reglab/statecodes huggingface dataset:
2023 Nevada Revised Statutes › Chapter 695A - Fraternal Benefit Societies › NRS 695A.070 - Organization: Solicitation of members; collection of advance premiums; reports to Commissioner.

1. Upon receipt of a preliminary certificate of authority from the Commissioner, the society:
(a) May solicit members for the purpose of completing its organization;
(b) Shall collect from each applicant the amount of not less than one regular monthly premium in accordance with its table of rates; and
(c) Shall issue to each applicant a receipt for the amount collected.
2. A society shall not incur any liability other than for the return of an advance premium, or issue any certificate, or pay, allow, or offer or promise to pay or allow, any death or disability benefit to any person until:
(a) Actual bona fide applications for benefits have been secured aggregating at least $500,000 on not less than 500 applicants, and all required evidence of insurability has been furnished to and approved by the society;
(b) Not less than 10 subordinate lodges have been established into which the 500 applicants have been admitted;
(c) There has been submitted to the Commissioner, under oath of the president or secretary, or corresponding officer of the society, a list of the applicants, giving their names and addresses, the date each was admitted, the name and number of the subordinate lodge of which each applicant is a member, the amount of benefits to be granted and the premiums therefor; and
(d) It has been shown to the Commissioner, by sworn statement of the treasurer or corresponding officer of the society, that at least 500 applicants have each paid in cash at least one regular monthly premium as provided in this chapter, which premiums in the aggregate must amount to at least $150,000.
3. The advance premiums provided for in subsection 2 must be held in trust during the period of organization and if the society has not qualified for a permanent certificate of authority within 1 year, as provided in this chapter, the premiums must be returned to the applicants.
(Added to NRS by 1971, 1837; A 1991, 225)
2023 Nevada Revised Statutes › Chapter 695A - Fraternal Benefit Societies › NRS 695A.080 - Certificate of authority: Issuance and renewal; effect; record; copies; fees.

1. The Commissioner may make such examination and require such further information as the Commissioner deems advisable. Upon presentation of satisfactory evidence that the society has complied with all applicable provisions of law, the Commissioner shall issue to the society a certificate of authority indicating that the society may transact business pursuant to the provisions of this chapter.
2. The certificate of authority is prima facie evidence of the existence of the society on the date of the certificate.
3. The Commissioner shall cause a record of the certificate of authority to be made. A certified copy of the record may be given in evidence with like effect as the original certificate of authority.
4. For the issuance or renewal of a certificate of authority, a society must pay to the Commissioner:
(a) A fee of $250 if the number of outstanding benefit contracts within Nevada of the society is 600 or less;
(b) A fee of $500 if the number of outstanding benefit contracts within Nevada of the society is more than 600 but less than 1,200;
(c) A fee of $2,450 if the number of outstanding benefit contracts within Nevada of the society is 1,200 or more; and
(d) In addition to any other fee or charge, all applicable fees required pursuant to NRS 680C.110.
Each such certificate or renewal expires on March 1 following its issuance.
5. If a society properly applies for the renewal of its certificate of authority but does not receive approval of its application by March 1, it may continue to transact business pursuant to this chapter unless it receives notice that the application for renewal is specifically denied.
6. A certified copy or duplicate of a certificate of authority is prima facie evidence that the society may lawfully transact business in this state pursuant to the provisions of this chapter during the period stated on the license.
(Added to NRS by 1971, 1838; A 1991, 226, 1633; 1993, 2304; 2009, 1814)
2023 Nevada Revised Statutes › Chapter 695A - Fraternal Benefit Societies › NRS 695A.090 - General powers and duties of society.

A society shall operate for the benefit of its members and their beneficiaries by providing benefits as specified in NRS 695A.180 and may:
1. Operate for any lawful social, intellectual, educational, charitable, benevolent, moral, fraternal, patriotic or religious purpose.
2. Carry out its purposes directly or through subsidiary corporations or affiliated organizations.
3. Create, maintain and operate, or establish organizations to operate, nonprofit institutions to further the society’s purposes. Such institutions may charge a reasonable amount for their services.
4. Organize and operate lodges for children under the minimum age for adult membership. Membership and initiation in local lodges must not be required of children, and they must not have a voice or vote in the management of the society.
5. Adopt laws and rules for the government of the society, the admission of its members and the management of its affairs.
6. Amend its laws and rules.
7. Exercise any other power which is necessary and incidental to carrying into effect the objects and purposes of the society and which is not inconsistent with the provisions of this chapter.
(Added to NRS by 1971, 1838; A 1991, 227)
2023 Nevada Revised Statutes › Chapter 695A - Fraternal Benefit Societies › NRS 695A.095 - Contracts between society and provider of health care: Prohibiting society from charging provider of health care fee for inclusion on list of providers given to insureds; society required to use form to obtain information on provider of health care; modification; submission by society of schedule of payments to provider.

1. A society shall not charge a provider of health care a fee to include the name of the provider on a list of providers of health care given by the society to its insureds.
2. A society shall not contract with a provider of health care to provide health care to an insured unless the society uses the form prescribed by the Commissioner pursuant to NRS 629.095 to obtain any information related to the credentials of the provider of health care.
3. A contract between a society and a provider of health care may be modified:
(a) At any time pursuant to a written agreement executed by both parties.
(b) Except as otherwise provided in this paragraph, by the society upon giving to the provider 45 days’ written notice of the modification of the society’s schedule of payments, including any changes to the fee schedule applicable to the provider’s practice. If the provider fails to object in writing to the modification within the 45-day period, the modification becomes effective at the end of that period. If the provider objects in writing to the modification within the 45-day period, the modification must not become effective unless agreed to by both parties as described in paragraph (a).
4. If a society contracts with a provider of health care to provide health care to an insured, the society shall:
(a) If requested by the provider of health care at the time the contract is made, submit to the provider of health care the schedule of payments applicable to the provider of health care; or
(b) If requested by the provider of health care at any other time, submit to the provider of health care the schedule of payments, including any changes to the fee schedule applicable to the provider’s practice, specified in paragraph (a) within 7 days after receiving the request.
5. As used in this section, "provider of health care" means a provider of health care who is licensed pursuant to chapter 630, 631, 632 or 633 of NRS.
(Added to NRS by 1999, 1649; A 2001, 2732; 2003, 3362; 2011, 2534)
2023 Nevada Revised Statutes › Chapter 695A - Fraternal Benefit Societies › NRS 695A.120 - Location of principal office; meetings of supreme governing body; minutes of certain proceedings; official publications; grievances by benefit members.

1. The principal office of any domestic society must be located in this state.
2. The meetings of its supreme governing body may be held in any state, district, province or territory in which the society has at least five subordinate lodges, and all business transacted at those meetings is as valid in all respects as if the meetings were held in this state.
3. The minutes of the proceedings of the supreme governing body and the board of directors must be written in the English language.
4. A society may provide in its laws for an official publication in which any notice, report or statement which is required by law to be given to a member, including a notice of election, may be published. Such a report, notice or statement must be printed conspicuously in the publication.
5. If the records of a society indicate that two or more benefit members have the same mailing address, an official publication mailed to one member shall be deemed to be mailed to all members at the same address unless a member requests a separate copy.
6. A society may provide in its laws or rules a procedure by which a benefit member may pursue a grievance or complaint against the society, its supreme governing body, officers, directors or other members.
(Added to NRS by 1971, 1839; A 1991, 227)
2023 Nevada Revised Statutes › Chapter 695A - Fraternal Benefit Societies › NRS 695A.140 - Conversion of fraternal benefit society into mutual life insurer.

Any domestic fraternal benefit society may be converted to and licensed as a mutual life insurer by compliance with all the applicable requirements of chapter 693A of NRS if a plan of conversion is:
1. Prepared by the board of directors of the society in writing setting forth in full the terms and conditions of the conversion;
2. Approved by the affirmative vote of two-thirds of all members of the supreme governing body of the society at a regular or special meeting; and
3. Approved by the Commissioner, who may give such approval if the Commissioner finds that the proposed change is in conformity with the laws of this state and not prejudicial to the certificate holders of the society.
(Added to NRS by 1971, 1840; A 1991, 229)
2023 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)
2023 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)
2023 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)
2023 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)
2023 Nevada Revised Statutes › Chapter 695A - Fraternal Benefit Societies › NRS 695A.155 - Certain accommodations required to be made by society 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)
2023 Nevada Revised Statutes › Chapter 695A - Fraternal Benefit Societies › NRS 695A.157 - Society required 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)
2023 Nevada Revised Statutes › Chapter 695A - Fraternal Benefit Societies › NRS 695A.160 - Amendment of laws of society: Manner; approval by Commissioner; provision to members.

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)
2023 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)
2023 Nevada Revised Statutes › Chapter 695A - Fraternal Benefit Societies › NRS 695A.184 - Benefit contract covering prescription drugs prohibited from limiting or excluding coverage for prescription drug previously approved for medical condition of insured; exception.

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)
2023 Nevada Revised Statutes › Chapter 695A - Fraternal Benefit Societies › NRS 695A.1844 - Coverage for testing, treatment and prevention of sexually transmitted diseases required; coverage for condoms for certain insureds required.

1. A society that offers or issues a benefit contract shall include in the contract:
(a) Coverage of testing for and the treatment and prevention of sexually transmitted diseases, including, without limitation,
Chlamydia trachomatis
, gonorrhea, syphilis, human immunodeficiency virus and hepatitis B and C, for all insureds, regardless of age. Such coverage must include, without limitation, the coverage required by NRS 695A.1843 and 695A.1856.
(b) Unrestricted coverage of condoms for insureds who are 13 years of age or older.
2. A benefit contract subject to the provisions of this chapter that is delivered, issued for delivery or renewed on or after January 1, 2024, has the legal effect of including the coverage required by subsection 1, and any provision of the contract that conflicts with the provisions of this section is void.
(Added to NRS by 2023, 3519)
2023 Nevada Revised Statutes › Chapter 695A - Fraternal Benefit Societies › NRS 695A.1853 - Coverage for screening, genetic counseling and testing related to BRCA gene required in certain circumstances.

1. A society that issues a benefit contract shall provide coverage for screening, genetic counseling and testing for harmful mutations in the BRCA gene for women under circumstances where such screening, genetic counseling or testing, as applicable, is required by NRS 457.301.
2. A society shall 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. A benefit contract subject to the provisions of this chapter that is delivered, issued for delivery or renewed on or after January 1, 2022, has the legal effect of including the coverage required by subsection 1, and any provision of the plan that conflicts with the provisions of this section is void.
4. As used in this section:
(a) "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.
(b) "Provider of health care" has the meaning ascribed to it in NRS 629.031.
(Added to NRS by 2021, 782)
2023 Nevada Revised Statutes › Chapter 695A - Fraternal Benefit Societies › NRS 695A.1856 - Coverage for examination of person who is pregnant for certain diseases required.

1. A society that issues a benefit contract shall provide coverage for the examination of a person who is pregnant for the discovery of:
(a)
Chlamydia trachomatis
, gonorrhea, hepatitis B and hepatitis C in accordance with NRS 442.013.
(b) Syphilis in accordance with NRS 442.010.
2. The coverage required by this section must be provided:
(a) Regardless of whether the benefits are provided to the insured by a provider of health care, facility or medical laboratory that participates in the network plan of the society; and
(b) Without prior authorization.
3. A benefit contract subject to the provisions of this chapter that is delivered, issued for delivery or renewed on or after July 1, 2021, has the legal effect of including the coverage required by subsection 1, and any provision of the contract that conflicts with the provisions of this section is void.
4. As used in this section:
(a) "Medical laboratory" has the meaning ascribed to it in NRS 652.060.
(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 2021, 2579)
2023 Nevada Revised Statutes › Chapter 695A - Fraternal Benefit Societies › NRS 695A.1857 - Benefit contract covering maternity care: Prohibited acts by society if insured is acting as gestational carrier; child deemed child of intended parent for purposes of benefit contract.

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)
2023 Nevada Revised Statutes › Chapter 695A - Fraternal Benefit Societies › NRS 695A.1873 - Coverage for management and treatment of sickle cell disease and its variants required; coverage for medically necessary prescription drugs to treat sickle cell disease and its variants required in benefit contract covering prescription drugs.

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)
2023 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.

1. Except as otherwise provided in subsection 2 and NRS 439B.754, 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; 2019, 331)
2023 Nevada Revised Statutes › Chapter 695A - Fraternal Benefit Societies › NRS 695A.195 - Society prohibited from denying coverage solely because claim involves act that constitutes domestic violence or applicant or insured was victim of domestic violence.

A society shall not deny a claim, refuse to issue a benefit contract or cancel a benefit contract 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 benefit contract 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, 1096)
2023 Nevada Revised Statutes › Chapter 695A - Fraternal Benefit Societies › NRS 695A.197 - Society prohibited from denying coverage solely because applicant or insured was intoxicated or under the influence of controlled substance; exceptions.

1. Except as otherwise provided in subsection 2, a society that provides health benefits shall not:
(a) Deny a claim under a benefit contract 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 benefit contract 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 benefit contract 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 a society from enforcing a provision included in a benefit contract 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 benefit contract solely because of such a claim; or
(c) Refuse to issue a benefit contract to an eligible applicant solely because of such a claim.
3. The provisions of this section do not apply to a society under a benefit contract that provides coverage for long-term care or disability income.
(Added to NRS by 2005, 2345; A 2007, 85)
2023 Nevada Revised Statutes › Chapter 695A - Fraternal Benefit Societies › NRS 695A.198 - Society prohibited from discriminating against person with respect to participation or coverage on basis of gender identity or expression.

A society that issues a benefit contract shall not discriminate against any person with respect to participation or coverage under the contract on the basis of actual or perceived gender identity or expression. Prohibited discrimination includes, without limitation:
1. Denying, cancelling, limiting or refusing to issue or renew a benefit contract on the basis of the actual or perceived gender identity or expression of a person or a family member of the person;
2. Imposing a payment or premium that is based on the actual or perceived gender identity or expression of an insured or a family member of the insured;
3. Designating the actual or perceived gender identity or expression of a person or a family member of the person as grounds to deny, cancel or limit participation or coverage; and
4. Denying, cancelling or limiting participation or coverage on the basis of actual or perceived gender identity or expression, including, without limitation, by limiting or denying coverage for health care services that are:
(a) Related to gender transition, provided that there is coverage under the contract for the services when the services are not related to gender transition; or
(b) Ordinarily or exclusively available to persons of any sex.
(Added to NRS by 2023, 2038)
2023 Nevada Revised Statutes › Chapter 695A - Fraternal Benefit Societies › NRS 695A.200 - Nonforfeiture benefits, cash surrender values, certificate loans and other options.

1. A society may grant paid-up nonforfeiture benefits, cash surrender values, certificate loans and such other options as its laws may permit.
2. In the case of certificates for which reserves are computed on the Commissioners 1980 Standard Ordinary Mortality Table or such other table of mortality as may be specified by the society and approved by the Commissioner, every paid-up nonforfeiture benefit and the amount of any cash surrender value, loan or other option granted must not be less than the corresponding amount ascertained in accordance with the provisions of the laws of this state applicable to life insurance companies issuing policies containing like insurance benefits based upon those tables.
(Added to NRS by 1971, 1843; A 1985, 1185; 1991, 231)
2023 Nevada Revised Statutes › Chapter 695A - Fraternal Benefit Societies › NRS 695A.210 - Beneficiaries; funeral benefits.

1. The owner of a benefit contract has the right at all times to change any beneficiary in accordance with the laws or rules of the society, unless the owner waives that right by requesting in writing that the owner’s designation of a beneficiary be irrevocable. Every society by its laws or rules may limit the scope of a designation of a beneficiary and shall provide that a revocable beneficiary does not have or obtain any vested interest in the proceeds of any certificate until the certificate has become due and payable in conformity with the provisions of the benefit contract.
2. A society may provide for the payment of funeral benefits to the extent of such portion of any payment under a certificate as might reasonably appear to be due to any person equitably entitled thereto by reason of having incurred expense occasioned by the burial of a member, but the portion so paid must not exceed $1,000.
3. If, at the death of any person insured under a benefit contract, there is no lawful beneficiary to whom the insurance benefits are payable, the amount of such benefits, except to the extent that funeral benefits may be paid as provided in subsection 2, are payable:
(a) To the estate of the deceased insured; or
(b) To the owner of the certificate if the owner is not the person insured under the benefit contract.
(Added to NRS by 1971, 1844; A 1991, 232)
2023 Nevada Revised Statutes › Chapter 695A - Fraternal Benefit Societies › NRS 695A.220 - Benefits not liable to attachment, garnishment or other process.

No money or other benefit, charity, relief or aid to be paid, provided or rendered by any society is liable to attachment, garnishment or other process, or to be seized, taken, appropriated or applied by any legal or equitable process or operation of law to pay any debt or liability of a benefit member or beneficiary, or any other person who may have a right thereunder, either before or after payment by the society.
(Added to NRS by 1971, 1844; A 1991, 233)
2023 Nevada Revised Statutes › Chapter 695A - Fraternal Benefit Societies › NRS 695A.230 - Terms and conditions of benefit contracts.

1. Every society authorized to do business in this state shall issue to each owner of a benefit contract a certificate specifying the amount of benefits provided thereby. The certificate, together with any riders or endorsements attached thereto, the laws of the society, the application for membership, the application for insurance and the declaration of insurability, if any, signed by the applicant, and all amendments to each thereof, constitute the agreement, as of the date of issuance, between the society and the member, and the certificate must so state. A copy of the application for insurance and the declaration of insurability, if any, must be endorsed upon or attached to the certificate.
2. All statements on an application for insurance are representations and not warranties. Any waiver of this provision is void.
3. Except with regard to contracts providing benefits payable in variable amounts, any changes, additions or amendments to the laws of the society duly made or enacted after the issuance of the certificate bind the owner and the beneficiaries, and govern and control the benefit contract as though the changes, additions or amendments were in force at the time of the application for insurance, except that no change, addition or amendment may destroy or diminish benefits which the society contracted to give the owner as of the date of issuance.
4. Any person upon whose life a benefit contract is issued before the person attains the age of majority is bound by the terms of the application and certificate and by all the laws and rules of the society as though the age of majority had been attained at the time of application.
5. Copies of any of the documents mentioned in this section, certified by the secretary or corresponding officer of the society, must be received in evidence of the terms and conditions thereof.
6. Except with regard to contracts providing benefits payable in variable amounts, a society shall provide in its laws that if its reserves as to all or any class of certificates become impaired, its supreme governing body or board of directors may require each owner of such certificates to pay to the society the amount of the owner’s equitable proportion of such deficiency as ascertained by its board, and that if the payment is not made, the owner may elect to:
(a) Let it stand as an indebtedness against the certificate and draw interest at a rate not to exceed that specified for loans made pursuant to the certificates; or
(b) In lieu of, or in combination with paragraph (a), accept a proportionate reduction in benefits under the certificate.
The society may specify the manner of the election and which alternative is to be presumed if no election is made by the owner.
(Added to NRS by 1971, 1844; A 1991, 233)
2023 Nevada Revised Statutes › Chapter 695A - Fraternal Benefit Societies › NRS 695A.232 - Society required to offer and issue plan regardless of health status of persons; prohibited acts.

1. A society shall offer and issue a health benefit plan to any person regardless of the health status of the person or any dependent of the person. Such health status includes, without limitation:
(a) Any preexisting medical condition of the person, including, without limitation, any physical or mental illness;
(b) The claims history of the person, including, without limitation, any prior health care services received by the person;
(c) Genetic information relating to the person; and
(d) Any increased risk for illness, injury or any other medical condition of the person, including, without limitation, any medical condition caused by an act of domestic violence.
2. A society that offers or issues a health benefit plan shall not:
(a) Deny, limit or exclude a covered benefit based on the health status of an insured; or
(b) Require an insured, as a condition of enrollment or renewal, to pay a premium, deductible, copay or coinsurance based on his or her health status which is greater than the premium, deductible, copay or coinsurance charged to a similarly situated insured who does not have such a health status.
3. A society that offers or issues a health benefit plan shall not adjust a premium, deductible, copay or coinsurance for any insured on the basis of genetic information relating to the insured or the covered dependent of the insured.
4. As used in this section, "health benefit plan" has the meaning ascribed to it in NRS 687B.470.
(Added to NRS by 2019, 305)
2023 Nevada Revised Statutes › Chapter 695A - Fraternal Benefit Societies › NRS 695A.235 - Offering policy of health insurance for purposes of establishing health savings account.

A society 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, 2158)
2023 Nevada Revised Statutes › Chapter 695A - Fraternal Benefit Societies › NRS 695A.240 - Approval and contents of certificates.

1. No certificate may be delivered or issued for delivery in this state unless a copy of the form of the certificate has been filed with and approved by the Commissioner in conformity with the requirements of NRS 687B.120.
2. The certificate must contain:
(a) A provision stating the amount of premiums which are payable under the certificate;
(b) A provision setting forth the society’s laws or rules which, if violated, will result in the termination or reduction of benefits payable under the certificate;
(c) If the laws of the society provide for the expulsion or suspension of a member, a provision that any member who is expelled or suspended, except for nonpayment of a premium or, during the period of contestability, for material misrepresentation in the application for membership or insurance, may maintain the certificate in force by continuing payment of the required premium; and
(d) All standard contractual provisions which are required by the provisions of chapters 687B, 688A, 688B, 689, 689A and 689B of NRS to be included in similar policies issued by life or health insurers in this state, and which are not inconsistent with the provisions of this chapter.
3. The certificate may contain:
(a) A provision that the member is entitled to a grace period of 1 month in which the payment of any premium after the first may be made.
(b) For a benefit contract issued on the life of a person under the society’s minimum age for membership as an adult, a provision governing the transfer of ownership to the insured at an age specified in the certificate. A society may require approval of an application for membership in order to make the transfer, and may provide for the regulation, government and control of such a certificate and all rights, obligations and liabilities incident to the certificate, including rights of ownership before the transfer.
(c) The terms and conditions governing the assignability of the benefit contract.
(Added to NRS by 1971, 1845; A 1991, 234)