reglab/statecodes huggingface dataset:
2023 Nebraska Revised Statutes › Chapter 44 - Insurance › 44-7008 - Health care professional's right to review credentialing verification information.

44-7008.
Health care professional's right to review credentialing verification information.
(1) A health carrier shall provide a health care professional the opportunity to review and correct information submitted in support of that health care professional's credentialing verification application as set forth below.
(2)(a) Each health care professional who is subject to the credentialing verification process shall have the right to review all information, including the source of that information, obtained by the health carrier to satisfy the requirements of the Health Care Professional Credentialing Verification Act during the health carrier's credentialing process.
(b) A health carrier shall notify a health care professional of any information obtained during the health carrier's credentialing verification process that does not meet the health carrier's credentialing verification standards or that varies substantially from the information provided to the health carrier by the health care professional, except that the health carrier shall not be required to reveal the source of information if the information is not obtained to meet the requirements of the act or if disclosure is prohibited by law.
(c) A health care professional shall have the right to correct any erroneous information. A health carrier shall have a formal process by which a health care professional may submit supplemental or corrected information to the health carrier's credentialing verification committee and request a reconsideration of the health care professional's credentialing verification application if the health care professional feels that the health carrier's credentialing verification committee has received information that is incorrect or misleading. Supplemental information shall be subject to confirmation by the health carrier.
Source
Laws 1998, LB 1162, § 33.
2023 Nebraska Revised Statutes › Chapter 44 - Insurance › 44-7009 - Contracts; duties.

44-7009.
Contracts; duties.
Whenever a health carrier contracts to have another entity perform the credentialing functions required by the Health Care Professional Credentialing Verification Act or applicable rules and regulations, the director shall hold the health carrier responsible for monitoring the activities of the entity with which it contracts and for ensuring that the requirements of the act and applicable rules and regulations are met.
Source
Laws 1998, LB 1162, § 34.
2023 Nebraska Revised Statutes › Chapter 44 - Insurance › 44-7010 - Health carrier violation; notice; hearing.

44-7010.
Health carrier violation; notice; hearing.
If the director finds that any health carrier doing business in this state is engaging in any violation of the Health Care Professional Credentialing Verification Act and that a proceeding in respect thereto would be in the public interest, the director shall issue and serve upon such health carrier a statement of the charges in that respect and a notice of hearing thereon, which notice shall set a hearing date not less than ten days after the date of the notice.
Source
Laws 1998, LB 1162, § 35.
2023 Nebraska Revised Statutes › Chapter 44 - Insurance › 44-7011 - Violation; penalty.

44-7011.
Violation; penalty.
If, after the hearing, the director finds a health carrier has violated the Health Care Professional Credentialing Verification Act, the director shall reduce his or her findings to writing and shall issue and cause to be served upon the health carrier charged with the violation a copy of the findings and an order requiring the health carrier to cease and desist from engaging in the violation and the director may order any one or more of the following:
(1) Payment of a monetary penalty of not more than one thousand dollars for each violation, not to exceed an aggregate penalty of thirty thousand dollars, unless the violation was committed flagrantly and in conscious disregard of the Health Care Professional Credentialing Verification Act, in which case the penalty shall not be more than fifteen thousand dollars for each violation, not to exceed an aggregate penalty of one hundred fifty thousand dollars; and
(2) Suspension or revocation of the health carrier's certificate of authority if the health carrier knew or reasonably should have known it was in violation of the act.
Source
Laws 1998, LB 1162, § 36.
2023 Nebraska Revised Statutes › Chapter 44 - Insurance › 44-7012 - Violation of cease and desist order; penalty.

44-7012.
Violation of cease and desist order; penalty.
Any health carrier who violates a cease and desist order of the director under section 44-7011 may after notice and hearing and upon order of the director be subject to:
(1) A monetary penalty of not more than thirty thousand dollars for each violation, not to exceed an aggregate penalty of one hundred fifty thousand dollars; and
(2) Suspension or revocation of the health carrier's certificate of authority.
Source
Laws 1998, LB 1162, § 37.
2023 Nebraska Revised Statutes › Chapter 44 - Insurance › 44-7102 - Purpose and intent.

44-7102.
Purpose and intent.
The purpose and intent of the Managed Care Plan Network Adequacy Act are to establish standards for the creation and maintenance of networks by health carriers and to assure the adequacy, accessibility, and quality of health care services offered under a managed care plan by establishing requirements for written agreements between health carriers offering managed care plans and participating providers regarding the standards, terms, and provisions under which the participating provider will provide services to covered persons.
Source
Laws 1998, LB 1162, § 40.
2023 Nebraska Revised Statutes › Chapter 44 - Insurance › 44-7107 - Intermediaries.

44-7107.
Intermediaries.
(1) A contract between a health carrier and an intermediary shall satisfy all the requirements contained in this section.
(2)(a) Intermediaries and participating providers with whom they contract shall comply with all the applicable requirements of section 44-7106.
(b) A health carrier's statutory responsibility to monitor the offering of covered benefits to covered persons shall not be delegated or assigned to the intermediary.
(c) A health carrier shall have the right to approve or disapprove participation status of a subcontracted provider in its own or a contracted network for the purpose of delivering covered benefits to the health carrier's covered persons.
(d) A health carrier shall maintain copies of all intermediary health care subcontracts at its principal place of business in the state, or ensure that it has access to all intermediary subcontracts, including the right to make copies to facilitate regulatory review, upon twenty days' prior written notice from the health carrier. A health carrier may meet the requirements of this subdivision by maintaining a copy of the intermediary health care subcontract forms used by its intermediaries, and if the health carrier does so, the health carrier shall also maintain a copy of any portion of an intermediary health care subcontract which substantially differs from the intermediary health care subcontract form in subject areas other than reimbursement.
(e) If applicable, an intermediary shall transmit utilization documentation and claims paid documentation to the health carrier. The health carrier shall monitor the timeliness and appropriateness of payments made to providers and health care services received by covered persons.
(f) If applicable, an intermediary shall maintain the books, records, financial information, and documentation of health care services provided to covered persons at its principal place of business in the state and preserve them for five years in a manner that facilitates regulatory review.
(g) An intermediary shall allow the director and a health maintenance organization shall allow the director and the Department of Health and Human Services access to the intermediary's books, records, financial information, and any documentation of health care services provided to covered persons, as necessary to determine compliance with the Managed Care Plan Network Adequacy Act.
(h) A health carrier shall have the right, in the event of the intermediary's insolvency, to require the assignment to the health carrier of the provisions of a provider's contract addressing the provider's obligation to furnish covered services.
Source
Laws 1998, LB 1162, § 45;
Laws 2007, LB296, § 199.
2023 Nebraska Revised Statutes › Chapter 44 - Insurance › 44-7108 - Filing requirements.

44-7108.
Filing requirements.
(1) A health carrier that offers closed plans or combination plans having a closed component shall file with the director sample contract forms proposed for use with its participating providers and intermediaries.
(2) A health carrier that offers closed plans or combination plans having a closed component shall submit material changes to a contract that would affect a provision required by the Managed Care Plan Network Adequacy Act or applicable rules and regulations to the director for approval. Changes in provider payment rates, coinsurance, copayments, or deductibles, or other plan benefit modifications are not considered material changes for the purpose of this subsection.
(3) If the director takes no action within thirty days after submission of a material change to a contract by a health carrier, the change is deemed approved.
(4) The health carrier shall maintain provider and intermediary contracts at its principal place of business in the state, or the health carrier shall have access to all contracts and provide copies to facilitate regulatory review upon twenty days' prior written notice from the director.
Source
Laws 1998, LB 1162, § 46.
2023 Nebraska Revised Statutes › Chapter 44 - Insurance › 44-7109 - Health carrier violation; notice; hearing.

44-7109.
Health carrier violation; notice; hearing.
If the director finds that any health carrier doing business in this state is engaging in any violation of the Managed Care Network Adequacy Act and that a proceeding in respect thereto would be in the public interest, the director shall issue and serve upon such health carrier a statement of the charges in that respect and a notice of hearing thereon, which notice shall set a hearing date not less than ten days after the date of the notice.
Source
Laws 1998, LB 1162, § 47.
2023 Nebraska Revised Statutes › Chapter 44 - Insurance › 44-7110 - Violation; penalty.

44-7110.
Violation; penalty.
If, after the hearing, the director finds a health carrier has violated the Managed Care Network Adequacy Act, the director shall reduce his or her findings to writing and shall issue and cause to be served upon the health carrier charged with the violation a copy of the findings and an order requiring the health carrier to cease and desist from engaging in the violation and the director may order any one or more of the following:
(1) Payment of a monetary penalty of not more than one thousand dollars for each violation, not to exceed an aggregate penalty of thirty thousand dollars, unless the violation was committed flagrantly and in conscious disregard of the Managed Care Network Adequacy Act, in which case the penalty shall not be more than fifteen thousand dollars for each violation, not to exceed an aggregate penalty of one hundred fifty thousand dollars; and
(2) Suspension or revocation of the health carrier's certificate of authority if the health carrier knew or reasonably should have known it was in violation of the act.
Source
Laws 1998, LB 1162, § 48.
2023 Nebraska Revised Statutes › Chapter 44 - Insurance › 44-7111 - Violation of cease and desist order; penalty.

44-7111.
Violation of cease and desist order; penalty.
Any health carrier who violates a cease and desist order of the director under section 44-7110 may after notice and hearing and upon order of the director be subject to:
(1) A monetary penalty of not more than thirty thousand dollars for each violation, not to exceed an aggregate penalty of one hundred fifty thousand dollars; and
(2) Suspension or revocation of the health carrier's certificate of authority.
Source
Laws 1998, LB 1162, § 49.
2023 Nebraska Revised Statutes › Chapter 44 - Insurance › 44-7202 - Purpose and intent.

44-7202.
Purpose and intent.
The Quality Assessment and Improvement Act establishes criteria for the quality assessment activities of all health carriers that offer managed care plans and for the quality improvement activities of health carriers issuing closed plans or combination plans having a closed component. The purpose of the criteria is to enable health carriers to evaluate, maintain, and improve the quality of health care services provided to covered persons.
Source
Laws 1998, LB 1162, § 52.
2023 Nebraska Revised Statutes › Chapter 44 - Insurance › 44-7204 - Applicability of act.

44-7204.
Applicability of act.
The Quality Assessment and Improvement Act applies to all health carriers that offer closed plans or combination plans having a closed component on and after July 15, 1998. The act, except sections 44-7207 to 44-7209, applies to all health carriers that offer open plans on and after July 1, 1999.
Source
Laws 1998, LB 1162, § 54.
2023 Nebraska Revised Statutes › Chapter 44 - Insurance › 44-7205 - Use of nationally recognized private accrediting entities; authorized.

44-7205.
Use of nationally recognized private accrediting entities; authorized.
The director may recognize accreditation by one or more nationally recognized private accrediting entities, with established and maintained standards, as evidence of meeting some or all of the requirements of the Quality Assessment and Improvement Act. A recognized accrediting entity shall make available to the director its current standards to demonstrate that the entity's standards meet or exceed this state's requirements. The health carrier may provide the director with documentation that a managed care plan has been accredited by the entity.
Source
Laws 1998, LB 1162, § 55.
2023 Nebraska Revised Statutes › Chapter 44 - Insurance › 44-7206 - Quality assessment; infrastructure and disclosure systems.

44-7206.
Quality assessment; infrastructure and disclosure systems.
A health carrier that provides managed care plans shall develop and maintain the infrastructure and disclosure systems necessary to measure the quality of health care services provided to covered persons on a regular basis and appropriate to the types of managed care plans offered by the health carrier. A health carrier shall:
(1) Establish a system designed to assess the quality of health care provided to covered persons and appropriate to the types of managed care plans offered by the health carrier. The system shall include systematic collection, analysis, and reporting of relevant data in accordance with statutory and regulatory requirements;
(2) Communicate findings in a timely manner to applicable regulatory agencies, providers, and consumers as provided in section 44-7209;
(3) Report to the appropriate licensing authority any persistent pattern of problematic care provided by a provider that is sufficient to cause the health carrier to terminate or suspend contractual arrangements with the provider. A health carrier acting in good faith shall be granted immunity from any cause of action under state law in making the report; and
(4) Develop a written description of the quality assessment program available for review by the director, which shall include a signed certification by a corporate officer of the health carrier that the filing meets the requirements of the Quality Assessment and Improvement Act. The written description of the quality assessment program of a health maintenance organization shall also be available for review by the Department of Health and Human Services.
Source
Laws 1998, LB 1162, § 56;
Laws 2007, LB296, § 200.
2023 Nebraska Revised Statutes › Chapter 44 - Insurance › 44-7208 - Quality assessment and quality improvement activities; oversight.

44-7208.
Quality assessment and quality improvement activities; oversight.
The chief medical officer or clinical director of the health carrier shall have primary responsibility for the quality assessment and quality improvement activities carried out by, or on behalf of, the health carrier and for ensuring that all requirements of the Quality Assessment and Improvement Act are met. The chief medical officer or clinical director shall approve the written quality assessment and quality improvement programs, as applicable, implemented in compliance with the act, and shall periodically review and revise the program document and act to assure ongoing appropriateness. Not less than semiannually, the chief medical officer or clinical director shall review reports of quality assessment and quality improvement activities. The director shall hold the health carrier responsible for the actions of the chief medical officer or clinical director carried out on behalf of the health carrier and shall hold the health carrier responsible for ensuring that all requirements of the act are met.
Source
Laws 1998, LB 1162, § 58.
2023 Nebraska Revised Statutes › Chapter 44 - Insurance › 44-7209 - Reporting and disclosure requirements.

44-7209.
Reporting and disclosure requirements.
(1) A health carrier shall document and communicate information, as provided in this section, about its quality assessment program and its quality improvement program, if it has one, and shall include a description of its quality assessment and quality improvement programs and a statement of patient rights and responsibilities with respect to those programs in the certificate of coverage or handbook provided to newly enrolled covered persons.
(2)(a) A health carrier shall certify to the director annually that its quality assessment program and its quality improvement program, if it has one, along with the materials provided to providers and consumers in accordance with subsection (1) of this section, meet the requirements of the Quality Assessment and Improvement Act.
(b) A health carrier shall make available for review by the public upon request, subject to a reasonable fee, the materials certified pursuant to subdivision (2)(a) of this section, except for the materials subject to the confidentiality requirements of section 44-7210 and materials that are proprietary to the health benefit plan. A health carrier shall retain all certified materials for at least three years from the date the material has been used or until the material has been examined as part of a market conduct examination, whichever is longer.
Source
Laws 1998, LB 1162, § 59.
2023 Nebraska Revised Statutes › Chapter 44 - Insurance › 44-7211 - Contracts; duties.

44-7211.
Contracts; duties.
Whenever a health carrier contracts to have another entity perform the quality assessment or quality improvement functions required by the Quality Assessment and Improvement Act or applicable rules and regulations, the director shall hold the health carrier responsible for monitoring the activities of the entity with which it contracts and for ensuring that the requirements of the act and applicable rules and regulations are met.
Source
Laws 1998, LB 1162, § 61.
2023 Nebraska Revised Statutes › Chapter 44 - Insurance › 44-7212 - Health carrier violation; notice; hearing.

44-7212.
Health carrier violation; notice; hearing.
If the director finds that any health carrier doing business in this state is engaging in any violation of the Quality Assessment and Improvement Act and that a proceeding in respect thereto would be in the public interest, the director shall issue and serve upon such health carrier a statement of the charges in that respect and a notice of hearing thereon, which notice shall set a hearing date not less than ten days from the date of the notice.
Source
Laws 1998, LB 1162, § 62.
2023 Nebraska Revised Statutes › Chapter 44 - Insurance › 44-7213 - Violation; penalty.

44-7213.
Violation; penalty.
If, after the hearing, the director finds a health carrier has violated the Quality Assessment and Improvement Act, the director shall reduce his or her findings to writing and shall issue and cause to be served upon the health carrier charged with the violation a copy of the findings and an order requiring the health carrier to cease and desist from engaging in the violation and the director may order any one or more of the following:
(1) Payment of a monetary penalty of not more than one thousand dollars for each violation, not to exceed an aggregate penalty of thirty thousand dollars, unless the violation was committed flagrantly and in conscious disregard of the Quality Assessment and Improvement Act, in which case the penalty shall not be more than fifteen thousand dollars for each violation, not to exceed an aggregate penalty of one hundred fifty thousand dollars; and
(2) Suspension or revocation of the health carrier's certificate of authority if the health carrier knew or reasonably should have known it was in violation of the act.
Source
Laws 1998, LB 1162, § 63.
2023 Nebraska Revised Statutes › Chapter 44 - Insurance › 44-7214 - Violation of cease and desist order; penalty.

44-7214.
Violation of cease and desist order; penalty.
Any health carrier who violates a cease and desist order of the director under section 44-7213 may after notice and hearing and upon order of the director be subject to:
(1) A monetary penalty of not more than thirty thousand dollars for each violation, not to exceed an aggregate penalty of one hundred fifty thousand dollars; and
(2) Suspension or revocation of the health carrier's certificate of authority.
Source
Laws 1998, LB 1162, § 64.
2023 Nebraska Revised Statutes › Chapter 44 - Insurance › 44-7302 - Purpose of act.

44-7302.
Purpose of act.
The purpose of the Health Carrier Grievance Procedure Act is to provide standards for the establishment and maintenance of procedures by health carriers to assure that covered persons have the opportunity for the appropriate resolution of their grievances as defined in the act.
Source
Laws 1998, LB 1162, § 67.
2023 Nebraska Revised Statutes › Chapter 44 - Insurance › 44-7305 - Use of nationally recognized private accrediting entities; authorized.

44-7305.
Use of nationally recognized private accrediting entities; authorized.
The director may recognize accreditation by one or more nationally recognized private accrediting entities, with established and maintained standards, as evidence of meeting some or all of the requirements of the Health Carrier Grievance Procedure Act. A recognized accrediting entity shall make available to the director its current standards to demonstrate that the entity's standards meet or exceed this state's requirements. The health carrier may provide the director with documentation that a managed care plan has been accredited by the entity.
Source
Laws 1998, LB 1162, § 70.
2023 Nebraska Revised Statutes › Chapter 44 - Insurance › 44-7306 - Grievance register.

44-7306.
Grievance register.
(1) A health carrier shall maintain in a grievance register written records to document all grievances received during a calendar year. A request for a review of an adverse determination shall be processed in compliance with section 44-7308 but not considered a grievance for purposes of the grievance register unless such request includes a written grievance. For each grievance required to be recorded in the grievance register, the grievance register shall contain, at a minimum, the following information:
(a) A general description of the reason for the grievance;
(b) Date received;
(c) Date of each review or hearing;
(d) Resolution of the grievance;
(e) Date of resolution; and
(f) Name of the covered person for whom the grievance was filed.
(2) The grievance register shall be maintained in a manner that is reasonably clear and accessible to the director. A grievance register maintained by a health maintenance organization shall also be accessible to the Department of Health and Human Services.
(3) A health carrier shall retain the grievance register compiled for a calendar year for the longer of three years or until the director has adopted a final report of an examination that contains a review of the grievance register for that calendar year.
Source
Laws 1998, LB 1162, § 71;
Laws 2007, LB296, § 201;
Laws 2013, LB147, § 19.
2023 Nebraska Revised Statutes › Chapter 44 - Insurance › 44-7307 - Grievance procedures.

44-7307.
Grievance procedures.
(1) Except as specified in section 44-7311, a health carrier shall use written procedures for receiving and resolving grievances from covered persons.
(2)(a) A copy of the grievance procedures, including all forms used to process a grievance, shall be made available to the director upon request. A health carrier shall file annually with the director a certificate of compliance stating that the health carrier has established and maintains grievance procedures that fully comply with the provisions of the Health Carrier Grievance Procedure Act.
(b) A description of the grievance procedure shall be set forth in or attached to the policy, certificate, membership booklet, outline of coverage, or other evidence of coverage provided to covered persons.
(c) The grievance procedure documents shall include a statement of a covered person's right to contact the director's office for assistance at any time. The statement shall include the telephone number and address of the director.
Source
Laws 1998, LB 1162, § 72.
2023 Nebraska Revised Statutes › Chapter 44 - Insurance › 44-7310 - Standard review of adverse determinations.

44-7310.
Standard review of adverse determinations.
(1) A health carrier shall establish written procedures for a standard review of an adverse determination. Review procedures shall be available to a covered person and to the provider acting on behalf of a covered person. For purposes of this section, covered person includes the representative of a covered person.
(2) When reasonably necessary or when requested by the provider acting on behalf of a covered person, standard reviews shall be evaluated by an appropriate clinical peer or peers in the same or similar specialty as would typically manage the case being reviewed. The clinical peer shall not have been involved in the initial adverse determination.
(3) For standard reviews the health carrier shall notify in writing both the covered person and the attending or ordering provider of the decision within fifteen working days after the request for a review. The written decision shall contain the provisions required in subsection (3) of section 44-7308.
(4) In any case in which the standard review process does not resolve a difference of opinion between the health carrier and the covered person or the provider acting on behalf of the covered person, the covered person or the provider acting on behalf of the covered person may submit a written grievance, unless the provider is prohibited from filing a grievance by federal or other state law.
Source
Laws 1998, LB 1162, § 75;
Laws 2013, LB147, § 21.
2023 Nebraska Revised Statutes › Chapter 44 - Insurance › 44-7312 - Health carrier violations; notice; hearing.

44-7312.
Health carrier violations; notice; hearing.
If the director finds that any health carrier doing business in this state is engaging in any violation of the Health Carrier Grievance Procedure Act and that a proceeding in respect thereto would be in the public interest, the director shall issue and serve upon such health carrier a statement of the charges in that respect and a notice of hearing thereon, which notice shall set a hearing date not less than ten days from the date of the notice.
Source
Laws 1998, LB 1162, § 77.
2023 Nebraska Revised Statutes › Chapter 44 - Insurance › 44-7313 - Violation; penalty.

44-7313.
Violation; penalty.
If, after the hearing, the director finds a health carrier has violated the Health Carrier Grievance Procedure Act, the director shall reduce his or her findings to writing and shall issue and cause to be served upon the health carrier charged with the violation a copy of the findings and an order requiring the health carrier to cease and desist from engaging in the violation and the director may order any one or more of the following:
(1) Payment of a monetary penalty of not more than one thousand dollars for each violation, not to exceed an aggregate penalty of thirty thousand dollars, unless the violation was committed flagrantly and in conscious disregard of the Health Carrier Grievance Procedure Act, in which case the penalty shall not be more than fifteen thousand dollars for each violation, not to exceed an aggregate penalty of one hundred fifty thousand dollars; and
(2) Suspension or revocation of the health carrier's certificate of authority if the health carrier knew or reasonably should have known it was in violation of the act.
Source
Laws 1998, LB 1162, § 78.
2023 Nebraska Revised Statutes › Chapter 44 - Insurance › 44-7314 - Violation of cease and desist order; penalty.

44-7314.
Violation of cease and desist order; penalty.
Any health carrier who violates a cease and desist order of the director under section 44-7313 may after notice and hearing and upon order of the director be subject to:
(1) A monetary penalty of not more than thirty thousand dollars for each violation, not to exceed an aggregate penalty of one hundred fifty thousand dollars; and
(2) Suspension or revocation of the health carrier's certificate of authority.
Source
Laws 1998, LB 1162, § 79.
2023 Nebraska Revised Statutes › Chapter 44 - Insurance › 44-7404 - Applicability of act.

44-7404.
Applicability of act.
The Unfair Discrimination Against Subjects of Abuse in Insurance Act applies to all insurers issuing, providing, delivering, arranging for, or renewing in this state any policy of insurance.
Source
Laws 1998, LB 1035, § 17.
2023 Nebraska Revised Statutes › Chapter 44 - Insurance › 44-7407 - Adverse effect on subject of abuse; explanation required.

44-7407.
Adverse effect on subject of abuse; explanation required.
An insurer that takes an action that adversely affects a subject of abuse on the basis of a medical condition or on the basis of claims history or other underwriting information that the insurer knows or has reason to know is abuse-related shall explain the reason for its action to the applicant or insured in writing and shall be able to demonstrate that its action, and any applicable policy provision:
(1) Does not treat abuse status as a medical condition or underwriting criterion;
(2) Is otherwise permissible by law and applies in the same manner and to the same extent to all applicants and insureds with a similar medical condition or a similar claim or claims history without regard to whether the condition is or the claims are abuse-related; and
(3) Except for claims actions, is based on a determination, made in conformance with sound actuarial principles or otherwise supported by actual or reasonably anticipated experience, that there is a correlation between the medical condition and a material increase in insurance risk.
Source
Laws 1998, LB 1035, § 20.
2023 Nebraska Revised Statutes › Chapter 44 - Insurance › 44-7408 - Violation of act; unfair trade practice.

44-7408.
Violation of act; unfair trade practice.
In addition to any other remedies available under the laws of this state, each violation of the Unfair Discrimination Against Subjects of Abuse in Insurance Act and any rules and regulations adopted and promulgated thereunder shall be an unfair trade practice in the business of insurance subject to the Unfair Insurance Trade Practices Act.
Source
Laws 1998, LB 1035, § 21.
Cross References
Unfair Insurance Trade Practices Act, see section 44-1521.
2023 Nebraska Revised Statutes › Chapter 44 - Insurance › 44-7410 - Applicability to actions on or after July 15, 1998.

44-7410.
Applicability to actions on or after July 15, 1998.
The Unfair Discrimination Against Subjects of Abuse in Insurance Act applies to all actions taken on or after July 15, 1998, except as otherwise explicitly stated. Nothing in the act shall require an insurer to conduct a comprehensive search of its contract files existing on July 15, 1998, solely to determine which applicants or insureds are subjects of abuse.
Source
Laws 1998, LB 1035, § 23.
2023 Nebraska Revised Statutes › Chapter 44 - Insurance › 44-7501 - Act, how cited.

44-7501.
Act, how cited.
Sections 44-7501 to 44-7535 shall be known and may be cited as the Property and Casualty Insurance Rate and Form Act.
Source
Laws 2000, LB 1119, § 1;
Laws 2001, LB 444, § 1;
Laws 2003, LB 216, § 18.
2023 Nebraska Revised Statutes › Chapter 44 - Insurance › 44-7502 - Purposes of act.

44-7502.
Purposes of act.
The purposes of the Property and Casualty Insurance Rate and Form Act are:
(1) To prohibit price-fixing agreements and other anticompetitive behavior by insurers;
(2) To protect policyholders and the public against excessive rates and the adverse effects of inadequate or unfairly discriminatory rates;
(3) To regulate insurance contracts so they: (a) Are not unjust, unfair, ambiguous, inconsistent, inequitable, misleading, deceptive, or contrary to public policy; (b) are not written so as to encourage the misrepresentation of coverage; (c) reasonably provide the general coverage for policies of that type; (d) comply with the provisions and the intent of the laws of this state; and (e) do not provide coverage contrary to the public interest;
(4) To promote rates that reflect the benefits of competition;
(5) To provide appropriate data reporting systems;
(6) To provide regulatory oversight in the absence of competition;
(7) To authorize essential cooperative action among insurers in the development of policy forms, prospective loss costs, and other information and to regulate such activity to prevent practices that tend to substantially lessen competition or create a monopoly; and
(8) To promote the dissemination of price and other information to enable consumers to purchase insurance suitable for their needs and to foster competitive insurance markets.
Source
Laws 2000, LB 1119, § 2.
2023 Nebraska Revised Statutes › Chapter 44 - Insurance › 44-7503 - Competition and uniformity; construction of act.

44-7503.
Competition and uniformity; construction of act.
Nothing in the Property and Casualty Insurance Rate and Form Act shall prohibit or discourage reasonable competition or prohibit or discourage uniformity in policy forms, rating systems, or underwriting practices except to the extent necessary to accomplish the purposes of the act. The act shall be liberally interpreted to carry into effect the purposes of the act.
Source
Laws 2000, LB 1119, § 3.
2023 Nebraska Revised Statutes › Chapter 44 - Insurance › 44-7505 - Applicability of act.

44-7505.
Applicability of act.
(1) The Property and Casualty Insurance Rate and Form Act applies to any insurer holding a certificate of authority issued by the director to transact insurance business in this state for the lines of insurance specified in subdivisions (5) through (14) and (16) through (20) of section 44-201 and to any combination of any of the foregoing on risks or operations in this state.
(2) The act does not apply to:
(a) Reinsurance, except as provided in section 44-7525 for joint reinsurance pools;
(b) Ocean marine insurance;
(c) Rating systems for insurance against loss or damage to aircraft or against liability, other than workers' compensation and employers liability, arising out of the ownership, maintenance, or use of aircraft;
(d) Rating systems or policy forms used by insurers to provide warranties or service contracts, or rating systems or policy forms used by insurers to provide coverage for the risk assumed by businesses that provide warranties or service contracts for their customers;
(e) Rating systems or policy forms for financial guaranty insurance as defined in subdivision (19) of section 44-201, except that the act applies to financial guaranty coverage for loss of value for motor vehicles leased or sold on credit to private parties;
(f) Rating systems for the lines of insurance specified in subdivisions (5), (7), and (18) of section 44-201 for insurance written by domestic assessment associations doing business under Chapter 44, article 8; and
(g) Policy forms or rates for contracts of suretyship, except that policy forms and prospective loss costs developed or filed by advisory organizations are subject to the act.
Source
Laws 2000, LB 1119, § 5;
Laws 2002, LB 1139, § 49.
2023 Nebraska Revised Statutes › Chapter 44 - Insurance › 44-7506 - Rating systems and prospective loss costs; filing required.

44-7506.
Rating systems and prospective loss costs; filing required.
(1) All rating systems and prospective loss costs shall be filed with the director in accordance with section 44-7508, except that filings for the following shall be filed in accordance with sections 44-7510 and 44-7511:
(a) Filings made by advisory organizations;
(b) Medical professional liability insurance;
(c) Insurance in noncompetitive markets as determined pursuant to section 44-7507;
(d) Liability and physical damage coverages relating to the rental of private passenger automobiles on a nonfleet basis;
(e) Insurance written by joint underwriting pools or joint reinsurance pools;
(f) Insurance written in an assigned risk plan; and
(g) Insurance covering risks of a personal nature written for business entities if the costs for the insurance are charged to individuals. This does not include coverage provided without a separate charge by business entities for their customers.
(2)(a) If the director, after notice and hearing in accordance with the Administrative Procedure Act, finds that an insurer has made filings pursuant to section 44-7508 that have failed to meet the filing standards contained in that section with such frequency as to indicate a general business practice that disregards the requirements of that section, the director shall order that the insurer's filings be made subject to the requirements of sections 44-7510 and 44-7511.
(b) Upon application by an insurer affected by an order issued pursuant to subdivision (2)(a) of this section, demonstrating that its filings made subsequent to the order have been in compliance with section 44-7508 without the need for the director to request that the original filings be amended, the director shall vacate such order. The director shall consider any such application within thirty days after its receipt for any order that has been in effect for more than nine months since its inception or since it was last reviewed by the director pursuant to an application by the insurer.
(c) For insurers whose rating system filings that would otherwise be subject to this section have been made subject to the prior approval requirements of section 44-7511 through the application of this subsection, the percentage rating flexibilities provided in section 44-7509 shall apply to such rating system filings made by such insurers once the rating system filing has been approved pursuant to section 44-7511.
Source
Laws 2000, LB 1119, § 6;
Laws 2005, LB 119, § 25.
Cross References
Administrative Procedure Act, see section 84-920.
2023 Nebraska Revised Statutes › Chapter 44 - Insurance › 44-7508.01 - Policy forms and related rules of attachment; filing; contents; failure to file; effect.

44-7508.01.
Policy forms and related rules of attachment; filing; contents; failure to file; effect.
(1) All policy forms and related rules of attachment shall be filed with the director in accordance with section 44-7508.02, except that an insurer may at its option file policy forms and related rules of attachment in accordance with section 44-7513 and filings for the following shall be filed in accordance with section 44-7513:
(a) Filings made by advisory organizations;
(b) Workers' compensation and employers liability insurance;
(c) Excess workers' compensation and employers liability insurance;
(d) Medical professional liability insurance;
(e) Insurance in noncompetitive markets as determined pursuant to section 44-7507;
(f) Liability and physical damage coverages relating to the rental of private passenger automobiles on a nonfleet basis;
(g) Insurance written by joint underwriting pools or joint reinsurance pools;
(h) Insurance written in an assigned risk plan; and
(i) Insurance covering risks of a personal nature written for business entities if the costs for the insurance are charged to individuals. This does not include coverage provided without a separate charge by business entities for their customers.
(2)(a) If the director, after notice and hearing in accordance with the Administrative Procedure Act, finds that an insurer has made filings pursuant to section 44-7508.02 that have failed to meet the filing standards contained in such section with such frequency as to indicate a general business practice that disregards the requirements of such section or finds that the insurer committed one or more egregious acts relating to the filing standards, the director shall order that the insurer's filings be made subject to the requirements of section 44-7513.
(b) Upon application by an insurer affected by an order issued pursuant to subdivision (2)(a) of this section demonstrating that its filings made subsequent to the order have been in compliance with section 44-7508.02 without the need for the director to request that the original filings be amended, the director may vacate such order. The director shall consider any such application within thirty days after its receipt for any order that has been in effect for more than nine months since its inception or since it was last reviewed by the director pursuant to an application by the insurer.
Source
Laws 2003, LB 216, § 19;
Laws 2005, LB 119, § 26.
Cross References
Administrative Procedure Act, see section 84-920.
2023 Nebraska Revised Statutes › Chapter 44 - Insurance › 44-7509 - Premium adjustments.

44-7509.
Premium adjustments.
(1) For medical professional liability insurance and for insurance subject to section 44-7508, insurers may increase or decrease premiums on an individual risk basis up to forty percent based on any factor except:
(a) The rate adjustment cannot be based upon the race, creed, national origin, or religion of the insured;
(b) The rate adjustment cannot violate the Unfair Discrimination Against Subjects of Abuse in Insurance Act;
(c) The rate adjustment cannot apply to (i) insurance covering risks of a personal nature, including insurance for homeowners, tenants, private passenger nonfleet automobiles, mobile homes, and other property and casualty insurance for personal, family, or household needs or (ii) insurance covering farms and ranches, including crop insurance; and
(d) The rate adjustment cannot be based solely upon the fact that the insured is deployed in the military on Title 10 orders that require the insured to be mobilized outside of the United States, United States territories, and the District of Columbia for a period of six months or greater.
(2) If the director finds after a hearing that (a) the utilization of this section by the insurance industry has produced a significant number of rate modifications at or near the upper limit and at the lower limit of the allowable range of modification and (b) the modifiers at and near the upper and lower limits of the allowable range of modification appear to be predominantly correlated with individual risk factors that relate to expected losses and expenses, the director may, by rules and regulations, broaden the range of plus or minus forty percent for any line or type of insurance subject to section 44-7508.
(3) If the director finds after a hearing that modifiers at or near the upper or lower limits of the allowable range of modification are not predominantly correlated with individual risk factors that relate to expected losses and expenses, the director may, by rules and regulations, reduce the range of plus or minus forty percent for any line or type of insurance subject to section 44-7508, but such reduction shall not be to less than plus or minus twenty-five percent.
Source
Laws 2000, LB 1119, § 9;
Laws 2002, LB 1139, § 50;
Laws 2005, LB 119, § 28;
Laws 2021, LB77, § 2.
Cross References
Unfair Discrimination Against Subjects of Abuse in Insurance Act, see section 44-7401.
2023 Nebraska Revised Statutes › Chapter 44 - Insurance › 44-7514 - Policy form approval requirements applying to qualifying multistate commercial policyholder; exemption.

44-7514.
Policy form approval requirements applying to qualifying multistate commercial policyholder; exemption.
(1) The policy form approval requirements set forth in section 44-7513 shall not apply to policies written for individual commercial risks of a qualifying multistate commercial policyholder. For the purposes of this section, a qualifying multistate commercial policyholder is an entity that meets the following qualifications:
(a) The policyholder is commercial in nature;
(b) If the policyholder is comprised of multiple corporations or other entities, there is common or majority ownership of each of the members by the same parent entity. Qualifying multistate commercial policyholder does not include franchise arrangements or other groups where individual members of the group are under different ownership; and
(c) The office with the largest number of the officers and senior management of the policyholder is located outside of Nebraska. If this criteria is not meaningful or is ambiguous for a policyholder, then the total premiums for lines of insurance subject to the Property and Casualty Insurance Rate and Form Act that are attributable to another jurisdiction must exceed those premiums attributable to Nebraska.
(2) Policy forms for commercial risks exempted by this section may include language that conflicts with sections 44-357, 44-358, and 44-501.02. If a conflict results between a policy form and the requirements of such sections, such sections shall apply.
(3) Policy forms for commercial risks exempted by this section may include language that conflicts with sections 44-349, 44-350, 44-501, 44-514 to 44-518, 44-520 to 44-523, and 44-6408 and the provision of section 44-601 that prohibits policies with a term longer than five years. If a conflict results between a policy form and the requirements of any of these sections, the language in the policy form shall apply to the extent that it is inconsistent with such sections.
(4) Except as set forth in subsections (2) and (3) of this section, the policy forms exempted from policy form approval requirements shall not violate any law of this state.
Source
Laws 2000, LB 1119, § 14;
Laws 2019, LB469, § 8.