2023 Nevada Revised Statutes › Chapter 686C - Nevada Life and Health Insurance Guaranty Association › NRS 686C.035 - Scope of chapter: Coverage not provided.

1. This chapter does not provide coverage for:
(a) A portion of a policy or contract not guaranteed by the member insurer, or under which the risk is borne by the owner of the policy or contract.
(b) A policy or contract of reinsurance unless assumption certificates have been issued pursuant to that policy or contract.
(c) A portion of a policy or contract, other than a portion of a policy or contract of health insurance or that provides benefits for long-term care, including, without limitation, a rider that provides such benefits, to the extent that the rate of interest on which it is based, or the interest rate, crediting rate or similar factor determined by the use of an index or other external reference stated in the policy or contract employed in calculating returns or changes in value:
(1) Averaged over the period of 4 years before the date on which the association becomes obligated with respect to the policy or contract, exceeds the rate of interest determined by subtracting 2 percentage points from Moody’s Corporate Bond Yield Average averaged for the same period, or for the period between the date of issuance of the policy or contract and the date the association became obligated, whichever period is less; and
(2) On or after the date on which the association becomes obligated with respect to the policy or contract, exceeds the rate of interest determined by subtracting 3 percentage points from Moody’s Corporate Bond Yield Average as most recently available.
(d) A portion of a policy or contract issued to a plan or program of an employer, association or other person to provide life, health or annuity benefits to its employees, members or other persons to the extent that the plan or program is self-funded or uninsured, including, but not limited to, benefits payable by an employer, association or other person under:
(1) A multiple employer welfare arrangement described in 29 U.S.C. § 1002(40);
(2) A minimum-premium group insurance plan;
(3) A stop-loss group insurance plan; or
(4) A contract for administrative services only.
(e) A portion of a policy or contract to the extent that it provides for dividends, credits for experience, voting rights or the payment of any fee or allowance to any person, including the owner of a policy or contract, for services or administration connected with the policy or contract.
(f) A policy or contract issued in this state by a member insurer at a time when the member insurer was not authorized to issue the policy or contract in this state.
(g) A portion of a policy or contract to the extent that the assessments required by NRS 686C.230 with respect to the policy or contract are preempted by federal law.
(h) An obligation that does not arise under the express written terms of the policy or contract issued by the member insurer, including:
(1) Claims based on marketing materials;
(2) Claims based on side letters or other documents that were issued by the member insurer without satisfying applicable requirements for filing or approval of policy or contract forms;
(3) Misrepresentations of or regarding policy or contract benefits;
(4) Extra-contractual claims; or
(5) A claim for penalties or consequential or incidental damages.
(i) A contractual agreement that establishes the member insurer’s obligation to provide a guarantee based on accounting at book value for participants in a defined-contribution benefit plan by reference to a portfolio of assets owned by the benefit plan or its trustee, which in each case is not an affiliate of the member insurer.
(j) A portion of a policy or contract to the extent that it provides for interest or other changes in value which are determined by the use of an index or other external reference stated in the policy or contract, but which have not been credited to the policy or contract, or as to which the rights of the owner of the policy or contract are subject to forfeiture, determined on the date the member insurer becomes an impaired or insolvent insurer, whichever occurs first. If the interest or changes in value of a policy or contract are credited less frequently than annually, for the purpose of determining the values that have been credited and are not subject to forfeiture, the interest or change in value determined by using procedures stated in the policy or contract must be credited as if the contractual date for crediting interest or changing values was the date of the impairment or insolvency of the insured member, whichever occurs first and is not subject to forfeiture.
(k) An unallocated annuity contract other than an annuity owned by a governmental retirement plan established under section 401, 403(b) or 457 of the Internal Revenue Code, 26 U.S.C. §§ 401, 403(b) and 457, respectively, or the trustees of such a plan.
(l) A policy or contract providing any hospital, medical, prescription drug or other health care benefits pursuant to 42 U.S.C. §§ 1395w-21 et seq. and 1395w-101 et seq. or 42 U.S.C. §§ 1396 et seq., and any regulations adopted pursuant thereto.
2. As used in this section, "Moody’s Corporate Bond Yield Average" means the monthly average for corporate bonds published by Moody’s Investors Service, Inc., or any successor average.
(Added to NRS by 1991, 864; A 1995, 1623; 1999, 2800; 2001, 1031; 2011, 3369; 2013, 3354; 2019, 1085)