reglab/statecodes huggingface dataset:
Nevada Administrative Code › Chapter 689B - Group and Blanket Health Insurance › PREMIUM RATES › Section 689B.230 - Limitation on frequency of increases; exceptions

Current through June 11, 2024
1. Except as
			 otherwise provided in this section, an insurer that issues group health
			 insurance in this State shall not increase the premium rates for the insurance
			 more frequently than every 6 months unless the increase in the premium rates is
			 being made because:
(a) An employer has
			 requested a change in its health benefit plan;
(b) There has been a change in the number of
			 employees covered by an employer that would affect the insurance premium rate
			 of the employer; or
(c) There has
			 been a change in federal or state law which affects the cost of providing
			 services under the health benefit plan.
Nevada Administrative Code › Chapter 689B - Group and Blanket Health Insurance › SYSTEM FOR RESOLVING COMPLAINTS OF INSUREDS › Section 689B.250 - Requirements for approval

Current through June 11, 2024
To obtain approval of a system for resolving complaints of
				insureds concerning health care services covered by an insurer from the
				Commissioner as required pursuant to
				NRS
				689B.0285, an insurer must:
1. Demonstrate that the system will resolve
			 oral and written complaints concerning:
(a)
			 Payment or reimbursement for covered health care services;
(b) The availability, delivery or quality of
			 covered health care services, including, without limitation, an adverse
			 determination made pursuant to utilization review; and
(c) The terms and conditions of the health
			 care plans of insureds.
Nevada Administrative Code › Chapter 689B - Group and Blanket Health Insurance › SYSTEM FOR RESOLVING COMPLAINTS OF INSUREDS › Section 689B.260 - Annual report

Current through June 11, 2024
1. An insurer shall
			 submit its annual report regarding its system for resolving complaints as
			 required pursuant to
			 NRS
			 689B.029 on or before June 1 of each year.
			 The insurer shall retain a copy of the annual report for at least 3 years or
			 until the next examination conducted by the Division, whichever is
			 longer.
2. The insurer is not
			 required to include in the annual report information concerning an oral inquiry
			 by an insured relating to a misunderstanding or miscommunication if the
			 misunderstanding or miscommunication was resolved within 1 working day after
			 the inquiry was made. If the misunderstanding or miscommunication was not
			 resolved within 1 working day, the insurer shall report it as a complaint in
			 the annual report.
Added to NAC by Comm'r of
				Insurance by R132-98, eff. 3-30-99; A by R008-02,
				5-23-2002
NRS
				  679B.130,
				  689B.029
Nevada Administrative Code › Chapter 689B - Group and Blanket Health Insurance › BLANKET POLICIES › Section 689B.280 - Compliance with NAC 689B.205 and 689B.230

Current through June 11, 2024
An insurer that offers blanket accident and health insurance in
				this State shall comply with the provisions of NAC 689B.205 and
				689B.230.
Added to NAC by Comm'r of
				Insurance by R009-02, eff. 5-23-2002; A by R009-02,
				7-11-2002
NRS
				  679B.130,
				  689B.090
Nevada Administrative Code › Chapter 689B - Group and Blanket Health Insurance › PORTABILITY AND ACCOUNTABILITY › Section 689B.295 - Definitions

Current through June 11, 2024
As used in NAC to 689B.310, inclusive, unless the context
				otherwise requires, the words and terms defined in
				NRS
				689B.350 to
				689B.460,
				inclusive, have the meanings ascribed to them in those sections.
Added to NAC by Comm'r of
				Insurance by R009-02, eff. 5-23-2002; A by R009-02,
				7-11-2002
NRS
				  679B.130
Nevada Administrative Code › Chapter 689B - Group and Blanket Health Insurance › PORTABILITY AND ACCOUNTABILITY › Section 689B.300 - Evidence of creditable coverage

Current through June 11, 2024
If a person is unable to obtain a certificate of creditable
				coverage pursuant to
				NRS
				689B.490, a carrier shall accept from the
				person other evidence of creditable coverage if it determines that the evidence
				reasonably establishes prior continuous creditable coverage. Such evidence may
				include, without limitation, a copy of:
1. A policy of health insurance or evidence
			 of coverage;
2. A billing statement
			 for the payment of premiums;
3. A
			 cancelled check evidencing payment for health insurance coverage;
4. A proof of insurance card issued by an
			 insurer;
5. An explanation of
			 benefits relating to a specific claim for medical services that were provided
			 to the person by an insurer;
6. A
			 letter notifying the person that he is eligible for coverage pursuant to the
			 Consolidated Omnibus Budget Reconciliation Act of 1985, Public Law
			 99-272;
7. A letter written by the
			 liquidator of an insurer that verifies the dates that the person was covered by
			 the insurer under a policy of health insurance;
8. A statement written by the person that
			 includes the name and telephone number of any insurer under which he previously
			 received health insurance coverage;
9. Evidence of a payroll deduction from the
			 person's salary for health insurance coverage;
10. Any record from a provider of medical
			 care that indicates that the person had health insurance coverage; or
11. Any combination thereof.
Added to NAC by Comm'r of
				Insurance by R224-97, eff. 11-16-98
NRS
				  679B.130,
				  689B.480
Nevada Administrative Code › Chapter 689B - Group and Blanket Health Insurance › PORTABILITY AND ACCOUNTABILITY › Section 689B.305 - Restrictions on rules of eligibility and on premium and contribution rates

Current through June 11, 2024
1. A group health plan and a carrier that
			 issues group health insurance pursuant to chapter 689B of NRS shall not include
			 or establish any rule of eligibility, including continued eligibility, for any
			 individual to enroll for benefits under the terms of the group health plan or
			 group health insurance that discriminates based upon any health status-related
			 factor that relates to the individual or a dependent of the
			 individual.
2. A group health plan
			 and a carrier that issues group health insurance pursuant to chapter 689B of
			 NRS shall not include or establish any rule of eligibility, or set a premium or
			 contribution rate, for any individual based on whether the individual is:
(a) Confined to a hospital or other health
			 care institution; or
(b) Actively
			 at work, including whether an individual is continuously employed, unless the
			 group health plan or group health insurance treats absence from work because of
			 a health factor as being actively at work.
Nevada Administrative Code › Chapter 689B - Group and Blanket Health Insurance › PORTABILITY AND ACCOUNTABILITY › Section 689B.310 - Converted policies

Current through June 11, 2024
1. If a person is
			 issued a converted policy before the date on which basic and standard health
			 benefit plans were required to be offered pursuant to subsection 1 of
			 NRS
			 689B.590, the carrier shall notify the person
			 in writing, not less than 60 days before the annual renewal date of the
			 converted policy, of his right to elect a basic or standard health benefit plan
			 as a substitute to his current converted policy. The notice must include,
			 without limitation, the premium rates charged by the carrier for the basic and
			 standard health benefit plans.
2. A
			 carrier that issues health benefit plans to small employers and large employers
			 in this State shall allocate premium and loss experience on its converted
			 policies issued pursuant to
			 NRS
			 689B.590 based on:
(a) The number of persons with converted
			 policies whose most recent coverage was under a health benefit plan issued to a
			 small employer or a large employer relative to the total number of persons with
			 converted policies; or
(b) The
			 proportion of total premiums earned in the book of health benefit plan business
			 containing small employers or large employers relative to the total premiums
			 earned from all health benefit plans for small employers and large employers
			 during the period of experience.
Nevada Administrative Code › Chapter 689B - Group and Blanket Health Insurance › POLICIES FOR STOP-LOSS INSURANCE › Section 689B.350 - General provisions

Current through June 11, 2024
1. A policy for
			 stop-loss insurance must:
(a) Not provide
			 direct coverage of the health care expenses of an individual;
(b) Have an annual specific attachment point
			 for claims incurred per individual that is not less than $20,000; and
(c) Have an annual aggregate attachment point
			 for:
(1) Small employer groups that is at
			 least the greater of:
(I) One hundred and
			 twenty percent of expected claims; or
(II) Twenty thousand dollars; or
(2) All other groups that is at
			 least 110 percent of expected claims.
Nevada Administrative Code › Chapter 689C - Health Insurance for Small Employers › HEALTH BENEFIT PLANS › Section 689C.100 - "Existing coverage" interpreted (Repealed)

Current through June 11, 2024
Added to NAC by Comm'r
				of Insurance, eff. 3-28-96;	R
				by
				R161-22A,
				eff. 12/16/2022
NRS 679B.130,
				  689C.155 and
				  695C.080
Nevada Administrative Code › Chapter 689C - Health Insurance for Small Employers › HEALTH BENEFIT PLANS › Section 689C.105 - Uniformity of benefits required

Current through June 11, 2024
A carrier serving small employers shall offer the same benefits
				to all of the small employers it serves regardless of the number of eligible
				employees employed by the small employer.
Added to NAC by Comm'r
				of Insurance by R224-97, eff. 11-16-98
NRS
				  679B.130,
				  689C.155,
				  689C.203
Nevada Administrative Code › Chapter 689C - Health Insurance for Small Employers › HEALTH BENEFIT PLANS › Section 689C.110 - Adoption of waiting period for new employees not prohibited

Current through June 11, 2024
The Commissioner will interpret the provisions of
				NRS
				689C.190 as not prohibiting an employer from
				adopting a waiting period for new employees to become eligible for
				participation in a plan of health insurance offered by the employer.
Added to NAC by Comm'r
				of Insurance, eff. 3-28-96
NRS
				  679B.130,
				  689C.190
Nevada Administrative Code › Chapter 689C - Health Insurance for Small Employers › HEALTH BENEFIT PLANS › Section 689C.113 - Carrier prohibited from requesting or considering certain information

Current through June 11, 2024
A carrier serving small employers shall not:
1. Request information about an employee or
			 dependent who has waived coverage; or
2. Consider any information about an employee
			 or dependent who has waived coverage when calculating a premium rate for a
			 small employer.
Added to NAC by Comm'r
				of Insurance by R193-99, eff. 1-27-2000
NRS
				  679B.130,
				  689C.155,
				  689C.203
Nevada Administrative Code › Chapter 689C - Health Insurance for Small Employers › HEALTH BENEFIT PLANS › Section 689C.117 - Carrier prohibited from requiring purchase of other insurance as prerequisite to purchase or renewal of group health plan

Current through June 11, 2024
A carrier serving small employers shall not require a small
				employer to purchase a group life insurance policy or any other form of
				insurance as a prerequisite to the purchase or renewal of a group health plan
				for small employers.
Added to NAC by Comm'r
				of Insurance by R193-99, eff. 1-27-2000
NRS
				  679B.130,
				  689C.155,
				  689C.203
Nevada Administrative Code › Chapter 689C - Health Insurance for Small Employers › HEALTH BENEFIT PLANS › Section 689C.120 - Compliance required

Current through June 11, 2024
A carrier that provides health benefit plans to small employers
				in this State shall comply with the provisions of this chapter and:
1. Chapter 689C of NRS;
2.NRS
			 689B.033 and
			 689B.290 to
			 689B.330,
			 inclusive, to the extent that those provisions do not conflict with the
			 provisions of chapter 689C of NRS; and
3. All other applicable provisions of title
			 57 of NRS.
Added to NAC by Comm'r
				of Insurance, eff. 3-28-96
NRS
				  679B.130,
				  689C.155
Nevada Administrative Code › Chapter 689C - Health Insurance for Small Employers › HEALTH BENEFIT PLANS › Section 689C.130 - Notice of cancellation, nonrenewal or renewal with altered terms

Current through June 11, 2024
A notice of cancellation, nonrenewal or renewal with altered
				terms issued by a carrier to a small employer must comply with the provisions
				of
				NRS
				687B.310 to
				687B.420,
				inclusive, to the extent that those provisions do not conflict with the
				provisions of chapter 689C of NRS.
Added to NAC by Comm'r
				of Insurance, eff. 3-28-96
NRS
				  679B.130,
				  689C.155,
				  689C.203
Nevada Administrative Code › Chapter 689C - Health Insurance for Small Employers › HEALTH BENEFIT PLANS › Section 689C.140 - Minimum care and services required (Repealed)

Current through June 11, 2024
Added to NAC by Comm'r
				of Insurance, eff. 3-28-96; R by
				R089-17AP,
				eff. 5/16/2018
NRS 679B.130
Nevada Administrative Code › Chapter 689C - Health Insurance for Small Employers › HEALTH BENEFIT PLANS › Section 689C.150 - Notification of conversion privilege; coverage of eligible dependent

Current through June 11, 2024
1. A certificate of coverage for a health
			 benefit plan must include notification of the conversion privilege provided by
			 NRS
			 689C.330.
2. An eligible dependent is entitled to be
			 covered under a policy of health insurance issued pursuant to
			 NRS
			 689C.330.
Added to NAC by Comm'r
				of Insurance, eff. 3-28-96
NRS
				  679B.130,
				  689C.203,
				  689C.330
Nevada Administrative Code › Chapter 689C - Health Insurance for Small Employers › HEALTH BENEFIT PLANS › Section 689C.155 - Evidence of creditable coverage

Current through June 11, 2024
If a person is unable to obtain a certificate of creditable
				coverage pursuant to
				NRS
				689C.192, a carrier shall accept from the
				person other evidence of creditable coverage if it determines that the evidence
				reasonably establishes prior continuous creditable coverage. Such evidence may
				include, without limitation, a copy of:
1. A policy of health insurance or evidence
			 of coverage;
2. A billing statement
			 for the payment of premiums;
3. A
			 cancelled check evidencing payment for health insurance coverage;
4. A proof of insurance card issued by an
			 insurer;
5. An explanation of
			 benefits relating to a specific claim for medical services that were provided
			 to the person by an insurer;
6. A
			 letter notifying the person that he or she is eligible for coverage pursuant to
			 the Consolidated Omnibus Budget Reconciliation Act of 1985, Public Law
			 99-272;
7. A letter written by the
			 liquidator of an insurer that verifies the dates that the person was covered by
			 the insurer under a policy of health insurance;
8. A statement written by the person that
			 includes the name and telephone number of any insurer under which he or she
			 previously received health insurance coverage;
9. Evidence of a payroll deduction from the
			 person's salary for health insurance coverage;
10. Any record from a provider of medical
			 care that indicates that the person had health insurance coverage; or
11. Any combination thereof.
Added to NAC by Comm'r
				of Insurance by R224-97, eff. 11-16-98
NRS
				  679B.130,
				  689C.155,
				  689C.191,
				  689C.203
Nevada Administrative Code › Chapter 689C - Health Insurance for Small Employers › HEALTH BENEFIT PLANS › Section 689C.160 - Annual report (Repealed)

Current through June 11, 2024
Added to NAC by Comm'r
				of Insurance, eff. 3-28-96; A by R224-97, 11-16-98; R by
				R089-17AP,
				eff. 5/16/2018
NRS 679B.130
Nevada Administrative Code › Chapter 689C - Health Insurance for Small Employers › HEALTH BENEFIT PLANS › Section 689C.170 - Contents of disclosure form (Repealed)

Current through June 11, 2024
Added to NAC by Comm'r
				of Insurance, eff. 3-28-96;	R
				by
				R161-22A,
				eff. 12/16/2022
NRS 679B.130,
				  689C.155 and
				  695C.080
Nevada Administrative Code › Chapter 689C - Health Insurance for Small Employers › HEALTH BENEFIT PLANS › Section 689C.172 - Disclosures in advertising and sales materials; inclusion of certain information in health benefit plan (Repealed)

Current through June 11, 2024
Added to NAC by Comm'r
				of Insurance by R009-02, eff. 5-23-2002; A by R009-02,
				7-11-2002;	R
				by
				R161-22A,
				eff. 12/16/2022
NRS 679B.130,
				  689C.155 and
				  695C.080
Nevada Administrative Code › Chapter 689C - Health Insurance for Small Employers › HEALTH BENEFIT PLANS › Section 689C.175 - Request for copy of disclosure (Repealed)

Current through June 11, 2024
Added to NAC by Comm'r
				of Insurance by R224-97, eff. 11-16-98;	R
				by
				R161-22A,
				eff. 12/16/2022
NRS 679B.130,
				  689C.155 and
				  695C.080
Nevada Administrative Code › Chapter 689C - Health Insurance for Small Employers › HEALTH BENEFIT PLANS › Section 689C.180 - Filing of forms required by NRS 687B.120

Current through June 11, 2024
A form required to be filed pursuant to
				NRS
				687B.120 for a health benefit plan
				must:
1. Be in a format prescribed by
			 the Commissioner;
2. Include an
			 affidavit signed by an officer of the carrier which certifies that the premium
			 rates and forms for the health benefit plan comply with the provisions of
			 chapter 689C of NRS and all other applicable provisions of title 57 of NRS;
			 and
3. Include all other reasonable
			 information requested by the Commissioner.
Added to NAC by Comm'r
				of Insurance, eff. 3-28-96
NRS
				  679B.130,
				  687B.120,
				  689C.203
REVISER'S NOTE.
The regulation of the Commissioner of Insurance filed with
				  the Secretary of State on March 28, 1996 (LCB File No. R179-95), the source of
				  this section, contains the following provision not included in NAC:
"1. A carrier serving small employers that offers a health
				  benefit plan shall, with regard to the plan, file a form which complies with
				  the requirements of section 10 of this regulation [NAC 689C.180 ] before April
				  1, 1996.
2. A form approved by the Commissioner before the effective
				  date of this regulation [March 28, 1996] shall be deemed to conform with the
				  applicable provisions of chapter 689C of NRS and may be used by the carrier
				  until a new form is approved by the Commissioner. Each small employer, covered
				  employee and dependent must be provided with a new form within 30 days after
				  approval of the form by the
				  Commissioner."
Nevada Administrative Code › Chapter 689C - Health Insurance for Small Employers › HEALTH BENEFIT PLANS › Section 689C.190 - Coverage under different plan constituting passage of fixed period

Current through June 11, 2024
A carrier serving small employers shall, with regard to
				employees that had existing coverage continuously under a different health plan
				in the 90-day period immediately preceding the effective date of the new
				coverage, deem satisfied any provision in the policy which requires the passage
				of a fixed period before coverage is provided for a preexisting condition. The
				previous carrier shall provide information concerning the previous coverage
				within 10 working days after receipt of a written request by the current
				carrier.
Added to NAC by Comm'r
				of Insurance, eff. 3-28-96
NRS
				  679B.130,
				  689C.190,
				  689C.203
Nevada Administrative Code › Chapter 689C - Health Insurance for Small Employers › HEALTH BENEFIT PLANS › Section 689C.195 - Restrictions on rules of eligibility and on contribution rates

Current through June 11, 2024
1. A group health plan and a carrier that
			 issues group health insurance pursuant to chapter 689C of NRS shall not include
			 or establish any rule of eligibility, including continued eligibility, for any
			 individual to enroll for benefits under the terms of the group health plan or
			 group health insurance that discriminates based upon any health status-related
			 factor that relates to the individual or a dependent of the
			 individual.
2. A group health plan
			 and a carrier that issues group health insurance pursuant to chapter 689C of
			 NRS shall not include or establish any rule of eligibility, or set a premium or
			 contribution rate, for any individual based on whether the individual is:
(a) Confined to a hospital or other health
			 care institution; or
(b) Actively
			 at work, including whether an individual is continuously employed, unless the
			 group health plan or group health insurance treats absence from work because of
			 a health factor as being actively at work.
Nevada Administrative Code › Chapter 689C - Health Insurance for Small Employers › HEALTH BENEFIT PLANS › Section 689C.200 - Development of rate manual; calculation of rates

Current through June 11, 2024
1. A
			 carrier serving small employers shall develop a rate manual for each class of
			 business established by the carrier. Base premium rates and new business
			 premium rates charged to small employers by the carrier must be computed solely
			 from the applicable rate manual. To the extent that a portion of the premium
			 rates charged by a carrier is based on the carrier's discretion, the manual
			 must specify the criteria and factors considered by the carrier in exercising
			 its discretion.
2. The rate manual
			 must specify the risk characteristics and rate factors to be applied by the
			 carrier in establishing premium rates for the class of business.
3. A carrier shall keep on file for at least
			 7 years the calculations used to determine the change in base premium rates and
			 new business premium rates for each health benefit plan for each rating
			 period.
Added to NAC by Comm'r
				of Insurance, eff. 3-28-96
NRS
				  679B.130,
				  689C.155,
				  689C.203
Nevada Administrative Code › Chapter 689C - Health Insurance for Small Employers › HEALTH BENEFIT PLANS › Section 689C.202 - Limitation on frequency of increases in premium rates; exceptions

Current through June 11, 2024
1. Except as otherwise provided in this
			 section, a carrier serving small employers shall not increase the premium rates
			 for a group health benefit plan more frequently than every 6 months unless the
			 increase in the premium rates is being made because:
(a) An employer has requested a change in its
			 group health benefit plan;
(b)
			 There has been a change in the number of employees covered by an employer that
			 would affect the insurance premium rate of the employer; or
(c) There has been a change in federal or
			 state law which affects the cost of providing services under the group health
			 benefit plan.
Nevada Administrative Code › Chapter 689C - Health Insurance for Small Employers › HEALTH BENEFIT PLANS › Section 689C.205 - Disclosure of variance in premium rate (Repealed)

Current through June 11, 2024
Added to NAC by Comm'r
				of Insurance by R224-97, eff. 11-16-98;	R
				by
				R161-22A,
				eff. 12/16/2022
NRS 679B.130,
				  689C.155 and
				  695C.080
Nevada Administrative Code › Chapter 689C - Health Insurance for Small Employers › HEALTH BENEFIT PLANS › Section 689C.210 - Marketing in established geographic area

Current through June 11, 2024
A carrier serving small employers shall, in accordance with the
				provisions of
				NRS
				689C.200, take reasonable steps to market its
				health benefit plans to small employers located in the carrier's established
				geographic area.
Added to NAC by Comm'r
				of Insurance, eff. 3-28-96
NRS
				  679B.130,
				  689C.203
Nevada Administrative Code › Chapter 689C - Health Insurance for Small Employers › HEALTH BENEFIT PLANS › Section 689C.220 - Requirement upon denial of coverage (Repealed)

Current through June 11, 2024
Added to NAC by Comm'r
				of Insurance, eff. 3-28-96;	R
				by
				R161-22A,
				eff. 12/16/2022
NRS 679B.130,
				  689C.155 and
				  695C.080
Nevada Administrative Code › Chapter 689C - Health Insurance for Small Employers › HEALTH BENEFIT PLANS › Section 689C.230 - Determination of reduction in liability of carrier because of benefits under other group coverage

Current through June 11, 2024
A reduction in the liability of a carrier serving small
				employers because of benefits under other valid group coverage must be
				determined in the manner provided in
				NRS
				689B.063 and
				689B.064.
Added to NAC by Comm'r
				of Insurance, eff. 12-9-92; A 3-28-96-Substituted in revision for NAC
				689C.080
NRS
				  679B.130
Nevada Administrative Code › Chapter 689C - Health Insurance for Small Employers › HEALTH BENEFIT PLANS › Section 689C.250 - Policies for stop-loss insurance

Current through June 11, 2024
1. A policy for
			 stop-loss insurance must:
(a) Not provide
			 direct coverage of the health care expenses of an individual;
(b) Have an annual specific attachment point
			 for claims incurred per individual that is not less than $20,000; and
(c) Have an annual aggregate attachment point
			 for:
(1) Small employer groups that is at
			 least the greater of:
(I) One hundred and
			 twenty percent of expected claims; or
(II) Twenty thousand dollars; or
(2) All other groups that is at
			 least 110 percent of expected claims.
Nevada Administrative Code › Chapter 689C - Health Insurance for Small Employers › HEALTH BENEFIT PLANS › Section 689C.260 - Prior notification of desire to change status as risk-assuming or reinsuring carrier (Repealed)

Current through June 11, 2024
Added to NAC by Comm'r
				of Insurance by R009-02, eff. 5-23-2002; A by R009-02, 7-11-2002; R by
				R089-17AP,
				eff. 5/16/2018
NRS 679B.130
Nevada Administrative Code › Chapter 689C - Health Insurance for Small Employers › HEALTH BENEFIT PLANS › Section 689C.265 - Application for change of status as risk-assuming or reinsuring carrier: Filing; action by Commissioner; confidentiality (Repealed)

Current through June 11, 2024
Added to NAC by Comm'r
				of Insurance by R009-02, eff. 5-23-2002; A by R009-02, 7-11-2002; R by
				R089-17AP,
				eff. 5/16/2018
NRS 679B.130
Nevada Administrative Code › Chapter 689C - Health Insurance for Small Employers › HEALTH BENEFIT PLANS › Section 689C.Sec. 3 - NEW

Current through June 11, 2024
1. A carrier that issues a health
			 benefit plan shall not require an insured to pay a higher deductible
			 or any copayment, coinsurance or other form of cost-sharing for or
			 use any medical management technique to restrict access by an insured
			 to:
(a) A visit to the office of a
			 provider of health care, an urgent care center, an independent center
			 for emergency medical care, the emergency room of a hospital or a
			 COVID-19 screening or testing site, if the purpose of the visit is to
			 determine whether the insured has COVID-19;
(b) A test to determine whether the
			 insured has COVID-19 if the attending provider of health care
			 determines, in accordance with generally accepted medical standards,
			 that the test is appropriate; or
(c) A vaccine to prevent the
			 insured from contracting COVID-19.
Nevada Administrative Code › Chapter 689C - Health Insurance for Small Employers › VOLUNTARY PURCHASING GROUPS › Section 689C.300 - Application for registration; submission of proposed material changes to business plan

Current through June 11, 2024
1. In addition to the requirements of
			 NRS
			 689C.500, the application for registration
			 must include:
(a) A statement authorizing the
			 representative of the voluntary purchasing group to complete and file the
			 application;
(b) A business plan,
			 which must be approved by the Commissioner, that:
(1) Explains the manner in which the group
			 will reduce the cost of providing health care, increase access to and improve
			 the quality of health care services for those persons eligible for
			 participation in the group; and
(2)
			 Demonstrates to the Commissioner that the applicant possesses the technical
			 expertise and physical capacity to serve at least 10 percent of the proposed
			 service area in which small employers are not currently being served by an
			 existing group;
(c) The
			 scope of services to be offered;
(d) A demonstration that the group is an
			 appropriate and effective representative of the interests of small employers in
			 the service area;
(e) Biographical
			 information concerning the principals of the group demonstrating that the
			 principals have sufficient expertise, experience and competence to represent
			 small employers in a fiduciary capacity;
(f) A description of the administrative and
			 accounting procedures established for the operation of the group;
(g) A description of the manner in which the
			 group will offer insurance coverage through marketing to small employers
			 currently not served by a group;
(h) A disclosure of any preexisting oral or
			 written agreements;
(i) Statements
			 and reports that show that the group itself will not bear the financial risk
			 related to coverage;
(j) An
			 application fee of $1,500; and
(k)
			 A bond posted or a certificate of deposit or securities deposited in an amount
			 to be determined by the Commissioner of not less than $100,000. The bond or
			 deposit must be accompanied by an irrevocable power of attorney authorizing the
			 Commissioner to transfer the bond or deposit, or any part thereof, for any
			 purpose within the scope of
			 NRS 689C.360 to
			 689C.600,
			 inclusive.
Nevada Administrative Code › Chapter 689C - Health Insurance for Small Employers › VOLUNTARY PURCHASING GROUPS › Section 689C.310 - Grounds for denial of application or suspension, revocation or refusal to renew certificate

Current through June 11, 2024
The Commissioner may deny the application of a voluntary
				purchasing group or suspend, revoke or refuse to renew the certificate of
				registration of a group for the following reasons:
1. Failure to comply with any applicable
			 provisions of title 57 of NRS;
2.
			 Failure to disclose a preexisting oral or written agreement during the
			 application process;
3. Failure to
			 comply with and carry out the approved business plan;
4. Failure to follow approved procedures or
			 maintain adequate controls;
5.
			 Failure to meet the standards of a financial or performance
			 examination;
6. Failure to market
			 health care services actively to small employers not currently served by the
			 group;
7. Failure to comply with an
			 order of the Commissioner;
8.
			 Commission of an unfair or deceptive act or practice as defined in chapter 686A
			 of NRS or NAC;
9. Filing a form
			 with the Commissioner that contains fraudulent information or
			 omissions;
10. Misappropriation of,
			 conversion of, illegal withholding of or refusal to pay obligations legally
			 owed from funds entrusted to the group in its fiduciary capacity;
11. Failure to offer the services of the
			 group to small employers not currently being served by a group; or
12. Failure to supply a business plan for the
			 group that will reduce and continue to reduce the cost of insurance and improve
			 quality and access to affordable health insurance or health care
			 services.
Added to NAC by Comm'r
				of Insurance, eff. 3-5-96
NRS
				  679B.130,
				  689C.600
Nevada Administrative Code › Chapter 689C - Health Insurance for Small Employers › VOLUNTARY PURCHASING GROUPS › Section 689C.320 - Annual renewal fee

Current through June 11, 2024
The voluntary purchasing group must pay an annual renewal fee
				of $1,000 to the Commissioner on or before March 1 of each year.
Added to NAC by Comm'r
				of Insurance, eff. 3-5-96
NRS
				  679B.130,
				  689C.530,
				  689C.600
Nevada Administrative Code › Chapter 689C - Health Insurance for Small Employers › VOLUNTARY PURCHASING GROUPS › Section 689C.330 - Disclosure by carrier

Current through June 11, 2024
In addition to the requirements of
				NRS 689C.440, the
				disclosure offered by a carrier must:
1. Be printed in at least 10-point
			 type;
2. Include the name, address
			 and telephone number of the insurer;
3. Include the name, address and telephone
			 number of any agent, broker or administrator which is under contract with the
			 voluntary purchasing group pursuant to
			 NRS 689C.540;
4. Include a statement describing the
			 principal benefits and the type of coverage being provided; and
5. Include a definition of the term "usual
			 and customary" or any similar term used in the policy.
Added to NAC by Comm'r
				of Insurance, eff. 3-5-96
NRS
				  679B.130,
				  689C.440
Nevada Administrative Code › Chapter 689C - Health Insurance for Small Employers › VOLUNTARY PURCHASING GROUPS › Section 689C.340 - Accessibility of coverage: Prohibited activity; enrollment of all eligible employees and dependents

Current through June 11, 2024
1. A participating
			 carrier, agent or broker shall not engage in any activity that would encourage
			 an eligible employee to decline coverage offered by the voluntary purchasing
			 group or to seek coverage from other participating carriers.
2. Participating carriers, agents or brokers
			 must enroll all eligible employees and dependents regardless of current health
			 status or history of prior claims.
Added to NAC by Comm'r
				of Insurance, eff. 3-5-96
NRS
				  679B.130,
				  689C.460
Nevada Administrative Code › Chapter 689C - Health Insurance for Small Employers › VOLUNTARY PURCHASING GROUPS › Section 689C.350 - Annual report

Current through June 11, 2024
Each voluntary purchasing group shall submit to the
				Commissioner no later than March 1, 1997, and annually thereafter, a report
				concerning:
1. The progress achieved
			 by the group in providing affordable coverage to eligible small employers
			 within the service area;
2. Any
			 proposed financial incentives or other activities designed to increase group
			 participation;
3. An evaluation of
			 the effectiveness of purchasing health care coverage exclusively through the
			 group; and
4. Any recommended
			 amendments to the law or regulations to improve the cost-effectiveness of the
			 coverage and fair operations of the group.
Added to NAC by Comm'r
				of Insurance, eff. 3-5-96
NRS
				  679B.130,
				  689C.530,
				  689C.600
Nevada Administrative Code › Chapter 689C - Health Insurance for Small Employers › VOLUNTARY PURCHASING GROUPS › Section 689C.360 - General powers

Current through June 11, 2024
A voluntary purchasing group may:
1. Offer other benefit plans approved by the
			 Commissioner, such as group coverage for vision care, dental care and other
			 limited contracts for other care;
2. Exclude or temporarily suspend the
			 registration of a participating insurance carrier that has failed to achieve
			 established standards for quality, access or the reporting of information as
			 provided in the contract;
3.
			 Require a member of the group who is seeking to withdraw from membership to pay
			 the agreed upon membership fee for the balance of the contract
			 period;
4. Establish uniform
			 standards for collecting data to evaluate the performance of participating
			 carriers; and
5. Negotiate the
			 component for administrative expenses of their premium rates with participating
			 carriers.
Added to NAC by Comm'r
				of Insurance, eff. 3-5-96
NRS
				  679B.130,
				  689C.600
Nevada Administrative Code › Chapter 689C - Health Insurance for Small Employers › VOLUNTARY PURCHASING GROUPS › Section 689C.370 - Prohibited acts

Current through June 11, 2024
A voluntary purchasing group shall not:
1. Purchase health care services for its
			 enrollees or otherwise assume the related financial risk;
2. Exclude any eligible small employer that
			 is willing to accept the rules and bylaws of membership;
3. Commit an act that constitutes a rebate as
			 prohibited by
			 NRS
			 686A.110;
4. Charge fees that are not directly related
			 to the operations of the group or for activities that are not related to health
			 care;
5. Require small employers to
			 subscribe to a limited benefit insurance or products or services not related to
			 health care; or
6. Operate the
			 group in a manner that excludes those small businesses that may have higher
			 than average health care costs.
Added to NAC by Comm'r
				of Insurance, eff. 3-5-96
NRS
				  679B.130,
				  689C.600
Nevada Administrative Code › Chapter 689C - Health Insurance for Small Employers › VOLUNTARY PURCHASING GROUPS › Section 689C.380 - Provisions of contract with participating carrier: Payment of premiums

Current through June 11, 2024
Each contract between a voluntary purchasing group and a
				participating carrier must include a provision which sets forth:
1. A statement of how the premiums are to be
			 paid;
2. The grace period after the
			 date the payment of premiums becomes due; and
3. The specific penalties for late
			 payment.
Added to NAC by Comm'r
				of Insurance, eff. 3-5-96
NRS
				  679B.130,
				  689C.600
Nevada Administrative Code › Chapter 689C - Health Insurance for Small Employers › VOLUNTARY PURCHASING GROUPS › Section 689C.390 - Provisions of contract with participating small employer: Group as policyholder of record; issuance of certificates of coverage; coverage through group required

Current through June 11, 2024
Each contract between a voluntary purchasing group and a
				participating small employer must provide that:
1. For administrative purposes, the group is
			 the policyholder of record for health care contracts on behalf of the small
			 employer;
2. Participating carriers
			 shall issue certificates of coverage; and
3. Eligible employees of small employers who
			 buy coverage through their employer must obtain the coverage through the
			 group.
Added to NAC by Comm'r
				of Insurance, eff. 3-5-96
NRS
				  679B.130,
				  689C.600
Nevada Administrative Code › Chapter 689C - Health Insurance for Small Employers › VOLUNTARY PURCHASING GROUPS › Section 689C.400 - Establishment of standards and guidelines for insurers

Current through June 11, 2024
A voluntary purchasing group shall establish standards and
				guidelines for compliance by insurers which will enable the group to conduct
				its business, meet its reporting obligations and offer contracts for health
				care coverage to its members.
Added to NAC by Comm'r
				of Insurance, eff. 3-5-96
NRS
				  679B.130,
				  689C.600
Nevada Administrative Code › Chapter 689C - Health Insurance for Small Employers › VOLUNTARY PURCHASING GROUPS › Section 689C.410 - Establishment of marketing standards and approval of marketing materials

Current through June 11, 2024
The voluntary purchasing group shall establish marketing
				standards for participating carriers and approve all marketing materials before
				use.
Added to NAC by Comm'r
				of Insurance, eff. 3-5-96
NRS
				  679B.130,
				  689C.600
Nevada Administrative Code › Chapter 689C - Health Insurance for Small Employers › VOLUNTARY PURCHASING GROUPS › Section 689C.420 - Board of directors and management personnel: Duties

Current through June 11, 2024
The board of directors and management personnel of a voluntary
				purchasing group shall:
1. Operate the
			 voluntary purchasing group;
2.
			 Publish the requirements that carriers must meet to participate in the
			 group;
3. Contract with at least
			 three unaffiliated carriers to create a choice of contracts at a range of
			 premiums with a difference of at least 20 percent between the premiums for the
			 most comprehensive plan and the least comprehensive plan. The Commissioner will
			 waive this condition upon demonstration of good cause;
4. Develop standard procedures for
			 enrollment;
5. Include a provision
			 for the prepayment of premiums;
6.
			 Act on all grievances received from small employers, review information and
			 recommendations received from participants and enrollees, and take appropriate
			 actions;
7. Establish procedures
			 for billing and collecting premiums from participating small
			 employers;
8. Establish procedures
			 for periods of open enrollment during which enrollees may choose any contract
			 available through the group; and
9.
			 Offer the same premiums on each contract to all classes of members.
Added to NAC by Comm'r
				of Insurance, eff. 3-5-96
NRS
				  679B.130,
				  689C.600
Nevada Administrative Code › Chapter 689C - Health Insurance for Small Employers › VOLUNTARY PURCHASING GROUPS › Section 689C.430 - Board members and management personnel: Prohibited acts

Current through June 11, 2024
No board members or management personnel of the voluntary
				purchasing group and their immediate families may, in any capacity:
1. Receive remuneration of any kind from any
			 carrier;
2. Provide representation
			 for any insurance agent, broker or insurance consultant;
3. Be licensed as an insurance agent, broker,
			 third-party administrator or insurance consultant; or
4. Have a direct or indirect financial
			 interest in any person licensed, certified or registered pursuant to title 57
			 of NRS.
Added to NAC by Comm'r
				of Insurance, eff. 3-5-96
NRS
				  679B.130,
				  689C.600
Nevada Administrative Code › Chapter 689C - Health Insurance for Small Employers › VOLUNTARY PURCHASING GROUPS › Section 689C.440 - Report of suspected violation

Current through June 11, 2024
A voluntary purchasing group shall report to the Commissioner
				any suspected violation of law or regulation relating to any transaction
				between the group and insurers who offer policies for group health
				insurance.
Added to NAC by Comm'r
				of Insurance, eff. 3-5-96
NRS
				  679B.130,
				  689C.600
Nevada Administrative Code › Chapter 689C - Health Insurance for Small Employers › VOLUNTARY PURCHASING GROUPS › Section 689C.450 - Insolvency of voluntary purchasing group: Jurisdiction of Commissioner

Current through June 11, 2024
If a voluntary purchasing group becomes insolvent, the
				Commissioner will maintain jurisdiction over the group to protect the interests
				of the enrollees in the group.
Added to NAC by Comm'r
				of Insurance, eff. 3-5-96
NRS
				  679B.130,
				  689C.600
Nevada Administrative Code › Chapter 690A - Credit Insurance › Section 690A.002 - Definitions

Current through June 11, 2024
As used in this chapter, unless the context otherwise requires, the words and terms defined in NAC 690A.005 to 690A.018, inclusive, have the meanings ascribed to them in those sections.
Added to NAC by Comm'r of Insurance by R014-06, 3-23-2007, eff. 4-1-2007
NRS 679B.130, 690A.277
Nevada Administrative Code › Chapter 690A - Credit Insurance › Section 690A.005 - "Actuarially consistent" defined

Current through June 11, 2024
"Actuarially consistent" means the present value of two patterns of cash flow that when measured using the same assumptions are approximately equivalent.
Added to NAC by Comm'r of Insurance by R014-06, 3-23-2007, eff. 4-1-2007
NRS 679B.130, 690A.277
Nevada Administrative Code › Chapter 690A - Credit Insurance › Section 690A.012 - "Indebtedness" defined

Current through June 11, 2024
"Indebtedness" means the total amount payable by a debtor to a creditor in connection with a loan or other credit transaction and includes the finance charge that is or will be assigned to the transaction.
Added to NAC by Comm'r of Insurance by R014-06, 3-23-2007, eff. 4-1-2007
NRS 679B.130, 690A.277
Nevada Administrative Code › Chapter 690A - Credit Insurance › Section 690A.014 - "Outstanding balance basis" defined

Current through June 11, 2024
"Outstanding balance basis" means premiums that are paid monthly using a rate per $1,000 of monthly outstanding insured indebtedness.
Added to NAC by Comm'r of Insurance by R014-06, 3-23-2007, eff. 4-1-2007
NRS 679B.130, 690A.277
Nevada Administrative Code › Chapter 690A - Credit Insurance › Section 690A.016 - "Prima facie rate" defined

Current through June 11, 2024
"Prima facie rate" means a rate that is deemed to be reasonable in relation to the benefits provided for credit insurance and may be used without filing additional actuarial information with the Commissioner.
Added to NAC by Comm'r of Insurance by R014-06, 3-23-2007, eff. 4-1-2007
NRS 679B.130, 690A.277
Nevada Administrative Code › Chapter 690A - Credit Insurance › Section 690A.018 - "Single premium basis" defined

Current through June 11, 2024
"Single premium basis" means the present value of the monthly premiums that are charged over the term of a policy.
Added to NAC by Comm'r of Insurance by R014-06, 3-23-2007, eff. 4-1-2007
NRS 679B.130, 690A.277
Nevada Administrative Code › Chapter 690A - Credit Insurance › Section 690A.020 - Disclosures to debtors: Requirement; filing of form for approval

Current through June 11, 2024
Before a debtor elects to purchase consumer credit insurance in connection with a credit transaction, the information found in the form NDOI-915, as specified in subsection 2 of NAC 690A.025, must be disclosed to the debtor in writing. The insurer is not required to file the form he or she uses for this disclosure with the Commissioner for approval if:
1. The insurer elects to use form NDOI-915 and notifies the Commissioner of its use; or
2. If an officer of the insurer submits a written certification to the Commissioner that the forms used by the insurer are identical to form NDOI-915.
Added to NAC by Comm'r of Insurance by R131-05, eff. 10-31-2005
NRS 679B.130, 690A.073, 690A.087, 690A.277
Nevada Administrative Code › Chapter 690A - Credit Insurance › Section 690A.025 - Disclosures to debtors: Approved form

Current through June 11, 2024
1. Except as otherwise provided in NAC 690A.020, an insurer that issues a policy of consumer credit insurance must disclose the limitations set forth in subsection 2 in the manner set forth in subsection 2.
2. The form of the disclosure statement shall be deemed approved by the Commissioner if it is written as follows:
CONSUMER CREDIT DISCLOSURE FORM
NDOI-915
1. The purchase of consumer credit insurance from the creditor is not mandatory and is not a condition for obtaining credit approval;
2. If more than one type of consumer credit insurance is made available to you, your creditor will advise you that you may purchase each separately or only as a package;
3. Please refer to your certificate of coverage for the specific information regarding the conditions of eligibility;
4. If you have other insurance that covers the risk, you may not want or need consumer credit insurance;
5. You may cancel the insurance at any time, or if evidence of insurance is required for the extension of credit, upon proof of insurance that is acceptable to the creditor, and obtain a refund of or credit for:
(a) If the cancellation is not more than 30 days after you receive the individual policy or certificate of insurance, any premium paid by you; or
(b) If the cancellation is more than 30 days after you receive the individual policy or certificate of insurance, any unearned premium paid by you;
6. Please refer to your certificate of coverage for the specific information regarding these items: a description of the coverage, including a description of the amount, term, exceptions, limitations and exclusions, the insured event, any waiting or elimination period, any deductible, any applicable waiver of premium, the person who would receive any benefits, and the premium or premium rate for the consumer credit insurance; and
7. If the premium or insurance charge is financed, it will be subject to finance charges at the rate applicable to the credit transaction.
Added to NAC by Comm'r of Insurance by R131-05, eff. 10-31-2005
NRS 679B.130, 690A.073, 690A.087, 690A.277