reglab/housing_qa huggingface dataset:
NV Rev Stat § 695A.188 (2021)
2021 Nevada Revised Statutes|Chapter 695A - Fraternal Benefit Societies|NRS 695A.188 - Approval or denial of claim; interest on unpaid claim; request for additional information; payment of claim; costs and attorney’s fees. [Effective January 1, 2020.]

  1. Except as otherwise provided in subsection 2 and NRS 439B.754, a society shall approve or deny a claim relating to a certificate of health insurance within 30 days after the society receives the claim. If the claim is approved, the society shall pay the claim within 30 days after it is approved. If the approved claim is not paid within that period, the society shall pay interest on the claim at the rate of interest established pursuant to NRS 99.040 unless a different rate of interest is established pursuant to an express written contract between the society and the provider of health care. The interest must be calculated from 30 days after the date on which the claim is approved until the claim is paid.  2. If the society requires additional information to determine whether to approve or deny the claim, it shall notify the claimant of its request for the additional information within 20 days after it receives the claim. The society shall notify the provider of health care of all the specific reasons for the delay in approving or denying the claim. The society shall approve or deny the claim within 30 days after receiving the additional information. If the claim is approved, the society shall pay the claim within 30 days after it receives the additional information. If the approved claim is not paid within that period, the society shall pay interest on the claim in the manner prescribed in subsection 1.  3. A society shall not request a claimant to resubmit information that the claimant has already provided to the society, unless the society provides a legitimate reason for the request and the purpose of the request is not to delay the payment of the claim, harass the claimant or discourage the filing of claims.  4. A society shall not pay only part of a claim that has been approved and is fully payable.  5. A court shall award costs and reasonable attorney’s fees to the prevailing party in an action brought pursuant to this section.  (Added to NRS by 1991, 1330; A 1999, 1649; 2019, 331, effective January 1, 2020)
NV Rev Stat § 695A.195 (2021)
2021 Nevada Revised Statutes|Chapter 695A - Fraternal Benefit Societies|NRS 695A.195 - Society prohibited from denying coverage solely because person was victim of domestic violence.

A society shall not deny a claim, refuse to issue a benefit contract or cancel a benefit contract solely because the claim involves an act that constitutes domestic violence pursuant to NRS 33.018, or because the person applying for or covered by the benefit contract was the victim of such an act of domestic violence, regardless of whether the insured or applicant contributed to any loss or injury.  (Added to NRS by 1997, 1096)
NV Rev Stat § 695A.197 (2021)
2021 Nevada Revised Statutes|Chapter 695A - Fraternal Benefit Societies|NRS 695A.197 - Society prohibited from denying coverage solely because insured was intoxicated or under the influence of controlled substance; exceptions.

  1. Except as otherwise provided in subsection 2, a society that provides health benefits shall not:  (a) Deny a claim under a benefit contract solely because the claim involves an injury sustained by an insured as a consequence of being intoxicated or under the influence of a controlled substance.  (b) Cancel a benefit contract solely because an insured has made a claim involving an injury sustained by the insured as a consequence of being intoxicated or under the influence of a controlled substance.  (c) Refuse to issue a benefit contract to an eligible applicant solely because the applicant has made a claim involving an injury sustained by the applicant as a consequence of being intoxicated or under the influence of a controlled substance.  2. The provisions of subsection 1 do not prohibit a society from enforcing a provision included in a benefit contract to:  (a) Deny a claim which involves an injury to which a contributing cause was the insured’s commission of or attempt to commit a felony;  (b) Cancel a benefit contract solely because of such a claim; or  (c) Refuse to issue a benefit contract to an eligible applicant solely because of such a claim.  3. The provisions of this section do not apply to a society under a benefit contract that provides coverage for long-term care or disability income.  (Added to NRS by 2005, 2345; A 2007, 85)
NV Rev Stat § 695A.200 (2021)
2021 Nevada Revised Statutes|Chapter 695A - Fraternal Benefit Societies|NRS 695A.200 - Nonforfeiture benefits, cash surrender values, certificate loans and other options.

  1. A society may grant paid-up nonforfeiture benefits, cash surrender values, certificate loans and such other options as its laws may permit.  2. In the case of certificates for which reserves are computed on the Commissioners 1980 Standard Ordinary Mortality Table or such other table of mortality as may be specified by the society and approved by the Commissioner, every paid-up nonforfeiture benefit and the amount of any cash surrender value, loan or other option granted must not be less than the corresponding amount ascertained in accordance with the provisions of the laws of this state applicable to life insurance companies issuing policies containing like insurance benefits based upon those tables.  (Added to NRS by 1971, 1843; A 1985, 1185; 1991, 231)
NV Rev Stat § 695A.210 (2021)
2021 Nevada Revised Statutes|Chapter 695A - Fraternal Benefit Societies|NRS 695A.210 - Beneficiaries; funeral benefits.

  1. The owner of a benefit contract has the right at all times to change any beneficiary in accordance with the laws or rules of the society, unless the owner waives that right by requesting in writing that the owner’s designation of a beneficiary be irrevocable. Every society by its laws or rules may limit the scope of a designation of a beneficiary and shall provide that a revocable beneficiary does not have or obtain any vested interest in the proceeds of any certificate until the certificate has become due and payable in conformity with the provisions of the benefit contract.  2. A society may provide for the payment of funeral benefits to the extent of such portion of any payment under a certificate as might reasonably appear to be due to any person equitably entitled thereto by reason of having incurred expense occasioned by the burial of a member, but the portion so paid must not exceed $1,000.  3. If, at the death of any person insured under a benefit contract, there is no lawful beneficiary to whom the insurance benefits are payable, the amount of such benefits, except to the extent that funeral benefits may be paid as provided in subsection 2, are payable:  (a) To the estate of the deceased insured; or  (b) To the owner of the certificate if the owner is not the person insured under the benefit contract.  (Added to NRS by 1971, 1844; A 1991, 232)
NV Rev Stat § 695A.220 (2021)
2021 Nevada Revised Statutes|Chapter 695A - Fraternal Benefit Societies|NRS 695A.220 - Benefits not liable to attachment, garnishment or other process.

No money or other benefit, charity, relief or aid to be paid, provided or rendered by any society is liable to attachment, garnishment or other process, or to be seized, taken, appropriated or applied by any legal or equitable process or operation of law to pay any debt or liability of a benefit member or beneficiary, or any other person who may have a right thereunder, either before or after payment by the society.  (Added to NRS by 1971, 1844; A 1991, 233)
NV Rev Stat § 695A.230 (2021)
2021 Nevada Revised Statutes|Chapter 695A - Fraternal Benefit Societies|NRS 695A.230 - Terms and conditions of benefit contracts.

  1. Every society authorized to do business in this state shall issue to each owner of a benefit contract a certificate specifying the amount of benefits provided thereby. The certificate, together with any riders or endorsements attached thereto, the laws of the society, the application for membership, the application for insurance and the declaration of insurability, if any, signed by the applicant, and all amendments to each thereof, constitute the agreement, as of the date of issuance, between the society and the member, and the certificate must so state. A copy of the application for insurance and the declaration of insurability, if any, must be endorsed upon or attached to the certificate.  2. All statements on an application for insurance are representations and not warranties. Any waiver of this provision is void.  3. Except with regard to contracts providing benefits payable in variable amounts, any changes, additions or amendments to the laws of the society duly made or enacted after the issuance of the certificate bind the owner and the beneficiaries, and govern and control the benefit contract as though the changes, additions or amendments were in force at the time of the application for insurance, except that no change, addition or amendment may destroy or diminish benefits which the society contracted to give the owner as of the date of issuance.  4. Any person upon whose life a benefit contract is issued before the person attains the age of majority is bound by the terms of the application and certificate and by all the laws and rules of the society as though the age of majority had been attained at the time of application.  5. Copies of any of the documents mentioned in this section, certified by the secretary or corresponding officer of the society, must be received in evidence of the terms and conditions thereof.  6. Except with regard to contracts providing benefits payable in variable amounts, a society shall provide in its laws that if its reserves as to all or any class of certificates become impaired, its supreme governing body or board of directors may require each owner of such certificates to pay to the society the amount of the owner’s equitable proportion of such deficiency as ascertained by its board, and that if the payment is not made, the owner may elect to:  (a) Let it stand as an indebtedness against the certificate and draw interest at a rate not to exceed that specified for loans made pursuant to the certificates; or  (b) In lieu of, or in combination with paragraph (a), accept a proportionate reduction in benefits under the certificate.  The society may specify the manner of the election and which alternative is to be presumed if no election is made by the owner.  (Added to NRS by 1971, 1844; A 1991, 233)
NV Rev Stat § 695A.232 (2021)
2021 Nevada Revised Statutes|Chapter 695A - Fraternal Benefit Societies|NRS 695A.232 - Requirements regarding issuance of health benefit plans and adjustment of costs. [Effective January 1, 2020.]

  1. A society shall offer and issue a health benefit plan to any person regardless of the health status of the person or any dependent of the person. Such health status includes, without limitation:  (a) Any preexisting medical condition of the person, including, without limitation, any physical or mental illness;  (b) The claims history of the person, including, without limitation, any prior health care services received by the person;  (c) Genetic information relating to the person; and  (d) Any increased risk for illness, injury or any other medical condition of the person, including, without limitation, any medical condition caused by an act of domestic violence.   2. A society that offers or issues a health benefit plan shall not:  (a) Deny, limit or exclude a covered benefit based on the health status of an insured; or  (b) Require an insured, as a condition of enrollment or renewal, to pay a premium, deductible, copay or coinsurance based on his or her health status which is greater than the premium, deductible, copay or coinsurance charged to a similarly situated insured who does not have such a health status.  3. A society that offers or issues a health benefit plan shall not adjust a premium, deductible, copay or coinsurance for any insured on the basis of genetic information relating to the insured or the covered dependent of the insured.  4. As used in this section, "health benefit plan" has the meaning ascribed to it in NRS 687B.470.  (Added to NRS by 2019, 305, effective January 1, 2020)
NV Rev Stat § 695A.235 (2021)
2021 Nevada Revised Statutes|Chapter 695A - Fraternal Benefit Societies|NRS 695A.235 - Offering policy of health insurance for purposes of establishing health savings account.

A society may, subject to regulation by the Commissioner, offer a policy of health insurance that has a high deductible and is in compliance with 26 U.S.C. § 223 for the purposes of establishing a health savings account.  (Added to NRS by 2005, 2158)
NV Rev Stat § 695A.240 (2021)
2021 Nevada Revised Statutes|Chapter 695A - Fraternal Benefit Societies|NRS 695A.240 - Approval and contents of certificates.

  1. No certificate may be delivered or issued for delivery in this state unless a copy of the form of the certificate has been filed with and approved by the Commissioner in conformity with the requirements of NRS 687B.120.  2. The certificate must contain:  (a) A provision stating the amount of premiums which are payable under the certificate;  (b) A provision setting forth the society’s laws or rules which, if violated, will result in the termination or reduction of benefits payable under the certificate;  (c) If the laws of the society provide for the expulsion or suspension of a member, a provision that any member who is expelled or suspended, except for nonpayment of a premium or, during the period of contestability, for material misrepresentation in the application for membership or insurance, may maintain the certificate in force by continuing payment of the required premium; and  (d) All standard contractual provisions which are required by the provisions of chapters 687B, 688A, 688B, 689, 689A and 689B of NRS to be included in similar policies issued by life or health insurers in this state, and which are not inconsistent with the provisions of this chapter.  3. The certificate may contain:  (a) A provision that the member is entitled to a grace period of 1 month in which the payment of any premium after the first may be made.  (b) For a benefit contract issued on the life of a person under the society’s minimum age for membership as an adult, a provision governing the transfer of ownership to the insured at an age specified in the certificate. A society may require approval of an application for membership in order to make the transfer, and may provide for the regulation, government and control of such a certificate and all rights, obligations and liabilities incident to the certificate, including rights of ownership before the transfer.  (c) The terms and conditions governing the assignability of the benefit contract.  (Added to NRS by 1971, 1845; A 1991, 234)
NV Rev Stat § 695A.255 (2021)
2021 Nevada Revised Statutes|Chapter 695A - Fraternal Benefit Societies|NRS 695A.255 - Coverage for prescription drugs: Provision of notice and information regarding use of formulary.

  1. A society that offers or issues a benefit contract which provides coverage for prescription drugs shall include with any certificate for such a contract provided to a benefit member, notice of whether a formulary is used and, if so, of the opportunity to secure information regarding the formulary from the society pursuant to subsection 2. The notice required by this subsection must:  (a) Be in a language that is easily understood and in a format that is easy to understand;  (b) Include an explanation of what a formulary is; and  (c) If a formulary is used, include:  (1) An explanation of:  (I) How often the contents of the formulary are reviewed; and  (II) The procedure and criteria for determining which prescription drugs are included in and excluded from the formulary; and  (2) The telephone number of the society for making a request for information regarding the formulary pursuant to subsection 2.  2. If a society offers or issues a benefit contract which provides coverage for prescription drugs and a formulary is used, the society shall:  (a) Provide to any insured or participating provider of health care, upon request:  (1) Information regarding whether a specific drug is included in the formulary.  (2) Access to the most current list of prescription drugs in the formulary, organized by major therapeutic category, with an indication of whether any listed drugs are preferred over other listed drugs. If more than one formulary is maintained, the society shall notify the requester that a choice of formulary lists is available.  (b) Notify each person who requests information regarding the formulary, that the inclusion of a drug in the formulary does not guarantee that a provider of health care will prescribe that drug for a particular medical condition.  (Added to NRS by 2001, 860)
NV Rev Stat § 695A.265 (2021)
2021 Nevada Revised Statutes|Chapter 695A - Fraternal Benefit Societies|NRS 695A.265 - Coverage for services provided through telehealth.

  1. A benefit contract must include coverage for services provided to an insured through telehealth to the same extent as though provided in person or by other means.  2. A society shall not:  (a) Require an insured to establish a relationship in person with a provider of health care or provide any additional consent to or reason for obtaining services through telehealth as a condition to providing the coverage described in subsection 1;  (b) Require a provider of health care to demonstrate that it is necessary to provide services to an insured through telehealth or receive any additional type of certification or license to provide services through telehealth as a condition to providing the coverage described in subsection 1;  (c) Refuse to provide the coverage described in subsection 1 because of the distant site from which a provider of health care provides services through telehealth or the originating site at which an insured receives services through telehealth; or  (d) Require covered services to be provided through telehealth as a condition to providing coverage for such services.  3. A benefit contract must not require an insured to obtain prior authorization for any service provided through telehealth that is not required for the service when provided in person. A benefit contract may require prior authorization for a service provided through telehealth if such prior authorization would be required if the service were provided in person or by other means.  4. The provisions of this section do not require a society to:  (a) Ensure that covered services are available to an insured through telehealth at a particular originating site;  (b) Provide coverage for a service that is not a covered service or that is not provided by a covered provider of health care; or  (c) Enter into a contract with any provider of health care or cover any service if the society is not otherwise required by law to do so.  5. A benefit contract subject to the provisions of this chapter that is delivered, issued for delivery or renewed on or after July 1, 2015, has the legal effect of including the coverage required by this section, and any provision of the contract or the renewal which is in conflict with this section is void.  6. As used in this section:  (a) "Distant site" has the meaning ascribed to it in NRS 629.515.  (b) "Originating site" has the meaning ascribed to it in NRS 629.515.  (c) "Provider of health care" has the meaning ascribed to it in NRS 439.820.  (d) "Telehealth" has the meaning ascribed to it in NRS 629.515.  (Added to NRS by 2015, 641)
NV Rev Stat § 695A.270 (2021)
2021 Nevada Revised Statutes|Chapter 695A - Fraternal Benefit Societies|NRS 695A.270 - Waiver of provisions of society’s laws.

The laws of the society may provide that no subordinate body or any of its subordinate officers or members may waive any of the provisions of the laws of the society. Such a provision is binding on the society and every member and beneficiary of a member.  (Added to NRS by 1971, 1849; A 1991, 237)
NV Rev Stat § 695A.280 (2021)
2021 Nevada Revised Statutes|Chapter 695A - Fraternal Benefit Societies|NRS 695A.280 - Reinsurance.

  1. Except as otherwise provided in subsection 3, a domestic society may, by a reinsurance agreement, cede any individual risk or risks in whole or in part to an insurer, other than another fraternal benefit society, authorized to provide reinsurance in this state, or if not so authorized, one which is approved in writing by the Commissioner, but no such society may reinsure substantially all of its insurance in force without the written permission of the Commissioner.  2. A society may take credit for the reserves on such ceded risks to the extent reinsured, but no credit may be allowed as an admitted asset or as a deduction from liability to a ceding society for reinsurance made, ceded, renewed or otherwise becoming effective after July 1, 1963, unless the reinsurance is payable by the assuming insurer on the basis of the liability of the ceding society under the benefit contract or contracts reinsured without diminution because of the insolvency of the ceding society.  3. A society may reinsure the risks of another society in a consolidation or merger which is approved by the Commissioner pursuant to NRS 695A.130.  (Added to NRS by 1971, 1849; A 1987, 649; 1991, 237)
NV Rev Stat § 695A.300 (2021)
2021 Nevada Revised Statutes|Chapter 695A - Fraternal Benefit Societies|NRS 695A.300 - Admission of foreign or alien society.

  1. A foreign or alien society shall not transact business in this state without a license issued by the Commissioner.  2. A foreign or alien society may be licensed to transact business in this state upon a showing that its assets are invested in accordance with the provisions of this chapter and upon filing with the Commissioner:  (a) A duly certified copy of its laws, certified by its secretary or corresponding officer;  (b) A power of attorney to the Commissioner as prescribed in NRS 695A.400;  (c) A statement of its business under oath of its president and secretary or corresponding officers in a form prescribed by the Commissioner, duly verified by an examination made by the supervising insurance officer of its home state or other state, territory, province or country, satisfactory to the Commissioner of this state;  (d) Certification from the proper officer of its home state, territory, province or country that the society is legally incorporated and licensed to transact business therein;  (e) Copies of its certificate forms; and  (f) Such other information as the Commissioner may deem necessary.  3. Any foreign or alien society desiring admission to this state must comply substantially with the requirements and limitations of this chapter applicable to domestic societies.  (Added to NRS by 1971, 1849; A 1991, 237)