reglab/statecodes huggingface dataset:
Nevada Administrative Code › Chapter 685A - Nonadmitted Insurance › GENERAL PROVISIONS › Section 685A.155 - "Qualified risk manager" interpreted

Current through June 11, 2024
The Commissioner will interpret the term "qualified risk
						manager," as used in
						NRS
						685A.032, to have the meaning ascribed to it
						in 15 U.S.C. §
									8206(13).
Added to NAC by Comm'r
						of Insurance by R034-12, eff. 9-14-2012
NRS
							679B.130,
							685A.210
Nevada Administrative Code › Chapter 685A - Nonadmitted Insurance › BROKERS › Section 685A.205 - Duties of brokers

Current through June 11, 2024
1. A broker shall
					make a reasonable effort to determine the financial solvency of any foreign or
					alien insurer which is not an admitted insurer and is not an insurer listed on
					the Quarterly Listing of Alien Insurers maintained by the International
					Insurers Department of the National Association of Insurance Commissioners
					before placing any surplus lines insurance for an insured for which Nevada is
					the home state with that insurer.
2. Upon the Commissioner's request, whether
					made before or after the placement of any surplus lines insurance for an
					insured for which Nevada is the home state with a foreign or alien insurer
					which is not an admitted insurer, the broker shall submit to the Commissioner
					the latest financial statement or any supplemental information concerning the
					insurer.
Comm'r of Insurance,
						PC-22, § 4, eff. 7-18-80-NAC A 3-5-91; 5-27-92; R034-12,
						9-14-2012
NRS
							679B.130,
							685A.210
Nevada Administrative Code › Chapter 685A - Nonadmitted Insurance › BROKERS › Section 685A.215 - Conditions for placement

Current through June 11, 2024
1. Except as
					otherwise provided in subsection 3, for an insured for which Nevada is the home
					state, insurance which is not readily obtainable from admitted insurers after a
					diligent effort has been made to obtain the insurance may be obtained from
					eligible brokers or procured by the insured. For surplus lines insurance, upon
					filing the report required by
					NRS 685A.050, the
					broker shall affirm that the coverage is unavailable from admitted insurers and
					provide evidence that at least three insurers which are marketing that line or
					class of insurance in this State have declined to provide that
					coverage.
2. The refusal of
					admitted insurers to write a form of contract is not a basis for a contention
					that the insurance is not procurable from admitted insurers if the form of
					contract involves a combination of classes of insurance which cannot lawfully
					be combined in a single certificate of authority to one insurer. Separate forms
					of contracts, each incorporating a class or a lawful combination of classes,
					must be offered to and refused by admitted insurers in the manner set forth in
					subsection 1 before the insurance may be placed with eligible
					insurers.
3. The provisions of
					subsection 1 do not apply to an exempt commercial purchaser.
Comm'r of Insurance,
						PC-22, § 5, eff. 7-18-80-NAC A 3-5-91; R034-12,
						9-14-2012
NRS
							679B.130,
							685A.040,
							685A.210
Nevada Administrative Code › Chapter 685A - Nonadmitted Insurance › BROKERS › Section 685A.220 - Acceptance of business from agents or brokers

Current through June 11, 2024
1. In accepting
					business from producing agents or brokers, the broker assumes the same
					statutory responsibilities and obligations as would exist if there were no
					other producing agent or broker.
2.
					The broker shall maintain the records and files prescribed by
					NRS 685A.160
					and NAC 685A.250 on coverage placed by him or her for any producing agent or
					broker.
Comm'r of Insurance,
						PC-22, § 6, eff. 7-18-80-NAC A 3-5-91
NRS
							679B.130,
							685A.210
Nevada Administrative Code › Chapter 685A - Nonadmitted Insurance › BROKERS › Section 685A.230 - Inspection fee and report

Current through June 11, 2024
1. For an insured
					for which Nevada is the home state, the broker may pass on an inspection fee to
					the insured and may collect the fee from him or her as a part of the premium if
					the fee is directly related to an independent inspection required by insurers
					for insurance. The broker shall maintain a copy of each inspection report and
					each invoice or statement related to the report in his or her files.
2. An inspection fee that is charged to the
					insured must be shown as a separate item on the broker's certificate, the cover
					note, or both.
Comm'r of Insurance,
						PC-22, § 7, eff. 7-18-80-NAC A 3-5-91; R090-03, 10-30-2003; R034-12,
						9-14-2012
NRS
							679B.130,
							685A.210
Nevada Administrative Code › Chapter 685A - Nonadmitted Insurance › BROKERS › Section 685A.240 - Broker's report

Current through June 11, 2024
1. The following
					provisions apply to the broker's report required by
					NRS 685A.050:
(a) The report constitutes the broker's
					statement of compliance with
					NRS
					685A.040,
					685A.070,
					685A.080
					and
					685A.090.
(b) A separate report must be filed with the
					broker's organization upon any renewal or extension of coverage of a contract
					of insurance for an insured for which Nevada is the home state.
(c) For an insured for which Nevada is the
					home state, an amended report must be filed with the broker's organization for
					each cancellation and each endorsement which changes the named insured, the
					description or location of the subject of insurance, or the coverage,
					conditions, terms, premium or participating insurers.
(d) The broker shall exercise due care in
					accounting for the premium, including any inspection fee charged as part of the
					premium, and for the premium tax on each report. The premium tax must be
					computed upon the total premium or deposit premium, plus the fee allowed by
					NRS
					685A.155, minus any return premium. The
					premium must include policy, membership, and other fees and assessments charged
					by the insurer as considerations for the insurance.
(e) If a type of coverage is on the list of
					open lines eligible for export which is approved by the Commissioner,
					statements of declinations from admitted insurers pursuant to subsection 1 of
					NAC 685A.215 are not required on the report.
(f) The Commissioner may require a broker to
					file with the broker's organization a complete copy of the policy, certificate
					or cover note to substantiate information which he or she has provided in a
					report.
Nevada Administrative Code › Chapter 685A - Nonadmitted Insurance › BROKERS › Section 685A.250 - Records; fiduciary account

Current through June 11, 2024
1. In addition to
					the records required by
					NRS 685A.160,
					the broker shall maintain complete copies of reports required by
					NRS 685A.050,
					including any amendment to a report, which have been filed with the
					Commissioner or the broker's organization.
2. The broker's files, accounts and other
					records of surplus lines transactions for an insured for which Nevada is the
					home state:
(a) Must be maintained in the
					office of the broker; and
(b) Must
					be open to examination by the Commissioner at any reasonable time.
Nevada Administrative Code › Chapter 685A - Nonadmitted Insurance › NONPROFIT ORGANIZATION OF BROKERS › Section 685A.350 - Duties of organization

Current through June 11, 2024
An organization shall:
1. Establish and maintain an office in this
					State to carry out the applicable provisions of this chapter and chapter 685A
					of NRS.
2. Maintain a plan of
					operation which ensures that the members of the organization and all associated
					nonadmitted insurance transactions comply with the provisions of title 57 of
					NRS and all other applicable rules and regulations adopted by the
					Commissioner.
3. Require each
					broker who is a member of the organization to file with the organization:
(a) The broker's report required by
					NRS 685A.050 and
					NAC 685A.240;
(b) A copy of the
					broker's cover note, declarations page or certificate; and
(c) A copy of the quarterly tax report
					required by
					NRS
					685A.175.
Nevada Administrative Code › Chapter 685A - Nonadmitted Insurance › NONPROFIT ORGANIZATION OF BROKERS › Section 685A.360 - General powers of organization

Current through June 11, 2024
An organization may:
1. Examine and evaluate the business of
					insurance to identify changes in coverage, premiums and volume that affect the
					business of insurance in this State, and make reports of such examinations to
					the Commissioner or the general public, or both.
2. Develop and maintain projects and programs
					dedicated to the continuing education and the technical and managerial skills
					of the members of the organization.
Added to NAC by Comm'r
						of Insurance, eff. 3-20-96
NRS
							679B.130,
							685A.210
Nevada Administrative Code › Chapter 685A - Nonadmitted Insurance › NONPROFIT ORGANIZATION OF BROKERS › Section 685A.370 - Fee for review of coverage

Current through June 11, 2024
Each broker who is a member of an organization shall pay to the
						organization a fee for the review of surplus lines coverage. The fee must be
						paid within 30 days after the broker receives an invoice from the organization.
						The fee for each policy is 0.4 percent of the amount subject to tax pursuant to
						NRS
						685A.180.
Added to NAC by Comm'r
						of Insurance, eff. 3-20-96; A by R090-03, 10-30-2003; R161-06, 12-7-2006, eff.
						1-1-2007
NRS
							679B.130,
							685A.075,
							685A.210
Nevada Administrative Code › Chapter 685A - Nonadmitted Insurance › NONPROFIT ORGANIZATION OF BROKERS › Section 685A.380 - Board of directors: Duties; assistance with investigations of alleged violations

Current through June 11, 2024
1. The board of
					directors shall:
(a) Promptly report alleged
					violations of this chapter and chapters 685A and 685B of NRS to the
					Commissioner;
(b) Report to the
					Commissioner:
(1) Delinquent, inaccurate,
					incomplete or improper reports required by
					NRS 685A.050 or
					tax reports filed by brokers with the organization pursuant to NAC 685A.350;
					and
(2) Insurance fraud or illegal
					insurance activity;
(c)
					Recommend to the Commissioner the class or classes of insurance to be included
					within the open lines eligible for export; and
(d) Maintain a current list of open lines
					eligible for export.
Nevada Administrative Code › Chapter 685A - Nonadmitted Insurance › NONPROFIT ORGANIZATION OF BROKERS › Section 685A.390 - Books and financial records of organization open to general public; exception; records of Division

Current through June 11, 2024
1. The books and
					financial records of an organization must be open to inspection by members of
					the general public upon written request, excluding records of investigations
					that are confidential pursuant to
					NRS
					679B.190.
2. All forms and other documents that a
					broker files with his or her organization shall be deemed the records of the
					Division.
Added to NAC by Comm'r
						of Insurance, eff. 3-20-96; A by R090-03,
						10-30-2003
NRS
							679B.130,
							685A.077,
							685A.210
Nevada Administrative Code › Chapter 685A - Nonadmitted Insurance › NONPROFIT ORGANIZATION OF BROKERS › Section 685A.400 - Deposit or investment of money; audit of accounts

Current through June 11, 2024
1. The
					money maintained by an organization must be:
(a) Deposited in a bank chartered by this
					State;
(b) Deposited in a bank that
					is a member of the United States Federal Reserve System; or
(c) Invested in securities described as
					acceptable collateral in
					NRS
					682A.007.
Nevada Administrative Code › Chapter 685A - Nonadmitted Insurance › TAX ON SURPLUS LINES COVERAGES › Section 685A.420 - Allocation of premiums for risks or exposures; filing of premium taxes

Current through June 11, 2024
For the purpose of determining the tax payable to the
						Commissioner pursuant to
						NRS
						685A.180:
1. For a multi-state risk:
(a) If the Commissioner has entered into a
					multi-state agreement pursuant to
					NRS
					685A.185, a broker shall use the allocation
					formulas and filing procedures established pursuant to the multi-state
					agreement to determine the allocation to this State of premiums as to persons,
					property, subjects or risks in this State insured under policies and contracts
					covering persons, property, subjects or risks located or resident in more than
					one state.
(b) If the Commissioner
					has not entered into a multi-state agreement pursuant to
					NRS
					685A.185, a broker shall file premium taxes
					through the Surplus Lines Information Portal, or a successor system, of the
					nonprofit organization of surplus lines brokers formed pursuant to
					NRS
					685A.075 for all risks for which Nevada is
					the home state of the insured.
Nevada Administrative Code › Chapter 686A - Insurance: Trade Practices and Frauds › GENERAL PROVISIONS › Section 686A.Sec. 2 - NEW

Current
			 through June 11, 2024
1.
			 An insurer that uses information from a consumer credit report shall not
			 increase a policyholder's premium or make an adverse underwriting decision as a
			 result of any change in the policyholder's consumer credit report or insurance
			 score which occurred on or after March 1, 2020, and on or before the date which
			 is 2 years after the termination date of the Declaration of Emergency for
			 COVID-19 issued by the Governor on March 12, 2020.
2. Every such change in the policyholder's
			 consumer credit report or insurance score which occurred during the period of
			 time described in subsection 1 shall be deemed by the Commissioner to be:
(a) Caused by the COVID-19 emergency, which
			 is the subject of the Declaration of Emergency mentioned in subsection
			 1;
(b) Independent of the choice or
			 the financial management decisions of any applicable individual; and
(c) Unrelated to expected losses and expenses
			 for all lines of insurance.
Nevada Administrative Code › Chapter 686A - Insurance: Trade Practices and Frauds › GENERAL PROVISIONS › Section 686A.Sec. 3 - NEW

Current
			 through June 11, 2024
1.
			 An insurer may use a consumer credit report or insurance score in rating a
			 policy if the information used for such a report or score was gathered,
			 calculated, updated or recalculated, as appropriate, and any changes to the
			 report or score occurred, before March 1, 2020, or after the date which is 2
			 years after the termination date of the Declaration of Emergency for COVID-19
			 issued by the Governor on March 12, 2020.
2. Except as otherwise provided in subsection
			 3, an insurer is not required to update such information, reports or scores for
			 changes that occurred on or after March 1, 2020, and on or before the date
			 which is 2 years after the termination date of the Declaration of Emergency for
			 COVID-19 issued by the Governor on March 12, 2020.
3. If, pursuant to subsection 2 of
			 NRS
			 686A.680, a policyholder or a policyholder's
			 agent requests an insurer to reunderwrite and rerate the policyholder's policy
			 based on a current consumer credit report or insurance score, the insurer may
			 use a consumer credit report of the policyholder that is updated during the
			 period described in subsection 2, or may recalculate the insurance score of the
			 policyholder during the period described in subsection 2, if the updated
			 consumer credit report or recalculation results in the policyholder paying a
			 lower premium than the policyholder would have paid absent the updated consumer
			 credit report or recalculation.
4.
			 If an insurer obtains an updated consumer credit report or recalculates the
			 insurance score of the policyholder without a request from the policyholder or
			 from the policyholder's agent pursuant to subsection 2 of
			 NRS
			 686A.680, the insurer may use the consumer
			 credit report of the policyholder that was updated during the period described
			 in subsection 2, or may use the insurance score of the policyholder that was
			 recalculated during the period described in subsection 2, if the updated
			 consumer credit report or recalculation results in the policyholder paying a
			 lower premium than the policyholder would have paid absent the updated consumer
			 credit report or recalculation.
Added
				to NAC by Comm'r of Insurance by
				R087-20A,
				eff. 12/18/2020
NRS
				679B.130,
				679B.150,
				686A.015,
				686A.100,
				686A.130
				and
				686A.680
Nevada Administrative Code › Chapter 686A - Insurance: Trade Practices and Frauds › GENERAL PROVISIONS › Section 686A.Sec. 4 - NEW

Current
			 through June 11, 2024
1.
			 An insurer that uses information from a consumer credit report shall identify
			 any policyholder whose premium was increased as a result of changes in the
			 policyholder's consumer credit report or insurance score which occurred on or
			 after March 1, 2020, and on or before the date which is 2 years after the
			 termination date of the Declaration of Emergency for COVID-19 issued by the
			 Governor on March 12, 2020.
2.
			 After identifying any increase pursuant to subsection 1, the insurer shall
			 revise the premium by
(a) Using a consumer
			 credit report or insurance score that is based on information which was
			 gathered, calculated, updated or recalculated, as appropriate, before March 1,
			 2020, in rating the policy; or
(b)
			 Reunderwriting and rerating the policyholder's policy pursuant to subsection 3
			 or 4 of section 3, as applicable, whichever results in the lower premium paid
			 by the policyholder.
Nevada Administrative Code › Chapter 686A - Insurance: Trade Practices and Frauds › GENERAL PROVISIONS › Section 686A.010 - Definitions

Current through June 11, 2024
As used in this chapter, unless the context otherwise
				requires:
1. "Broker" has the meaning
			 ascribed to it in
			 NRS
			 683A.321.
2. "Commissioner" means the Commissioner of
			 Insurance.
3. "Division" means the
			 Division of Insurance of the Department of Business and Industry.
Supplied in
				codification; A by Div. of Insurance by R089-98, 9-25-98; A by Comm'r of
				Insurance by R054-12, 11-1-2012
NRS
				  679B.130,
				  686A.015
Nevada Administrative Code › Chapter 686A - Insurance: Trade Practices and Frauds › DISCRIMINATION › Section 686A.110 - Scope and applicability

Current through June 11,
			 2024
NAC 686A.110 to 686A.150, inclusive:
1. Prohibit the denial of benefits or
			 coverage on the basis of sex or marital status in the terms and conditions of
			 insurance contracts and in the underwriting criteria of insurers.
2. Apply to all contracts delivered or issued
			 for delivery in Nevada on or after September 11, 1977.
Comm'r of Insurance, M-7
				§§ 1 and 4, eff. 9-11-77
NRS
				  679B.130,
				  686A.015
Nevada Administrative Code › Chapter 686A - Insurance: Trade Practices and Frauds › DISCRIMINATION › Section 686A.120 - Definitions

Current through June 11, 2024
As used in NAC 686A.110 to 686A.150, inclusive, unless the
				context otherwise requires:
1.
			 "Contract" means any insurance policy, plan or written agreement for or
			 affecting insurance, by whatever name called, and includes all clauses, riders
			 or endorsements offered by any insurer.
2. "Insured" means any person who is insured
			 under a contract or who has made application for insurance.
3. "Insurer" means any insurance company,
			 association, reciprocal or interinsurance exchange, not-for-profit hospital or
			 professional health service plan administrator, health maintenance
			 organization, fraternal benefit society, beneficial association or other person
			 acting as an insurer.
4. "Person"
			 means a natural person, corporation, association, partnership or other
			 entity.
Comm'r of Insurance, M-7
				§ 3, eff. 9-11-77
NRS
				  679B.130,
				  686A.015
Nevada Administrative Code › Chapter 686A - Insurance: Trade Practices and Frauds › DISCRIMINATION › Section 686A.130 - Availability of insurance; restrictions; marital status

Current
			 through June 11, 2024
1.
			 Availability of insurance may not be denied to an insured on the basis of sex
			 or marital status. The amount of benefits payable, conditions or types of
			 coverage may not be restricted, modified, excluded or reduced solely on the
			 basis of sex or marital status of the insured, except as a result of the
			 application of rate differentials permitted under the insurance code.
2. Restrictions of terms, conditions and
			 types of coverage, and other modifications, exclusions or reductions of the
			 benefits payable are permitted if established by agreement between the insured
			 and the insurer.
3. Marital status
			 may be considered for the purpose of determining eligibility for dependent or
			 family coverage.
Comm'r of Insurance, M-7
				part § 5, eff. 9-11-77
NRS
				  679B.130,
				  686A.015
Nevada Administrative Code › Chapter 686A - Insurance: Trade Practices and Frauds › DISCRIMINATION › Section 686A.140 - Prohibited practices

Current through June 11,
			 2024
Practices prohibited by NAC 686A.110 to 686A.150, inclusive,
				include, but are not limited to:
1.
			 Denying coverage to women who are gainfully employed at home, part-time or by
			 relatives when coverage is offered to men who are similarly employed.
2. Denying policy riders to women when the
			 riders are available to men.
3.
			 Denying maternity coverage to an unmarried woman who is seeking to purchase an
			 individual contract when comparable coverage is available to a married
			 woman.
4. Denying dependent
			 coverage under a group contract to husbands of female employees when dependent
			 coverage is available to wives of male employees.
5. Denying disability income contracts to
			 employed women when coverage is offered to men who are similarly
			 employed.
6. Treating complications
			 of pregnancy differently from any other illness or sickness under the
			 contract.
7. Restricting, reducing,
			 modifying or excluding benefits relating to coverage involving the genital
			 organs of only one sex when the restriction, reduction, modification or
			 exclusion is not required for both sexes.
8. Offering lower maximum monthly benefits
			 under a disability income contract to women than to men who are in the same
			 classification.
9. Offering more
			 restrictive benefit periods and more restrictive definitions of disability
			 under a disability income contract to women than to men who are in the same
			 classification.
10. Establishing
			 different conditions under which policyholders of different sexes may exercise
			 benefit options contained in the contract.
11. Limiting the amount of coverage available
			 for purchase based upon marital status, unless the limitation is for the
			 purpose of defining persons eligible for dependent benefits.
12. Denying equal consideration for coverage
			 for either spouse because of a change in marital status, including denying an
			 individual policy to a woman who is no longer eligible under her husband's
			 policy when the husband is allowed to continue the existing policy.
Comm'r of Insurance, M-7
				part § 5, eff. 9-11-77
NRS
				  679B.130,
				  686A.015
Nevada Administrative Code › Chapter 686A - Insurance: Trade Practices and Frauds › DISCRIMINATION › Section 686A.150 - Rates

Current through June 11, 2024
No rate differential may be applied on the basis of the sex or
				marital status of an insured unless the rate differential is based on sound
				actuarial data. Any justification for a rate differential based on sex or
				marital status must be furnished to the Commissioner upon request.
Comm'r of Insurance, M-7
				§ 6, eff. 9-11-77
NRS
				  679B.130,
				  686A.015
Nevada Administrative Code › Chapter 686A - Insurance: Trade Practices and Frauds › DISCRIMINATION › Section 686A.160 - Blindness or partial blindness

Current through June 11,
			 2024
1. With regard to
			 any policy or contract of life insurance, health insurance or annuity:
(a) The following acts or practices
			 constitute unfair discrimination between persons of the same class:
(1) Refusing to insure;
(2) Refusing to continue to insure;
(3) Limiting the amount, extent or kind of
			 coverage available to a person; or
(4) Charging a person a different rate for
			 the same coverage, solely because of blindness or partial blindness.
Nevada Administrative Code › Chapter 686A - Insurance: Trade Practices and Frauds › PROPERTY AND CASUALTY INSURANCE › Section 686A.210 - Transfer of property with existing coverage

Current through June
			 11, 2024
1. No agent,
			 broker or insurer may participate in any transaction in which an insured is
			 forced to cancel existing coverage on property which the insured is
			 transferring to another and purchase other coverage on newly acquired property
			 if the coverage is adequate for the newly acquired property.
2. This section applies to all agents,
			 brokers and insurers, including, without limitation, lenders which issue
			 coverage as agents and agencies with which the lender is in any way
			 connected.
3. As used in this
			 section, "agent" has the meaning ascribed to it in
			 NRS
			 683A.321.
Comm'r of Insurance,
				PC-8, eff. 9-23-72-NAC A by Div. of Insurance by R089-98, 9-25-98; A by Comm'r
				of Insurance by R054-12, 11-1-2012
NRS
				  679B.130,
				  686A.015
Nevada Administrative Code › Chapter 686A - Insurance: Trade Practices and Frauds › PROPERTY AND CASUALTY INSURANCE › Section 686A.220 - Insurer prohibited from taking certain actions with respect to property or casualty insurance on basis of status of person as victim or potential victim of domestic violence; permissible bases for action; exceptions

Current through June 11, 2024
1. Except as otherwise provided in this
			 section, an insurer shall not:
(a) Deny or
			 refuse to accept an application for property or casualty insurance;
(b) Refuse to issue or renew a policy of
			 property or casualty insurance;
(c)
			 Cancel, restrict or otherwise terminate a policy of property or casualty
			 insurance; or
(d) Charge a person a
			 rate for property or casualty insurance coverage that is different from the
			 rate that the insurer charges another person for the same coverage, solely
			 because the person applying for or covered by the policy of property or
			 casualty insurance is, has been or may be a victim of an act that constitutes
			 domestic violence pursuant to
			 NRS
			 33.018.
Nevada Administrative Code › Chapter 686A - Insurance: Trade Practices and Frauds › REPAIR OF MOTOR VEHICLES › Section 686A.240 - Disclosure when estimate of cost of repair based on use of body part not manufactured for or by original manufacturer of vehicle

Current through
			 June 11, 2024
1. If an
			 insurer or a representative of the insurer bases an estimate of the cost of
			 repairing the body of a motor vehicle upon the use of a body part which was not
			 manufactured for or by the original manufacturer of the vehicle to be repaired,
			 the insurer shall disclose or cause the representative to disclose that fact to
			 the claimant.
2. The disclosure
			 must:
(a) Be printed on or attached to the
			 copy of the estimate for repairs which is received by the claimant;
(b) Be printed in not less than 10-point
			 type; and
(c) Contain the following
			 statement:
THIS ESTIMATE IS BASED ON THE USE OF BODY PARTS FOR YOUR MOTOR
				VEHICLE WHICH WERE NOT MANUFACTURED FOR OR BY THE ORIGINAL MANUFACTURER OF THE
				MOTOR VEHICLE. ANY WARRANTIES PROVIDED FOR THESE BODY PARTS ARE PROVIDED BY THE
				MANUFACTURER OR DISTRIBUTOR OF THESE PARTS, NOT BY THE MANUFACTURER OF YOUR
				MOTOR VEHICLE. PLEASE CONTACT YOUR INSURER TO DETERMINE YOUR RIGHTS REGARDING
				THE USE OF SUCH BODY PARTS.
Nevada Administrative Code › Chapter 686A - Insurance: Trade Practices and Frauds › HEALTH CARE PRACTITIONERS › Section 686A.270 - Payment for services rendered

Current through June 11,
			 2024
1. If a benefit or
			 medical service is otherwise covered by a policy, the insurer shall pay for the
			 service without regard to the type of health care practitioner providing the
			 service, if the practitioner is:
(a) Licensed
			 in accordance with the law of this State; and
(b) Operating within the scope of the
			 practitioner's authority.
Nevada Administrative Code › Chapter 686A - Insurance: Trade Practices and Frauds › HEALTH INSURANCE CLAIMS › Section 686A.280 - Definitions

Current through June 11, 2024
As used in NAC 686A.280 to 686A.306, inclusive, unless the
				context otherwise requires, the words and terms defined in NAC 686A.282,
				686A.284 and 686A.286 have the meanings ascribed to them in those
				sections.
Added to NAC by Comm'r
				of Insurance by R175-01, eff. 5-23-2002
NRS
				  679B.130,
				  686A.015
Nevada Administrative Code › Chapter 686A - Insurance: Trade Practices and Frauds › HEALTH INSURANCE CLAIMS › Section 686A.282 - "Clean claim" defined

Current through June 11,
			 2024
A "clean claim" means a claim:
1. That contains the information required to
			 be included for the applicable use of a form prescribed in NAC
			 686A.288; and
2. For which any additional information that
			 has been requested pursuant to subsection 2 of
			 NRS
			 683A.0879,
			 689A.410,
			 689B.255,
			 689C.485,
			 695B.2505,
			 695C.185
			 or
			 695D.215
			 because of any particular or unusual circumstances that would have impeded the
			 payer from paying the claim has been received.
Added to NAC by Comm'r
				of Insurance by R175-01, eff. 5-23-2002; A by R026-12, 9-14-2012; A by
				R119-16A,
				eff. 12/21/2016
NRS
				679B.130,
				686A.015
Nevada Administrative Code › Chapter 686A - Insurance: Trade Practices and Frauds › HEALTH INSURANCE CLAIMS › Section 686A.284 - "Health care practitioner" defined

Current through June 11,
			 2024
"Health care practitioner" means a person licensed to practice
				one of the health professions regulated by title 54 of NRS.
Added to NAC by Comm'r
				of Insurance by R175-01, eff. 5-23-2002
NRS
				  679B.130,
				  686A.015
Nevada Administrative Code › Chapter 686A - Insurance: Trade Practices and Frauds › HEALTH INSURANCE CLAIMS › Section 686A.286 - "Payer" defined

Current through June 11,
			 2024
"Payer" includes administrators, individual health insurers,
				group health insurers, nonprofit hospitals, medical and dental service
				corporations and health maintenance organizations who pay claims under any
				contract for health insurance.
Added to NAC by Comm'r
				of Insurance by R175-01, eff. 5-23-2002
NRS
				  679B.130,
				  686A.015
Nevada Administrative Code › Chapter 686A - Insurance: Trade Practices and Frauds › HEALTH INSURANCE CLAIMS › Section 686A.288 - Forms for submission of claims

Current through June 11,
			 2024
1. The payer of a
			 claim under a contract for health insurance:
(a) Shall accept a claim submitted on a form
			 that:
(1) Has been approved by the
			 Commissioner for the filing of a claim under a contract for health insurance;
			 and
(2) Contains the information
			 necessary to constitute a clean claim.
Nevada Administrative Code › Chapter 686A - Insurance: Trade Practices and Frauds › HEALTH INSURANCE CLAIMS › Section 686A.290 - Commencement of time for adjudication and payment of claims

Current
			 through June 11, 2024
The time for a payer to adjudicate and pay claims pursuant to
				NRS
				683A.0879,
				689A.410,
				689B.255,
				689C.485,
				695B.2505,
				695C.185
				and
				695D.215
				begins when the payer receives a clean claim.
Added to NAC by Comm'r
				of Insurance by R175-01, eff. 5-23-2002; A by
				R119-16A,
				eff. 12/21/2016
NRS
				679B.130,
				686A.015
Nevada Administrative Code › Chapter 686A - Insurance: Trade Practices and Frauds › HEALTH INSURANCE CLAIMS › Section 686A.302 - Claim by hospital or other institutional provider: Prohibited use of field; optional inclusion of additional data

Current through June 11,
			 2024
1. A payer shall
			 not use or require a hospital or other institutional provider to use any field
			 for purposes that are inconsistent with the data required for the submission of
			 a clean claim, or in addition to the applicable standard code set.
2. A hospital or other institutional provider
			 may elect to include data in addition to the data required for the submission
			 of a clean claim.
Added to NAC by Comm'r
				of Insurance by R175-01, eff. 5-23-2002; A by R026-12,
				9-14-2012
NRS
				  679B.130,
				  679B.138,
				  686A.015
Nevada Administrative Code › Chapter 686A - Insurance: Trade Practices and Frauds › HEALTH INSURANCE CLAIMS › Section 686A.303 - Coverage for dental procedures for children

Current through June
			 11, 2024
1. A policy or
			 contract of health insurance issued pursuant to chapter 689A, 689B, 689C, 695B
			 or 695C of NRS which is delivered or issued for delivery in this State and
			 which provides coverage for medically required hospital services must not deny
			 coverage for a dependent child covered by that policy or contract who is
			 referred by a dentist to a hospital, a surgical center for ambulatory patients,
			 an independent center for emergency medical care or a rural clinic, licensed
			 pursuant to chapter 449 of NRS, for general anesthesia and associated care and
			 is being referred because, in the opinion of the dentist, the child:
(a) Has a physical, mental or medically
			 compromising condition;
(b) Has
			 dental needs for which local anesthesia is ineffective because of an acute
			 infection, an anatomic anomaly or an allergy;
(c) Is extremely uncooperative, unmanageable
			 or anxious; or
(d) Has sustained
			 extensive orofacial and dental trauma to a degree that would require
			 unconscious sedation.
Nevada Administrative Code › Chapter 686A - Insurance: Trade Practices and Frauds › HEALTH INSURANCE CLAIMS › Section 686A.304 - Processing of claims: Duties of payer; date of receipt of claim

Current through June 11, 2024
1. Each payer shall establish a tracking
			 system to monitor the timeliness of the payer's processing of a
			 claim.
2. Each payer shall:
(a) Maintain a written or electronic record
			 of the date of receipt of a claim;
(b) For receipt of a written claim,
			 date-stamp the claim with the date received; and
(c) For receipt of an electronic claim,
			 assign the document a batch number that includes the date received.
Nevada Administrative Code › Chapter 686A - Insurance: Trade Practices and Frauds › HEALTH INSURANCE CLAIMS › Section 686A.306 - Proof of compliance by payer

Current through June 11,
			 2024
The Commissioner, when deemed appropriate, will require a payer
				to report substantial compliance with the provisions of NAC 686A.280 to
				686A.306, inclusive. Proof that claims are being paid by a payer within the
				specified limits includes, without limitation, records demonstrating that a
				tracking system required by NAC 686A.304 has been developed and
				implemented.
Added to NAC by Comm'r
				of Insurance by R175-01, eff. 5-23-2002; A by R129-03,
				4-16-2004
NRS
				  679B.130,
				  679B.136,
				  679B.138,
				  686A.015
Nevada Administrative Code › Chapter 686A - Insurance: Trade Practices and Frauds › FINANCIAL PLANNERS, AGENTS, BROKERS AND INSURANCE CONSULTANTS › Section 686A.320 - Definitions

Current through June 11, 2024
As used in NAC 686A.320 to
				686A.340, inclusive, and section
				1 of this regulation, unless the context otherwise requires:
1. "Agent" has the meaning ascribed to it in
			 NRS
			 683A.321.
2. "Financial planner" means a producer of
			 insurance who has successfully completed a course of instruction required for
			 designation as a financial planner by a recognized professional association of
			 financial planners.
3. "Health
			 insurance" includes any:
(a) Individual
			 health insurance or group health insurance provided pursuant to chapter 689A or
			 689B of NRS;
(b) Contract for
			 hospital, medical or dental services entered into pursuant to chapter 695B of
			 NRS;
(c) Health care plan provided
			 pursuant to chapter 695C of NRS;
(d) Plan for dental care provided pursuant to
			 chapter 695D of NRS; or
(e) Plan
			 for prepaid limited health service provided pursuant to chapter 695F of
			 NRS.
Nevada Administrative Code › Chapter 686A - Insurance: Trade Practices and Frauds › FINANCIAL PLANNERS, AGENTS, BROKERS AND INSURANCE CONSULTANTS › Section 686A.330 - Agreement for consultation or related advice: Contents; copies; fee

Current through June 11, 2024
1. Any agreement for consultation or related
			 advice which is entered into by a financial planner, producer of insurance or
			 insurance consultant must be in writing and must contain:
(a) The name and address of the client or
			 prospective client seeking the consultation or related advice;
(b) The name, address, telephone number and
			 electronic mail address of the financial planner, producer of insurance or
			 insurance consultant;
(c) If
			 applicable, the name and address of any person or entity licensed pursuant to
			 title 57 of NRS which the financial planner, producer of insurance or insurance
			 consultant represents;
(d) A
			 description of any license the financial planner, producer of insurance or
			 insurance consultant holds;
(e) A
			 description of any fee to be charged and the services to be provided under the
			 agreement;
(f) A provision allowing
			 the client, without penalty, to rescind the agreement within 10 days after it
			 is entered into; and
(g) A
			 statement of whether the financial planner, producer of insurance or insurance
			 consultant is to receive any commission or other compensation for services in
			 addition to any fee paid by the client.
Nevada Administrative Code › Chapter 686A - Insurance: Trade Practices and Frauds › FINANCIAL PLANNERS, AGENTS, BROKERS AND INSURANCE CONSULTANTS › Section 686A.335 - Agreement for consultation or related advice: Provisions for commissions and fees; written contract

Current through June 11,
			 2024
1. Except as
			 otherwise provided in subsection 2, an agreement for consultation or related
			 advice which is entered into by an agent who is also licensed as a broker of
			 casualty, property or surety insurance may, with respect to property, casualty
			 or surety insurance that the agent sells to businesses, provide for the agent
			 to receive:
(a) A commission paid by the
			 insurer;
(b) A fee paid by the
			 client; or
(c) A combination of a
			 commission paid by the insurer and a fee paid by the client.
Nevada Administrative Code › Chapter 686A - Insurance: Trade Practices and Frauds › FINANCIAL PLANNERS, AGENTS, BROKERS AND INSURANCE CONSULTANTS › Section 686A.340 - Commission for services to be taxed as premium

Current through
			 June 11, 2024
Any commission received by a financial planner, agent or broker
				or producer of insurance pursuant to NAC
				686A.320 to 686A.340, inclusive,
				and section 1 for services related to the sale of insurance shall be deemed a
				premium for purposes of the tax imposed by chapter 680B of
				NRS.
Added to NAC by Comm'r
				of Insurance, eff. 8-12-88; A 3-28-96; A by
				R001-18A,
				eff. 8/21/2018; A by
				R001-18AP,
				eff. 8/30/2018
NRS
				679B.130,
				686A.015
Nevada Administrative Code › Chapter 686A - Insurance: Trade Practices and Frauds › SOLICITATION AND SALE OF LIFE INSURANCE › General Provisions › Section 686A.410 - Scope

Current through June 11, 2024
1. This regulation requires insurers to
				deliver to purchasers of life insurance, information which will:
(a) Improve the buyer's ability to select the
				most appropriate plan of life insurance for his or her needs;
(b) Improve the buyer's understanding of the
				basic features of the policy which has been purchased or which is under
				consideration; and
(c) Improve the
				ability of the buyer to evaluate the relative costs of similar plans of life
				insurance.
Nevada Administrative Code › Chapter 686A - Insurance: Trade Practices and Frauds › SOLICITATION AND SALE OF LIFE INSURANCE › General Provisions › Section 686A.415 - Applicability

Current through June 11, 2024
1. This regulation applies to:
(a) Any solicitation, negotiation, or
				procurement of life insurance occurring within this State; and
(b) Any issuer of life insurance contracts,
				including fraternal benefit societies.
Nevada Administrative Code › Chapter 686A - Insurance: Trade Practices and Frauds › SOLICITATION AND SALE OF LIFE INSURANCE › General Provisions › Section 686A.420 - Definitions

Current through June 11, 2024
As used in NAC 686A.410 to 686A.455, inclusive, unless the
				  context otherwise requires, the following words and terms have the meanings
				  ascribed to them:
1. "Agent" has the
				meaning ascribed to it in
				NRS
				683A.321.
2. "Buyer's guide" means a document which
				contains, and is limited to, the language contained in the appendix* to this
				regulation or language approved by the Commissioner.
3. "Cash dividend" means the current
				illustrated dividend which can be applied toward payment of the gross
				premium.
4. "Generic name" means a
				short title which is descriptive of the premium and benefit pattern of a policy
				or a rider.
5. This "regulation"
				means NAC 686A.410 to 686A.455, inclusive.
*The appendix is not codified but is available in the Office
				  of the Secretary of State or the Division.
Comm'r of Insurance,
				  LH-6 § IV, eff. 11-22-78-NAC A 5-27-92; A by Div. of Insurance by R089-98,
				  9-25-98; A by Comm'r of Insurance by R054-12,
				  11-1-2012
NRS
					 679B.130,
					 686A.015
Nevada Administrative Code › Chapter 686A - Insurance: Trade Practices and Frauds › SOLICITATION AND SALE OF LIFE INSURANCE › General Provisions › Section 686A.425 - General requirements

Current through June 11,
				2024
1. Each insurer
				shall maintain at its home office or principal office, a complete file
				containing one copy of each document which it has authorized for use pursuant
				to this regulation. The file must contain one copy of each authorized form for
				a period of 3 years following the date of the last authorized use of the
				form.
2. An agent shall inform the
				prospective purchaser, prior to commencing a life insurance sales presentation,
				that he or she is acting as a life insurance agent and of the full name of the
				insurance company which he or she is representing. In sales situations in which
				an agent is not involved, the insurer shall identify its full name.
3. Terms such as "financial planner,"
				"investment adviser," "financial consultant" or "financial counseling" may not
				be used in a way which implies that the insurance agent is generally engaged in
				an advisory business in which compensation is unrelated to sales, unless that
				is actually the case.
4. Any
				reference to policy dividends must include a statement that dividends are not
				guaranteed.
5. A system or
				presentation which does not recognize the time value of money through the use
				of appropriate interest adjustments may not be used for comparing the cost of
				two or more life insurance policies. Such a system may not be used to
				demonstrate the cash-flow pattern of a policy if the presentation is
				accompanied by a statement disclosing that the presentation does not recognize
				that, because of inflation, a dollar in the future may have less
				value.
6. A presentation of
				benefits may not display guaranteed benefits and benefits which are not
				guaranteed as a single sum unless they are shown separately in close proximity
				to the single sum.
7. A statement
				regarding the use of the life insurance cost indexes must include an
				explanation to the effect that the indexes are useful only for the comparison
				of the relative costs of two or more similar policies.
8. A life insurance cost index which reflects
				dividends or an equivalent level annual dividend must be accompanied by a
				statement that it is based on the company's current dividend scale and is not
				guaranteed.
9. For the purposes of
				this regulation, the annual premium for a basic policy or rider for which the
				company reserves the right to change the premium must be the maximum annual
				premium.
Comm'r of Insurance,
				  LH-6 § VIII, eff. 11-22-78
NRS
					 679B.130,
					 679B.137,
					 686A.015
Nevada Administrative Code › Chapter 686A - Insurance: Trade Practices and Frauds › SOLICITATION AND SALE OF LIFE INSURANCE › General Provisions › Section 686A.430 - Insurer to provide buyer's guide and policy summary to applicant; exception

Current through June 11,
				2024
1. Except as
				otherwise provided in subsection 4, an insurer shall provide a buyer's guide
				and a policy summary to each applicant before accepting the applicant's initial
				premium or premium deposit, unless the policy summary or the policy for which
				application is made contains a provision for an unconditional refund of at
				least 12 days, in which event the buyer's guide and policy summary must be
				delivered with the policy or before the delivery of the policy.
2. The insurer shall provide a buyer's guide
				and a policy summary to any prospective purchaser upon request.
3. The requirement to provide policy
				summaries for policies whose equivalent level death benefit, calculated as
				required by NAC 686A.440, does not exceed $5,000 is satisfied by delivery of a
				written statement containing the information described in paragraphs (b), (c)
				and (d), subparagraphs (1), (2) and (3) of paragraph (e), and paragraphs (f),
				(g), (j), and (k) of subsection 1 of NAC 686A.435.
4. The policy summary required pursuant to
				subsection 1 is not required if an illustration that conforms with the
				provisions of NAC 686A.460 to 686A.479, inclusive, is provided.
Comm'r of Insurance,
				  LH-6 § V, eff. 11-22-78-NAC by A R089-97,
				  1-14-98
NRS
					 679B.130,
					 686A.015
Nevada Administrative Code › Chapter 686A - Insurance: Trade Practices and Frauds › SOLICITATION AND SALE OF LIFE INSURANCE › General Provisions › Section 686A.440 - Equivalent level death benefit

Current through June 11,
				2024
The equivalent level death benefit of a policy or term life
				  insurance rider is an amount calculated as follows:
1. Accumulate the guaranteed amount payable
				upon death, regardless of the cause of death, at the beginning of each policy
				year for 10 and 20 years at 5 percent interest compounded annually to the end
				of the 10th and 20th policy years respectively.
2. Divide each accumulation obtained in
				subsection 1 by an interest factor that converts it into one equivalent level
				annual amount which, if paid at the beginning of each year, would accrue to the
				value obtained in subsection 1 over the respective periods stipulated in
				subsection 1. If the period is 10 years, the factor is 13.207. If the period is
				20 years, the factor is 34.719.
Comm'r of Insurance,
				  LH-6 § VII, eff. 11-22-78
NRS
					 679B.130,
					 686A.015