reglab/statecodes huggingface dataset:
2023 Nevada Revised Statutes › Chapter 695A - Fraternal Benefit Societies › NRS 695A.255 - Benefit contract covering prescription drugs: Provision of notice and information regarding use of formulary.

1. A society that offers or issues a benefit contract which provides coverage for prescription drugs shall include with any certificate for such a contract provided to a benefit member, notice of whether a formulary is used and, if so, of the opportunity to secure information regarding the formulary from the society pursuant to subsection 2. The notice required by this subsection must:
(a) Be in a language that is easily understood and in a format that is easy to understand;
(b) Include an explanation of what a formulary is; and
(c) If a formulary is used, include:
(1) An explanation of:
(I) How often the contents of the formulary are reviewed; and
(II) The procedure and criteria for determining which prescription drugs are included in and excluded from the formulary; and
(2) The telephone number of the society for making a request for information regarding the formulary pursuant to subsection 2.
2. If a society offers or issues a benefit contract which provides coverage for prescription drugs and a formulary is used, the society shall:
(a) Provide to any insured or participating provider of health care, upon request:
(1) Information regarding whether a specific drug is included in the formulary.
(2) Access to the most current list of prescription drugs in the formulary, organized by major therapeutic category, with an indication of whether any listed drugs are preferred over other listed drugs. If more than one formulary is maintained, the society shall notify the requester that a choice of formulary lists is available.
(b) Notify each person who requests information regarding the formulary, that the inclusion of a drug in the formulary does not guarantee that a provider of health care will prescribe that drug for a particular medical condition.
(Added to NRS by 2001, 860)
2023 Nevada Revised Statutes › Chapter 695A - Fraternal Benefit Societies › NRS 695A.256 - Benefit contract covering prescription drugs: Submission to step therapy protocol for drug to treat psychiatric condition prohibited in certain circumstances.

1. A benefit contract which provides coverage for prescription drugs must not require an insured to submit to a step therapy protocol before covering a drug approved by the Food and Drug Administration that is prescribed to treat a psychiatric condition of the insured, if:
(a) The drug has been approved by the Food and Drug Administration with indications for the psychiatric condition of the insured or the use of the drug to treat that psychiatric condition is otherwise supported by medical or scientific evidence;
(b) The drug is prescribed by:
(1) A psychiatrist;
(2) A physician assistant under the supervision of a psychiatrist;
(3) An advanced practice registered nurse who has the psychiatric training and experience prescribed by the State Board of Nursing pursuant to NRS 632.120; or
(4) A primary care provider that is providing care to an insured in consultation with a practitioner listed in subparagraph (1), (2) or (3), if the closest practitioner listed in subparagraph (1), (2) or (3) who participates in the network plan of the society is located 60 miles or more from the residence of the insured; and
(c) The practitioner listed in paragraph (b) who prescribed the drug knows, based on the medical history of the insured, or reasonably expects each alternative drug that is required to be used earlier in the step therapy protocol to be ineffective at treating the psychiatric condition.
2. Any provision of a benefit contract subject to the provisions of this chapter that is delivered, issued for delivery or renewed on or after July 1, 2023, which is in conflict with this section is void.
3. As used in this section:
(a) "Medical or scientific evidence" has the meaning ascribed to it in NRS 695G.053.
(b) "Network plan" means a benefit contract offered by a society under which the financing and delivery of medical care is 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) "Step therapy protocol" means a procedure that requires an insured to use a prescription drug or sequence of prescription drugs other than a drug that a practitioner recommends for treatment of a psychiatric condition of the insured before his or her benefit contract provides coverage for the recommended drug.
(Added to NRS by 2023, 1784)
2023 Nevada Revised Statutes › Chapter 695A - Fraternal Benefit Societies › NRS 695A.257 - Benefit contract covering prescription drugs: Required actions by society related to acquisition of prescription drugs for certain insureds residing in area for which emergency or disaster has been declared.

1. If the Governor or the Legislature proclaims the existence of a state of emergency or issues a declaration of disaster pursuant to NRS 414.070, a society that has issued a benefit contract which provides coverage for prescription drugs shall, notwithstanding any provision of the benefit contract to the contrary:
(a) Waive any provision of the benefit contract restricting the time within which an insured may refill a covered prescription if the insured:
(1) Has not exceeded the number of refills authorized by the prescribing practitioner;
(2) Resides in the area for which the emergency or disaster has been declared; and
(3) Requests the refill not later than the end of the state of emergency or disaster or 30 days after the issuance of the proclamation or declaration, whichever is later; and
(b) Authorize payment for, and may apply a copayment, coinsurance or deductible to, a supply of a covered prescription drug for up to 30 days for an insured who requests a refill pursuant to paragraph (a).
2. The Commissioner may extend the time periods prescribed by subsection 1 in increments of 15 or 30 days as he or she determines to be necessary.
3. As used in this section, "practitioner" has the meaning ascribed to it in NRS 639.0125.
(Added to NRS by 2021, 825)
2023 Nevada Revised Statutes › Chapter 695A - Fraternal Benefit Societies › NRS 695A.261 - Benefit contract covering anatomical gifts, organ transplants or treatments or services related to organ transplants: Prohibited acts by society if insured is person with disability.

1. A society that offers or issues a benefit contract that includes coverage for anatomical gifts, organ transplants or treatments or services related to an organ transplant shall not:
(a) Deny, limit or seek reimbursement from an insured for care related to an organ transplant because the insured is a person with a disability;
(b) Deny a person with a disability eligibility or continued eligibility to enroll or renew coverage to avoid providing coverage in accordance with this section;
(c) Reduce or limit the reimbursement of or otherwise penalize a provider of medical or related services because the provider of medical or related services acted in accordance with NRS 460.160; or
(d) Provide monetary or nonmonetary incentives for a provider of medical or related services to induce the provider of medical or related services to provide care to an insured in a manner inconsistent with NRS 460.160.
2. As used in this section:
(a) "Anatomical gift" has the meaning ascribed to it in NRS 451.513.
(b) "Disability" has the meaning ascribed to it in 42 U.S.C. § 12102(1).
(c) "Provider of medical or related services" has the meaning ascribed to it in NRS 460.160.
(Added to NRS by 2021, 1172)
2023 Nevada Revised Statutes › Chapter 695A - Fraternal Benefit Societies › NRS 695A.270 - Authority to prohibit in society’s laws waiver of provisions of society’s laws.

The laws of the society may provide that no subordinate body or any of its subordinate officers or members may waive any of the provisions of the laws of the society. Such a provision is binding on the society and every member and beneficiary of a member.
(Added to NRS by 1971, 1849; A 1991, 237)
2023 Nevada Revised Statutes › Chapter 695A - Fraternal Benefit Societies › NRS 695A.280 - Reinsurance.

1. Except as otherwise provided in subsection 3, a domestic society may, by a reinsurance agreement, cede any individual risk or risks in whole or in part to an insurer, other than another fraternal benefit society, authorized to provide reinsurance in this state, or if not so authorized, one which is approved in writing by the Commissioner, but no such society may reinsure substantially all of its insurance in force without the written permission of the Commissioner.
2. A society may take credit for the reserves on such ceded risks to the extent reinsured, but no credit may be allowed as an admitted asset or as a deduction from liability to a ceding society for reinsurance made, ceded, renewed or otherwise becoming effective after July 1, 1963, unless the reinsurance is payable by the assuming insurer on the basis of the liability of the ceding society under the benefit contract or contracts reinsured without diminution because of the insolvency of the ceding society.
3. A society may reinsure the risks of another society in a consolidation or merger which is approved by the Commissioner pursuant to NRS 695A.130.
(Added to NRS by 1971, 1849; A 1987, 649; 1991, 237)
2023 Nevada Revised Statutes › Chapter 695A - Fraternal Benefit Societies › NRS 695A.300 - Foreign or alien society: License required to transact business; required information.

1. A foreign or alien society shall not transact business in this state without a license issued by the Commissioner.
2. A foreign or alien society may be licensed to transact business in this state upon a showing that its assets are invested in accordance with the provisions of this chapter and upon filing with the Commissioner:
(a) A duly certified copy of its laws, certified by its secretary or corresponding officer;
(b) A power of attorney to the Commissioner as prescribed in NRS 695A.400;
(c) A statement of its business under oath of its president and secretary or corresponding officers in a form prescribed by the Commissioner, duly verified by an examination made by the supervising insurance officer of its home state or other state, territory, province or country, satisfactory to the Commissioner of this state;
(d) Certification from the proper officer of its home state, territory, province or country that the society is legally incorporated and licensed to transact business therein;
(e) Copies of its certificate forms; and
(f) Such other information as the Commissioner may deem necessary.
3. Any foreign or alien society desiring admission to this state must comply substantially with the requirements and limitations of this chapter applicable to domestic societies.
(Added to NRS by 1971, 1849; A 1991, 237)
2023 Nevada Revised Statutes › Chapter 695A - Fraternal Benefit Societies › NRS 695A.320 - Suspension, revocation or refusal of license of foreign or alien society.

1. When the Commissioner upon investigation finds that a foreign or alien society transacting or applying to transact business in this state:
(a) Has exceeded its powers;
(b) Has failed to comply with any provision of this chapter;
(c) Is not fulfilling its contracts in good faith; or
(d) Is conducting its business fraudulently or in a manner hazardous to its members or creditors or the public,
the Commissioner shall notify the society of his or her findings, state in writing the reasons for the Commissioner’s dissatisfaction and issue a written order requiring the society to make the necessary corrections. If the Commissioner finds that the society has failed to comply with the order within 30 days after receiving it, the Commissioner shall notify the society of his or her finding of noncompliance and require the society to show cause on a date named why its license should not be suspended, revoked or refused.
2. If on that date the society does not present good and sufficient reason why its authority to do business in this state should not be suspended, revoked or refused, the Commissioner may suspend or refuse the license of the society to do business in this state until satisfactory evidence is furnished to the Commissioner that the suspension or refusal should be withdrawn, or the Commissioner may revoke the authority of the society to do business in this state.
3. Nothing contained in this section prevents a society from continuing in good faith all contracts made in this state during the time the society was legally authorized to transact business in this state.
(Added to NRS by 1971, 1851; A 1991, 239)
2023 Nevada Revised Statutes › Chapter 695A - Fraternal Benefit Societies › NRS 695A.330 - Licensing of insurance agents of society; persons exempt from licensing.

1. Every insurance agent of a society must be licensed pursuant to chapter 683A of NRS and any regulations adopted by the Commissioner which apply to health and life insurance agents.
2. No written or other examination is required of a person who held a license as an insurance agent on July 1, 1977, for renewals of his or her license.
3. No examination or license is required of:
(a) Any regular salaried officer or employee of a licensed society who devotes substantially all of his or her services to activities other than the solicitation of fraternal insurance contracts from the public, and who does not receive for the solicitation of such contracts any commission or other compensation directly dependent upon the amount of business obtained; or
(b) Any member of the society who does not write insurance contracts, and whose solicitation or negotiation is incidental to securing new members for the society, and whose only remuneration consists of prizes in the form of merchandise or payments of a nominal amount of money.
(Added to NRS by 1971, 1851; A 1977, 693; 1991, 239)
2023 Nevada Revised Statutes › Chapter 695A - Fraternal Benefit Societies › NRS 695A.400 - Service of process on society.

1. Every society authorized to do business in this state shall appoint in writing the Commissioner as attorney-in-fact upon whom all lawful process in any action or proceeding against it must be served, and shall agree in the writing that any lawful process against it which is served on the Commissioner is of the same legal force and validity as if served upon the society, and that the authority continues in force so long as any liability remains outstanding in this state. A copy of the appointment, certified by the Commissioner, constitutes sufficient evidence of the appointment and must be admitted in evidence with the same validity as the original.
2. Service of process against a society must be made in accordance with NRS 680A.260.
3. No such service may require a society to file its answer, pleading or defense in less than 30 days from the date the copy of the service was forwarded to the society.
4. Legal process must not be served upon a society except in the manner provided in this section.
(Added to NRS by 1971, 1854; A 1971, 1956; 1985, 612; 1991, 240; 2021, 2994)
2023 Nevada Revised Statutes › Chapter 695A - Fraternal Benefit Societies › NRS 695A.410 - Injunctions against societies.

No application or petition for injunction against any domestic, foreign or alien society, or any of its lodges, may be recognized in any court of this state unless made by the Attorney General upon request of the Commissioner.
(Added to NRS by 1971, 1855; A 1991, 240)
2023 Nevada Revised Statutes › Chapter 695A - Fraternal Benefit Societies › NRS 695A.430 - Assets, funds and accounts of society.

1. All assets must be held, invested and disbursed for the use and benefit of the society and no member or beneficiary may have or acquire individual rights therein or become entitled to any apportionment or the surrender of any part thereof, except as provided in the benefit contract.
2. A society may create, maintain, invest, disburse and apply any special fund necessary to carry out any purpose permitted by the laws of the society.
3. A society may, pursuant to a resolution of its supreme governing body and subject to the provisions of NRS 688A.390, establish and operate one or more separate accounts and issue contracts providing benefits payable in variable amounts. For the purposes of NRS 688A.390, a society shall be deemed to be a domestic life insurer.
(Added to NRS by 1971, 1855; A 1991, 241)
2023 Nevada Revised Statutes › Chapter 695A - Fraternal Benefit Societies › NRS 695A.440 - Investments.

1. A society shall invest its money only in such investments as are authorized by the laws of this state for the investment of assets of life insurers and subject to the limitations thereon.
2. Any foreign or alien society permitted or seeking to do business in this state which invests its money in accordance with the laws of the state, district, territory, country or province in which it is incorporated shall be deemed to meet the requirements of this section for the investment of money.
(Added to NRS by 1971, 1855; A 1991, 241)
2023 Nevada Revised Statutes › Chapter 695A - Fraternal Benefit Societies › NRS 695A.450 - Annual statement of financial condition, transactions and affairs: Filing; fee; contents; provision to members; valuation of certificates.

1. Every society transacting business in this state shall annually, on or before the first day of March, unless for cause shown the time has been extended by the Commissioner, file with the Commissioner a true statement of its financial condition, transactions and affairs for the preceding calendar year and pay a filing fee of $25. The statement must be in such general form and context as approved by the National Association of Insurance Commissioners for fraternal benefit societies and as supplemented by additional information required by the Commissioner. The statement must include separately from the society’s admitted assets all real or personal property owned, held or leased by the society for the purposes of its nonprofit institutions operated pursuant to NRS 695A.090.
2. A synopsis of its annual statement providing an explanation of the facts concerning the condition of the society thereby disclosed must be printed and mailed to each benefit member of the society not later than June 1 of each year, or, in lieu thereof, the synopsis may be published in the society’s official publication established pursuant to NRS 695A.120.
3. As a part of the annual statement required by subsection 1, each society shall, on or before the first day of March, file with the Commissioner a valuation of its certificates in force on the preceding December 31. The Commissioner may, in the discretion of the Commissioner for cause shown, extend the time for filing the valuation for not more than 2 calendar months. The valuation must be done pursuant to NRS 695A.490. The valuation and supporting data must be certified by a qualified actuary or, at the expense of the society, verified by the actuary of the department of insurance of the state in which the society is domiciled.
(Added to NRS by 1971, 1856; A 1987, 466; 1991, 241)
2023 Nevada Revised Statutes › Chapter 695A - Fraternal Benefit Societies › NRS 695A.460 - Annual statement of financial condition, transactions and affairs: Penalties for failure to file properly.

If a society fails to file the annual statement in the form and within the time provided by NRS 695A.450, it shall pay to the Commissioner $100 for each day that the statement remains unfiled or deficient, and, upon notice by the Commissioner to that effect, its authority to do business in this state ceases until the statement is properly filed.
(Added to NRS by 1971, 1857; A 1991, 242)
2023 Nevada Revised Statutes › Chapter 695A - Fraternal Benefit Societies › NRS 695A.500 - Examination of societies transacting or applying to transact business in State.

The Commissioner, or any person the Commissioner may appoint, may examine any domestic, foreign or alien society which is transacting business or applying for admission to transact business in this state in the same manner as authorized for the examination of domestic, foreign or alien insurers. For the purposes of this section, the provisions of NRS 679B.230 to 679B.300, inclusive, are applicable to societies.
(Added to NRS by 1971, 1859; A 1991, 244)
2023 Nevada Revised Statutes › Chapter 695A - Fraternal Benefit Societies › NRS 695A.530 - Applicability of provisions relating to trade practices and frauds.

A society authorized to do business in this state and its agents are subject to the provisions of chapter 686A of NRS relating to trade practices and frauds, except that nothing in that chapter applies to or affects:
1. The right of a society to determine its eligibility requirements for membership; or
2. The offering of benefits exclusively to members or persons eligible for membership in the society by a subsidiary corporation or affiliated organization of the society.
(Added to NRS by 1971, 1860; A 1991, 245)
2023 Nevada Revised Statutes › Chapter 695A - Fraternal Benefit Societies › NRS 695A.550 - Exemption of societies from certain taxes.

Every society organized or licensed under this chapter is hereby declared to be a charitable and benevolent institution, and is exempt from every state, county, district, municipal and school tax other than the commerce tax imposed pursuant to chapter 363C of NRS and taxes on real property and office equipment.
(Added to NRS by 1971, 1861; A 1991, 245; 2015, 2953)
2023 Nevada Revised Statutes › Chapter 695A - Fraternal Benefit Societies › NRS 695A.555 - Nonexemption of societies from certain fees.

Societies are not exempt from the provisions of NRS 679B.700. If a society is an admitted health insurer, as that term is defined in NRS 449.450, it is not exempt from the fees imposed pursuant to NRS 449.465.
(Added to NRS by 1985, 1071)
2023 Nevada Revised Statutes › Chapter 695A - Fraternal Benefit Societies › NRS 695A.560 - Exemption of societies from other insurance laws; exceptions.

Except as otherwise provided in this chapter or by specific statute, societies are governed by this chapter and are exempt from all other provisions of the insurance laws of this state.
(Added to NRS by 1971, 1861; A 1991, 246)
2023 Nevada Revised Statutes › Chapter 695A - Fraternal Benefit Societies › NRS 695A.570 - Applicability of chapter; effect of exemption.

1. Nothing contained in this chapter shall be construed to affect or apply to:
(a) Grand or subordinate lodges of societies, orders or associations now doing business in this state which provide benefits exclusively through local or subordinate lodges;
(b) Orders, societies or associations which admit to membership only persons engaged in one or more crafts or hazardous occupations, in the same or similar lines of business, insuring only their own members and their families and the ladies’ societies or ladies’ auxiliaries to such orders, societies or associations;
(c) Domestic societies which limit their membership to employees of a particular city or town, designated firm, business house or corporation which provide for a death benefit of not more than $400 or disability benefits of not more than $350 to any person in any 1 year, or both; or
(d) Domestic societies or associations of a purely religious, charitable or benevolent description, which provide for a death benefit of not more than $400 or for disability benefits of not more than $350 to any one person in any 1 year, or both.
2. Any society or association described in paragraphs (c) or (d) of subsection 1 which provides for death or disability benefits for which benefit certificates are issued, and any such society or association included in paragraph (d) of subsection 1 which has more than 1,000 members, shall not be exempted from the provisions of this chapter but shall comply with all requirements thereof.
3. No society which, by the provisions of this section, is exempt from the requirements of this chapter, except any society described in paragraph (b) of subsection 1, shall give or allow, or promise to give or allow, to any person any compensation for procuring new members.
4. Every society which provides for benefits in case of death or disability resulting solely from accident and which does not obligate itself to pay natural death or sick benefits shall have all of the privileges and be subject to all the applicable provisions and regulations of this chapter, except that the provisions thereof relating to medical examination, valuations of benefit certificates and incontestability shall not apply to such society.
5. The Commissioner may require from any society or association, by examination or otherwise, such information as will enable the Commissioner to determine whether such society or association is exempt from the provisions of this chapter.
6. Societies, exempted under the provisions of this section, shall also be exempt from all other provisions of the insurance laws of this state.
(Added to NRS by 1971, 1861)
2023 Nevada Revised Statutes › Chapter 695A - Fraternal Benefit Societies › NRS 695A.580 - Penalties.

1. Any person who makes a false or fraudulent statement in or relating to an application for membership or for the purpose of obtaining money from or a benefit in any society is guilty of a gross misdemeanor.
2. Any person who solicits membership for, or in any manner assists in procuring membership in, any society not licensed to do business in this State is subject to an administrative fine, imposed by the Commissioner, of not less than $25 nor more than $500 for each violation. In addition if the person is an insurance agent of the society, the Commissioner may suspend, revoke, limit or refuse to continue his or her license in the manner provided in NRS 683A.451 and 683A.461.
3. Any person convicted of a willful violation of, or neglect or refusal to comply with, any provision of this chapter for which a penalty is not otherwise prescribed shall be punished by a fine of not more than $1,000 for each violation, and not more than $10,000 for all related violations.
(Added to NRS by 1971, 1862; A 1977, 695; 1979, 1493; 2001, 2248)
2023 Nevada Revised Statutes › Chapter 695B - Nonprofit Corporations for Hospital, Medical and Dental Service › NRS 695B.020 - Scope.

1. This chapter does not:
(a) Apply to or govern any corporation which is organized for profit, which contemplates any pecuniary gain to its shareholders or members, or which conducts or is authorized by its articles of incorporation to conduct any business whatsoever on a profit basis.
(b) Authorize and must not be construed to authorize, directly or indirectly, any corporation to operate a hospital or a medical or dental service plan on a profit basis.
2. Except as otherwise provided in subsection 3, a corporation subject to the provisions of this chapter shall not own or operate any hospital or engage in any business other than that of establishing, maintaining and operating a nonprofit hospital, medical or dental service plan.
3. A corporation subject to the provisions of this chapter may, with the approval of the Commissioner, engage in any business reasonably and necessarily incidental to the business of a nonprofit hospital, medical or dental service plan.
(Added to NRS by 1971, 1863; A 1991, 654)
2023 Nevada Revised Statutes › Chapter 695B - Nonprofit Corporations for Hospital, Medical and Dental Service › NRS 695B.030 - Definitions.

As used in this chapter:
1. "Dental services" means general and special dental services ordinarily provided by dentists licensed under the provisions of chapter 631 of NRS to practice in the State of Nevada in accordance with the generally accepted practices of the community at the time the service is rendered, and the furnishing of necessary appliances, drugs, medicines and supplies, prosthetic appliances, orthodontic appliances, metal, ceramic and other restorations.
2. "Hospital services" means the furnishing or providing of any or all of the following:
(a) Maintenance and care in the hospital, including but not limited to, nursing care, drugs, medicines, supplies, physiotherapy, transportation and use of facilities and appliances.
(b) Reimbursement of the beneficiary or subscriber for, but without requiring that the beneficiary or subscriber first pay, expenses incurred for any of the items included in paragraph (a).
(c) Reimbursement, at a uniform rate, of the beneficiary or subscriber for, but without requiring that the beneficiary or subscriber first pay, the costs and expenses incurred for medical supplies.
(d) Reimbursement for expenses incurred outside of the hospital for continued care and treatment following the subscriber’s discharge from the hospital, for nursing service, necessary appliances, drugs, medicines, supplies and any other services which would have been available in the hospital (excluding physicians’ services), whether or not provided through a hospital.
(e) Reimbursement for ambulance service expenses.
3. "Medical services" means the furnishing or providing of any or all of the following:
(a) Medical or surgical services, in or out of a hospital, by a physician licensed to practice under the laws of Nevada.
(b) Reimbursement for expenses incurred for nursing services, necessary appliances, drugs, medicines, supplies and any other health care services.
(Added to NRS by 1971, 1863; A 1977, 966)
2023 Nevada Revised Statutes › Chapter 695B - Nonprofit Corporations for Hospital, Medical and Dental Service › NRS 695B.035 - Contract between corporation and provider of health care: Prohibiting corporation from charging provider of health care fee for inclusion on list of providers given to insureds; corporation required to use form to obtain information on provider of health care; modification; submission by corporation of schedule of payments to provider.

1. A corporation subject to the provisions of this chapter 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 corporation to its insureds.
2. A corporation specified in subsection 1 shall not contract with a provider of health care to provide health care to an insured unless the corporation 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 corporation specified in subsection 1 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 corporation upon giving to the provider 45 days’ written notice of the modification of the corporation’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 corporation specified in subsection 1 contracts with a provider of health care to provide health care to an insured, the corporation 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, 1650; A 2001, 2732; 2003, 3364; 2011, 2534)
2023 Nevada Revised Statutes › Chapter 695B - Nonprofit Corporations for Hospital, Medical and Dental Service › NRS 695B.040 - Corporations authorized to undertake and operate plans.

Any corporation which is organized under the laws of the State of Nevada, or the laws of any other state, without capital stock, for the purpose of maintaining and operating a hospital, medical or dental service plan, and which does not contemplate pecuniary gain or profit to its members, may undertake and operate a hospital, medical or dental service plan for rendering hospital, medical or dental service to its subscribers under and subject to the provisions of this chapter.
(Added to NRS by 1971, 1864; A 1991, 654)
2023 Nevada Revised Statutes › Chapter 695B - Nonprofit Corporations for Hospital, Medical and Dental Service › NRS 695B.050 - Manner of incorporation.

Persons desiring to form a nonprofit hospital, medical or dental service corporation shall incorporate pursuant to the provisions of this chapter, and the provisions of the nonprofit corporation laws of the State of Nevada, including NRS 81.410 to 81.540, inclusive, or chapter 82 of NRS, as applicable, so far as the provisions of such laws are applicable and not inconsistent with this chapter.
(Added to NRS by 1971, 1864; A 2013, 1289)
2023 Nevada Revised Statutes › Chapter 695B - Nonprofit Corporations for Hospital, Medical and Dental Service › NRS 695B.060 - Directors: Qualifications.

1. A majority of the board of directors of a corporation providing or rendering hospital services shall be persons who are not duly appointed representatives of hospitals with which the corporation has contracts for the rendering of hospital services.
2. A majority of the board of directors of a corporation providing medical services shall be persons who are not physicians or duly appointed representatives of the physicians who have signed participating agreements with the corporation for the rendering of medical services.
3. A majority of the board of directors of a corporation providing dental services shall be persons who are not dentists or duly appointed representatives of the dentists who have signed participating agreements with the corporation for the rendering of dental services.
4. This section does not apply to any duly appointed representative of a hospital, physician or dentist who is a member of the board of directors of a corporation on July 1, 1977. Such a person may continue to serve as a member of the board of directors until the term of the person expires.
(Added to NRS by 1971, 1864; A 1971, 1956; 1977, 624)
2023 Nevada Revised Statutes › Chapter 695B - Nonprofit Corporations for Hospital, Medical and Dental Service › NRS 695B.070 - Merger and consolidation: Procedure.

Any corporation operating under this chapter may merge and consolidate with any other corporation operating or to operate under this chapter as follows:
1. The agreement of merger and consolidation shall be submitted to and approved by a two-thirds vote of the members of the ceding corporation present in person or by proxy at a meeting called to consider that agreement. A written or printed notice of such meeting shall be mailed or personally delivered to each member at least 30 days before the day fixed for the meeting.
2. Before the merger and consolidation is effected, the corporation which proposes to assume the liabilities of the ceding corporation shall submit to its members the question of merger and consolidation and a similar notice shall be given and a similar vote required as in the case of members of the ceding corporation.
3. If the vote in the case of both corporations is in the affirmative by the required majority, a certified copy of all proceedings relating to the proposed merger and consolidation shall be filed with the Commissioner. If the Commissioner finds that the proceedings have been in accordance with law, the Commissioner shall approve the agreement.
4. Upon the approval by the Commissioner of such agreement, the consolidated corporation shall issue certificates of assumption to each and every subscriber of the ceding corporation. Such certificates shall be in a form approved by the Commissioner.
5. The approval of the Commissioner of the agreement of merger and consolidation shall operate to dissolve the ceding corporation, and all its liability upon its insurance contracts or benefit certificates shall thereupon cease, but its officers may thereafter perform any act necessary to close its affairs. The officers of the ceding corporation shall file a certified copy of the agreement in the Office of the Secretary of State. Such certified copy shall be in lieu of any certificate of dissolution required by the provisions of the general corporation law.
6. The consolidated corporation shall be entitled to all the assets of the ceding corporation and shall assume all its liabilities.
(Added to NRS by 1971, 1865)
2023 Nevada Revised Statutes › Chapter 695B - Nonprofit Corporations for Hospital, Medical and Dental Service › NRS 695B.080 - Merger and consolidation: Continuance of contracts and contribution certificates.

In the event of any merger and consolidation as provided by this chapter, contracts and contribution certificates issued in compliance with the provisions of this chapter and outstanding at the time of the date of the merger and consolidation may be continued in force, reinstated, renewed and repaid without change of provisions, except as such change may be necessary or advisable at or following the next renewal or reinstatement.
(Added to NRS by 1971, 1865)
2023 Nevada Revised Statutes › Chapter 695B - Nonprofit Corporations for Hospital, Medical and Dental Service › NRS 695B.110 - Certificate of authority: Required; fees.

A corporation shall not establish, maintain or operate a nonprofit service plan as authorized by the provisions of this chapter unless it has:
1. Procured a certificate of authority from the Commissioner for the establishment, maintenance and operation of the plan.
2. Paid to the Commissioner the fees required of insurers by NRS 680B.010 for:
(a) The filing of the initial application;
(b) The issuance of the certificate of authority;
(c) Each annual continuation of the certificate of authority; and
(d) The filing of each annual report.
3. Paid, in addition to any other fee or charge, all applicable fees required pursuant to NRS 680C.110.
(Added to NRS by 1971, 1866; A 1987, 468; 2009, 1815)
2023 Nevada Revised Statutes › Chapter 695B - Nonprofit Corporations for Hospital, Medical and Dental Service › NRS 695B.120 - Certificate of authority: Qualifications.

The Commissioner shall not issue or renew a certificate of authority to any corporation proposing to establish, maintain or operate a nonprofit hospital, medical or dental service plan until such corporation establishes:
1. If a nonprofit hospital service corporation, that it has entered into contracts with hospitals in the State of Nevada having an aggregate bed capacity sufficient to render the services contemplated to be furnished under the hospital service plan to persons in the State of Nevada.
2. That the hospital, medical or dental service contract proposed to be entered into by such corporation with those who may become subscribers is not such as will work a fraud or injustice upon such subscribers or any person.
3. That a schedule of the rates, dues, fees or other periodic charges to be paid by subscribers has been filed with the Commissioner and the same are not such as will, after providing for such legal reserves as are required by NRS 695B.140, result in profit to, or in the accumulation of excessive reserves or surpluses by, such corporation and are such as will enable such corporation to furnish or provide the hospital, medical or dental services which it proposes to make available to its beneficiaries and subscribers without impairment of its legal reserves and without a constant depletion of the assets of such corporation. A reserve or surplus over and above all approved and required reserves in an amount in excess of the average annual gross income of such corporation for the immediately preceding 3 calendar years shall be prima facie an excessive accumulation.
(Added to NRS by 1971, 1866)
2023 Nevada Revised Statutes › Chapter 695B - Nonprofit Corporations for Hospital, Medical and Dental Service › NRS 695B.130 - Certificate of authority: Application; issuance.

1. An application for a certificate of authority must be filed with the Commissioner in writing by the corporation for medical service which is applying for the certificate on forms furnished or accepted by the Commissioner. The application must set forth such information concerning the applicant and its qualifications and in other respects as the Commissioner may reasonably require.
2. The application must be accompanied by:
(a) A copy of the applicant’s charter or articles of incorporation, certified by the public officer with whom the original is required to be filed in its state of domicile;
(b) A copy of the applicant’s bylaws, certified by the corporate secretary;
(c) A copy of each contract the applicant has made or proposed to make with hospitals, or physicians or dentists in this state;
(d) A copy of each service contract proposed to be issued to its subscribers in this state;
(e) The schedule of the rates, dues, fees or other periodical charges proposed to be charged for such service contracts; and
(f) All applicable fees for an initial application and the issuance of a certificate of authority.
3. If upon completion of the application the Commissioner determines that the applicant is fully qualified and entitled to a certificate of authority under this chapter, the Commissioner shall promptly issue a certificate of authority to the applicant. If the Commissioner refuses to issue the certificate of authority, the Commissioner shall give the applicant written notice of the refusal setting forth the grounds therefor.
(Added to NRS by 1971, 1867; A 1971, 1956; 1987, 468; 2009, 1815)
2023 Nevada Revised Statutes › Chapter 695B - Nonprofit Corporations for Hospital, Medical and Dental Service › NRS 695B.135 - Certificate of authority: Expiration; renewal.

1. A certificate of authority issued pursuant to this chapter expires on March 1 of the year following its date of issuance or renewal.
2. To renew a certificate of authority a corporation for medical service must:
(a) File a written request for renewal with the Commissioner; and
(b) Pay all applicable fees for renewal for a certificate of authority.
3. The Commissioner may accept a request for renewal received by the Commissioner within 30 days after the expiration of the certificate if the request is accompanied by a fee for renewal of 150 percent of all applicable fees otherwise required, except for any fee required pursuant to NRS 680C.110.
(Added to NRS by 1987, 467; A 2009, 1816)
2023 Nevada Revised Statutes › Chapter 695B - Nonprofit Corporations for Hospital, Medical and Dental Service › NRS 695B.140 - Reserve fund: Minimum amounts; computation; contracts with hospitals; participation of physicians or dentists.

1. No corporation subject to the provisions of this chapter may establish, maintain or operate a hospital, medical or dental service plan unless it has and at all times maintains a reserve fund equal to the following minimum amounts in relation to the number of natural persons entitled to hospital, medical or dental services under contracts issued by the corporation:
Amount of
Number of Natural Persons Reserve
Entitled to Benefits Fund
1 to 1,000, inclusive..................................................................................... $100,000
1,001 to 10,000, inclusive............................................................................. 500,000
10,000 or more................................................................................................ 750,000
but such a reserve fund is not required of a corporation acting only as a fiscal administrator of programs funded by public agencies, authorized insurers and other authorized health service plans.
2. In computing the amount of a reserve fund, the Commissioner shall include the amounts agreed to be paid by contracting hospitals to the corporation or its equivalent value of hospital service to be rendered without charge by the contracting hospital to the hospital service corporation.
3. In addition to the reserve fund provided for in this chapter, the Commissioner shall require every corporation subject to this chapter to make, and to maintain in force, such contracts with enough hospitals in the State of Nevada to be adequate, in the opinion of the Commissioner, to provide care for all natural persons entitled to hospital benefits in the State of Nevada under contracts issued by such a corporation.
4. In addition, the Commissioner shall require medical or dental service corporations to give evidence of the participation of a sufficient number of physicians or dentists, in the judgment of the Commissioner, to render the medical or dental services specified under the contract.
(Added to NRS by 1971, 1868; A 1971, 1957; 1985, 613)
2023 Nevada Revised Statutes › Chapter 695B - Nonprofit Corporations for Hospital, Medical and Dental Service › NRS 695B.150 - Insolvency; determination of financial condition; actions by Commissioner; review; regulations.

1. A corporation organized under this chapter shall be deemed to be insolvent if:
(a) The corporation fails to meet its obligations as they mature;
(b) The assets of the corporation are less than the sum of its liabilities and the minimum surplus required to be maintained by the corporation under this Code for authority to transact the kinds of insurance transacted; and
(c) The reserve fund of the corporation is less than the amounts set forth in NRS 695B.140.
2. In addition to the provisions of subsection 1, a corporation organized under this chapter shall be deemed to be insolvent as otherwise expressly provided in this Code.
3. For the purposes of determining insolvency pursuant to subsection 1 or 2 and the financial condition of the corporation, for the purposes of preparation of annual statements, and for all other purposes not otherwise expressly provided for in this chapter, the corporation is subject to all requirements of the laws of the State of Nevada as to assets, liabilities and reserves which are applicable to mutual nonassessable life or health insurers.
4. A corporation organized under this chapter shall be deemed to be impaired if the assets of the corporation are less than the sum of its liabilities and the minimum surplus required to be maintained by the corporation under this Code for authority to transact the kinds of insurance transacted.
5. The Commissioner may adopt regulations to define when a corporation organized under this chapter is considered to be in a hazardous financial condition and to set forth the standards to be considered by the Commissioner in determining whether the continued operation of such a corporation transacting business in this State may be considered to be hazardous to its insureds or creditors or to the general public.
6. If the Commissioner determines after a hearing that any corporation organized under this chapter is in a hazardous financial condition, the Commissioner may, instead of suspending or revoking the certificate of authority of the corporation, limit the certificate of authority as the Commissioner deems reasonably necessary to correct, eliminate or remedy any conduct, condition or ground that is deemed to be a cause of the hazardous financial condition.
7. An order or decision of the Commissioner under this section is subject to review in accordance with NRS 679B.310 to 679B.370, inclusive, at the request of any party to the proceedings whose interests are substantially affected.
(Added to NRS by 1971, 1868; A 2005, 2158; 2017, 2384)