reglab/housing_qa huggingface dataset:
NV Rev Stat § 695C.275 (2021)
2021 Nevada Revised Statutes|Chapter 695C - Health Maintenance Organizations|NRS 695C.275 - Commissioner to adopt regulations for licensing of provider-sponsored organizations.

  1. To the extent authorized by federal law, the Commissioner shall adopt regulations for the licensing of provider-sponsored organizations in this State.  2. As used in this section, "provider-sponsored organization" has the meaning ascribed to it in 42 U.S.C. § 1395w-25(d).  (Added to NRS by 1999, 2817)
NV Rev Stat § 695C.280 (2021)
2021 Nevada Revised Statutes|Chapter 695C - Health Maintenance Organizations|NRS 695C.280 - Commissioner authorized to adopt regulations for licensing of agents or brokers.

The Commissioner may adopt such reasonable regulations as are necessary to provide for the licensing of agents or brokers. An agent is a person directly or indirectly associated with a health care plan who engages in solicitation or enrollment. A broker is a person who is directly involved with the insured in the manner provided in chapter 683A of NRS.  (Added to NRS by 1973, 1254; A 1981, 107; 1993, 2401)
NV Rev Stat § 695C.290 (2021)
2021 Nevada Revised Statutes|Chapter 695C - Health Maintenance Organizations|NRS 695C.290 - Insurance company may establish or contract with health maintenance organization.

  1. An insurance company licensed in this State may either directly or through a subsidiary or affiliate organize and operate a health maintenance organization under the provisions of this chapter. Notwithstanding any other law which may be inconsistent herewith, any two or more such insurance companies or subsidiaries or affiliates thereof may jointly organize and operate a health maintenance organization. The business of insurance is deemed to include the providing of health care by a health maintenance organization owned or operated by an insurer or a subsidiary thereof.  2. An insurer may contract with a health maintenance organization to provide insurance or similar protection against the cost of care provided through health maintenance organizations and to provide coverage in the event of the failure of the health maintenance organization to meet its obligations. Among other things, under such contracts the insurer may make benefit payments to health maintenance organizations for health care services rendered by providers pursuant to the health care plan.  (Added to NRS by 1973, 1254)
NV Rev Stat § 695C.300 (2021)
2021 Nevada Revised Statutes|Chapter 695C - Health Maintenance Organizations|NRS 695C.300 - Prohibited practices.

  1. No health maintenance organization or representative thereof may cause or knowingly permit the use of advertising which is untrue or misleading, solicitation which is untrue or misleading or any form of evidence of coverage which is deceptive. For purposes of this chapter:  (a) A statement or item of information shall be deemed to be untrue if it does not conform to fact in any respect which is or may be significant to an enrollee of, or person considering enrollment in, a health care plan.  (b) A statement or item of information shall be deemed to be misleading, whether or not it may be literally untrue if, in the total context in which such statement is made or such item of information is communicated, such statement or item of information may be reasonably understood by a reasonable person not possessing special knowledge regarding health care coverage, as indicating any benefit or advantage or the absence of any exclusion, limitation or disadvantage of possible significance to an enrollee of, or person considering enrollment in, a health care plan if such benefit or advantage or absence of limitation, exclusion or disadvantage does not in fact exist.  (c) An evidence of coverage shall be deemed to be deceptive if the evidence of coverage taken as a whole, and with consideration given to typography and format as well as language, shall be such as to cause a reasonable person not possessing special knowledge regarding health care plans and evidences of coverage therefor to expect benefits, services, charges or other advantages which the evidence of coverage does not provide or which the health care plan issuing such evidence of coverage does not regularly make available for enrollees covered under such evidence of coverage.  2. NRS 686A.010 to 686A.310, inclusive, shall be construed to apply to health maintenance organizations, health care plans and evidences of coverage except to the extent that the nature of health maintenance organizations, health care plans and evidences of coverage render the sections therein clearly inappropriate.  3. An enrollee may not be cancelled or not renewed except for the failure to pay the charge for such coverage or for cause as determined in the master contract.  4. No health maintenance organization, unless licensed as an insurer, may use in its name, contracts, or literature any of the words "insurance," "casualty," "surety," "mutual" or any other words descriptive of the insurance, casualty or surety business or deceptively similar to the name or description of any insurance or surety corporation doing business in this State.  5. No person not certificated under this chapter shall use in its name, contracts or literature the phrase "health maintenance organization" or the initials "HMO."  (Added to NRS by 1973, 1253)
NV Rev Stat § 695C.311 (2021)
2021 Nevada Revised Statutes|Chapter 695C - Health Maintenance Organizations|NRS 695C.311 - Periodic examination by Commissioner to determine financial condition of health maintenance organization.

  1. For the purpose of determining its financial condition, fulfillment of its contractual obligations and compliance with law, the Commissioner shall, as often as the Commissioner deems advisable, examine the affairs, transactions, accounts, records and assets of a health maintenance organization and of any person as to any matter relevant to the financial affairs of the health maintenance organization or to the examination. Except as otherwise provided in this Code, the Commissioner shall examine each health maintenance organization at least once every 3 years.  2. The Commissioner shall examine each health maintenance organization applying for an initial certificate of authority.  3. In lieu of making his or her own examination, the Commissioner may, in the discretion of the Commissioner, accept a full report of the last recent examination of a foreign or alien health maintenance organization, certified to by the supervisory officer of insurance of another state.  4. To the extent that it is practical, the examination of a foreign or alien health maintenance organization must be made in cooperation with the insurance supervisory officers of other states in which the organization transacts business.  (Added to NRS by 1991, 2035)
NV Rev Stat § 695C.313 (2021)
2021 Nevada Revised Statutes|Chapter 695C - Health Maintenance Organizations|NRS 695C.313 - Financial examination: Procedure; appointment of examiner; maintenance and use of records; penalty for obstruction or interference.

  1. If the Commissioner determines to examine a health maintenance organization pursuant to NRS 695C.311, the Commissioner shall designate one or more examiners and instruct them as to the scope of the examination. The examiner shall, upon demand, exhibit his or her official credentials to the health maintenance organization being examined.  2. The Commissioner shall conduct each examination in an expeditious, fair and impartial manner.  3. The Commissioner, or the examiner if the examiner is authorized in writing by the Commissioner, may administer oaths and examine under oath any person concerning any matter relevant to the examination.  4. Every health maintenance organization and its officers, attorneys, employees, agents and representatives shall make available to the Commissioner or the examiners of the Commissioner the accounts, records, documents, files, information, assets and matters of the health maintenance organization in his or her possession or control relating to the subject of the examination and shall facilitate the examination.  5. If the Commissioner or examiner finds any accounts or records to be inadequate or inadequately kept or posted, he or she shall so notify the health maintenance organization and give the health maintenance organization a reasonable opportunity to reconstruct, rewrite, post or balance the account or record. If the health maintenance organization fails to maintain, complete or correct the records or accounting after the Commissioner or examiner has given the health maintenance organization written notice and a reasonable opportunity to do so, the Commissioner may employ experts to reconstruct, rewrite, post or balance the account or record at the expense of the health maintenance organization being examined.  6. The Commissioner or an examiner shall not remove any record, account, document, file or other property of the health maintenance organization being examined from the office or place of business of the health maintenance organization unless the Commissioner or examiner has the written consent of an officer of the health maintenance organization before the removal or pursuant to an order of court. This provision does not prohibit the Commissioner or examiner from making or removing copies or abstracts of a record, account, document or file.  7. Any person who, without just cause, refuses to be examined under oath or who willfully obstructs or interferes with an examiner in the exercise of his or her authority is guilty of a misdemeanor.  (Added to NRS by 1991, 2035)
NV Rev Stat § 695C.315 (2021)
2021 Nevada Revised Statutes|Chapter 695C - Health Maintenance Organizations|NRS 695C.315 - Financial examination: Payment of expense.

  1. The health maintenance organization being examined shall pay the expense of an examination. The expenses to be paid include only the reasonable and proper travel and lodging expenses of the Commissioner and the examiners and assistants of the Commissioner, including expert assistance, reasonable compensation to the examiners and assistants and incidental expenses as necessarily incurred in the examination. The Commissioner shall consider the scales and limitations recommended by the National Association of Insurance Commissioners regarding the expense and compensation for an examination.  2. The health maintenance organization shall promptly pay to the Commissioner the expenses of the examination upon presentation by the Commissioner of a reasonably detailed written statement thereof.  (Added to NRS by 1991, 2036)
NV Rev Stat § 695C.317 (2021)
2021 Nevada Revised Statutes|Chapter 695C - Health Maintenance Organizations|NRS 695C.317 - Statutory procedures required for examination and hearing.

The Commissioner shall use the procedures required by:  1. NRS 679B.230 to 679B.290, inclusive, when conducting an examination of a health maintenance organization.  2. NRS 679B.310 to 679B.370, inclusive, when conducting a hearing involving a health maintenance organization.  (Added to NRS by 1991, 2036)
NV Rev Stat § 695C.3175 (2021)
2021 Nevada Revised Statutes|Chapter 695C - Health Maintenance Organizations|NRS 695C.3175 - Required contract with insurance company for provision of insurance, indemnity or reimbursement against cost of health care services; required provisions. [Effective through December 31, 2019.]

  1. A health maintenance organization shall contract with an insurance company licensed in this State or authorized to do business in this State for the provision of insurance, indemnity or reimbursement against the cost of health care services which are provided by the health maintenance organization.  2. The contract of insurance required by subsection 1 must include a provision that, in the case of the insolvency or impairment of the health maintenance organization, the insurance company will pay all claims made by an enrollee for the period for which a premium has been or will be paid to the health maintenance organization for the enrollee. The contract of insurance required by subsection 1 must specifically provide for the:  (a) Continuation of benefits to each enrollee for the period for which a premium has been or will be paid to the health maintenance organization for the enrollee until the expiration or termination of the enrollee’s contract with the health maintenance organization;   (b) Continuation of benefits for each enrollee who is receiving inpatient services in a medical facility or facility for the dependent at the time of the insolvency or impairment of the health maintenance organization until the inpatient services are no longer medically necessary and the enrollee is discharged from the medical facility or facility for the dependent; and  (c) Payment of a provider of health care not affiliated with the health maintenance organization who provided medically necessary services to an enrollee, as described in the enrollee’s evidence of coverage.  3. As used in this section:  (a) "Facility for the dependent" has the meaning ascribed to it in NRS 449.0045.   (b) "Impairment" means that a health maintenance organization is not insolvent and has been:  (1) Deemed to be impaired pursuant to NRS 695C.318; or  (2) Placed under an order of rehabilitation or conservation by a court of competent jurisdiction.  (c) "Insolvency" or "insolvent" means that a health maintenance organization has been:   (1) Deemed to be insolvent pursuant to NRS 695C.318;   (2) Declared insolvent by a court of competent jurisdiction; or   (3) Placed under an order of liquidation by a court of competent jurisdiction.  (d) "Medical facility" has the meaning ascribed to it in NRS 449.0151.  (e) "Medically necessary" has the meaning ascribed to it in NRS 695G.055.  (f) "Provider of health care" has the meaning ascribed to it in NRS 629.031.  (Added to NRS by 2017, 2391; R 2019, 1110, effective January 1, 2020)
NV Rev Stat § 695C.318 (2021)
2021 Nevada Revised Statutes|Chapter 695C - Health Maintenance Organizations|NRS 695C.318 - Insolvency; determination of financial condition; regulations.

  1. A health maintenance organization shall be deemed to be insolvent if:  (a) The health maintenance organization fails to meet its obligations as they mature; and   (b) The assets of the health maintenance organization are less than the sum of its liabilities and the minimum surplus required to be maintained by the health maintenance organization under this Code for authority to transact business in this State.  2. In addition to the provisions of subsection 1, a health maintenance organization shall be deemed to be insolvent as otherwise expressly provided in this Code.  3. A health maintenance organization shall be deemed to be impaired if the assets of the health maintenance organization are less than the sum of its liabilities and the minimum surplus required to be maintained by the health maintenance organization under this Code for authority to transact business in this State.  4. The Commissioner may adopt regulations to define when a health maintenance organization is considered to be in a hazardous financial condition and to set forth the standards to be considered by the Commissioner in determining whether the continued operation of a health maintenance organization transacting business in this State may be considered to be hazardous to its enrollees or creditors or to the general public.  5. If the Commissioner determines after a hearing that any health maintenance organization is in a hazardous financial condition, the Commissioner may, instead of suspending or revoking the certificate of authority of the health maintenance organization, limit the certificate of authority as the Commissioner deems reasonably necessary to correct, eliminate or remedy any conduct, condition or ground that is deemed to be a cause of the hazardous financial condition.  6. An order or decision of the Commissioner under this section is subject to review in accordance with NRS 679B.310 to 679B.370, inclusive, at the request of any party to the proceedings whose interests are substantially affected.  (Added to NRS by 2017, 2392)
NV Rev Stat § 695C.3185 (2021)
2021 Nevada Revised Statutes|Chapter 695C - Health Maintenance Organizations|NRS 695C.3185 - Plan for continuation of benefits if health maintenance organization becomes insolvent or impaired; approval by Commissioner; contents. [Effective through December 31, 2019.]

  1. Each health maintenance organization shall develop, submit to the Commissioner for approval and, after such approval, put into effect a plan to provide for the continuation of benefits to enrollees in the event of the insolvency or impairment of the health maintenance organization, including, without limitation, the benefits described in subsection 2 of NRS 695C.3175. A plan developed pursuant to this subsection must include, without limitation:  (a) A contract of insurance which complies with the requirements of NRS 695C.3175; and  (b) Provisions in each contract between the health maintenance organization and a provider which obligate the provider, in the event of the health maintenance organization’s insolvency or impairment, to provide all covered services as described in the contract to enrollees through the periods of time described in subsection 2 of NRS 695C.3175.  2. Before approving a plan submitted pursuant to subsection 1, the Commissioner may require the health maintenance organization to include in the plan:  (a) Reserves or additional reserves for protection against insolvency or impairment;  (b) Letters of credit acceptable to the Commissioner; and  (c) Any other arrangements determined by the Commissioner to be appropriate to ensure the continuation of benefits as described in subsection 2 of NRS 695C.3175 to enrollees.  (Added to NRS by 2017, 2392; R 2019, 1110, effective January 1, 2020)
NV Rev Stat § 695C.319 (2021)
2021 Nevada Revised Statutes|Chapter 695C - Health Maintenance Organizations|NRS 695C.319 - Power of Commissioner to order corrective action for hazardous operation or violation of law; regulations.

  1. If the Commissioner determines that, because of the financial condition of a health maintenance organization, the continued operation of the health maintenance organization is or may be hazardous to its enrollees or creditors or to the general public, or that the health maintenance organization has violated any law of this State to which the health maintenance organization is subject, the Commissioner may, after notice and a hearing, order the health maintenance organization to take any action the Commissioner deems reasonably necessary to correct, eliminate or remedy the condition or violation, including, without limitation:  (a) Reducing the total amount of the present and potential liability of the health maintenance organization for benefits by reinsurance or any other method acceptable to the Commissioner;  (b) Suspending, limiting or reducing the volume of new business being written or accepted by the health maintenance organization for any period of time specified by the Commissioner;  (c) Reducing the expenses of the health maintenance organization by any method acceptable to the Commissioner; and  (d) Increasing the capital and surplus of the health maintenance organization by contribution.  2. The Commissioner may adopt regulations to:  (a) Set standards and criteria for early warning that the continued operation of a health maintenance organization may be hazardous to its enrollees or creditors or to the general public; and   (b) For the purposes of subsection 1, set standards for evaluating the financial condition of a health maintenance organization.   3. The authority conferred upon the Commissioner pursuant to this section is in addition to the authority of the Commissioner pursuant to chapter 696B of NRS. Any order issued by the Commissioner pursuant to this section may, at the discretion of the Commissioner, be in addition to any order issued by the Commissioner pursuant to chapter 696B of NRS.  (Added to NRS by 2017, 2393)
NV Rev Stat § 695C.3195 (2021)
2021 Nevada Revised Statutes|Chapter 695C - Health Maintenance Organizations|NRS 695C.3195 - Conservation, rehabilitation or liquidation of health maintenance organization: Powers of Commissioner; claims of enrollees; distribution of general assets.

  1. Any conservation, rehabilitation or liquidation of a health maintenance organization shall be deemed to be the conservation, rehabilitation or liquidation of an insurer and must be conducted under the supervision of the Commissioner pursuant to chapter 696B of NRS.  2. The Commissioner may apply to a court of competent jurisdiction for an order directing the Commissioner to conserve, rehabilitate or liquidate a health maintenance organization:  (a) Upon any ground provided in chapter 696B of NRS; or  (b) If, as determined by the Commissioner, the continued operation of the health maintenance organization is or may be hazardous to its enrollees or creditors or to the general public.  3. In the event of a rehabilitation or liquidation of a health maintenance organization, a claim of an enrollee or of a beneficiary of an enrollee shall be deemed to have the same priority as would be provided to a claim of a policyholder or insured of an insurer, or of a beneficiary of such a policyholder or insured, in the event of the rehabilitation or liquidation of the insurer.   4. In the event of a distribution of the general assets of a health maintenance organization:  (a) If an enrollee is liable to a provider for health care services provided pursuant to and covered by the applicable health care plan, that liability shall be deemed to be a claim of the enrollee for distribution of the general assets of the health maintenance organization.  (b) A provider under contract with the health maintenance organization who is obligated by law or contract to hold an enrollee harmless from liability for health care services provided pursuant to and covered by the applicable health care plan shall be deemed to have a priority for distribution of the general assets of the health maintenance organization immediately following that of an enrollee as described in this section and immediately preceding any other priority for distribution which, pursuant to this section and chapter 696B of NRS, would follow that of an enrollee.  (Added to NRS by 2017, 2393)
NV Rev Stat § 695C.320 (2021)
2021 Nevada Revised Statutes|Chapter 695C - Health Maintenance Organizations|NRS 695C.320 - Rehabilitation, liquidation or conservation.

Any rehabilitation, liquidation or conservation of a health maintenance organization shall be deemed to be the rehabilitation, liquidation or conservation of an insurance company and shall be conducted under the supervision of the Commissioner pursuant to the law governing the rehabilitation, liquidation, or conservation of insurance companies.  (Added to NRS by 1973, 1256)
NV Rev Stat § 695C.325 (2021)
2021 Nevada Revised Statutes|Chapter 695C - Health Maintenance Organizations|NRS 695C.325 - Authorization to offer health care plan to small employer for purpose of establishing medical savings accounts.

A health maintenance organization may offer to a small employer who has not less than 2 and not more than 50 employees, a health care plan that has a high deductible and that is in compliance with 26 U.S.C. § 220 for the purposes of establishing medical savings accounts for any person insured by the health care plan.  (Added to NRS by 1997, 2957)