Enrollment in Nevada’s health insurance exchange is way ahead of the same period last year. The Department of Health and Human Services says nearly 78,000 Nevadans have signed up for a plan in the enrollment period that began Nov. 1. Enrollment closes Jan. 31. Last year about 73,000 Nevadans signed up for plans through the exchange during the entire open enrollment period. Most of the people who sign up for plans are eligible for subsidies or tax breaks based on their income.