reglab/housing_qa huggingface dataset:
NV Rev Stat § 689C.325 (2021)
2021 Nevada Revised Statutes|Chapter 689C - Health Insurance for Small Employers|NRS 689C.325 - Coverage offered through network plan not required to be offered to eligible employee who does not reside or work in geographic service area or if carrier lacks capacity to deliver adequate service to additional employers and employees.

A carrier that offers coverage through a network plan is not required to offer coverage to or accept any applications for coverage from the eligible employees of a small employer pursuant to NRS 689C.310 and 689C.320 if:  1. The eligible employees do not reside or work in the geographic service area of the network plan.  2. For a small employer whose eligible employees reside or work in the geographic service area of the network plan, the carrier demonstrates to the satisfaction of the Commissioner that the carrier does not have the capacity to deliver adequate service to additional small employers and eligible employees because of the existing obligations of the carrier. If a carrier is authorized by the Commissioner not to offer coverage pursuant to this subsection, the carrier shall not thereafter offer coverage to additional small employers and eligible employees within that geographic service area until the carrier demonstrates to the satisfaction of the Commissioner that it has regained the capacity to deliver adequate service to additional small employers and eligible employees within that service area.  (Added to NRS by 1997, 2921; A 2013, 3633)
NV Rev Stat § 689C.350 (2021)
2021 Nevada Revised Statutes|Chapter 689C - Health Insurance for Small Employers|NRS 689C.350 - Health benefit plan with preferred providers of health care: Deductible; when service is deemed to be provided by preferred provider.

A health benefit plan which offers a difference of payment between preferred providers of health care and providers of health care who are not preferred:  1. Must require that the deductible and payment for coinsurance paid by the insured to a preferred provider of health care be applied to the negotiated reduced rates of that provider.  2. Must provide that if there is a particular service which a preferred provider of health care does not provide and the provider of health care who is treating the insured requests the service and the insurer determines that the use of the service is necessary for the health of the insured, the service shall be deemed to be provided by the preferred provider of health care.  (Added to NRS by 1995, 987; A 2013, 3634; 2017, 2374)
NV Rev Stat § 689C.355 (2021)
2021 Nevada Revised Statutes|Chapter 689C - Health Insurance for Small Employers|NRS 689C.355 - Prohibited acts of carrier or producer; denial of application for coverage; violation may constitute unfair trade practice; applicability of section.

  1. Except as otherwise provided in this section, a carrier or a producer shall not, directly or indirectly:  (a) Encourage or direct a small employer to refrain from filing an application for coverage with the carrier because of the health status, claims experience, industry, occupation or geographic location of the small employer.  (b) Encourage or direct a small employer to seek coverage from another carrier because of the health status, claims experience, industry, occupation or geographic location of the small employer.  2. The provisions of subsection 1 do not apply to information provided to a small employer by a carrier or a producer relating to the geographic service area or a provision for a restricted network of the carrier.  3. A carrier shall not, directly or indirectly, enter into any contract, agreement or arrangement with a producer if the contract, agreement or arrangement provides for or results in a variation to the compensation that is paid to a producer for the sale of a health benefit plan because of the health status, claims experience, industry, occupation or geographic location of the small employer at the time that the health benefit plan is issued to or renewed by the small employer.  4. A carrier shall not terminate, fail to renew, or limit its contract or agreement of representation with a producer for any reason related to the health status, claims experience, occupation or geographic location of a small employer at the time that the health benefit plan is issued to or renewed by the small employer placed by the producer with the carrier.  5. A carrier or producer shall not induce or otherwise encourage a small employer to separate or otherwise exclude an employee or a dependent of the employee from health coverage or benefits provided in connection with the employment of the employee.  6. A violation of any provision of this section by a carrier may constitute an unfair trade practice for the purposes of chapter 686A of NRS.  7. The provisions of this section apply to a third-party administrator if the third-party administrator enters into a contract, agreement or other arrangement with a carrier to provide administrative, marketing or other services related to the offering of a health benefit plan to small employers in this state.  8. Nothing in this section interferes with the right and responsibility of a producer to advise and represent the best interests of a small employer who is seeking health insurance coverage from a small employer carrier.  (Added to NRS by 1997, 2923; A 2013, 3634)
NV Rev Stat § 689C.360 (2021)
2021 Nevada Revised Statutes|Chapter 689C - Health Insurance for Small Employers|NRS 689C.360 - Definitions.

As used in NRS 689C.360 to 689C.600, inclusive, unless the context otherwise requires, the words and terms defined in NRS 689C.380 to 689C.420, inclusive, have the meanings ascribed to them in those sections.  (Added to NRS by 1995, 2677; A 1997, 2951)
NV Rev Stat § 689C.380 (2021)
2021 Nevada Revised Statutes|Chapter 689C - Health Insurance for Small Employers|NRS 689C.380 - "Contract" defined.

Contract means a policy or certificate for hospital or medical expenses, a contract for dental, hospital or medical services, or a health care plan of a health maintenance organization available for use by or offered or sold to a small employer. The term does not include coverage issued as a supplement to liability insurance, workers’ compensation or similar insurance, automobile medical payment insurance, coverage for a specified disease, hospital confinement indemnity or limited-benefit health insurance.  (Added to NRS by 1995, 2677)
NV Rev Stat § 689C.390 (2021)
2021 Nevada Revised Statutes|Chapter 689C - Health Insurance for Small Employers|NRS 689C.390 - "Dependent" defined.

Dependent means a spouse, a domestic partner as defined in NRS 122A.030, or a child on or before the last day of the month in which the child attains 26 years of age.  (Added to NRS by 1995, 2677; A 2013, 3635)
NV Rev Stat § 689C.420 (2021)
2021 Nevada Revised Statutes|Chapter 689C - Health Insurance for Small Employers|NRS 689C.420 - "Voluntary purchasing group" defined.

Voluntary purchasing group means the employers and their eligible employees and dependents who form a group pursuant to NRS 689C.360 to 689C.600, inclusive, and hold a certificate of registration issued by the Commission pursuant to NRS 689C.510.  (Added to NRS by 1995, 2677)
NV Rev Stat § 689C.425 (2021)
2021 Nevada Revised Statutes|Chapter 689C - Health Insurance for Small Employers|NRS 689C.425 - Applicability of other provisions.

A voluntary purchasing group and any contract issued to such a group pursuant to NRS 689C.360 to 689C.600, inclusive, are subject to the provisions of NRS 689C.015 to 689C.355, inclusive, to the extent applicable and not in conflict with the express provisions of NRS 687B.408 and 689C.360 to 689C.600, inclusive.  (Added to NRS by 1997, 2929; A 2001, 860; 2009, 1812; 2015, 207, 641, 2125; 2017, 1828, 3943; 2019, 1006, 2171)
NV Rev Stat § 689C.430 (2021)
2021 Nevada Revised Statutes|Chapter 689C - Health Insurance for Small Employers|NRS 689C.430 - Entities which are authorized to offer contracts to voluntary purchasing groups.

Every insurer, fraternal benefit society, corporation providing hospital or medical services or health maintenance organization, whose policies or activities relating to health insurance are governed by the provisions of chapter 689B, 695A, 695B or 695C of NRS, may offer contracts to voluntary purchasing groups and, if it does so, shall comply with the provisions of NRS 689C.360 to 689C.600, inclusive.  (Added to NRS by 1995, 2677)
NV Rev Stat § 689C.435 (2021)
2021 Nevada Revised Statutes|Chapter 689C - Health Insurance for Small Employers|NRS 689C.435 - Contracts between carrier and providers of health care: Prohibiting carrier from charging provider of health care fee for inclusion on list of providers given to insureds; form to obtain information on provider of health care; modification; schedule of fees.

  1. A carrier serving small employers and a carrier that offers a contract to a voluntary purchasing group shall not charge a provider of health care a fee to include the name of the provider on a list of providers of health care given by the carrier to its insureds.  2. A carrier specified in subsection 1 shall not contract with a provider of health care to provide health care to an insured unless the carrier uses the form prescribed by the Commissioner pursuant to NRS 629.095 to obtain any information related to the credentials of the provider of health care.  3. A contract between a carrier specified in subsection 1 and a provider of health care may be modified:  (a) At any time pursuant to a written agreement executed by both parties.  (b) Except as otherwise provided in this paragraph, by the carrier upon giving to the provider 45 days’ written notice of the modification of the carrier’s schedule of payments, including any changes to the fee schedule applicable to the provider’s practice. If the provider fails to object in writing to the modification within the 45 day period, the modification becomes effective at the end of that period. If the provider objects in writing to the modification within the 45 day period, the modification must not become effective unless agreed to by both parties as described in paragraph (a).  4. If a carrier specified in subsection 1 contracts with a provider of health care to provide health care to an insured, the carrier shall:  (a) If requested by the provider of health care at the time the contract is made, submit to the provider of health care the schedule of payments applicable to the provider of health care; or  (b) If requested by the provider of health care at any other time, submit to the provider of health care the schedule of payments, including any changes to the fee schedule applicable to the provider’s practice, specified in paragraph (a) within 7 days after receiving the request.  5. As used in this section, "provider of health care" means a provider of health care who is licensed pursuant to chapter 630, 631, 632 or 633 of NRS.  (Added to NRS by 1999, 1648; A 2001, 2731; 2003, 3359; 2011, 2533)
NV Rev Stat § 689C.455 (2021)
2021 Nevada Revised Statutes|Chapter 689C - Health Insurance for Small Employers|NRS 689C.455 - Coverage for prescription drugs: Provision of notice and information regarding use of formulary.

  1. A carrier that offers or issues a contract which provides coverage for prescription drugs shall include with any summary, certificate or evidence of that coverage provided to an insured, notice of whether a formulary is used and, if so, of the opportunity to secure information regarding the formulary from the carrier 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 carrier for making a request for information regarding the formulary pursuant to subsection 2.  2. If a carrier offers or issues a contract which provides coverage for prescription drugs and a formulary is used, the carrier 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 carrier 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, 859)
NV Rev Stat § 689C.460 (2021)
2021 Nevada Revised Statutes|Chapter 689C - Health Insurance for Small Employers|NRS 689C.460 - Carrier to offer same coverage to all eligible employees; denial of coverage to otherwise eligible employee.

  1. If a carrier offers a contract to a voluntary purchasing group, the carrier shall offer the same coverage to all of the eligible employees of the small employers that are members of the voluntary purchasing group and their dependents. A carrier shall not offer coverage to only certain members of that group or to only part of that group, but may exclude an otherwise eligible employee, or a dependent of the otherwise eligible employee, who requests enrollment in the contract after the end of the initial period during which the employee or dependent is entitled to enroll under the terms of the contract, if the initial period is at least 30 days.  2. A carrier shall not exclude an eligible employee or dependent if:  (a) The employee or dependent:  (1) Was covered under other creditable coverage at the time of the initial period for enrollment;  (2) Lost coverage under the other creditable coverage as a result of termination of employment or eligibility, the involuntary termination of the creditable coverage, the death of a spouse or divorce; and  (3) Requests enrollment within 30 days after termination of the other creditable coverage;  (b) The employee is employed by an employer that offers multiple contracts and elects a different contract during an open period for enrollment; or  (c) A court has ordered that coverage be provided for a dependent under a covered employee’s contract and the request for enrollment is made within 30 days after issuance of the court order.  (Added to NRS by 1995, 2678; A 1997, 2951)
NV Rev Stat § 689C.470 (2021)
2021 Nevada Revised Statutes|Chapter 689C - Health Insurance for Small Employers|NRS 689C.470 - Renewal of contract; discontinuing product.

  1. Except as otherwise provided in NRS 689C.360 to 689C.600, inclusive, a carrier shall renew a contract as to all insured small employers that are members of a voluntary purchasing group and their employees and dependents at the request of the purchaser unless:  (a) Required premiums are not paid;  (b) The insured employer or other purchaser is guilty of fraud or misrepresentation;  (c) Provisions of the contract are breached;  (d) The number or percentage of employees covered under the contract is less than the number or percentage of eligible employees required by the contract;  (e) The employer or purchaser is no longer engaged in the business in which it was engaged on the effective date of the contract; or  (f) The Commissioner finds that the continuation of the coverage is not in the best interests of the persons insured under the contract or would impair the carrier’s ability to meet its contractual obligations. If nonrenewal occurs as a result of findings pursuant to this subsection, the Commissioner shall assist affected persons in replacing coverage.  2. A carrier may discontinue a product offered to a small employer or purchasers pursuant to NRS 689C.360 to 689C.600, inclusive, only if:  (a) The carrier notifies the Commissioner of its decision pursuant to this subsection to discontinue the product at least 60 days before the carrier notifies the affected small employers and purchasers pursuant to paragraph (b).  (b) The carrier notifies each affected small employer and purchaser of the decision of the carrier to discontinue the product. The notice must be made at least 90 days before the date on which the carrier will discontinue offering the product.  (c) The carrier offers to each affected small employer and purchaser the option to purchase any other health benefit plan currently offered by the carrier to small employers in this state.  (d) In exercising the option to discontinue the product and in offering the option to purchase other coverage pursuant to paragraph (c), the carrier acts uniformly without regard to the claim experience of the affected small employers and any health status-related factor relating to any participant or beneficiary covered by the discontinued product or any new participant or beneficiary who may become eligible for such coverage.  3. A carrier may discontinue the issuance and renewal of a health benefit plan offered to a voluntary purchasing group pursuant to this chapter only through a bona fide association if:  (a) The membership of the small employer who employs the members of the voluntary purchasing group or the purchaser in the association was the basis for the provision of coverage;  (b) The membership of that small employer or the purchaser in the association ceases; and  (c) The coverage is terminated pursuant to this subsection uniformly without regard to any health status-related factor relating to the small employer or the purchaser or his or her dependent.  (Added to NRS by 1995, 2679; A 1997, 2951; 2017, 2374)
NV Rev Stat § 689C.480 (2021)
2021 Nevada Revised Statutes|Chapter 689C - Health Insurance for Small Employers|NRS 689C.480 - Required notification when carrier ceases to renew all contracts; restrictions on carrier that ceases to renew all contracts.

  1. A carrier may cease to renew all contracts covering voluntary purchasing groups and discontinue issuing and delivering for issuance any such contracts. The carrier shall provide notice:  (a) At least 60 days before the notice of termination is provided pursuant to paragraph (b), to the Commissioner and the chief regulatory officer for insurance of each state in which the carrier is licensed to transact insurance; and  (b) At least 180 days before termination of coverage to holders of all affected contracts and to the Commissioner and the chief regulatory officer for insurance in each state in which an affected insured person is known to reside.  2. A carrier that exercises its right to cease to renew all contracts covering voluntary purchasing groups shall not transfer or otherwise provide coverage to any of the insureds from a nonrenewed voluntary purchasing group unless the carrier offers to transfer or provide coverage to all affected employers and eligible employees and dependents without regard to characteristics of the insured, experience as to claims, health or duration of coverage.  3. A carrier that decides to terminate its contracts and to discontinue issuing and delivering for issuance any contracts pursuant to this section:  (a) Shall discontinue issuance and delivery for issuance all health benefit plans pursuant to this chapter in this state and, except as otherwise provided in this section, not renew any such contracts; and  (b) Shall not enter into any new contract with a voluntary purchasing group for 5 years after the date on which the carrier terminated its contracts with voluntary purchasing groups.  (Added to NRS by 1995, 2679; A 1997, 2953)
NV Rev Stat § 689C.490 (2021)
2021 Nevada Revised Statutes|Chapter 689C - Health Insurance for Small Employers|NRS 689C.490 - Formation of voluntary purchasing group by small employers; requirements when affiliate of group ceases to qualify as small employer.

  1. A small employer may, in accordance with the provisions of NRS 689C.490 to 689C.600, inclusive, choose to affiliate voluntarily with other small employers as a voluntary purchasing group to purchase health benefits for eligible employees and their dependents.  2. An employer who affiliates with a voluntary purchasing group shall notify the carrier for that group when the employer has less than 2 or more than 50 employees. The carrier shall:  (a) Upon receiving such a notification, inform the employer of the provisions of paragraph (b).  (b) If the employer ceases to be a small employer, refuse to renew the coverage of that employer and employees of that employer and their dependents under any contract provided through the voluntary purchasing group.  (Added to NRS by 1995, 2679; A 1997, 2953)
NV Rev Stat § 689C.500 (2021)
2021 Nevada Revised Statutes|Chapter 689C - Health Insurance for Small Employers|NRS 689C.500 - Requirements for registration as voluntary purchasing group; application.

  1. An organization seeking to be registered as a voluntary purchasing group:  (a) Must be incorporated as a Nevada corporation not for profit for the purpose of securing health benefits for its members and their eligible employees and dependents;  (b) Shall file articles of incorporation with the Secretary of State and provide a copy of the articles to the Commissioner in such a form as the Commissioner may require; and  (c) Must apply to the Commissioner for and obtain a certificate of registration to operate as a voluntary purchasing group.  2. The contents of the application must be established by the Commissioner and include at least:  (a) The name of the voluntary purchasing group and any agent for service of process;  (b) Provisions to govern the business and affairs of the group, including the management and organizational structure;  (c) An affidavit by an officer of the organization that the group is in compliance with the requirements of NRS 689C.490 to 689C.600, inclusive; and  (d) The names of managing personnel of the voluntary purchasing group.  (Added to NRS by 1995, 2680)
NV Rev Stat § 689C.510 (2021)
2021 Nevada Revised Statutes|Chapter 689C - Health Insurance for Small Employers|NRS 689C.510 - Fee for application; response to application.

  1. The application must be accompanied by a fee in an amount to be established by the Commissioner by regulation to cover the direct costs of examining the qualifications of an applicant.  2. The Commissioner shall respond to each application for a certificate of registration within 30 days after receipt. The Commissioner shall either approve the application or shall inform the organization of specific changes to the application necessary to permit approval.  (Added to NRS by 1995, 2680)
NV Rev Stat § 689C.520 (2021)
2021 Nevada Revised Statutes|Chapter 689C - Health Insurance for Small Employers|NRS 689C.520 - Additional requirements for registration.

  1. Before the issuance of a certificate of registration, each voluntary purchasing group shall, to the satisfaction of the Commissioner:  (a) Establish the conditions of membership in the group and require as a condition of membership that all employers include all their eligible employees. The group may not differentiate among classes of membership on the basis of the kind of employment, race, religion, sex, sexual orientation, gender identity or expression, education, health or income. The group shall set reasonable fees for membership which will finance all reasonable and necessary costs incurred in administering the group.  (b) Provide to members of the group and their eligible employees any applicable disclosures of the coverage provided by any proposed contracts and any applicable information regarding available benefits and carriers provided by any proposed contracts.  2. In addition to the information required pursuant to subsection 1, a voluntary purchasing group shall provide annually to members of the group information regarding available benefits and carriers.  (Added to NRS by 1995, 2680; A 2017, 1080, 2375)