reglab/statecodes huggingface dataset:
2023 Nevada Revised Statutes › Chapter 687B - Contracts of Insurance › NRS 687B.350 - Renewal with change in policy or coverage provisions without certain notice to insured prohibited; exceptions.

1. Except as otherwise provided in subsections 2 and 3, an insurer shall not renew a policy if the renewal includes a change in policy or coverage provisions, including a change in rates or premiums charged to the insured, unless the insurer notifies the insured in writing of the change in policy or coverage provisions at least 30 days before the expiration of the policy. If the insurer fails to provide adequate and timely notice, the insurer shall renew the policy using the expiring policy or coverage provisions:
(a) For a period that is equal to the expiring term if the agreed term is 1 year or less; or
(b) For 1 year if the agreed term is more than 1 year.
2. The provisions of this section do not apply to a change in the rate for a policy of industrial insurance which is based on:
(a) A change to a prospective loss cost filed by the Advisory Organization pursuant to NRS 686B.177 that is applicable to the risk; or
(b) A correction based on the experience that is applicable to the risk in accordance with the Uniform Plan for Rating Experience filed with the Commissioner pursuant to NRS 686B.177.
3. The provisions of this section do not apply to a renewal of a policy in which the change in policy or coverage provisions consists only of a:
(a) Decrease in the amount of the total premium charged to the insured for the renewal of the policy;
(b) Change in the effective date and expiration date of the policy if the duration of the renewed policy remains unchanged; or
(c) Change in one or more conditions of the policy that are intended to make an aspect of the coverage provided by the policy more favorable to the insured and is not accompanied by a change in one or more conditions of the policy that are intended to make an aspect of the coverage provided by the policy less favorable to the insured.
(Added to NRS by 1971, 1725; A 1995, 1747; 2003, 3314; 2007, 3322; 2021, 126)
2023 Nevada Revised Statutes › Chapter 687B - Contracts of Insurance › NRS 687B.355 - Insurer required to provide to policyholder information about claims paid on behalf of policyholder; fee; regulations.

1. If a policyholder requests information for the renewal of his or her policy, an insurer shall provide to the policyholder information regarding claims paid on behalf of the policyholder. The information must be provided within 30 working days after the insurer receives a written request from the policyholder. The insurer may charge the policyholder a reasonable fee for the information.
2. The Commissioner may adopt regulations to carry out the provisions of subsection 1.
(Added to NRS by 1991, 2033)
2023 Nevada Revised Statutes › Chapter 687B - Contracts of Insurance › NRS 687B.360 - Notice of cancellation or nonrenewal: Insurer required to provide to policyholder information about grounds upon request; notice ineffective unless contains information about right of policyholder to make such a request.

If a notice of cancellation or nonrenewal under NRS 687B.310 to 687B.420, inclusive, does not state with reasonable precision the facts on which the insurer’s decision is based, the insurer shall supply that information within 6 days after receipt of a written request by the policyholder. No notice is effective unless it contains adequate information about the policyholder’s right to make such a request.
(Added to NRS by 1971, 1725; A 1971, 1950; 1993, 2399; 2003, 3314)
2023 Nevada Revised Statutes › Chapter 687B - Contracts of Insurance › NRS 687B.370 - Certain notice ineffective unless contains information about applying for insurance through certain plans.

Except for a notice of cancellation for the failure to pay a premium when due, no notice required pursuant to NRS 687B.310 to 687B.420, inclusive, is effective unless it contains adequate instructions enabling the policyholder to apply for insurance through any voluntary or mandatory risk-sharing plan established pursuant to NRS 686B.180 and 686B.200 existing at the time of the notice, for which the policyholder may be eligible.
(Added to NRS by 1971, 1726; A 1985, 577; 1993, 2400; 2003, 3314)
2023 Nevada Revised Statutes › Chapter 687B - Contracts of Insurance › NRS 687B.380 - Immunity.

There is no liability on the part of and no cause of action of any nature may arise against any insurer, its authorized representative, its agents, its employees, or any person furnishing to the insurer information as to reasons for cancellation or nonrenewal, for any statement made by them in complying with NRS 687B.310 to 687B.420, inclusive, or for the providing of information pertaining thereto.
(Added to NRS by 1971, 1726; A 1993, 2400; 2003, 3315)
2023 Nevada Revised Statutes › Chapter 687B - Contracts of Insurance › NRS 687B.383 - Refusal to issue, cancellation of, nonrenewal of or increase in premium or rate for certain policies solely on basis of breed of dog prohibited; exception; permissible inquiry by insurer regarding dog.

1. Except as otherwise provided in subsection 2, an insurer shall not:
(a) Refuse to issue;
(b) Cancel;
(c) Refuse to renew; or
(d) Increase a premium or rate for,
a policy of insurance based solely on the specific breed or mixture of breeds of a dog that is harbored or owned on an applicable property.
2. The provisions of subsection 1 do not prohibit an insurer from:
(a) Refusing to issue;
(b) Cancelling;
(c) Refusing to renew; or
(d) Imposing a reasonable increase to a premium or rate for,
a policy of insurance based on sound underwriting and actuarial principles on the basis that a particular dog which is harbored or owned on an applicable property is known to be dangerous or vicious or has been declared to be dangerous or vicious in accordance with NRS 202.500.
3. An insurer may not ask or inquire about the specific breed or mixture of breeds of a dog which is harbored or owned on an applicable property except to ask if the dog is known to be dangerous or vicious or has been declared to be dangerous or vicious in accordance with NRS 202.500.
4. As used in this section, "policy of insurance" means:
(a) A policy of homeowner’s insurance;
(b) A policy of renter’s insurance;
(c) A policy of insurance which covers a manufactured home or a mobile home; and
(d) An umbrella policy as defined in NRS 687B.440.
(Added to NRS by 2021, 1524)
2023 Nevada Revised Statutes › Chapter 687B - Contracts of Insurance › NRS 687B.385 - Refusal to issue, cancellation, nonrenewal or increase in premium of policy of motor vehicle insurance due to claims for which insured was not at fault, claims for which insurer made no payment or recovered entirety of payment or inquiries relating to a claim prohibited.

An insurer shall not refuse to issue, cancel, refuse to renew or increase the premium for renewal of a policy of motor vehicle insurance covering private passenger cars or commercial vehicles as a result of any:
1. Claims made under any policy of insurance with respect to which the insured was not at fault;
2. Claims made under any policy of insurance for which the insurer has not made any payment or for which the insurer recovered the entirety of the insurer’s payment on the claim by means of salvage, subrogation or another mechanism; or
3. Inquiries made regarding an actual or potential claim under any policy of insurance regarding:
(a) The existence of insurance coverage for any matter; or
(b) Any hypothetical or informational matter pertaining to insurance.
(Added to NRS by 1987, 1063; A 1997, 3033; 2017, 2354)
2023 Nevada Revised Statutes › Chapter 687B - Contracts of Insurance › NRS 687B.390 - Cancellation or nonrenewal of automobile liability insurance policy on sole basis of age, residence, race, color, creed, national origin, ancestry, sexual orientation, gender identity or expression or occupation of insured prohibited.

No insurer shall cancel or refuse to renew an automobile liability insurance policy solely because of the age, residence, race, color, creed, national origin, ancestry, sexual orientation, gender identity or expression or occupation of anyone who is an insured.
(Added to NRS by 1971, 1726; A 2017, 1080)
2023 Nevada Revised Statutes › Chapter 687B - Contracts of Insurance › NRS 687B.400 - Refusal to issue, reduction of liability limits of or increase in premium of automobile liability insurance policy on sole basis of reaching certain age prohibited; burden of proof; cost of medical examination; exception.

1. No insurer shall refuse to issue, reduce liability limits of, or increase the premium of any automobile liability insurance policy issued to a resident of this state for the sole reason that the policyholder has reached a certain age.
2. Where age is a factor in an increase of rates for an individual policyholder, the increase must be justified to the Commissioner and the burden of proving justification is on the insurer. If a medical examination is required for the purpose of a rate increase, such examination shall be at the expense of the insurer.
3. This section does not apply to applicants and policyholders under the age of 25 years.
(Added to NRS by 1973, 251)
2023 Nevada Revised Statutes › Chapter 687B - Contracts of Insurance › NRS 687B.402 - Compliance of certain insurers or organizations providing health coverage with certain federal laws regarding genetic information.

An insurer or other organization providing health coverage pursuant to chapter 689A, 689B, 689C, 695A, 695B, 695C, 695D or 695F of NRS shall comply with the provisions of the Genetic Information Nondiscrimination Act of 2008, Public Law 110-233, and any federal regulations issued pursuant thereto.
(Added to NRS by 2009, 1785)
2023 Nevada Revised Statutes › Chapter 687B - Contracts of Insurance › NRS 687B.404 - Adherence by insurer or organization providing health coverage to certain federal laws regarding mental health and addiction data request; submission of data or report to Commissioner; confidentiality of information; report by Commissioner; regulations.

1. An insurer or other organization providing health coverage pursuant to chapter 689A, 689B, 689C, 695A, 695B, 695C, 695F or 695G of NRS, including, without limitation, a health maintenance organization or managed care organization that provides health care services through managed care to recipients of Medicaid under the State Plan for Medicaid, shall adhere to the applicable provisions of the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008, Public Law 110-343, Division C, Title V, Subtitle B, and any federal regulations issued pursuant thereto.
2. On or before July 1 of each year, the Commissioner shall prescribe and provide to each insurer or other organization providing health coverage subject to the provisions of subsection 1 a data request that solicits information necessary to evaluate the compliance of an insurer or other organization with the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008, Public Law 110-343, Division C, Title V, Subtitle B, including, without limitation, the comparative analyses specified in 42 U.S.C. § 300gg-26(a)(8).
3. On or before October 1 of each year, each insurer or other organization providing health coverage subject to the provisions of subsection 1 shall:
(a) Complete and submit to the Commissioner the data request prescribed pursuant to subsection 2; or
(b) Submit to the Commissioner a copy of a report submitted by the insurer or other organization to the Federal Government demonstrating compliance with the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008, Public Law 110-343, Division C, Title V, Subtitle B, including, without limitation, the comparative analyses specified in 42 U.S.C. § 300gg-26(a)(8). The Commissioner may request from an insurer or other organization who submits a copy of such a report any supplemental information necessary to determine whether the insurer or other organization is in compliance with that federal law.
4. Any information provided by an insurer or other organization to the Commissioner pursuant to subsection 3 is confidential.
5. On or before December 31 of each year, the Commissioner shall compile a report summarizing the information submitted to the Commissioner pursuant to this section and submit the report to:
(a) The Patient Protection Commission created by NRS 439.908;
(b) The Governor; and
(c) The Director of the Legislative Counsel Bureau for transmittal to:
(1) In even-numbered years, the next regular session of the Legislature; and
(2) In odd-numbered years, the Joint Interim Standing Committee on Health and Human Services.
6. The Commissioner may adopt any regulations necessary to carry out the provisions of this section.
(Added to NRS by 2009, 1785; A 2021, 870)
2023 Nevada Revised Statutes › Chapter 687B - Contracts of Insurance › NRS 687B.406 - Compliance of certain insurers or organizations providing health coverage with certain federal laws regarding dependent students.

An insurer or other organization providing health coverage pursuant to chapter 689B, 689C, 695A, 695B, 695C or 695F of NRS shall comply with the provisions of Michelle’s Law, Public Law 110-381, and any federal regulations issued pursuant thereto.
(Added to NRS by 2009, 1785)
2023 Nevada Revised Statutes › Chapter 687B - Contracts of Insurance › NRS 687B.407 - Authority of nonprofit health benefit plan to use list of preferred prescription drugs developed by Department of Health and Human Services as formulary and obtain such drugs through purchasing agreements negotiated by Department; notification of Department.

1. A nonprofit health benefit plan may use the list of preferred prescription drugs developed by the Department of Health and Human Services pursuant to subsection 1 of NRS 422.4025 as its formulary and obtain prescription drugs through the purchasing agreements negotiated by the Department pursuant to that section by notifying the Department in the form prescribed by the Department.
2. As used in this section "health benefit plan" has the meaning ascribed to it in NRS 422.4021.
(Added to NRS by 2019, 4032)
2023 Nevada Revised Statutes › Chapter 687B - Contracts of Insurance › NRS 687B.408 - Insurer that issues certain policies of health insurance required to notify insured and physician before effective date of changes related to prescription drugs used for transplanted organs.

If a policy of health insurance issued pursuant to chapter 689A, 689B, 689C, 695A, 695B, 695C or 695G of NRS includes coverage for a prescription drug that is necessary for an insured to prevent the rejection of a transplanted organ, the insurer must notify the insured and, if known, the physician of the insured who prescribed the drug at least 30 days before a change in the formulary of the insurer within the plan year which affects that prescription becomes effective.
(Added to NRS by 2009, 1785)
2023 Nevada Revised Statutes › Chapter 687B - Contracts of Insurance › NRS 687B.410 - Withdrawal of provision of insurance for particular class of insureds: Notice to Commissioner; administrative review upon request from insured.

1. An insurer which intends to withdraw from providing insurance for a particular class of insureds shall notify the Commissioner of that intention at least 60 days before the notice of cancellation or nonrenewal is delivered or mailed to the insureds.
2. Upon receipt of a written request from an insured, the Division shall, within 15 days after the receipt of the request, review the ground for cancellation or nonrenewal. If after the review the Division fails to find that the insurer can demonstrate the grounds for cancellation or nonrenewal by clear and convincing evidence, the cancellation or nonrenewal shall be deemed withdrawn by the insurer and the policy reinstated or renewed. Such a request for review by the Division must be made within 30 days after the insured receives the notice of cancellation or nonrenewal.
(Added to NRS by 1987, 985; A 1991, 1631; 1993, 1918)
2023 Nevada Revised Statutes › Chapter 687B - Contracts of Insurance › NRS 687B.420 - Notice of proposed cancellation, nonrenewal or alteration of terms of certain policies, contracts or plans of insurance.

1. An insurer shall not cancel, fail to renew or renew with altered terms a policy or contract issued pursuant to chapter 688B, 689A, 689B, 689C, 695A, 695B, 695C, 695D or 695F of NRS unless notice in writing of the proposal is given to the insured at least 60 days before the date the proposed action becomes effective. The notice must include, without limitation, any changes in specific rates by line of coverage.
2. An insurer shall not cancel, fail to renew or renew with altered terms an individual health benefit plan that is not grandfathered pursuant to applicable law unless notice in writing of the proposal is given to the insured at least 30 days before the beginning of the open enrollment period described in NRS 686B.080. The notice must include the specific changes in terms or rates, as applicable.
(Added to NRS by 1989, 1248; A 1993, 1982, 2400, 2405; 2015, 3477)
2023 Nevada Revised Statutes › Chapter 687B - Contracts of Insurance › NRS 687B.430 - Regulations: Form, content and sale of policies which provide for payment of expenses not covered by Medicare; sale of more than one policy of health insurance to same person.

1. The Commissioner may adopt regulations relating to the form, content and sale of policies of insurance which provide for the payment of expenses which are not covered by Medicare.
2. The Commissioner may adopt regulations relating to the sale of more than one policy of health insurance to the same person.
3. As used in this section, "Medicare" means the program of health insurance for aged persons and persons with disabilities established pursuant to Title XVIII of the Social Security Act (42 U.S.C. §§ 1395 et seq.).
(Added to NRS by 1993, 2398)
2023 Nevada Revised Statutes › Chapter 687B - Contracts of Insurance › NRS 687B.440 - Umbrella policies: Requirement of signed disclosure statement from individual indicating whether policy includes uninsured or underinsured motorist coverage; form.

1. An insurer offering an umbrella policy to an individual shall obtain a signed disclosure statement from the individual indicating whether the umbrella policy includes uninsured or underinsured vehicle coverage.
2. The disclosure statement for an umbrella policy that includes uninsured or underinsured vehicle coverage must be on a form provided by the Commissioner or in substantially the following form:
UMBRELLA POLICY DISCLOSURE STATEMENT
UNINSURED/UNDERINSURED VEHICLE COVERAGE
¨ Your Umbrella Policy
does provide
coverage in excess of the limits of the uninsured/underinsured vehicle coverage in your
primary
auto insurance only if the requirements for the uninsured/underinsured vehicle coverage in your underlying auto insurance are maintained. Your uninsured/underinsured vehicle coverage provided by this umbrella policy is limited to $........ .
I understand and acknowledge the above disclosure.
.................................................. ...............................
Insured Date
3. The disclosure statement for an umbrella policy that does not include uninsured or underinsured vehicle coverage must be on a form provided by the commissioner or in substantially the following form:
¨ Your Umbrella Liability Policy
does not provide
any uninsured/underinsured vehicle coverage.
I understand and acknowledge the above disclosure.
.................................................. ...............................
Insured Date
4. As used in this section, "umbrella policy" means a policy that protects a person against losses in excess of the underlying amount required to be covered by other policies.
(Added to NRS by 1997, 3031; A 1999, 2801)
2023 Nevada Revised Statutes › Chapter 687B - Contracts of Insurance › NRS 687B.450 - Required medical examination of applicant or insured: Duty of insurer to provide notification of potentially serious medical condition; exception; regulations.

1. Except as otherwise provided in this subsection, if an insurer requires a medical examination of an applicant or an insured before the issuance, renewal, reinstatement or reevaluation of the terms of any policy or certificate of insurance or annuity contract, the insurer shall:
(a) If the applicant or insured has a primary care physician, notify:
(1) The physician of any potentially serious medical condition that is detected as a result of that medical examination; and
(2) The applicant or insured:
(I) Of any potentially serious medical condition that is detected as a result of that medical examination; and
(II) That the primary care physician of the applicant or insured has also been notified of any potentially serious medical condition detected as a result of that medical examination.
(b) If the applicant or insured does not have a primary care physician, notify the applicant or insured of any potentially serious medical condition that is detected as a result of that medical examination.
Any notice required pursuant to this section must be sent by registered or certified mail not later than 30 days after the date on which the potentially serious medical condition is detected. If the applicant or insured is under the age of 18 years, any notice required pursuant to this section must not be sent to the applicant or insured, but instead must be sent to a parent or legal guardian of the applicant or insured.
2. The Commissioner may adopt regulations to carry out the provisions of this section.
3. The provisions of this section do not apply to a policy of workers’ compensation insurance or industrial insurance.
4. As used in this section, "potentially serious medical condition" includes, without limitation, any medical condition that:
(a) Is life-threatening or potentially life-threatening if it is not treated immediately or is not closely monitored; or
(b) Causes the insurer to refuse to issue, renew, reinstate or reevaluate the terms of a policy or certificate of insurance or annuity contract.
(Added to NRS by 2007, 249)
2023 Nevada Revised Statutes › Chapter 687B - Contracts of Insurance › NRS 687B.460 - Certificates of insurance for property or casualty insurance: Not part of, amend any term of or alter or expand coverage, exclusion or condition of contract or policy.

A certificate of insurance issued regarding a contract or policy of property or casualty insurance, other than a group master policy, which is delivered or issued for delivery in this State:
1. Does not constitute any part of the contract or policy of insurance; and
2. Does not amend any term or alter or extend any coverage, exclusion or condition of the contract or policy of insurance.
(Added to NRS by 2011, 1834)
2023 Nevada Revised Statutes › Chapter 687B - Contracts of Insurance › NRS 687B.480 - Required manner of availability; required notice related to Silver State Health Insurance Exchange in certain circumstances; regulations.

1. All health benefit plans must be made available in the manner required by 45 C.F.R. § 147.104.
2. Except as otherwise provided in this subsection, a carrier offering a health benefit plan for individuals that is not being purchased on the Silver State Health Insurance Exchange established by NRS 695I.210 must include on its enrollment Internet website and printed enrollment information a notice to inform consumers that consumers may be eligible for financial assistance with their health insurance premiums or other out-of-pocket expenses by enrolling on the Silver State Health Insurance Exchange established by NRS 695I.210. A carrier is not required to provide the notice required by this subsection if such financial assistance is not available. The notice required by this subsection must contain the following statement:
You can also enroll in a health insurance plan for you and your family through the Silver State Health Insurance Exchange (Nevada’s state-based health insurance exchange). The Silver State Health Insurance Exchange allows you to get quotes from different insurance companies that are available on the Exchange. You can compare different plans, get quotes and find out if you qualify for financial assistance. The Silver State Health Insurance Exchange is the only way to receive financial assistance for your health insurance. You can enroll online by visiting www.nevadahealthlink.com or by calling 1-800-547-2927 TTY 711.
3. The Commissioner may adopt regulations to carry out the provisions of subsection 2, including, without limitation, regulations to require additional information to be provided in the notice required by subsection 2.
(Added to NRS by 2013, 3607; A 2019, 1428, 1440)
2023 Nevada Revised Statutes › Chapter 687B - Contracts of Insurance › NRS 687B.500 - Basis for premium rate; exceptions.

1. The premium rate charged by a health insurer for health benefit plans offered in the individual or small employer group market may vary with respect to the particular plan or coverage involved based solely on these characteristics:
(a) Whether the plan or coverage applies to an individual or a family;
(b) Geographic rating area;
(c) Tobacco use, except that the rate shall not vary by a ratio of more than 1.5 to 1 for like individuals who vary in tobacco use; and
(d) Age, except that the rate must not vary by a ratio of more than 3 to 1 for like individuals of different age who are age 21 years or older and that the variation in rate must be actuarially justified for individuals who are under the age of 21 years, consistent with the uniform age rating curve established in the Federal Act. For the purpose of identifying the appropriate age adjustment under this paragraph and the age band defined in the Federal Act to a specific enrollee, the enrollee’s age as of the date of policy issuance or renewal must be used.
2. The provisions of subsection 1:
(a) Apply to a fraternal benefit society organized under chapter 695A of NRS; and
(b) Do not apply to grandfathered plans.
3. As used in this section, "small employer" has the meaning ascribed to it in NRS 689C.095.
(Added to NRS by 2013, 3608; A 2017, 2356)
2023 Nevada Revised Statutes › Chapter 687B - Contracts of Insurance › NRS 687B.600 - Definitions.

As used in NRS 687B.600 to 687B.850, inclusive, unless the context otherwise requires, the words and terms defined in NRS 687B.602 to 687B.665, inclusive, have the meanings ascribed to them in those sections.
(Added to NRS by 2017, 2349; A 2019, 298, 1605; 2021, 3527; 2023, 864, 2112, 2266)
2023 Nevada Revised Statutes › Chapter 687B - Contracts of Insurance › NRS 687B.630 - "Intermediary" defined.

"Intermediary" means a person authorized to negotiate and execute a contract between a provider of health care and a health carrier entered into for the purposes of a network plan, whether the person acts on behalf of the provider of health care or the health carrier.
(Added to NRS by 2017, 2349)
2023 Nevada Revised Statutes › Chapter 687B - Contracts of Insurance › NRS 687B.645 - "Network plan" defined.

"Network plan" means a health benefit plan offered or issued by a health carrier under which the financing and delivery of health care services, including, without limitation, items and services paid for as health care services, are provided, in whole or in part, through a defined set of providers of health care under contract with the health carrier. The term does not include an arrangement for the financing of premiums.
(Added to NRS by 2017, 2349)
2023 Nevada Revised Statutes › Chapter 687B - Contracts of Insurance › NRS 687B.650 - "Participating provider of health care" defined.

"Participating provider of health care" means a provider of health care who, under a contract with a health carrier, has agreed to provide health care services to covered persons pursuant to a network plan with an expectation of receiving payment, other than coinsurance, copayments or deductibles, directly or indirectly from the health carrier.
(Added to NRS by 2017, 2349)
2023 Nevada Revised Statutes › Chapter 687B - Contracts of Insurance › NRS 687B.670 - Requirements to offer or issue network plan.

If a health carrier offers or issues a network plan, the health carrier shall, with regard to that network plan:
1. Comply with all applicable requirements set forth in NRS 687B.600 to 687B.850, inclusive;
2. As applicable, ensure that each contract entered into for the purposes of the network plan between a participating provider of health care and the health carrier complies with the requirements set forth in NRS 687B.600 to 687B.850, inclusive; and
3. As applicable, ensure that the network plan complies with the requirements set forth in NRS 687B.600 to 687B.850, inclusive.
(Added to NRS by 2017, 2350; A 2019, 298; 2021, 3527; 2023, 864, 2112, 2266)
2023 Nevada Revised Statutes › Chapter 687B - Contracts of Insurance › NRS 687B.675 - Provision of information to Office for Consumer Health Assistance.

1. A health carrier which offers or issues a network plan shall:
(a) Provide to the Office for Consumer Health Assistance at least annually the telephone number and electronic mail address of a navigator, case manager or facilitator employed by the health carrier and update that information when the information changes.
(b) On or before December 31 of each year, submit to the Office for Consumer Health Assistance, for the immediately preceding 12 months, for each type of provider of health care in the applicable network:
(1) The number of times covered persons reported difficulty accessing health care services;
(2) The number of times covered persons used a navigator, case manager or facilitator to assist in accessing health care services;
(3) The number of cases described in subparagraph (2) that were resolved by navigators, case managers or facilitators; and
(4) The average period between when a covered person reports difficulty accessing health care services to the resolution of the case by a navigator, case manager or facilitator.
2. As used in this section:
(a) "Navigator, case manager or facilitator" means an employee of a health carrier whose duties include assisting covered persons in accessing health care services.
(b) "Office for Consumer Health Assistance" means the Office for Consumer Health Assistance established by NRS 232.458.
(Added to NRS by 2019, 297)
2023 Nevada Revised Statutes › Chapter 687B - Contracts of Insurance › NRS 687B.680 - Health carrier required to establish mechanism for ongoing notification of participating providers of health care of services covered by network plan and for which provider is responsible.

A health carrier which offers or issues a network plan shall, with regard to that network plan, establish a mechanism by which each participating provider of health care in the network will be notified on an ongoing basis of the specific health care services which are covered by the network plan and for which the participating provider of health care will be responsible, including, without limitation, any restrictions or conditions on the health care services.
(Added to NRS by 2017, 2350)
2023 Nevada Revised Statutes › Chapter 687B - Contracts of Insurance › NRS 687B.690 - Required provisions in contract between participating provider of health care and health carrier.

Each contract entered into for the purposes of a network plan between a participating provider of health care and the health carrier must include, without limitation, a provision which is substantially similar to the following:
Provider of health care agrees that in no event, including but not limited to, nonpayment by the health carrier or intermediary, insolvency of the health carrier or intermediary or breach of this agreement, shall the provider of health care bill, charge, collect a deposit from, seek compensation, remuneration or reimbursement from, or have any recourse against, a covered person or a person (other than the health carrier or intermediary) acting on behalf of the covered person for health care services provided pursuant to this agreement. This agreement does not prohibit the provider of health care from collecting coinsurance, deductibles or copayments, as specifically provided in the evidence of coverage, or fees for uncovered services delivered on a fee-for-service basis to covered persons. This agreement does not prohibit a provider of health care (except for a provider of health care who is employed full-time on the staff of the health carrier and has agreed to provide health care services exclusively to the health carrier’s covered persons and no others) and a covered person from agreeing to continue health care services solely at the expense of the covered person, as long as the provider of health care has clearly informed the covered person that the health carrier may not cover or continue to cover a specific health care service or health care services. Except as provided herein, this agreement does not prohibit the provider of health care from pursuing any available legal remedy.
(Added to NRS by 2017, 2350)
2023 Nevada Revised Statutes › Chapter 687B - Contracts of Insurance › NRS 687B.692 - Provider network contract: Circumstances in which health carrier prohibited from denying request to enter into contract from a provider of health care employed or accepting employment with medical school; grounds for denial of request or termination of contract.

1. A health carrier which offers or issues a network plan may not deny a request from a provider of health care to enter into a provider network contract with the health carrier if the provider of health care:
(a) Meets and accepts the terms and conditions for participation in the network of the health carrier, including, without limitation:
(1) Meeting any credentialing requirement of the health carrier;
(2) Agreeing to all provisions of the provider network contract, including, without limitation, provisions setting forth the grounds and procedures for terminating providers of health care from participation in the network; and
(3) Agreeing to participate in a review of the performance and experience of the provider of health care at least once each year or as otherwise required by the health carrier;
(b) Is employed by or has accepted an offer of employment from a school of medicine or school of osteopathic medicine in this State to serve in a position where the provider of health care teaches students studying to become providers of health care or resident physicians at least 50 percent of the time the provider of health care is performing his or her duties for the school;
(c) Does not have a clinical practice already established in this State at the time the request to enter into a provider network contract is made; and
(d) Requests to be a participating provider of health care in the network of the health carrier.
2. A health carrier which offers or issues a network plan may deny a request from a provider of health care to enter into a provider network contract with the health carrier if:
(a) The health carrier contracts with a third party for the delivery of services to covered persons;
(b) Participating providers of health care are paid though capitation agreements; or
(c) Accepting the provider of health care into the network plan would disrupt existing provider network contracts.
3. A health carrier may terminate a provider network contract entered into pursuant to subsection 1 for any grounds authorized under the contract. Such grounds may include, without limitation, failure to maintain the employment described in paragraph (b) of subsection 1 or issues of inconsistency with other participating providers of health care with regard to:
(a) Access for covered persons to the services of the provider of health care;
(b) The cost of the services of the provider of health care;
(c) The quality of care provided by the provider of health care; or
(d) Other issues relating to the utilization of the services of the provider of health care.
(Added to NRS by 2023, 863)
2023 Nevada Revised Statutes › Chapter 687B - Contracts of Insurance › NRS 687B.693 - Access to services and contractual discounts of a provider of health care: Inapplicability of provisions.

NRS 687B.693 to 687B.697, inclusive, do not apply:
1. To provider network contracts for health care services provided to covered persons under Medicare or the State Plan for Medicaid, or the Children’s Health Insurance Program.
2. In circumstances where access to the provider network contract is granted to an entity operating under the same brand license program as the contracting entity.
3. To a health benefit plan which provides:
(a) Coverage that is only for accident or disability income insurance, or any combination thereof.
(b) Coverage issued as a supplement to liability insurance.
(c) Coverage for on-site medical clinics.
(d) Coverage under a blanket student accident and health insurance policy.
(e) Other similar insurance coverage specified pursuant to the Health Insurance Portability and Accountability Act of 1996, Public Law 104-191, under which benefits for medical care are secondary or incidental to other insurance benefits.
4. To credit insurance.
5. To the following benefits if the benefits are provided under a separate policy, certificate or contract of insurance or are otherwise not an integral part of a health benefit plan:
(a) Limited-scope vision benefits;
(b) Benefits for long-term care, nursing home care, home health care or community-based care, or any combination thereof; and
(c) Such other similar benefits as are specified in any federal regulations adopted pursuant to the Health Insurance Portability and Accountability Act of 1996, Public Law 104-191.
6. To the following benefits if the benefits are provided under a separate policy, certificate or contract, there is no coordination between the provisions of the benefits and any exclusion of benefits under any group health plan maintained by the same plan sponsor, and the benefits are paid for a claim without regard to whether benefits are provided for such a claim under any group health plan maintained by the same plan sponsor:
(a) Coverage that is only for a specified disease or illness; and
(b) Hospital indemnity or other fixed indemnity insurance.
7. To any of the following, if offered as a separate policy, certificate or contract of insurance:
(a) Medicare supplemental health insurance as defined in section 1882(g)(1) of the Social Security Act, 42 U.S.C. § 1395ss, as that section existed on July 16, 1997;
(b) Coverage supplemental to the coverage provided pursuant to the Civilian Health and Medical Program of Uniformed Services, TRICARE, 10 U.S.C. §§ 1071 et seq.; and
(c) Similar supplemental coverage provided under a group health plan.
(Added to NRS by 2019, 1602)
2023 Nevada Revised Statutes › Chapter 687B - Contracts of Insurance › NRS 687B.695 - Access to services and contractual discounts of a provider of health care: Obligations of third party that grants access to another third party.

1. A third party, having itself been granted access to services and contractual discounts of a provider of health care pursuant to a provider network contract, that subsequently grants access to another third party, is obligated to comply with the rights and responsibilities imposed on contracting entities pursuant to NRS 687B.694 and 687B.696.
2. A third party that enters into a contract with another third party to access services and contractual discounts of a provider of health care pursuant to a provider network contract is obligated to comply with the rights and responsibilities imposed on third parties under this section.
(Added to NRS by 2019, 1604)
2023 Nevada Revised Statutes › Chapter 687B - Contracts of Insurance › NRS 687B.696 - Access to services and contractual discounts of a provider of health care: Information required to be provided to health carrier and providers of health care by third parties; update of information.

1. A third party shall inform the health carrier and providers of health care under the provider network contract of the health carrier of the location of a website, toll-free number, or other readily available mechanism to identify the name of a person or entity to which the third party subsequently grants access to the services and contractual discounts of the provider of health care pursuant to the provider network contract.
2. The website must be updated on a routine basis when additional persons or entities are granted access. The website must be updated every 90 days to reflect all current persons and entities with access. Upon request, a health carrier shall make access to information available to a provider of health care via telephone or through direct notification.
(Added to NRS by 2019, 1604)
2023 Nevada Revised Statutes › Chapter 687B - Contracts of Insurance › NRS 687B.697 - Access to services and contractual discounts of a provider of health care: Obligations of health carrier and third parties concerning remittance advice or explanation of payment; refusal of discount taken on such advice or explanation by provider of health care; correction of error in advice or explanation; requirements of third party for such access.

1. A health carrier and third parties are obligated to comply with NRS 687B.694 and 687B.696 concerning the services referenced on a remittance advice or explanation of payment. A provider of health care may refuse the discount taken on the remittance advice or explanation of payment if the discount is taken without a contractual basis or in violation of NRS 687B.693 or 687B.695. An error in the remittance advice or explanation of payment may be corrected not more than 30 days after given notice of the error by the provider of health care.
2. A health carrier may not lease, rent or otherwise grant to a third party, access to a provider network contract unless the third party accessing the provider network contract is:
(a) A payer or third party, administrator or other entity that administers or processes claims on behalf of the payer;
(b) A preferred provider of health care organization or preferred provider of health care network, including a physician organization or a physician-hospital organization; or
(c) An entity engaged in the electronic claims transport between the health carrier and the payer that does not provide access to the services and discounts of a provider of health care to any other third party.
(Added to NRS by 2019, 1605)
2023 Nevada Revised Statutes › Chapter 687B - Contracts of Insurance › NRS 687B.700 - Contract required to provide requirement that participating provider of health care continue delivery of services if health carrier or intermediary insolvent or ceases operations for specified period; billing of covered person.

Each contract entered into for the purposes of a network plan between a participating provider of health care and the health carrier must provide that in the event of the insolvency of the health carrier or any applicable intermediary, or in the event of any other cessation of operations of the health carrier or intermediary, the participating provider of health care must continue to deliver health care services covered by the network plan to a covered person without billing the covered person for any amount other than coinsurance, deductibles or copayments, as specifically provided in the evidence of coverage, until the earlier of:
1. The date of the cancellation of the covered person’s coverage under the network plan pursuant to NRS 687B.310, including, without limitation, any extension of coverage provided pursuant to:
(a) The terms of the contract between the covered person and the health carrier;
(b) NRS 689A.04036, 689B.0303, 695B.1901, 695C.1691 and 695G.164, as applicable; or
(c) Any applicable federal law for covered persons who are in an active course of treatment or totally disabled; or
2. The date on which the contract between the health carrier and the provider of health care would have terminated if the health carrier or intermediary, as applicable, had remained in operation, including, without limitation, any extension of coverage provided pursuant to:
(a) The terms of the contract between the covered person and the health carrier;
(b) NRS 689A.04036, 689B.0303, 695B.1901, 695C.1691 and 695G.164, as applicable; or
(c) Any applicable federal law for covered persons who are in an active course of treatment or totally disabled.
(Added to NRS by 2017, 2351)
2023 Nevada Revised Statutes › Chapter 687B - Contracts of Insurance › NRS 687B.710 - Certain provisions included in contract required to be construed in favor of covered person, survive termination of contract and supersede certain contrary agreements.

The provisions included in a contract to comply with the requirements set forth in NRS 687B.690 and 687B.700 shall be construed in favor of the covered person, shall survive the termination of the contract regardless of the reason for the termination, including, without limitation, the insolvency of the health carrier or any applicable intermediary, and shall supersede any oral or written contrary agreement between a participating provider of health care and a covered person or the representative of a covered person if the contrary agreement is inconsistent with provisions included in the contract to comply with the requirements set forth in NRS 687B.690 and 687B.700.
(Added to NRS by 2017, 2351)
2023 Nevada Revised Statutes › Chapter 687B - Contracts of Insurance › NRS 687B.720 - Contract required to provide for notice of insolvency or cessation of operations of health carrier or intermediary to participating provider of health care.

Each contract entered into for the purposes of a network plan between a participating provider of health care and the health carrier must provide that written notice must be provided to the participating provider of health care as soon as practicable in the event:
1. That a court determined the health carrier or any applicable intermediary to be insolvent; or
2. Of any other cessation of operations of the health carrier or any applicable intermediary.
(Added to NRS by 2017, 2351)
2023 Nevada Revised Statutes › Chapter 687B - Contracts of Insurance › NRS 687B.725 - Claim for dental care: Requirements and limitations related to recovery of overpayments.

1. A health carrier which provides dental coverage or any administrator of a health benefit plan that includes dental coverage who recovers overpayments shall provide written notice to a dentist of any attempt to recover the overpayment, other than a duplicate payment. The notice must include, without limitation:
(a) A description of the error that justifies the recovery; and
(b) The date on which the dental care for which the overpayment was made was provided and the name of the patient to whom the dental care was provided.
2. A health carrier who provides dental coverage or an administrator who recovers overpayments under a health benefit plan that includes dental coverage shall establish written procedures by which a dentist may challenge an attempt to recover an overpayment. Those procedures must include, without limitation, procedures for sharing information concerning a disputed claim with the dentist.
3. Except as otherwise provided in this subsection, a health carrier who provides dental coverage or an administrator who recovers overpayments under a health benefit plan that includes dental coverage shall not attempt to recover an overpayment more than 12 months after the date of the overpayment. This subsection does not apply to an attempt to recover an overpayment that is:
(a) Based on a reasonable belief that the overpayment involved fraud, abuse or other intentional misconduct;
(b) Initiated by or at the request of a self-insured employer; or
(c) Based on dental care that is covered by the Public Employees’ Benefits Program or a system of health insurance for the benefit of local officers and employees, and the dependents of local officers and employees, pursuant to chapter 287 of NRS.
4. Any provision of a contract that conflicts with this section is against public policy, void and unenforceable.
(Added to NRS by 2021, 3525)