reglab/statecodes huggingface dataset:
2023 Nevada Revised Statutes › Chapter 689A - Individual Health Insurance › NRS 689A.0465 - Policy prohibited from excluding coverage of treatment of temporomandibular joint; exception.

1. Except as otherwise provided in this section, no policy of health insurance may be delivered or issued for delivery in this state if it contains an exclusion of coverage of treatment of the temporomandibular joint whether by specific language in the policy or by a claims settlement practice. A policy may exclude coverage of those methods of treatment which are recognized as dental procedures, including, but not limited to, the extraction of teeth and the application of orthodontic devices and splints.
2. The insurer may limit its liability on the treatment of the temporomandibular joint to:
(a) No more than 50 percent of the usual and customary charges for such treatment actually received by an insured, but in no case more than 50 percent of the maximum benefits provided by the policy for such treatment; and
(b) Treatment which is medically necessary.
3. Any provision of a policy subject to the provisions of this chapter and issued or delivered on or after January 1, 1990, which is in conflict with this section is void.
(Added to NRS by 1989, 2137)
2023 Nevada Revised Statutes › Chapter 689A - Individual Health Insurance › NRS 689A.0475 - Acupuncture.

If any policy of health insurance provides coverage for acupuncture performed by a physician, the insured is entitled to reimbursement for acupuncture performed by a person who is licensed pursuant to chapter 634A of NRS.
(Added to NRS by 1991, 1133)
2023 Nevada Revised Statutes › Chapter 689A - Individual Health Insurance › NRS 689A.048 - Treatment by licensed psychologist.

If any policy of health insurance provides coverage for treatment of an illness which is within the authorized scope of the practice of a qualified psychologist, the insured is entitled to reimbursement for treatments by a licensed psychologist.
(Added to NRS by 1979, 367; A 1989, 1553; 2017, 935)
2023 Nevada Revised Statutes › Chapter 689A - Individual Health Insurance › NRS 689A.0483 - Treatment by licensed marriage and family therapist or licensed clinical professional counselor.

If any policy of health insurance provides coverage for treatment of an illness which is within the authorized scope of practice of a licensed marriage and family therapist or licensed clinical professional counselor, the insured is entitled to reimbursement for treatment by a marriage and family therapist or clinical professional counselor who is licensed pursuant to chapter 641A of NRS.
(Added to NRS by 1987, 2133; A 2007, 3093)
2023 Nevada Revised Statutes › Chapter 689A - Individual Health Insurance › NRS 689A.0485 - Treatment by licensed associate in social work, social worker, master social worker, independent social worker or clinical social worker.

If any policy of health insurance provides coverage for treatment of an illness which is within the authorized scope of the practice of a licensed associate in social work, a social worker, a master social worker, an independent social worker or a clinical social worker, the insured is entitled to reimbursement for treatment by an associate in social work, a social worker, a master social worker, an independent social worker or a clinical social worker who is licensed pursuant to chapter 641B of NRS.
(Added to NRS by 1987, 1123; A 2021, 3507)
2023 Nevada Revised Statutes › Chapter 689A - Individual Health Insurance › NRS 689A.0487 - Treatment by licensed podiatrist.

1. If any policy of health insurance provides coverage for treatment of an illness which is within the authorized scope of practice of a qualified podiatrist, the insured is entitled to reimbursement for treatments by a podiatrist who is licensed pursuant to chapter 635 of NRS.
2. The terms of the policy must not limit:
(a) Coverage for treatments by a podiatrist to a number less than for treatments by other physicians.
(b) Reimbursement for treatments by a podiatrist to an amount less than that reimbursed for similar treatments by other physicians.
(Added to NRS by 2007, 1046)
2023 Nevada Revised Statutes › Chapter 689A - Individual Health Insurance › NRS 689A.049 - Treatment by licensed chiropractic physician; restriction on policy limitations.

1. If any policy of health insurance provides coverage for treatment of an illness which is within the authorized scope of practice of a qualified chiropractic physician, the insured is entitled to reimbursement for treatments by a chiropractic physician who is licensed pursuant to chapter 634 of NRS.
2. The terms of the policy must not limit:
(a) Coverage for treatments by a chiropractic physician to a number less than for treatments by other physicians.
(b) Reimbursement for treatments by a chiropractic physician to an amount less than that reimbursed for similar treatments by other physicians.
(Added to NRS by 1981, 930; A 1983, 327)
2023 Nevada Revised Statutes › Chapter 689A - Individual Health Insurance › NRS 689A.0493 - Treatment by licensed clinical alcohol and drug counselor.

If any policy of health insurance provides coverage for treatment of an illness which is within the authorized scope of practice of a licensed clinical alcohol and drug counselor, the insured is entitled to reimbursement for treatment by a clinical alcohol and drug counselor who is licensed pursuant to chapter 641C of NRS unless the clinical alcohol and drug counselor must be directly reimbursed pursuant to:
1. An assignment of benefits described in NRS 687B.409; or
2. Any other applicable assignment of benefits.
(Added to NRS by 2007, 3093; A 2017, 2210)
2023 Nevada Revised Statutes › Chapter 689A - Individual Health Insurance › NRS 689A.0495 - Services provided by certain registered nurses.

1. If any policy of health insurance provides coverage for services which are within the authorized scope of practice of a registered nurse who is authorized pursuant to chapter 632 of NRS to perform additional acts in an emergency or under other special conditions as prescribed by the State Board of Nursing, and which are reimbursed when provided by another provider of health care, the insured is entitled to reimbursement for services provided by such a registered nurse.
2. The terms of the policy must not limit:
(a) Coverage for services provided by such a registered nurse to a number of occasions less than for services provided by another provider of health care.
(b) Reimbursement for services provided by such a registered nurse to an amount less than that reimbursed for similar services provided by another provider of health care.
3. An insurer is not required to pay for services provided by such a registered nurse which duplicate services provided by another provider of health care.
(Added to NRS by 1985, 1446)
2023 Nevada Revised Statutes › Chapter 689A - Individual Health Insurance › NRS 689A.0497 - Provider of medical transportation.

1. Except as otherwise provided in subsection 3, every policy of health insurance amended, delivered or issued for delivery in this State after October 1, 1989, that provides coverage for medical transportation, must contain a provision for the direct reimbursement of a provider of medical transportation for covered services if that provider does not receive reimbursement from any other source.
2. The insured or the provider may submit the claim for reimbursement. The provider shall not demand payment from the insured until after that reimbursement has been granted or denied.
3. Subsection 1 does not apply to any agreement between an insurer and a provider of medical transportation for the direct payment by the insurer for the provider’s services.
(Added to NRS by 1989, 1273)
2023 Nevada Revised Statutes › Chapter 689A - Individual Health Insurance › NRS 689A.050 - Entire contract; changes.

There shall be a provision as follows:
Entire Contract; Changes: This policy, including the endorsements and the attached papers, if any, constitutes the entire contract of insurance. No change in this policy shall be valid until approved by an executive officer of the insurer and unless such approval is endorsed hereon or attached hereto. No agent has authority to change this policy or to waive any of its provisions.
(Added to NRS by 1971, 1753)
2023 Nevada Revised Statutes › Chapter 689A - Individual Health Insurance › NRS 689A.060 - Time limit on certain defenses.

There shall be a provision as follows:
Time Limit on Certain Defenses:
1. After 3 years from the date of issue of this policy no misstatements, except fraudulent misstatements, made by the applicant in the application for such policy shall be used to void the policy or to deny a claim for loss incurred or disability (as defined in the policy) commencing after the expiration of such 3-year period.
The foregoing policy provision shall not be so construed as to affect any legal requirement for avoidance of a policy or denial of a claim during such initial 3-year period, nor to limit the application of NRS 689A.200 to 689A.230, inclusive, in the event of misstatement with respect to age or occupation or other insurance. A policy which the insured has the right to continue in force subject to its terms by the timely payment of the premium until at least age 50 or, in the case of a policy issued after age 44, for at least 5 years from its date of issue, may contain in lieu of the foregoing the following provision (from which the clause in parentheses may be omitted at the insurer’s option): "Incontestable: After this policy has been in force for a period of three years during the lifetime of the insured (excluding any period during which the insured is disabled), it shall become incontestable as to the statements contained in the application."
2. No claim for loss incurred or disability (as defined in the policy) commencing after 3 years from the date of issue of this policy shall be reduced or denied on the ground that a disease or physical condition not excluded from coverage by name or specific description effective on the date of loss had existed prior to the effective date of coverage of this policy.
(Added to NRS by 1971, 1753)
2023 Nevada Revised Statutes › Chapter 689A - Individual Health Insurance › NRS 689A.070 - Grace period.

There shall be a provision as follows:
Grace Period: A grace period of ..... (insert a number not less than "7" for weekly premium policies, "10" for monthly premium policies and "31" for all other policies) days will be granted for the payment of each premium falling due after the first premium, during which grace period the policy shall continue in force.
A policy in which the insurer reserves the right to refuse any renewal shall have, at the beginning of the above provision:
Unless not less than 30 days prior to the premium due date the company has delivered to the insured or has mailed to the last address of the insured as shown by the records of the insurer written notice of its intention not to renew this policy beyond the period for which the premium has been accepted.
(Added to NRS by 1971, 1754)
2023 Nevada Revised Statutes › Chapter 689A - Individual Health Insurance › NRS 689A.075 - Cancellation and rescission of short-term limited duration medical plan.

1. A short-term limited duration medical plan shall not be cancelled by the carrier during the coverage period except for the following:
(a) Nonpayment of premium;
(b) Violation of published policies of the carrier approved by the Commissioner;
(c) Failure of a member to pay any deductible or copayment amount owed to the carrier and not the provider of health care services;
(d) Members committing fraudulent acts as to the carrier;
(e) A member’s material breach of the medical plan; or
(f) Change or implementation of federal or state laws that no longer permit the continued offering of such coverage.
2. Except as otherwise provided in subsections 3 and 4, a short-term limited duration medical plan must not be rescinded by the carrier during the coverage period except for nonpayment of premium.
3. Except as provided in subsection 4 of this section, no oral or written misrepresentation or warranty made by the person applying for coverage or on his or her behalf in the process of applying for a short-term limited duration medical plan shall be deemed material or allow the carrier to rescind the medical plan, unless the misrepresentation or warranty is made to deceive.
4. In any application for a short-term limited duration medical plan made in writing by a person, all statements in the application by the person shall, in the absence of fraud, be deemed representations and not warranties. The falsity of any such statement shall not bar the right to recovery under the contract unless such false statement was made with actual intent to deceive or unless it materially affected either the acceptance of the risk or the hazard assumed by the carrier.
5. When cancellation or rescission is for nonpayment of premium, the carrier must notify the member in writing 10 days prior to the cancellation or rescission that his or her short-term limited duration medical plan will be cancelled, unless payment is made prior to the cancellation date. When cancellation is for any other reason allowed under subsection 1, the carrier must notify the member in writing 20 days prior to the cancellation date. The notice must specifically state the reason or reasons for the cancellation. The written communications required by this subsection must be phrased in simple language that is readily understood.
(Added to NRS by 2019, 1429)
2023 Nevada Revised Statutes › Chapter 689A - Individual Health Insurance › NRS 689A.080 - Reinstatement.

1. There shall be a provision as follows:
Reinstatement: If any renewal premium be not paid within the time granted the insured for payment, a subsequent acceptance of premium by the insurer or by any agent duly authorized by the insurer to accept such premium, without requiring in connection therewith an application for reinstatement, shall reinstate the policy; provided, however, that if the insurer or such agent requires an application for reinstatement and issues a conditional receipt for the premium tendered, the policy will be reinstated upon approval of such application by the insurer or, lacking such approval, upon the 45th day following the date of such conditional receipt unless the insurer has previously notified the insured in writing of its disapproval of such application. The reinstated policy shall cover only loss resulting from such accidental injury as may be sustained after the date of reinstatement and loss due to such sickness as may begin more than 10 days after such date. In all other respects the insured and insurer shall have the same rights thereunder as they had under the policy immediately before the due date of the defaulted premium, subject to any provisions endorsed herein or attached hereto in connection with the reinstatement. Any premium accepted in connection with a reinstatement shall be applied to a period for which premium has not been previously paid, but not to any period more than 60 days prior to the date of reinstatement.
2. The last sentence of subsection 1 may be omitted from any policy which the insured has the right to continue in force subject to its terms by the timely payment of premiums:
(a) Until at least age 50; or
(b) In the case of a policy issued after age 44, for at least 5 years from its date of issue.
3. Pursuant to the last sentence in subsection 1, the insurer shall apply the premium accepted in such manner as to place the policy currently in force, exclusive of any applicable grace period, but not in any event to any period more than 60 days prior to the date of reinstatement.
(Added to NRS by 1971, 1754)
2023 Nevada Revised Statutes › Chapter 689A - Individual Health Insurance › NRS 689A.090 - Notice of claim.

1. There shall be a provision as follows:
Notice of Claim: Written notice of claim must be given to the insurer within 20 days after the occurrence or commencement of any loss covered by the policy, or as soon thereafter as is reasonably possible. Notice given by or on behalf of the insured or the beneficiary to the insurer at ................ (insert the location of such office as the insurer may designate for the purpose), or to any authorized agent of the insurer, with information sufficient to identify the insured, shall be deemed notice to the insurer.
2. In a policy providing a loss-of-time benefit which may be payable for at least 2 years, an insurer may at its option insert the following between the first and second sentence of subsection 1:
Subject to the qualifications set forth below, if the insured suffers loss of time on account of disability for which indemnity may be payable for at least 2 years, the insured shall, at least once in every 6 months after having given notice of the claim, give to the insurer notice of continuance of said disability, except in the event of legal incapacity. The period of 6 months following any filing of proof by the insured or any payment by the insurer on account of such claim or any denial of liability in whole or in part by the insurer shall be excluded in applying this provision. Delay in the giving of such notice shall not impair the insured’s right to any indemnity which would otherwise have accrued during the period of 6 months preceding the date on which such notice is actually given.
(Added to NRS by 1971, 1755)
2023 Nevada Revised Statutes › Chapter 689A - Individual Health Insurance › NRS 689A.100 - Claim forms: Required provision.

There shall be a provision as follows:
Claim Forms: The insurer, upon receipt of a notice of claim, will furnish to the claimant such forms as are usually furnished by it for filing proofs of loss. If such forms are not furnished within 15 days after the giving of such notice the claimant shall be deemed to have complied with the requirements of this policy as to proof of loss upon submitting, within the time fixed in the policy for filing proofs of loss, written proof covering the occurrence, the character and the extent of the loss for which claim is made.
(Added to NRS by 1971, 1756)
2023 Nevada Revised Statutes › Chapter 689A - Individual Health Insurance › NRS 689A.105 - Claim forms: Uniform billing and claims forms.

Every insurer under a health insurance contract and every state agency for its records shall accept from:
1. A hospital the Uniform Billing and Claims Forms established by the American Hospital Association in lieu of its individual billing and claims forms.
2. An individual who is licensed to practice one of the health professions regulated by title 54 of NRS such uniform health insurance claims forms as the Commissioner shall prescribe, except in those cases where the Commissioner has excused uniform reporting.
(Added to NRS by 1975, 897; A 2021, 1648)
2023 Nevada Revised Statutes › Chapter 689A - Individual Health Insurance › NRS 689A.110 - Claim forms: Proofs of loss.

There shall be a provision as follows:
Proofs of Loss: Written proof of loss must be furnished to the insurer at its office in case of claim for loss for which this policy provides any periodic payment contingent upon continuing loss within 90 days after the termination of the period for which the insurer is liable and in case of claim for any other loss within 90 days after the date of such loss. Failure to furnish such proof within the time required shall not invalidate nor reduce any claim if it was not reasonably possible to give proof within such time, provided such proof is furnished as soon as reasonably possible and in no event, except in the absence of legal capacity, later than 1 year from the time proof is otherwise required.
(Added to NRS by 1971, 1756)
2023 Nevada Revised Statutes › Chapter 689A - Individual Health Insurance › NRS 689A.120 - Time of payment of claims.

There shall be a provision as follows:
Time of Payment of Claims: Indemnities payable under this policy for any loss, other than loss for which this policy provides any periodic payment, will be paid immediately upon receipt of due written proof of such loss. Subject to due written proof of loss, all accrued indemnities for loss for which this policy provides periodic payment will be paid ................ (insert period for payment which must not be less frequently than monthly) and any balance remaining unpaid upon the termination of liability will be paid immediately upon receipt of due written proof.
(Added to NRS by 1971, 1756)
2023 Nevada Revised Statutes › Chapter 689A - Individual Health Insurance › NRS 689A.130 - Payment of claims.

1. There shall be a provision as follows:
Payment of Claims: Indemnity for loss of life will be payable in accordance with the beneficiary designation and the provisions respecting such payment which may be prescribed herein and effective at the time of payment. If no such designation or provision is then effective, such indemnity shall be payable to the estate of the insured. Any other accrued indemnities unpaid at the insured’s death may, at the option of the insurer, be paid either to such beneficiary or to such estate. All other indemnities will be payable to the insured.
2. The following provisions, or either of them, may be included with the provision in subsection 1 at the option of the insurer:
If any indemnity of this policy shall be payable to the estate of the insured, or to an insured or beneficiary who is a minor or otherwise not competent to give a valid release, the insurer may pay such indemnity, up to an amount not exceeding $..... (insert an amount which shall not exceed $1,000), to any relative by blood or connection by marriage of the insured or beneficiary who is deemed by the insurer to be equitably entitled thereto. Any payment made by the insurer in good faith pursuant to this provision shall fully discharge the insurer to the extent of such payment.
Subject to any written direction of the insured in the application or otherwise all or a portion of any indemnities provided by this policy on account of hospital, nursing, medical or surgical services may, at the insurer’s option and unless the insured requests otherwise in writing not later than the time of filing proofs of such loss, be paid directly to the hospital or person rendering such services; but it is not required that the service be rendered by a particular hospital or person.
(Added to NRS by 1971, 1756)
2023 Nevada Revised Statutes › Chapter 689A - Individual Health Insurance › NRS 689A.135 - Assignment of benefits by insured to provider of health care.

1. A person insured under a policy of health insurance may assign his or her right to benefits to the provider of health care who provided the services covered by the policy. The insurer shall pay all or the part of the benefits assigned by the insured to the person designated by the insured. A payment made pursuant to this subsection discharges the insurer’s obligation to pay those benefits.
2. If the insured makes an assignment under this section, but the insurer after receiving a copy of the assignment pays the benefits to the insured, the insurer shall also pay those benefits to the provider of health care who received the assignment as soon as the insurer receives notice of the incorrect payment.
3. For the purpose of this section, "provider of health care" has the meaning ascribed to it in NRS 629.031.
(Added to NRS by 1983, 879)
2023 Nevada Revised Statutes › Chapter 689A - Individual Health Insurance › NRS 689A.140 - Physical examination and autopsy.

There shall be a provision as follows:
Physical Examinations and Autopsy: The insurer at its own expense shall have the right and opportunity to examine the person of the insured when and as often as it may reasonably require during the pendency of a claim hereunder and to make an autopsy in case of death where it is not forbidden by law.
(Added to NRS by 1971, 1757)
2023 Nevada Revised Statutes › Chapter 689A - Individual Health Insurance › NRS 689A.150 - Legal actions.

There shall be a provision as follows:
Legal Actions: No action at law or in equity shall be brought to recover on this policy prior to the expiration of 60 days after written proof of loss has been furnished in accordance with the requirements of this policy. No such action shall be brought after the expiration of 3 years after the time written proof of loss is required to be furnished.
(Added to NRS by 1971, 1757)
2023 Nevada Revised Statutes › Chapter 689A - Individual Health Insurance › NRS 689A.160 - Change of beneficiary.

1. There shall be a provision as follows:
Change of Beneficiary: Unless the insured makes an irrevocable designation of beneficiary, the right to change of beneficiary is reserved to the insured and the consent of the beneficiary or beneficiaries shall not be requisite to surrender or assignment of this policy or to any change of beneficiary or beneficiaries, or to any other changes in this policy.
2. The first clause of the provision set forth in subsection 1, relating to the irrevocable designation of beneficiary, may be omitted at the insurer’s option.
(Added to NRS by 1971, 1757)
2023 Nevada Revised Statutes › Chapter 689A - Individual Health Insurance › NRS 689A.170 - Right to examine and return policy.

1. Except as to nonrenewable accident policies and individual credit health insurance policies, every individual health insurance policy shall contain a provision therein or in a separate rider attached thereto when delivered, stating in substance that the person to whom the policy is issued shall be permitted to return the policy within 10 days of its delivery to such person and to have a refund of the premium paid if after examination of the policy the purchaser is not satisfied with it for any reason. The provision shall be set forth in the policy under an appropriate caption, and if not so printed on the face page of the policy adequate notice of the provision shall be printed or stamped conspicuously on the face page.
2. The policy may be so returned to the insurer at its home or branch office or to the agent through whom it was applied for, and thereupon shall be void as from the beginning and as if the policy had not been issued.
(Added to NRS by 1971, 1758)
2023 Nevada Revised Statutes › Chapter 689A - Individual Health Insurance › NRS 689A.180 - Optional provisions: Requirements; substitution of provisions; captions.

Except as otherwise provided in NRS 689A.040, no such policy delivered or issued for delivery to any person in this State may contain provisions respecting the matters set forth in NRS 689A.190 to 689A.270, inclusive, unless the provisions are in the words in which the provisions appear in the applicable section, except that the insurer may, at its option, use in lieu of any such provision a corresponding provision of different wording approved by the Commissioner which is not less favorable in any respect to the insured or the beneficiary. Any such provision contained in the policy must be preceded individually by the appropriate caption or, at the option of the insurer, by such appropriate individual or group captions or subcaptions as the Commissioner may approve.
(Added to NRS by 1971, 1758; A 1985, 1060; 2005, 2343)
2023 Nevada Revised Statutes › Chapter 689A - Individual Health Insurance › NRS 689A.200 - Change of occupation.

There may be a provision as follows:
Change of Occupation: If the insured be injured or contracts sickness after having changed his or her occupation to one classified by the insurer as more hazardous than that stated in this policy or while doing for compensation anything pertaining to an occupation so classified, the insurer will pay only such portion of the indemnities provided in this policy as the premium paid would have purchased at the rates and within the limits fixed by the insurer for such more hazardous occupation. If the insured changes his or her occupation to one classified by the insurer as less hazardous than that stated in this policy, the insurer, upon receipt of proof of such change of occupation, will reduce the premium rate accordingly, and will return the excess pro rata unearned premium from the date of change of occupation or from the policy anniversary date immediately preceding receipt of such proof, whichever is the more recent. In applying this provision, the classification of occupational risk and the premium rates shall be such as have been last filed by the insurer prior to the occurrence of the loss for which the insurer is liable or prior to date of proof of change in occupation with the state official having supervision of insurance in the state where the insured resided at the time this policy was issued; but if such filing was not required, then the classification of occupational risk and the premium rates shall be those last made effective by the insurer in such state prior to the occurrence of the loss or prior to the date of proof of change in occupation.
(Added to NRS by 1971, 1758)
2023 Nevada Revised Statutes › Chapter 689A - Individual Health Insurance › NRS 689A.210 - Misstatement of age.

There may be a provision as follows:
Misstatement of Age: If the age of the insured has been misstated, all amounts payable under this policy shall be such as the premium paid would have purchased at the correct age.
(Added to NRS by 1971, 1759)
2023 Nevada Revised Statutes › Chapter 689A - Individual Health Insurance › NRS 689A.220 - Coordination of benefits: Same insurer.

There may be a provision as follows:
If an accident or sickness or accident and sickness policy or policies previously issued by the insurer to the insured be in force concurrently herewith, making the aggregate indemnity for ................ (insert type of coverage or coverages) in excess of $..... (insert maximum limit of indemnity or indemnities), the excess shall be void and all premiums paid for such excess shall be returned to the insured or to the estate of the insured.
Or, in lieu thereof:
Insurance effective at any one time on the insured under this policy and like policy or policies in this insurer is limited to the one policy elected by the insured or the beneficiary or estate of the insured, as the case may be, and the insurer will return all premiums paid for all other such policies.
(Added to NRS by 1971, 1759)
2023 Nevada Revised Statutes › Chapter 689A - Individual Health Insurance › NRS 689A.260 - Conformity with state statutes.

There may be a provision as follows:
Conformity with State Statutes: Any provision of this policy which, on its effective date is in conflict with the statutes of the state in which the insured resides on such date is hereby amended to conform to the minimum requirements of such statutes.
(Added to NRS by 1971, 1763)
2023 Nevada Revised Statutes › Chapter 689A - Individual Health Insurance › NRS 689A.270 - Illegal occupation.

There may be a provision as follows:
Illegal Occupation: The insurer shall not be liable for any loss to which a contributing cause was the insured’s commission of or attempt to commit a felony or to which a contributing cause was the insured’s being engaged in an illegal occupation.
(Added to NRS by 1971, 1763)
2023 Nevada Revised Statutes › Chapter 689A - Individual Health Insurance › NRS 689A.290 - Renewability.

Health insurance policies, other than accident insurance only policies, in which the insurer reserves the right to refuse renewal on an individual basis, shall provide in substance in a provision thereof or in an endorsement thereon or rider attached thereto that subject to the right to terminate the policy upon nonpayment of premium when due, such right to refuse renewal may not be exercised so as to take effect before the renewal date occurring on, or after and nearest, each policy anniversary (or in the case of lapse and reinstatement, at the renewal date occurring on, or after and nearest, each anniversary of the last reinstatement), and that any refusal of renewal shall be without prejudice to any claim originating while the policy is in force. (The parenthetic reference to lapse and reinstatement may be omitted at the insurer’s option.)
(Added to NRS by 1971, 1764)
2023 Nevada Revised Statutes › Chapter 689A - Individual Health Insurance › NRS 689A.300 - Order of certain provisions.

The provisions which are the subject of NRS 689A.050 to 689A.290, inclusive, or any corresponding provisions which are used in lieu thereof in accordance with such sections shall be printed in the consecutive order of the provisions in such sections or, at the option of the insurer, any such provision may appear as a unit in any part of the policy, with other provisions to which it may be logically related, provided that the resulting policy shall not be in whole or in part unintelligible, uncertain, ambiguous, abstruse or likely to mislead a person to whom the policy is offered, delivered or issued.
(Added to NRS by 1971, 1764)
2023 Nevada Revised Statutes › Chapter 689A - Individual Health Insurance › NRS 689A.310 - Ownership of policy by person other than insured.

The word "insured," as used in this chapter, shall not be construed as preventing a person other than the insured with a proper insurable interest from making application for and owning a policy covering the insured or from being entitled under such a policy to any indemnities, benefits and rights provided therein.
(Added to NRS by 1971, 1764)
2023 Nevada Revised Statutes › Chapter 689A - Individual Health Insurance › NRS 689A.320 - Requirements of other jurisdictions.

1. Any policy of a foreign or alien insurer, when delivered or issued for delivery to any person in this state, may contain any provision which is not less favorable to the insured or the beneficiary than the provisions of this chapter and which is prescribed or required by the law of the state or country under which the insurer is organized.
2. Any policy of a domestic insurer may, when issued for delivery in any other state or country, contain any provision permitted or required by the laws of such other state or country.
(Added to NRS by 1971, 1764)
2023 Nevada Revised Statutes › Chapter 689A - Individual Health Insurance › NRS 689A.330 - Policies issued for delivery in another state.

If any policy is issued by a domestic insurer for delivery to a person residing in another state, and if the insurance commissioner or corresponding public officer of that other state has informed the Commissioner that the policy is not subject to approval or disapproval by that officer, the Commissioner may by ruling require that the policy meet the standards set forth in NRS 689A.030 to 689A.320, inclusive.
(Added to NRS by 1971, 1765; A 1985, 1447; 1989, 1273; 1997, 743; 1999, 760, 1997; 2003, 1334, 3355, 3522; 2007, 3237; 2009, 1467; 2013, 1998; 2015, 206, 638, 2124; 2017, 1813, 3936; 2019, 299, 1005, 2169; 2021, 781, 824, 1171, 2578, 2661, 3207; 2023, 809, 1782, 2029, 2213, 2372, 3512)
2023 Nevada Revised Statutes › Chapter 689A - Individual Health Insurance › NRS 689A.340 - Limitation on provisions not subject to chapter; effect of violation of chapter; conflict among provisions.

1. No policy provision which is not subject to this chapter shall make a policy, or any portion thereof, less favorable in any respect to the insured or the beneficiary than the provisions thereof which are subject to this chapter.
2. A policy delivered or issued for delivery to any person in this state in violation of this chapter shall be held valid but shall be construed as provided in this chapter. When any provision in a policy subject to this chapter is in conflict with any provision of this chapter, the rights, duties and obligations of the insurer, the insured and the beneficiary shall be governed by the provisions of this chapter.
(Added to NRS by 1971, 1765)
2023 Nevada Revised Statutes › Chapter 689A - Individual Health Insurance › NRS 689A.350 - Age limit.

If any such policy contains a provision establishing, as an age limit or otherwise, a date after which the coverage provided by the policy will not be effective, and if such date falls within a period for which a premium is accepted by the insurer or if the insurer accepts a premium after such date, the coverage provided by the policy will continue in force subject to any right of termination until the end of the period for which the premium has been accepted. If the age of the insured has been misstated and if, according to the correct age of the insured, the coverage provided by the policy would not have become effective, or would have ceased prior to the acceptance of such premium or premiums, then the liability of the insurer shall be limited to the refund of all premiums paid for the period not covered by the policy.
(Added to NRS by 1971, 1765)
2023 Nevada Revised Statutes › Chapter 689A - Individual Health Insurance › NRS 689A.380 - Definitions of terms used in policies.

As used in any policy of health insurance delivered, issued for delivery or used in this state, unless otherwise provided in the policy or in an endorsement thereon or in a rider attached thereto:
1. "Accidental death" means death by accident exclusively and independently of all other causes.
2. "Confinement to house" or "house confinement" includes the activities of a convalescent not able to be gainfully employed.
3. "Medical or surgical services" includes also services within the scope of his or her license rendered by any person while duly licensed by the State of Nevada under any of the following chapters of NRS: 631 (dentistry); 633 (osteopathic medicine); 634 (chiropractic); 634A (Oriental medicine); 635 (podiatry); or 636 (optometry). No policy of health insurance may provide that the insured does not have the option of selecting any licensee provided for in this subsection to perform any medical or surgical services covered by a policy of insurance if the service is within the scope of his or her license.
4. "Total disability" means inability to perform the duties of any gainful occupation for which the insured is reasonably fitted by training, experience and accomplishment.
(Added to NRS by 1971, 1766; A 1971, 1953; 1975, 240; 1977, 966)
2023 Nevada Revised Statutes › Chapter 689A - Individual Health Insurance › NRS 689A.405 - Policy covering prescription drugs: Provision of notice and information regarding use of formulary.

1. An insurer that offers or issues a policy of health insurance 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 insurer 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 insurer for making a request for information regarding the formulary pursuant to subsection 2.
2. If an insurer offers or issues a policy of health insurance which provides coverage for prescription drugs and a formulary is used, the insurer 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 insurer 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.
(c) During each period for open enrollment, publish on an Internet website that is operated by the insurer and accessible to the public or include in any enrollment materials distributed by the insurer a notice of all prescription drugs that:
(1) Are included on the most recent list of drugs that are essential for treating diabetes in this State compiled by the Department of Health and Human Services pursuant to paragraph (a) of subsection 1 of NRS 439B.630; and
(2) Have been removed or will be removed from the formulary during the current plan year or the next plan year.
(d) Update the notice required by paragraph (c) throughout the period for open enrollment.
(Added to NRS by 2001, 856; A 2017, 4308; 2019, 1466; 2021, 3731)
2023 Nevada Revised Statutes › Chapter 689A - Individual Health Insurance › NRS 689A.413 - Insurer prohibited from denying coverage solely because claim involves act that constitutes domestic violence or applicant or insured was victim of domestic violence.

An insurer shall not deny a claim, refuse to issue a policy of health insurance or cancel a policy of health insurance solely because the claim involves an act that constitutes domestic violence pursuant to NRS 33.018, or because the person applying for or covered by the health insurance policy was the victim of such an act of domestic violence, regardless of whether the insured or applicant contributed to any loss or injury.
(Added to NRS by 1997, 1095)
2023 Nevada Revised Statutes › Chapter 689A - Individual Health Insurance › NRS 689A.415 - Insurer prohibited from denying coverage solely because applicant or insured was intoxicated or under influence of controlled substance; exceptions.

1. Except as otherwise provided in subsection 2, an insurer shall not:
(a) Deny a claim under a policy of health insurance solely because the claim involves an injury sustained by an insured as a consequence of being intoxicated or under the influence of a controlled substance.
(b) Cancel a policy of health insurance solely because an insured has made a claim involving an injury sustained by the insured as a consequence of being intoxicated or under the influence of a controlled substance.
(c) Refuse to issue a policy of health insurance to an eligible applicant solely because the applicant has made a claim involving an injury sustained by the applicant as a consequence of being intoxicated or under the influence of a controlled substance.
2. The provisions of subsection 1 do not prohibit an insurer from enforcing a provision included in a policy of health insurance pursuant to NRS 689A.270 to:
(a) Deny a claim which involves an injury to which a contributing cause was the insured’s commission of or attempt to commit a felony;
(b) Cancel a policy of health insurance solely because of such a claim; or
(c) Refuse to issue a policy of health insurance to an eligible applicant solely because of such a claim.
3. The provisions of this section do not apply to an insurer under a policy of health insurance that provides coverage for long-term care or disability income.
(Added to NRS by 2005, 2343; A 2007, 84)
2023 Nevada Revised Statutes › Chapter 689A - Individual Health Insurance › NRS 689A.417 - Insurer prohibited from requiring or using information concerning genetic testing; exceptions.

1. Except as otherwise provided in subsection 2, an insurer who provides health insurance shall not:
(a) Require an insured person or any member of the family of the insured person to take a genetic test;
(b) Require an insured person to disclose whether the insured person or any member of the family of the insured person has taken a genetic test or any genetic information of the insured person or a member of the family of the insured person; or
(c) Determine the rates or any other aspect of the coverage or benefits for health care provided to an insured person based on whether the insured person or any member of the family of the insured person has taken a genetic test.
2. The provisions of this section do not apply to an insurer who issues a policy of health insurance that provides coverage for long-term care or disability income.
3. As used in this section:
(a) "Genetic information" means any information that is obtained from a genetic test.
(b) "Genetic test" means a test, including a laboratory test that uses deoxyribonucleic acid extracted from the cells of a person or a diagnostic test, to determine the presence of abnormalities or deficiencies, including carrier status, that:
(1) Are linked to physical or mental disorders or impairments; or
(2) Indicate a susceptibility to illness, disease, impairment or any other disorder, whether physical or mental.
(Added to NRS by 1997, 1459; A 2019, 299)
2023 Nevada Revised Statutes › Chapter 689A - Individual Health Insurance › NRS 689A.419 - Offering policy of health insurance for purposes of establishing health savings account.

An insurer may, subject to regulation by the Commissioner, offer a policy of health insurance that has a high deductible and is in compliance with 26 U.S.C. § 223 for the purposes of establishing a health savings account.
(Added to NRS by 2005, 2136)
2023 Nevada Revised Statutes › Chapter 689A - Individual Health Insurance › NRS 689A.420 - Definitions.

As used in NRS 689A.420 to 689A.460, inclusive, unless the context otherwise requires:
1. "Medicaid" means a program established in any state pursuant to Title XIX of the Social Security Act (42 U.S.C. §§ 1396 et seq.) to provide assistance for part or all of the cost of medical care rendered on behalf of indigent persons.
2. "Order for medical coverage" means an order of a court or administrative tribunal to provide coverage under a policy of health insurance to a child pursuant to the provisions of 42 U.S.C. § 1396g-1.
(Added to NRS by 1995, 2427)
2023 Nevada Revised Statutes › Chapter 689A - Individual Health Insurance › NRS 689A.440 - Insurer prohibited from asserting certain grounds to deny enrollment of child of insured pursuant to order.

An insurer shall not deny the enrollment of a child pursuant to an order for medical coverage, under a policy of health insurance 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 insurer’s geographic area of service.
(Added to NRS by 1995, 2427)
2023 Nevada Revised Statutes › Chapter 689A - Individual Health Insurance › NRS 689A.450 - Certain accommodations required to be made when child is covered under policy of noncustodial parent.

If a child has coverage under a policy of health insurance pursuant to which a noncustodial parent of the child is insured, the insurer issuing that policy 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, 2428)