reglab/housing_qa huggingface dataset:
NV Rev Stat § 689C.1674 (2021)
2021 Nevada Revised Statutes|Chapter 689C - Health Insurance for Small Employers|NRS 689C.1674 - Coverage for mammograms for certain women; prohibited acts.

  1. A health benefit plan must provide coverage for benefits payable for expenses incurred for a mammogram every 2 years, or annually if ordered by a provider of health care, for women 40 years of age or older.  2. A carrier must ensure that the benefits required by subsection 1 are made available to an insured through a provider of health care who participates in the network plan of the carrier.  3. Except as otherwise provided in subsection 5, a carrier that offers or issues a health benefit plan shall not:  (a) Require an insured to pay a higher deductible, any copayment or coinsurance or require a longer waiting period or other condition to obtain any benefit provided in the health benefit plan pursuant to subsection 1;  (b) Refuse to issue a health benefit plan or cancel a health benefit plan solely because the person applying for or covered by the plan uses or may use any such benefit;  (c) Offer or pay any type of material inducement or financial incentive to an insured to discourage the insured from obtaining any such benefit;  (d) Penalize a provider of health care who provides any such benefit to an insured, including, without limitation, reducing the reimbursement of the provider of health care;   (e) Offer or pay any type of material inducement, bonus or other financial incentive to a provider of health care to deny, reduce, withhold, limit or delay access to any such benefit to an insured; or  (f) Impose any other restrictions or delays on the access of an insured to any such benefit.  4. A plan subject to the provisions of this chapter which is delivered, issued for delivery or renewed on or after January 1, 2018, has the legal effect of including the coverage required by subsection 1, and any provision of the plan or the renewal which is in conflict with this section is void.  5. Except as otherwise provided in this section and federal law, a carrier may use medical management techniques, including, without limitation, any available clinical evidence, to determine the frequency of or treatment relating to any benefit required by this section or the type of provider of health care to use for such treatment.  6. As used in this section:  (a) "Medical management technique" means a practice which is used to control the cost or utilization of health care services or prescription drug use. The term includes, without limitation, the use of step therapy, prior authorization or categorizing drugs and devices based on cost, type or method of administration.  (b) "Network plan" means a health benefit plan offered by a carrier under which the financing and delivery of medical care, including items and services paid for as medical care, are provided, in whole or in part, through a defined set of providers under contract with the carrier. The term does not include an arrangement for the financing of premiums.  (c) "Provider of health care" has the meaning ascribed to it in NRS 629.031.  (Added to NRS by 2017, 1827)
NV Rev Stat § 689C.168 (2021)
2021 Nevada Revised Statutes|Chapter 689C - Health Insurance for Small Employers|NRS 689C.168 - Coverage for prescription drug previously approved for medical condition of insured.

  1. Except as otherwise provided in this section, a health benefit plan which provides coverage for prescription drugs must not limit or exclude coverage for a drug if the drug:  (a) Had previously been approved for coverage by the carrier for a medical condition of an insured and the insured’s provider of health care determines, after conducting a reasonable investigation, that none of the drugs which are otherwise currently approved for coverage are medically appropriate for the insured; and  (b) Is appropriately prescribed and considered safe and effective for treating the medical condition of the insured.  2. The provisions of subsection 1 do not:  (a) Apply to coverage for any drug that is prescribed for a use that is different from the use for which that drug has been approved for marketing by the Food and Drug Administration;  (b) Prohibit:  (1) The carrier from charging a deductible, copayment or coinsurance for the provision of benefits for prescription drugs to the insured or from establishing, by contract, limitations on the maximum coverage for prescription drugs;  (2) A provider of health care from prescribing another drug covered by the plan that is medically appropriate for the insured; or  (3) The substitution of another drug pursuant to NRS 639.23286 or 639.2583 to 639.2597, inclusive; or  (c) Require any coverage for a drug after the term of the plan.  3. Any provision of a health benefit plan subject to the provisions of this chapter that is delivered, issued for delivery or renewed on or after October 1, 2001, which is in conflict with this section is void.  (Added to NRS by 2001, 859; A 2003, 2299; 2017, 637)
NV Rev Stat § 689C.1683 (2021)
2021 Nevada Revised Statutes|Chapter 689C - Health Insurance for Small Employers|NRS 689C.1683 - Coverage for prescription drugs irregularly dispensed for purpose of synchronization of chronic medications.

  1. A carrier who offers or issues a health benefit plan which provides coverage for prescription drugs:  (a) Must authorize coverage for and may apply a copayment and deductible to a prescription that is dispensed by a pharmacy for less than a 30-day supply if, for the purpose of synchronizing the insured’s chronic medications:  (1) The prescriber or pharmacist determines that filling or refilling the prescription in that manner is in the best interest of the insured; and  (2) The insured requests less than a 30-day supply.  (b) May not deny coverage for a prescription described in paragraph (a) which is otherwise approved for coverage by the carrier.  (c) Unless otherwise provided by a contract or other agreement, may not prorate any pharmacy dispensing fees for a prescription described in paragraph (a).  2. A health benefit plan subject to the provisions of this chapter which provides coverage for prescription drugs and that is delivered, issued for delivery or renewed on or after January 1, 2017, has the legal effect of providing that coverage subject to the requirements of this section, and any provision of the health benefit plan or renewal which is in conflict with this section is void.  3. The provisions of this section do not apply to unit-of-use packaging for which synchronization is not practicable or to a controlled substance.  4. As used in this section:  (a) "Chronic medication" means any drug that is prescribed to treat any disease or other condition which is determined to be permanent, persistent or lasting indefinitely.  (b) "Synchronization" means the alignment of the dispensing of multiple medications by a single contracted pharmacy for the purpose of improving a patient’s adherence to a prescribed course of medication.  (c) "Unit-of-use packaging" means medication that is prepackaged by the manufacturer in blister packs, compliance packs, course-of-therapy packs or any other packaging which is designed and intended to be dispensed directly to the patient without modification by the dispensing pharmacy, except for the addition of a prescription label.  (Added to NRS by 2015, 2125)
NV Rev Stat § 689C.1685 (2021)
2021 Nevada Revised Statutes|Chapter 689C - Health Insurance for Small Employers|NRS 689C.1685 - Coverage for early refills of topical ophthalmic products.

  1. A carrier who offers or issues a health benefit plan which provides coverage for prescription drugs shall not deny coverage for a topical ophthalmic product which is otherwise approved for coverage by the carrier when the insured, pursuant to NRS 639.2395, receives a refill of the product:  (a) After 21 days or more but before 30 days after receiving any 30-day supply of the product;  (b) After 42 days or more but before 60 days after receiving any 60-day supply of the product; or  (c) After 63 days or more but before 90 days after receiving any 90-day supply of the product.  2. The provisions of this section do not affect any deductibles, copayments or coinsurance established by the health benefit plan.  3. A health benefit plan subject to the provisions of this chapter which provides coverage for prescription drugs and that is delivered, issued for delivery or renewed on or after January 1, 2016, has the legal effect of including the coverage required by this section, and any provision of the plan or renewal which is in conflict with this section is void.  4. As used in this section, "topical ophthalmic product" means a liquid prescription drug which is applied directly to the eye from a bottle or by means of a dropper.  (Added to NRS by 2015, 207)
NV Rev Stat § 689C.1687 (2021)
2021 Nevada Revised Statutes|Chapter 689C - Health Insurance for Small Employers|NRS 689C.1687 - Coverage for management and treatment of sickle cell disease.

  1. A carrier that issues a health benefit plan shall include in the plan coverage for:  (a) Necessary case management services for an insured who has been diagnosed with sickle cell disease and its variants; and  (b) Medically necessary care for an insured who has been diagnosed with sickle cell disease and its variants.  2. A carrier that issues a health benefit plan which provides coverage for prescription drugs shall include in the plan coverage for medically necessary prescription drugs to treat sickle cell disease and its variants.  3. A carrier may use medical management techniques, including, without limitation, any available clinical evidence, to determine the frequency of or treatment relating to any benefit required by this section or the type of provider of health care to use for such treatment.  4. As used in this section:  (a) "Case management services" means medical or other health care management services to assist patients and providers of health care, including, without limitation, identifying and facilitating additional resources and treatments, providing information about treatment options and facilitating communication between providers of services to a patient.  (b) "Medical management technique" means a practice which is used to control the cost or utilization of health care services. The term includes, without limitation, the use of step therapy, prior authorization or categorizing drugs and devices based on cost, type or method of administration.  (c) "Medically necessary" has the meaning ascribed to it in NRS 695G.055.  (d) "Sickle cell disease and its variants" has the meaning ascribed to it in NRS 439.4927.  (Added to NRS by 2019, 2170)
NV Rev Stat § 689C.169 (2021)
2021 Nevada Revised Statutes|Chapter 689C - Health Insurance for Small Employers|NRS 689C.169 - Coverage for severe mental illness.

  1. A policy of group health insurance delivered or issued for delivery in this State pursuant to this chapter must provide coverage for the treatment of conditions relating to severe mental illness.  2. As used in this section, "severe mental illness" means any of the following mental illnesses that are biologically based and for which diagnostic criteria are prescribed in the latest edition of the Diagnostic and Statistical Manual of Mental Disorders, published by the American Psychiatric Association:  (a) Schizophrenia.  (b) Schizoaffective disorder.  (c) Bipolar disorder.  (d) Major depressive disorders.  (e) Panic disorder.  (f) Obsessive-compulsive disorder.  (Added to NRS by 2009, 1811; A 2013, 3627)
NV Rev Stat § 689C.170 (2021)
2021 Nevada Revised Statutes|Chapter 689C - Health Insurance for Small Employers|NRS 689C.170 - Authorized variation of minimum participation and contributions; denial of coverage based on industry prohibited.

  1. A carrier serving small employers may vary the application of requirements for minimum participation of eligible employees and minimum employer’s contributions only by the size of the small employer’s group or the product offered.  2. In applying requirements for minimum participation with respect to a small employer, a carrier shall not consider employees or dependents who have creditable coverage when determining whether the applicable percentage of participation is met, but may consider employees or dependents who have coverage under another health benefit plan that is sponsored by the employer.  3. A carrier shall not deny an application for coverage solely because the applicant works in a certain industry.  4. After a small employer has been accepted for coverage, a carrier shall not increase any requirement for minimum employee participation or modify any requirement for minimum employer contribution applicable to the small employer.  (Added to NRS by 1995, 980; A 1997, 2942; 2007, 3327)
NV Rev Stat § 689C.180 (2021)
2021 Nevada Revised Statutes|Chapter 689C - Health Insurance for Small Employers|NRS 689C.180 - Carrier to offer same coverage to all eligible employees; denial of coverage to otherwise eligible employee.

  1. If a carrier serving small employers offers coverage to a small employer, the carrier shall offer the same coverage to all of the eligible employees of the small employer and their dependents. A carrier shall not offer coverage to only certain members of a small employer’s group or to only part of the group, but may exclude an otherwise eligible employee, or a dependent of the eligible employee, who requests enrollment in a health benefit plan after the end of the initial period during which the employee or dependent is entitled to enroll under the terms of the plan, 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 health benefit plans and elects a different plan during an open period for enrollment; or  (c) A court has ordered that coverage be provided for a dependent under a covered employee’s health benefit plan and the request for enrollment is made within 30 days after issuance of the court order.  (Added to NRS by 1995, 981; A 1997, 2942)
NV Rev Stat § 689C.183 (2021)
2021 Nevada Revised Statutes|Chapter 689C - Health Insurance for Small Employers|NRS 689C.183 - Plan and carrier required to permit employee or dependent of employee to enroll for coverage under certain circumstances.

A health benefit plan and a carrier offering such a plan shall permit an employee or a dependent of an employee covered by the health benefit plan who is eligible, but not enrolled, for coverage in connection with the health benefit plan to enroll for coverage under the terms of the health benefit plan if:  1. The employee or dependent was covered under a different health benefit plan or had other health insurance coverage at the time coverage was previously offered to the employee or dependent;  2. The employee stated in writing at that time that the other coverage was the reason for declining enrollment, but only if the plan sponsor or carrier required such a written statement and informed the employee of that requirement and the consequences of the requirement; and  3. The employee or dependent:  (a) Was covered under any provision of the Consolidated Omnibus Budget Reconciliation Act of 1985 relating to the continuation of coverage and such continuation of coverage was exhausted; or  (b) Was not covered under such a provision and his or her insurance coverage was lost as a result of cessation of contributions by his or her employer, termination of employment or eligibility, reduction in the number of hours of employment, or the death of, or divorce or legal separation from, a covered spouse.  (Added to NRS by 1997, 2921)
NV Rev Stat § 689C.187 (2021)
2021 Nevada Revised Statutes|Chapter 689C - Health Insurance for Small Employers|NRS 689C.187 - Manner and period for enrolling dependent of covered employee; period of special enrollment.

  1. A health benefit plan and a carrier of such a plan that makes coverage available to the dependent of a covered employee shall permit the employee to enroll a dependent after the close of a period of open enrollment if:  (a) The employee is a participant in the health benefit plan, or has met any waiting period applicable to becoming a participant and is eligible to be enrolled under the plan, except for a failure to enroll during a previous period of open enrollment; and  (b) The person to be enrolled became a dependent of the employee through marriage, birth, adoption or placement for adoption.  2. The health benefit plan or carrier shall provide a period of special enrollment for the enrollment of a dependent of an employee pursuant to this section. Such a period must be not less than 30 days and must begin on:  (a) The date specified by the health benefit plan or carrier for the period of special enrollment; or  (b) The date of the marriage, birth, adoption or placement for adoption, as appropriate.  3. If an employee seeks to enroll a dependent during the first 30 days of the period for special enrollment provided pursuant to subsection 2, the coverage of the dependent becomes effective:  (a) In the case of a marriage, not later than the first day of the first month beginning after the date on which the completed request for enrollment is received;  (b) In the case of a birth, on the date of the birth; and  (c) In the case of an adoption or placement for adoption, on the date of the adoption or the placement for adoption.  4. In the case of a birth, an adoption or a placement for adoption of a child of an employee, the spouse of the employee may be enrolled as a dependent pursuant to this section if the spouse is otherwise eligible for coverage under the health benefit plan.  (Added to NRS by 1997, 2922)
NV Rev Stat § 689C.190 (2021)
2021 Nevada Revised Statutes|Chapter 689C - Health Insurance for Small Employers|NRS 689C.190 - Coverage of preexisting conditions. [Effective through December 31, 2019.]

A carrier serving small employers that issues a health benefit plan shall not deny, exclude or limit a benefit for a preexisting condition.  (Added to NRS by 1995, 981; A 1997, 2943; 2013, 3628)
NV Rev Stat § 689C.190 (2021)
2021 Nevada Revised Statutes|Chapter 689C - Health Insurance for Small Employers|NRS 689C.190 - Requirements regarding issuance of health benefit plans and adjustment of costs. [Effective January 1, 2020.]

  1. A carrier that issues a health benefit plan shall offer and issue a health benefit plan to any small employer regardless of the health status of the employees of the small employer. Such health status includes, without limitation:  (a) Any preexisting medical condition of an insured, including, without limitation, any physical or mental illness;  (b) The claims history of the insured, including, without limitation, any prior health care services received by the insured;  (c) Genetic information relating to the insured; and  (d) Any increased risk for illness, injury or any other medical condition of the insured, including, without limitation, any medical condition caused by an act of domestic violence.   2. A carrier 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 carrier 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. A carrier that offers or issues a health benefit plan may include in the plan a wellness program that reduces a premium, deductible or copayment based on health status if:  (a) An insured who is eligible to participate in the wellness program is given the opportunity to qualify for the discount at least once each year;  (b) The amount of all discounts provided pursuant to such a wellness program does not exceed 30 percent, or if the program is designed to prevent or reduce tobacco use, 50 percent, of the cost of coverage for an insured or an insured and his or her dependents, as applicable, under the plan;  (c) The wellness program is reasonably designed to promote health or prevent disease;  (d) The carrier ensures that the full discount under the wellness program is available to all similarly situated insureds by providing a reasonable alternative standard by which an insured may qualify for the discount which, if based on health status, must accommodate the recommendations of the physician of the insured; and  (e) The plan discloses in all plan materials describing the terms of the wellness program, and in any disclosure that an insured did not satisfy the initial standard to be eligible for the discount, the availability of a reasonable alternative standard described in paragraph (d).  (Added to NRS by 1995, 981; A 1997, 2943; 2013, 3628; 2019, 302, effective January 1, 2020)
NV Rev Stat § 689C.191 (2021)
2021 Nevada Revised Statutes|Chapter 689C - Health Insurance for Small Employers|NRS 689C.191 - Determination of applicable creditable coverage of person; determining period of creditable coverage of person; required statement; applicability.

  1. In determining the applicable creditable coverage of a person, a period of creditable coverage must not be included if, after the expiration of that period but before the enrollment date, there was a 63-day period during all of which the person was not covered under any creditable coverage. To establish a period of creditable coverage, an eligible employee must present any certificates of coverage provided to the eligible employee in accordance with NRS 689C.192 and such other evidence of coverage as required by regulations adopted by the Commissioner. For the purposes of this subsection, any waiting period for coverage or an affiliation period must not be considered in determining the applicable period of creditable coverage.  2. In determining the period of creditable coverage of a person, a carrier shall include each applicable period of creditable coverage without regard to the specific benefits covered during that period, except that the carrier may elect to include applicable periods of creditable coverage based on coverage of specific benefits as specified by the United States Department of Health and Human Services by regulation, if such an election is made on a uniform basis for all participants and beneficiaries of the health benefit plan or coverage. Pursuant to such an election, the carrier shall include each applicable period of creditable coverage with respect to any class or category of benefits if any level of benefits is covered within that class or category, as specified by those regulations.  3. Regardless of whether coverage is actually provided, if a carrier elects in accordance with subsection 2 to determine creditable coverage based on specified benefits, a statement that such an election has been made and a description of the effect of the election must be:  (a) Included prominently in any disclosure statement concerning the health benefit plan; and  (b) Provided to each eligible employee at the time of enrollment in the health benefit plan.  4. The provisions of this section apply only to grandfathered plans.  (Added to NRS by 1997, 2926; A 2013, 3630)