up to the plate and covered it. I hope they don't leave Nevada when 2016 ends.