reglab/housing_qa huggingface dataset:
NV Rev Stat § 695A.150 (2021)
2021 Nevada Revised Statutes|Chapter 695A - Fraternal Benefit Societies|NRS 695A.150 - Qualifications for and rights and privileges of membership.

  1. Subject to the limitations set forth in subsections 2, 3 and 4, a society shall specify in its laws or rules for each class of membership:  (a) The standards of eligibility and the process for admission to membership in that class; and  (b) The rights and privileges of membership in that class, provided that only benefit members may have the right to vote on the management of the business of the society relating to insurance.  2. If benefits are provided on the lives of children, the minimum age for membership as an adult must be not less than 15 and not greater than 21 years of age.  3. A society may also admit social members, who have no voice or vote in the management of its affairs relating to insurance.  4. Membership rights in the society must not be assignable.  (Added to NRS by 1971, 1841; A 1973, 1582; 1991, 229)
NV Rev Stat § 695A.151 (2021)
2021 Nevada Revised Statutes|Chapter 695A - Fraternal Benefit Societies|NRS 695A.151 - Effect of eligibility for medical assistance under Medicaid on eligibility for coverage; assignment of rights to state agency.

  1. A society shall not, when considering eligibility for coverage or making payments under a certificate for health benefits, consider the availability of, or eligibility of a person for, medical assistance under Medicaid.  2. To the extent that payment has been made by Medicaid for health care, a society:  (a) Shall treat Medicaid as having a valid and enforceable assignment of an insured’s benefits regardless of any exclusion of Medicaid or the absence of a written assignment; and  (b) May, as otherwise allowed by its certificate for health benefits, evidence of coverage or contract and applicable law or regulation concerning subrogation, seek to enforce any reimbursement rights of a recipient of Medicaid against any other liable party if:  (1) It is so authorized pursuant to a contract with Medicaid for managed care; or  (2) It has reimbursed Medicaid in full for the health care provided by Medicaid to its insured.  3. If a state agency is assigned any rights of a person who is:  (a) Eligible for medical assistance under Medicaid; and  (b) Covered by a certificate for health benefits,  the society that issued the health policy shall not impose any requirements upon the state agency except requirements it imposes upon the agents or assignees of other persons covered by the certificate.  4. If a state agency is assigned any rights of an insured who is eligible for medical assistance under Medicaid, a society that issues a certificate for health benefits, evidence of coverage or contract shall:  (a) Upon request of the state agency, provide to the state agency information regarding the insured to determine:  (1) Any period during which the insured, a spouse or dependent of the insured may be or may have been covered by the society; and  (2) The nature of the coverage that is or was provided by the society, including, without limitation, the name and address of the insured and the identifying number of the certificate for health benefits, evidence of coverage or contract;  (b) Respond to any inquiry by the state agency regarding a claim for payment for the provision of any medical item or service not later than 3 years after the date of the provision of the medical item or service; and  (c) Agree not to deny a claim submitted by the state agency solely on the basis of the date of submission of the claim, the type or format of the claim form or failure to present proper documentation at the point of sale that is the basis for the claim if:  (1) The claim is submitted by the state agency not later than 3 years after the date of the provision of the medical item or service; and  (2) Any action by the state agency to enforce its rights with respect to such claim is commenced not later than 6 years after the submission of the claim.  (Added to NRS by 1995, 2431; A 2007, 2404)
NV Rev Stat § 695A.152 (2021)
2021 Nevada Revised Statutes|Chapter 695A - Fraternal Benefit Societies|NRS 695A.152 - Society required to comply with certain provisions concerning portability and availability of health insurance.

  1. To the extent reasonably applicable, a fraternal benefit society shall comply with the provisions of NRS 689B.340 to 689B.580, inclusive, and chapter 689C of NRS relating to the portability and availability of health insurance offered by the society to its members. If there is a conflict between the provisions of this chapter and the provisions of NRS 689B.340 to 689B.580, inclusive, and chapter 689C of NRS, the provisions of NRS 689B.340 to 689B.580, inclusive, and chapter 689C of NRS control.  2. For the purposes of subsection 1, unless the context requires that a provision apply only to a group health plan or a carrier that provides coverage under a group health plan, any reference in those sections to "group health plan" or "carrier" must be replaced by "fraternal benefit society."  (Added to NRS by 1997, 2954; A 2001, 1923; 2013, 3636)
NV Rev Stat § 695A.153 (2021)
2021 Nevada Revised Statutes|Chapter 695A - Fraternal Benefit Societies|NRS 695A.153 - Society prohibited from asserting certain grounds to deny enrollment of child of insured pursuant to order.

A society shall not deny the enrollment of a child pursuant to an order for medical coverage under a certificate for health benefits pursuant to which a parent of the child is insured, on the ground that the child:  1. Was born out of wedlock;  2. Has not been claimed as a dependent on the parent’s federal income tax return; or  3. Does not reside with the parent or within the society’s geographic area of service.  (Added to NRS by 1995, 2431)
NV Rev Stat § 695A.155 (2021)
2021 Nevada Revised Statutes|Chapter 695A - Fraternal Benefit Societies|NRS 695A.155 - Certain accommodations to be made when child is covered under policy of noncustodial parent.

If a child has coverage under a certificate for health benefits pursuant to which a noncustodial parent of the child is insured, the society issuing that certificate shall:  1. Provide to the custodial parent such information as necessary for the child to obtain any benefits under that coverage.  2. Allow the custodial parent or, with the approval of the custodial parent, a provider of health care to submit claims for covered services without the approval of the noncustodial parent.  3. Make payments on claims submitted pursuant to subsection 2 directly to the custodial parent, the provider of health care or an agency of this or another state responsible for the administration of Medicaid.  (Added to NRS by 1995, 2432)
NV Rev Stat § 695A.157 (2021)
2021 Nevada Revised Statutes|Chapter 695A - Fraternal Benefit Societies|NRS 695A.157 - Society to authorize enrollment of child of parent who is required by order to provide medical coverage under certain circumstances; termination of coverage of child.

If a parent is required by an order for medical coverage to provide coverage under a certificate for health benefits for a child and the parent is eligible for coverage of members of the parent’s family under a certificate for health benefits, the society that issued the certificate:  1. Shall, if the child is otherwise eligible for that coverage, allow the parent to enroll the child in that coverage without regard to any restrictions upon periods for enrollment.  2. Shall, if:  (a) The child is otherwise eligible for that coverage; and  (b) The parent is enrolled in that coverage but fails to apply for enrollment of the child,  enroll the child in that coverage upon application by the other parent of the child, or by an agency of this or another state responsible for the administration of Medicaid or a state program for the enforcement of child support established pursuant to 42 U.S.C. §§ 651 et seq., without regard to any restrictions upon periods for enrollment.  3. Shall not terminate the enrollment of the child in that coverage or otherwise eliminate that coverage of the child unless the society has written proof that:  (a) The order for medical coverage is no longer in effect; or  (b) The child is or will be enrolled in comparable coverage through another insurer on or before the effective date of the termination of enrollment or elimination of coverage.  (Added to NRS by 1995, 2432)
NV Rev Stat § 695A.159 (2021)
2021 Nevada Revised Statutes|Chapter 695A - Fraternal Benefit Societies|NRS 695A.159 - Society prohibited from restricting coverage of child based on preexisting condition when person who is eligible for group coverage adopts or assumes legal obligation for child. [Effective through December 31, 2019.]

  1. If a person:  (a) Adopts a dependent child; or  (b) Assumes and retains a legal obligation for the total or partial support of a dependent child in anticipation of adopting the child,  while the person is eligible for group coverage under a certificate for health benefits, the society issuing that certificate shall not restrict the coverage, in accordance with NRS 689B.340 to 689B.580, inclusive, and chapter 689C of NRS relating to the portability and availability of health insurance, of the child solely because of a preexisting condition the child has at the time he or she would otherwise become eligible for coverage pursuant to that policy.  2. For the purposes of this section, "child" means a person who is under 18 years of age at the time of his or her adoption or the assumption of a legal obligation for his or her support in anticipation of his or her adoption.  (Added to NRS by 1995, 2432; A 1997, 2954; 2013, 3636; R 2019, 318, effective January 1, 2020)
NV Rev Stat § 695A.160 (2021)
2021 Nevada Revised Statutes|Chapter 695A - Fraternal Benefit Societies|NRS 695A.160 - Amendment of laws of society.

  1. A domestic society may amend its laws in accordance with the provisions thereof by action of its supreme governing body at any regular or special meeting thereof or, if its laws so provide, by referendum. Such a referendum may be held in accordance with the provisions of its laws by the vote of the voting members of the society, by the vote of delegates or representatives of voting members or by the vote of local lodges. A society may provide for voting by mail. No amendment submitted for adoption by referendum may be adopted unless, within 6 months after the date of submission thereof, a majority of all of the voting members of the society have signified their consent to the amendment by one of the methods specified in this section.  2. No amendment to the laws of any domestic society becomes effective unless approved by the Commissioner, who shall approve the amendment if the Commissioner finds that it has been duly adopted and is not inconsistent with any requirement of the laws of this state or with the character, objects and purposes of the society. Unless the Commissioner disapproves an amendment within 60 days after it is filed, such amendment shall be deemed approved. The approval or disapproval of the Commissioner must be in writing and mailed to the secretary or corresponding officer of the society at its principal office. If the Commissioner disapproves an amendment, the reasons therefor must be stated in the written notice.  3. Within 90 days after their approval by the commissioner, all the amendments, or a synopsis thereof, must be furnished to all members of the society either by mail or by publication in full in the official publication of the society. The affidavit of any officer of the society or of anyone authorized by it to mail any amendments or synopsis thereof, stating facts which show that the amendments or synopsis thereof have been duly addressed and mailed, is prima facie evidence that the amendments or synopsis thereof have been furnished the addressee.  4. Every foreign or alien society authorized to do business in this state shall file with the Commissioner a duly certified copy of all amendments of, or additions to, its laws within 90 days after their enactment.  5. Printed copies of the laws as amended, certified by the secretary or corresponding officer of the society, are prima facie evidence of the legal adoption thereof.  (Added to NRS by 1971, 1841; A 1991, 230)
NV Rev Stat § 695A.180 (2021)
2021 Nevada Revised Statutes|Chapter 695A - Fraternal Benefit Societies|NRS 695A.180 - Scope of contractual benefits.

  1. A society authorized to do business in this state may provide the following contractual benefits in any form:  (a) Death benefits;  (b) Endowment benefits;  (c) Annuity benefits;  (d) Temporary or permanent disability benefits;  (e) Hospital, medical or nursing benefits;  (f) Monument or tombstone benefits to the memory of deceased members; and  (g) Any other benefits which life insurance companies are authorized to pay which are not inconsistent with the provisions of this chapter.  2. A society shall specify in its laws or rules those persons who may be issued, or covered by, the contractual benefits set forth in subsection 1, consistent with the purpose of providing benefits to members and their dependents. A society may provide benefits on the lives of children under the minimum age for adult membership upon the application of an adult.  (Added to NRS by 1971, 1842; A 1991, 231)
NV Rev Stat § 695A.184 (2021)
2021 Nevada Revised Statutes|Chapter 695A - Fraternal Benefit Societies|NRS 695A.184 - Coverage for prescription drug previously approved for medical condition of insured.

  1. Except as otherwise provided in this section, a benefit contract 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 society 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 society 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 benefit contract 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 benefit contract.  3. Any provision of a benefit contract 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, 861; A 2003, 2299; 2017, 638)
NV Rev Stat § 695A.1855 (2021)
2021 Nevada Revised Statutes|Chapter 695A - Fraternal Benefit Societies|NRS 695A.1855 - Coverage for mammograms for certain women; prohibited acts.

  1. A benefit contract 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 society 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 society.  3. Except as otherwise provided in subsection 5, a society that offers or issues a benefit contract shall not:  (a) Require an insured to pay a higher deductible, any copayment or coinsurance or require a longer waiting period or other condition for coverage to obtain any benefit provided in a benefit contract pursuant to subsection 1;  (b) Refuse to issue a benefit contract or cancel a benefit contract solely because the person applying for or covered by the contract 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 benefit contract 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 benefit contract or the renewal which is in conflict with this section is void.  5. Except as otherwise provided in this section and federal law, a society 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 benefit contract offered by a society 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 society. 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, 1833)
NV Rev Stat § 695A.1857 (2021)
2021 Nevada Revised Statutes|Chapter 695A - Fraternal Benefit Societies|NRS 695A.1857 - Benefit contract that includes coverage for maternity care must not deny coverage to gestational carrier; status of child in relation to intended parent. [Effective January 1, 2020.]

  1. A society that offers or issues a benefit contract that includes coverage for maternity care shall not deny, limit or seek reimbursement for maternity care because the insured is acting as a gestational carrier.  2. If an insured acts as a gestational carrier, the child shall be deemed to be a child of the intended parent, as defined in NRS 126.590, for purposes related to the benefit contract.  3. As used in this section, "gestational carrier" has the meaning ascribed to it in NRS 126.580.  (Added to NRS by 2019, 1006, effective January 1, 2020)
NV Rev Stat § 695A.1873 (2021)
2021 Nevada Revised Statutes|Chapter 695A - Fraternal Benefit Societies|NRS 695A.1873 - Coverage for management and treatment of sickle cell disease.

  1. A society that issues a benefit contract shall include in the benefit contract 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 society that issues a benefit contract which provides coverage for prescription drugs shall include in the benefit contract coverage for medically necessary prescription drugs to treat sickle cell disease and its variants.  3. A society 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, 2171)
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 through December 31, 2019.]

  1. Except as otherwise provided in subsection 2, 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)