reglab/statecodes huggingface dataset:
Nevada Administrative Code › Chapter 686B - Rates and Essential Insurance › INDUSTRIAL INSURANCE › Nevada Workers' Compensation Insurance Plan › Section 686B.830 - Requirements of insurers

Current through June 11, 2024
1. Each insurer
				providing industrial insurance in this State shall:
(a) Participate in the Nevada Workers'
				Compensation Insurance Plan; and
(b) Subscribe to the Articles of Agreement of
				the National Workers' Compensation Reinsurance Pool,
which are hereby adopted by reference.
Nevada Administrative Code › Chapter 686B - Rates and Essential Insurance › INDUSTRIAL INSURANCE › Nevada Workers' Compensation Insurance Plan › Section 686B.835 - Distribution of premiums paid and losses incurred

Current through June 11, 2024
1. The
				premiums paid and losses incurred by insurers for industrial insurance provided
				pursuant to the Nevada Workers' Compensation Insurance Plan must be:
(a) Ceded first to the National Workers'
				Compensation Reinsurance Pool; and
(b) Redistributed periodically based on the
				proportionate voluntary market share of each participant in the pool, as set
				forth in:
(1) The Articles of Agreement of the
				National Workers' Compensation Reinsurance Pool; or
(2) The Quota Share Reinsurance Agreement of
				the National Council on Compensation Insurance, which is hereby adopted by
				reference.
Nevada Administrative Code › Chapter 686B - Rates and Essential Insurance › INDUSTRIAL INSURANCE › Nevada Workers' Compensation Insurance Plan › Section 686B.840 - Requirements for qualification for insurance

Current through June 11, 2024
1. To
				qualify for insurance under the Nevada Workers' Compensation Insurance Plan, an
				employer must have been declined coverage by at least two insurers that are not
				affiliated with each other
.
2. The provisions of subsection 1 must not be
				construed to prohibit an employer from continuing to apply for industrial
				insurance after the employer has been declined coverage by two qualified
				insurers.
Added to NAC by Comm'r
				  of Insurance by R091-98, 11-2-98, eff. 7-1-99; A by R091-98, 11-2-98, eff.
				  1-1-2001; R196-99, 1-27-2000
NRS
					 679B.130,
					 686B.1771
Nevada Administrative Code › Chapter 686B - Rates and Essential Insurance › INDUSTRIAL INSURANCE › Miscellaneous Provisions › Section 686B.843 - Filing requirements for final rates and loss cost multipliers; use of loss cost multipliers

Current through June 11, 2024
1. For each filing
				of final rates or loss cost multipliers for policies of industrial insurance
				made pursuant to
				NRS
				686B.1775, the insurer:
(a) Shall complete and include, without
				limitation:
(1) If an expense constant
				applies, Expense Worksheet A, which is prescribed by the Commissioner;
				or
(2) If an expense constant does
				not apply, Expense Worksheet B, which is prescribed by the
				Commissioner.
Nevada Administrative Code › Chapter 686B - Rates and Essential Insurance › INDUSTRIAL INSURANCE › Miscellaneous Provisions › Section 686B.845 - Plan for payment of dividends; plan for payment of savings, unearned premium deposits or equivalent abatement for premiums allowed or returned for policy

Current through June 11, 2024
1. An insurer must
				file its plan for the payment of dividends for a policy of industrial insurance
				with the Commissioner at least 30 days before the effective date of the
				plan.
2. The plan for the payment
				of dividends filed pursuant to subsection 1 must include:
(a) The dividend plan disclosure forms and
				dividend payment forms used by the insurer;
(b) The conditions under which the insured
				will be eligible to receive a dividend;
(c) The criteria used by the insurer for
				determining which plan is applicable for each particular kind of risk;
				and
(d) Any applicable formula or
				factor used by the insurer for calculating dividends, including, without
				limitation:
(1) Loss ratios;
(2) Tax multipliers;
(3) Loss conversion factors; and
(4) Premiums.
Nevada Administrative Code › Chapter 687B - Contracts of Insurance › GENERAL PROVISIONS › Section 687B.0005 - "Commissioner" defined

Current through June 11, 2024
"Commissioner" means the Commissioner of Insurance.
Added to NAC by Comm'r of
				Insurance, eff. 11-21-88-Substituted in revision for NAC
				687B.020
NRS
				  679B.130
Nevada Administrative Code › Chapter 687B - Contracts of Insurance › GENERAL PROVISIONS › Section 687B.004 - Procedures for filing certain forms and paying certain fees

Current through June 11, 2024
1. Any form required to be filed pursuant to
			 the provisions of
			 NRS
			 687B.120 must be filed in accordance with the
			 System for Electronic Rate and Form Filing developed and implemented by the
			 National Association of Insurance Commissioners.
2. Any fee required when filing a rate, rule
			 or form pursuant to
			 NRS
			 680B.010 must be paid using the Electronic
			 Funds Transfer function within the System for Electronic Rate and Form
			 Filing.
Added to NAC by Comm'r of
				Insurance by R115-02, eff. 3-18-2003; A by R129-06, 9-18-2006; R097-10,
				12-16-2010, eff. 12-31-2010
NRS
				  679B.130,
				  679B.136,
				  687B.120
Nevada Administrative Code › Chapter 687B - Contracts of Insurance › CONTRACTS FOR LONG-TERM CARE › Section 687B.005 - Definitions

Current through June 11, 2024
As used in NAC 687B.005 to 687B.140, inclusive, unless the
				context otherwise requires, the words and terms defined in NAC 687B.010 to
				687B.0342, inclusive, have the meanings ascribed to them in those
				sections.
Added to NAC by Comm'r of
				Insurance, eff. 11-21-88; A 1-4-91; 12-15-94; R121-07, 9-18-2008, eff.
				10-1-2008
NRS
				  679B.130
Nevada Administrative Code › Chapter 687B - Contracts of Insurance › CONTRACTS FOR LONG-TERM CARE › Section 687B.010 - "Applicant" defined

Current through June 11, 2024
"Applicant" means:
1.
			 In the case of an individual long-term care insurance contract, the person who
			 seeks to contract for benefits.
2.
			 In the case of a group long-term care insurance contract, the proposed
			 certificate holder.
Added to NAC by Comm'r of
				Insurance, eff. 11-21-88; A by R028-10, 12-16-2010, eff.
				10-1-2011
NRS
				  679B.130
Nevada Administrative Code › Chapter 687B - Contracts of Insurance › CONTRACTS FOR LONG-TERM CARE › Section 687B.012 - "Basis for continuation of coverage" defined

Current through June 11, 2024
"Basis for continuation of coverage" means a provision that
				maintains coverage under the existing group long-term care insurance contract,
				subject only to the continued timely payment of premiums, when such coverage
				would otherwise terminate.
Added to NAC by Comm'r of
				Insurance, eff. 12-15-94; A by R028-10, 12-16-2010, eff. 10-1-2011-Substituted
				in revision for NAC 687B.031
NRS
				  679B.130
Nevada Administrative Code › Chapter 687B - Contracts of Insurance › CONTRACTS FOR LONG-TERM CARE › Section 687B.013 - "Basis for conversion of coverage" defined

Current through June 11, 2024
"Basis for conversion of coverage" means a provision that a
				person:
1. Whose coverage under the
			 group long-term care insurance contract would otherwise terminate, or whose
			 coverage has been terminated for any reason, including discontinuance of the
			 group long-term care insurance contract in its entirety or with respect to an
			 insured class; and
2. Who has been
			 continuously insured under the group long-term care insurance contract and any
			 group long-term care insurance contract which it replaced for at least the 6
			 months immediately preceding the date of termination,
Is entitled to the issuance of a converted policy by the
				insurer under whose group long-term care insurance contract he or she is
				covered, without evidence of insurability.
Added to NAC by Comm'r of
				Insurance, eff. 12-15-94; A by R028-10, 12-16-2010, eff. 10-1-2011-Substituted
				in revision for NAC 687B.032
NRS
				  679B.130
Nevada Administrative Code › Chapter 687B - Contracts of Insurance › CONTRACTS FOR LONG-TERM CARE › Section 687B.015 - "Certificate" defined

Current through June 11, 2024
"Certificate" means any certificate issued under a group
				long-term care insurance contract which is delivered or issued for delivery in
				this State.
Added to NAC by Comm'r of
				Insurance, eff. 11-21-88; A by R028-10, 12-16-2010, eff.
				10-1-2011
NRS
				  679B.130
Nevada Administrative Code › Chapter 687B - Contracts of Insurance › CONTRACTS FOR LONG-TERM CARE › Section 687B.019 - "Converted policy" defined

Current through June 11, 2024
"Converted policy" means an individual long-term care insurance
				contract providing benefits identical to, or benefits determined by the
				Commissioner to be substantially equivalent to, or in excess of, those provided
				under the group long-term care insurance contract from which conversion is
				made.
Added to NAC by Comm'r of
				Insurance, eff. 12-15-94; A by R028-10, 12-16-2010, eff.
				10-1-2011
NRS
				  679B.130
Nevada Administrative Code › Chapter 687B - Contracts of Insurance › CONTRACTS FOR LONG-TERM CARE › Section 687B.021 - "Exceptional increase" defined

Current through June 11, 2024
"Exceptional increase" means an increase which is filed by an
				insurer as exceptional and for which the Commissioner determines the need for
				the premium rate increase is justified:
1. Because of changes in laws or regulations
			 applicable to long-term care insurance coverage in this State; or
2. Because of increased and unexpected
			 utilization that affects the majority of insurers of similar
			 products.
Added to NAC by Comm'r of
				Insurance by R028-10, 12-16-2010, eff. 10-1-2011
NRS
				  679B.130
Nevada Administrative Code › Chapter 687B - Contracts of Insurance › CONTRACTS FOR LONG-TERM CARE › Section 687B.025 - "Group long-term care insurance" defined

Current through June 11, 2024
"Group long-term care insurance" means a long-term care
				insurance contract which is delivered or issued for delivery in this State
				to:
1. One or more employers or labor
			 organizations, or to a trust or to the trustees of a fund established by one or
			 more employers or labor organizations, or both, for employees or former
			 employees, or both, or for members or former members, or both, of the labor
			 organizations;
2. Any professional,
			 trade or occupational association for its members or former or retired members,
			 or any combination thereof, if the association:
(a) Is composed of persons who are or were
			 actively engaged in the same profession, trade or occupation; and
(b) Has been maintained in good faith for
			 purposes other than obtaining insurance;
Nevada Administrative Code › Chapter 687B - Contracts of Insurance › CONTRACTS FOR LONG-TERM CARE › Section 687B.030 - "Long-term care insurance" defined

Current through June 11, 2024
1. "Long-term care
			 insurance" means any group or individual insurance advertised, marketed,
			 offered or designed to provide coverage for not less than 12 consecutive months
			 for each person covered by the insurance on an expense-incurred, indemnity,
			 prepaid or other basis, for necessary diagnostic, preventive, therapeutic,
			 rehabilitative, maintenance or personal care services provided in a setting
			 other than an acute care unit of a hospital.
2. The term includes insurance that provides
			 for payment of benefits based upon cognitive impairment or the loss of
			 functional capacity.
3. The term
			 does not include insurance which is offered primarily to provide:
(a) Basic coverage to supplement
			 Medicare;
(b) Basic coverage for
			 hospital expenses;
(c) Basic
			 coverage for medical-surgical expenses;
(d) Indemnity coverage for confinement in a
			 hospital;
(e) Coverage for major
			 medical expenses;
(f) Coverage to
			 protect income received for or to protect assets in the event of a disability,
			 unless the conditions set forth in paragraph (b) of subsection 6 of NAC
			 687B.035 are met;
(g) Coverage for
			 accidents only;
(h) Coverage for
			 specified diseases or accidents; or
(i) Limited benefit health
			 coverage.
Nevada Administrative Code › Chapter 687B - Contracts of Insurance › CONTRACTS FOR LONG-TERM CARE › Section 687B.0303 - "Long-term care insurance contract" defined

Current through June 11, 2024
1.
			 "Long-term care insurance contract" means:
(a)
			 An insurance policy or contract, or any portion thereof; or
(b) A rider or endorsement to a policy of
			 life insurance, a policy of disability income insurance or an annuity contract,
			 or any portion thereof,
Which is delivered or issued for delivery in this State, by an
				insurer or similar organization, and which provides direct or supplemental
				coverage for long-term care insurance.
Nevada Administrative Code › Chapter 687B - Contracts of Insurance › CONTRACTS FOR LONG-TERM CARE › Section 687B.0306 - "Partnership certificate" defined

Current through June 11, 2024
"Partnership certificate" means a certificate issued under a
				group partnership contract.
Added to NAC by Comm'r of
				Insurance by R028-10, 12-16-2010, eff. 10-1-2011
NRS
				  679B.130
Nevada Administrative Code › Chapter 687B - Contracts of Insurance › CONTRACTS FOR LONG-TERM CARE › Section 687B.0309 - "Partnership policy" defined

Current through June 11, 2024
"Partnership policy" means an insurance policy delivered or
				issued for delivery in this State that is a "partnership contract" as defined
				in NAC 687B.0335.
Added to NAC by Comm'r of
				Insurance by R028-10, 12-16-2010, eff. 10-1-2011
NRS
				  679B.130
Nevada Administrative Code › Chapter 687B - Contracts of Insurance › CONTRACTS FOR LONG-TERM CARE › Section 687B.033 - "Qualified actuary" defined

Current through June 11, 2024
"Qualified actuary" means a person who is qualified to sign a
				statement of actuarial opinion pursuant to the "Qualification Standards for
				Actuaries Issuing Statements of Actuarial Opinion in the United States,"
				approved by the Board of Directors of the American Academy of Actuaries.
Added to NAC by Comm'r of
				Insurance by R028-10, 12-16-2010, eff. 10-1-2011
NRS
				  679B.130
Nevada Administrative Code › Chapter 687B - Contracts of Insurance › CONTRACTS FOR LONG-TERM CARE › Section 687B.0332 - "Qualified long-term care insurance contract" or "federally tax-qualified long-term care insurance contract" defined

Current through June 11, 2024
"Qualified long-term care insurance contract" or "federally
				tax-qualified long-term care insurance contract" means:
1. Any individual insurance contract or group
			 insurance contract that meets the requirements of
			 26 U.S.C. §
									7702 B(b);
2. The portion of any life insurance contract
			 which provides long-term care insurance coverage by rider, endorsement or as
			 part of the contract and which satisfies the requirements of
			 26 U.S.C. §§
									7702 B(b) and 7702B(e); or
3. The portion of any annuity contract which
			 provides long-term care insurance coverage by rider, endorsement or as part of
			 the contract and which satisfies the requirements of
			 26 U.S.C. §
									7702 B(b) and section 844 of the Pension
			 Protection Act of 2006, Public Law 109-280.
Added to NAC by Comm'r of
				Insurance by R121-07, 9-18-2008, eff. 10-1-2008; A by R028-10, 12-16-2010, eff.
				10-1-2011
NRS
				  679B.130
Nevada Administrative Code › Chapter 687B - Contracts of Insurance › CONTRACTS FOR LONG-TERM CARE › Section 687B.0335 - "Qualified state long-term care insurance partnership contract" or "partnership contract" defined

Current through June 11, 2024
"Qualified state long-term care insurance partnership contract"
				or "partnership contract" means a qualified long-term care insurance contract
				that:
1. Provides coverage for
			 insureds who are residents of Nevada on the date that coverage under the
			 contract first becomes effective;
2. Is issued on or after January 1,
			 2007;
3. Satisfies all the
			 requirements of
			 42 U.S.C. §
									1396 p(b)(1)(C)(iii)(I) to
			 1396p(b)(1)(C)(iii)(IV), inclusive;
4. Is filed with and approved by the
			 Commissioner as a partnership contract;
5. Is issued by an insurer who complies with
			 the provisions of
			 42 U.S.C. §
									1396 p(b)(1)(C)(iii)(VI); and
6. Is sold by a producer who has received
			 training in and has demonstrated an understanding of partnership contracts and
			 how partnership contracts relate to public and private coverage for long-term
			 care.
Added to NAC by Comm'r of
				Insurance by R121-07, 9-18-2008, eff. 10-1-2008
NRS
				  679B.130
Nevada Administrative Code › Chapter 687B - Contracts of Insurance › CONTRACTS FOR LONG-TERM CARE › Section 687B.034 - "Similar long-term care insurance contract forms" defined

Current through June 11, 2024
1. "Similar long-term care insurance contract
			 forms" means all long-term care insurance contracts and certificates issued by
			 an insurer within the same classification of long-term care benefits as the
			 long-term care insurance contract form being considered.
2. A long-term care insurance contract or
			 certificate delivered to any group described in subsection 1 of NAC 687B.025
			 shall be deemed not similar to other long-term care insurance contracts and
			 certificates, except that such a contract or certificate shall be deemed
			 similar to other comparable long-term care insurance contracts and certificates
			 with the same long-term care benefit classification.
3. For the purpose of determining whether
			 long-term care insurance contract forms are similar, the long-term care
			 benefits provided by long-term care insurance contracts and certificates must
			 be classified as:
(a) Institutional long-term
			 care benefits only;
(b)
			 Noninstitutional long-term care benefits only; or
(c) Comprehensive long-term care
			 benefits.
Nevada Administrative Code › Chapter 687B - Contracts of Insurance › CONTRACTS FOR LONG-TERM CARE › Section 687B.0342 - "Similar organization" defined

Current through June 11, 2024
"Similar organization" means a company other than an insurer
				that is authorized to offer long-term care insurance contracts pursuant to the
				provisions of chapter 695A, 695B, 695C or 695F of NRS.
Added to NAC by Comm'r of
				Insurance by R121-07, 9-18-2008, eff. 10-1-2008
NRS
				  679B.130
Nevada Administrative Code › Chapter 687B - Contracts of Insurance › CONTRACTS FOR LONG-TERM CARE › Section 687B.035 - Scope

Current through June 11, 2024
1. Except as otherwise provided in this
			 subsection, the provisions of NAC 687B.005 to 687B.140, inclusive, apply to a
			 long-term care insurance contract delivered or issued for delivery in this
			 State on or after November 21, 1988. The provisions of NAC 687B.113, 687B.116
			 and 687B.118 apply to a long-term care insurance contract delivered or issued
			 for delivery in this State on or after January 11, 1991.
2. The provisions of NAC 687B.005 to
			 687B.140, inclusive, do not supersede the obligations of entities subject to
			 them to comply with other applicable regulations insofar as they do not
			 conflict with the provisions of NAC 687B.005 to 687B.140, inclusive.
3. Applicable regulations governing contracts
			 of insurance which supplement Medicare do not apply to long-term care insurance
			 contracts.
4. Except as otherwise
			 provided in subsection 6, a contract of insurance which is not advertised,
			 marketed or offered as long-term care insurance or nursing home insurance is
			 not required to comply with the provisions of NAC 687B.005 to 687B.140,
			 inclusive.
5. NAC 688B.010 and
			 689B.010 to 689B.080, inclusive, do not apply to long-term care insurance
			 contracts.
6. Except as otherwise
			 expressly provided in NAC 687B.005 to 687B.140, inclusive, the provisions of
			 NAC 687B.005 to 687B.140, inclusive, apply to:
(a) Any long-term care insurance contract,
			 including a qualified long-term care insurance contract, partnership contract,
			 annuity contract and life insurance policy that accelerates benefits for
			 long-term care delivered or issued for delivery in this State on or after
			 October 1, 2011, by insurers and all similar organizations.
(b) Policies having indemnity benefits that
			 are triggered by activities of daily living and sold as disability income
			 insurance if:
(1) The benefits of the
			 disability income policy are dependent upon or vary in amount based on the
			 receipt of long-term care services;
(2) The disability income policy is
			 advertised, marketed or offered as insurance for long-term care services;
			 or
(3) Benefits under the policy
			 may commence after the policyholder has reached the normal retirement age for
			 Social Security unless benefits are designated to replace lost income or pay
			 for specific expenses other than long-term care services.
Nevada Administrative Code › Chapter 687B - Contracts of Insurance › CONTRACTS FOR LONG-TERM CARE › Section 687B.040 - Compliance required

Current through June 11, 2024
A policy of insurance, rider or endorsement may not be
				advertised, marketed or offered as long-term care insurance or insurance which
				provides coverage for care received in a nursing home unless it complies with
				the provisions of NAC 687B.005 to 687B.140, inclusive.
Added to NAC by Comm'r of
				Insurance, eff. 11-21-88; A 1-4-91; R121-07, 9-18-2008, eff. 10-1-2008;
				R028-10, 12-16-2010, eff. 10-1-2011
NRS
				  679B.130
Nevada Administrative Code › Chapter 687B - Contracts of Insurance › CONTRACTS FOR LONG-TERM CARE › Section 687B.045 - Modification or suspension of provisions

Current through June 11, 2024
The Commissioner may, upon receiving a written request therefor
				and after an administrative hearing, issue an order to modify or suspend any
				provision of NAC 687B.005 to 687B.140, inclusive, with respect to a specific
				long-term care insurance contract or certificate upon a written finding
				that:
1. The modification or
			 suspension would be in the best interest of the insureds;
2. The purposes to be achieved would not be
			 effectively or efficiently achieved without the modification or suspension;
			 and
3. One of the following:
(a) The modification or suspension is
			 necessary to the development of an innovative and reasonable approach for
			 insuring long-term care;
(b) The
			 long-term care insurance contract or certificate is to be issued to residents
			 of a life care or continuing care retirement community or some other
			 residential community for the elderly, and the modification or suspension is
			 reasonably related to the special needs or nature of that community;
			 or
(c) The modification or
			 suspension is necessary to permit long-term care insurance to be sold as part
			 of, or in conjunction with, another policy of insurance.
Nevada Administrative Code › Chapter 687B - Contracts of Insurance › CONTRACTS FOR LONG-TERM CARE › Section 687B.050 - Organizational requirements

Current through June 11, 2024
1. Before
			 advertising, marketing or offering a group long-term care insurance contract
			 within this State, the insurer of an association shall file evidence with the
			 Commissioner that it has complied with NAC 679B.036, and that the association
			 has:
(a) At the outset, at least 100
			 members;
(b) Been organized and
			 maintained in good faith for purposes other than that of obtaining
			 insurance;
(c) Been in active
			 existence for at least 1 year; and
(d) A constitution and bylaws which provide
			 that:
(1) The association holds regular
			 meetings not less than annually to further the purposes of the
			 members;
(2) Except for credit
			 unions, the association collects dues or solicits contributions from members;
			 and
(3) The members have voting
			 privileges and are represented on the governing board and committees.
Nevada Administrative Code › Chapter 687B - Contracts of Insurance › CONTRACTS FOR LONG-TERM CARE › Section 687B.051 - Licensing and training requirements

Current through June 11, 2024
1. A person may not
			 sell, solicit or negotiate long-term care insurance unless the person:
(a) Is licensed as a producer of insurance
			 for health insurance;
(b) Has
			 successfully completed an initial course of training consisting of at least 8
			 hours; and
(c) Successfully
			 completes ongoing courses of training as specified in subsection 2.
Nevada Administrative Code › Chapter 687B - Contracts of Insurance › CONTRACTS FOR LONG-TERM CARE › Section 687B.052 - Required reports

Current through June 11, 2024
1. An insurer shall
			 maintain records for each agent which:
(a)
			 Specify the amount of replacement sales by the agent as a percentage of the
			 total annual sales by the agent; and
(b) Specify the amount of lapses in policies
			 sold by the agent as a percentage of the total annual sales by the
			 agent.
Nevada Administrative Code › Chapter 687B - Contracts of Insurance › CONTRACTS FOR LONG-TERM CARE › Section 687B.053 - Compensation to producers for sale, renewal or replacement of contract or certificate

Current through June 11, 2024
1. An insurer or
			 similar organization may pay compensation to a producer for the sale of a
			 long-term care insurance contract or certificate on the basis of a set
			 schedule. The amount of the compensation paid for the replacement of a
			 long-term care insurance contract or certificate must be made in accordance
			 with the renewal schedule of the replacing insurer unless the long-term care
			 insurance contract or certificate cannot be renewed by the original
			 insurer.
2. The compensation
			 provided by the insurer or similar organization for the renewal of a
			 replacement long-term care insurance contract in subsequent years by the
			 replacing insurer must be the same compensation schedule as provided by the
			 replacing insurer unless the original insurer cannot renew the long-term care
			 insurance contract or certificate.
3. If long-term care insurance is provided as
			 part of an annuity contract, life insurance policy, disability income insurance
			 policy or rider or endorsement, the requirements of this section apply only to
			 the compensation attributable to the long-term care insurance provided by the
			 policy.
4. As used in this section,
			 "compensation" has the meaning ascribed to it in NAC 683A.708.
Added to NAC by Comm'r of
				Insurance by R121-07, 9-18-2008, eff. 10-1-2008; A by R053-09, 10-27-2009;
				R028-10, 12-16-2010, eff. 10-1-2011
NRS
				  679B.130
Nevada Administrative Code › Chapter 687B - Contracts of Insurance › CONTRACTS FOR LONG-TERM CARE › Section 687B.054 - Producer not authorized to sell, solicit or negotiate except as authorized by certain statutes

Current through June 11, 2024
A producer is not authorized to sell, solicit or negotiate with
				respect to long-term care insurance except as authorized by chapter 683A of
				NRS.
Added to NAC by Comm'r of
				Insurance by R028-10, 12-16-2010, eff. 10-1-2011
NRS
				  679B.130
Nevada Administrative Code › Chapter 687B - Contracts of Insurance › CONTRACTS FOR LONG-TERM CARE › Section 687B.055 - Contracts issued in other states

Current through June 11, 2024
1. No group
			 long-term care insurance may be offered to a resident of this State under a
			 group long-term care insurance contract issued in another state to a group
			 described in subsection 4 of NAC 687B.025, unless this State or another state
			 having statutory and regulatory requirements for long-term care insurance
			 substantially similar to those adopted in this State, has made a determination
			 that those requirements have been met.
2. Before an insurer or similar organization
			 offers group long-term care insurance to a resident of this State pursuant to
			 this section, it shall file with the Commissioner evidence that the group
			 long-term care insurance contract or certificate issued pursuant thereto has
			 been approved by a state having statutory and regulatory requirements for
			 long-term care insurance substantially similar to those adopted in this
			 State.
Added to NAC by Comm'r of
				Insurance, eff. 11-21-88; A by R028-10, 12-16-2010, eff.
				10-1-2011
NRS
				  679B.130
Nevada Administrative Code › Chapter 687B - Contracts of Insurance › CONTRACTS FOR LONG-TERM CARE › Section 687B.056 - Standards of suitability: Development; use

Current through June 11, 2024
1. The
			 provisions of this section do not apply to a policy of life insurance or a
			 rider or endorsement to a policy of life insurance that contains accelerated
			 benefits for long-term care.
2.
			 Every insurer or other organization that markets or offers long-term care
			 insurance contracts or certificates in this State shall:
(a) Develop standards of suitability to
			 determine whether the purchase or replacement of long-term care insurance is
			 appropriate for the needs of an applicant;
(b) Train its agents in the use of the
			 standards of suitability; and
(c)
			 Maintain a copy of the standards of suitability and make the standards
			 available for inspection upon request by the Commissioner.
Nevada Administrative Code › Chapter 687B - Contracts of Insurance › CONTRACTS FOR LONG-TERM CARE › Section 687B.0565 - Standards of suitability: Procedure when applicant does not meet standards or declines to provide information

Current through June 11, 2024
1. If an insurer
			 determines that an applicant does not meet the standards of suitability
			 developed pursuant to NAC 687B.056, or if the applicant declines to provide any
			 information required by NAC 687B.056, the insurer may:
(a) Reject the application; or
(b) Mail a letter to the applicant using form
			 NDOI-950, which is available from the Division, or containing a statement that
			 is substantially in the format of form NDOI-950.
Nevada Administrative Code › Chapter 687B - Contracts of Insurance › CONTRACTS FOR LONG-TERM CARE › Section 687B.057 - Standards of suitability: Annual report to Commissioner

Current through June 11, 2024
On or before April 1 of each year, for the preceding calendar
				year, an insurer shall report to the Commissioner using form NDOI-947, which is
				available from the Division:
1. The
			 number of applications for long-term care insurance received by the insurer
			 from residents of this State;
2.
			 The number of applicants who declined to provide information on the worksheet
			 described in subsection 9 of NAC
			 687B.056;
3. The number of applicants who did not meet
			 the standards of suitability developed by the insurer pursuant to NAC
			 687B.056; and
4. The number of applicants who chose to
			 purchase long-term care insurance after receiving the letter described in
			 paragraph (b) of subsection 1 of NAC
			 687B.0565.
Added to NAC by Comm'r of
				Insurance by R121-07, 9-18-2008, eff. 10-1-2008; A by R028-10, 12-16-2010, eff.
				10-1-2011; A by
				R081-16A,
				eff. 11/2/2016
NRS
				679B.130
Nevada Administrative Code › Chapter 687B - Contracts of Insurance › CONTRACTS FOR LONG-TERM CARE › Section 687B.058 - Partnership program notice

Current through June 11, 2024
1. The provisions
			 of this section apply to any qualified state long-term care insurance
			 partnership contract.
2. An insurer
			 or agent soliciting or offering to sell a long-term care insurance contract
			 that is intended to qualify as a partnership contract shall provide to each
			 prospective applicant a partnership program notice. The partnership program
			 notice must:
(a) Outline the requirements and
			 benefits of a partnership contract.
(b) Be provided with the required outline of
			 coverage.
(c) Be in the following
			 form, unless a similar form is filed with, and approved by, the
			 Commissioner:
Nevada Administrative Code › Chapter 687B - Contracts of Insurance › CONTRACTS FOR LONG-TERM CARE › Section 687B.0585 - Required disclosures regarding rate revisions

Current through June 11, 2024
1. For
			 any long-term care insurance contract or certificate issued in this State on or
			 after October 1, 2008, other than a long-term care insurance contract or
			 certificate for which no applicable increases in premium rates or rate
			 schedules can be made, the insurer shall provide to the applicant:
(a) A statement that the long-term care
			 insurance contract or certificate may be subject to rate increases in the
			 future;
(b) An explanation of
			 potential future premium rate revisions, and the options available to the
			 applicant in the event of a premium rate revision;
(c) The premium rate or rate schedules
			 applicable to the applicant that will be in effect until a request is made for
			 an increase;
(d) A general
			 explanation for applying adjustments to premium rates or rate schedules that
			 must include:
(1) A description of when such
			 adjustments will be effective; and
(2) A statement that the applicant must be
			 provided with a revised premium rate or rate schedule if the premium rate or
			 rate schedule is changed;
(e) Except as otherwise provided in
			 subsection 3, information relating to each increase in premium rates on the
			 long-term care insurance contract form or similar long-term care insurance
			 contract forms during the previous 10 years for this State or any other state,
			 including, without limitation, information that identifies:
(1) The long-term care insurance contract
			 forms for which premium rates have increased;
(2) The calendar years when the long-term
			 care insurance contract form was available for purchase; and
(3) The amount or percentage of each rate
			 increase which may be expressed as a percentage of the premium rate before the
			 increase or as minimum and maximum percentages if the rate increase is variable
			 by rating characteristics; and
(f) Any additional explanatory information
			 related to rate increases that the insurer chooses to provide.
Nevada Administrative Code › Chapter 687B - Contracts of Insurance › CONTRACTS FOR LONG-TERM CARE › Section 687B.059 - Insurer to submit disclosures regarding rate revisions and actuarial certification to Commissioner for approval

Current through June 11, 2024
1. The provisions
			 of this section do not apply to:
(a) A
			 long-term care insurance contract issued before October 1, 2008;
(b) A policy of life insurance or a rider or
			 endorsement to a policy of life insurance that contains accelerated benefits
			 for long-term care; or
(c) An
			 annuity contract or a rider or endorsement to an annuity contract that contains
			 benefits for long-term care.
Nevada Administrative Code › Chapter 687B - Contracts of Insurance › CONTRACTS FOR LONG-TERM CARE › Section 687B.060 - Right to return individual contracts or certificates; notice of right

Current through June 11, 2024
1. An applicant for long-term care insurance
			 may return the long-term care insurance contract or certificate within 30 days
			 after its delivery and have the premium refunded if, after examining the
			 long-term care insurance contract or certificate, he or she is not satisfied
			 for any reason.
2. Except as
			 otherwise provided in subsection 5, a long-term care insurance contract or
			 certificate must contain a notice prominently printed on the first page or
			 attached thereto stating in substance that the applicant may return the
			 long-term care insurance contract or certificate within 30 days after its
			 delivery and have the premium refunded if, after examining the long-term care
			 insurance contract or certificate, he or she is not satisfied for any
			 reason.
3. If an application for
			 long-term care insurance is denied, any premium paid by the applicant must be
			 refunded.
4. Any refund pursuant to
			 this section must be made within 30 days after the return of the long-term care
			 insurance contract or certificate or the denial of the application, as
			 applicable.
5. Subsection 2 does
			 not apply to a certificate issued pursuant to a long-term care insurance
			 contract issued to a group described in subsection 1 of NAC 687B.025.
Added to NAC by Comm'r of
				Insurance, eff. 11-21-88; A 12-15-94; R028-10, 12-16-2010, eff.
				10-1-2011
NRS
				  679B.130
Nevada Administrative Code › Chapter 687B - Contracts of Insurance › CONTRACTS FOR LONG-TERM CARE › Section 687B.0655 - Requirements for long-term care insurance sold in conjunction with another insurance product

Current through June 11, 2024
Long-term care insurance sold in conjunction with another
				insurance product, including, but not limited to, life insurance or an annuity
				must:
1. Be issued as a separate rider
			 that complies with the provisions of NAC 687B.005 to 687B.140, inclusive;
			 or
2. Be incorporated directly into
			 the policy or contract of another insurance product, including, but not limited
			 to, a policy of life insurance or an annuity contract, and comply with the
			 provisions of NAC 687B.005 to 687B.140, inclusive, as well as the provisions of
			 any other statute or regulation that apply to the other insurance product. For
			 a policy or contract sold pursuant to this subsection, except for those
			 provisions relating to premium rates and premium rate increases which shall
			 apply separately to each insurance product, if there is a conflict between a
			 provision required for the long-term care insurance and a provision required
			 for the other insurance product, the provision which is more generous to the
			 consumer shall apply to all aspects of the policy or contract.
Added to NAC by Comm'r of
				Insurance by R028-10, 12-16-2010, eff. 10-1-2011
NRS
				  679B.130
Nevada Administrative Code › Chapter 687B - Contracts of Insurance › CONTRACTS FOR LONG-TERM CARE › Section 687B.066 - Provision for reinstatement in event of lapse of coverage

Current through June 11, 2024
1. A long-term care insurance contract or
			 certificate must include a provision which provides that, in the event of a
			 lapse in coverage, coverage will be reinstated if:
(a) The insured provides proof of cognitive
			 impairment or loss of functional capacity before the grace period contained in
			 the long-term care insurance contract or certificate expires;
(b) The insured requests reinstatement of
			 coverage within 5 months of the date of termination of coverage; and
(c) The insured pays any premiums which are
			 past due.
Nevada Administrative Code › Chapter 687B - Contracts of Insurance › CONTRACTS FOR LONG-TERM CARE › Section 687B.067 - Applications: Questions; required statements; required information for applicants 80 years of age or older

Current through June 11, 2024
1. An application
			 for a long-term care insurance contract or certificate that is not guaranteed
			 issue must contain clear and unambiguous questions designed to ascertain the
			 condition of the applicant's health.
2. If an application for a long-term care
			 insurance contract or certificate contains a question which asks whether the
			 applicant has had medication prescribed by a physician, the applicant must be
			 required to list any medication that has been prescribed. If an insurer knows,
			 or should know, at the time of application that a medication listed by the
			 applicant on the application is directly related to a medical condition for
			 which coverage would otherwise be denied, the insurer shall not later rescind
			 the long-term care insurance contract or certificate for that
			 condition.
3. Except for a
			 long-term care insurance contract or certificate that is guaranteed issue:
(a) A statement in the following form must be
			 set out conspicuously and in close proximity to the block for the applicant's
			 signature on an application for a long-term care insurance contract or
			 certificate:
Caution: If your answers on this application are incorrect or
				untrue, [Company Name] has the right to deny benefits or rescind your
				policy.
(b) A statement in
			 substantially the following form must be set out conspicuously on the long-term
			 care insurance contract or certificate at the time of delivery:
Caution: The issuance of this [policy] [certificate] of
				long-term care insurance is based upon your responses to the questions on your
				application. A copy of your [application] [enrollment form] [is enclosed] [was
				retained by you when you applied]. If your answers are incorrect or untrue, the
				company has the right to deny benefits or rescind your [policy] [certificate].
				The best time to clear up any questions is now, before a claim arises! If, for
				any reason, any of your answers is incorrect, contact the company at this
				address: [insert address].
(c) Prior to issuing a long-term care
			 insurance contract or certificate to an applicant who is at least 80 years old,
			 an insurer shall obtain one of the following:
(1) A report of a physical
			 examination;
(2) An assessment of
			 functional capacity;
(3) An
			 attending physician's statement; or
(4) Copies of medical records.
Nevada Administrative Code › Chapter 687B - Contracts of Insurance › CONTRACTS FOR LONG-TERM CARE › Section 687B.068 - Right to copy of application or enrollment form

Current through June 11, 2024
An insurer shall deliver a copy of the completed application or
				enrollment form, whichever is applicable, to the insured no later than at the
				time of delivery of the long-term care insurance contract or certificate unless
				a copy is retained by the applicant at the time of application.
Added to NAC by Comm'r of
				Insurance, eff. 12-15-94; A by R028-10, 12-16-2010, eff.
				10-1-2011
NRS
				  679B.130
Nevada Administrative Code › Chapter 687B - Contracts of Insurance › CONTRACTS FOR LONG-TERM CARE › Section 687B.0681 - Designation of person to receive notice of lapse or termination of coverage

Current through June 11, 2024
1. Except as otherwise provided in subsection
			 3, an insurer shall not issue an individual long-term care insurance contract
			 in this State unless the insurer has received from the applicant:
(a) A written designation of at least one
			 person, in addition to the applicant, who must receive notice of any lapse or
			 termination of coverage under the policy for nonpayment of premium;
			 or
(b) A written waiver dated and
			 signed by the applicant stating that the applicant has chosen not to designate
			 another person to receive notice of any lapse or termination of coverage for
			 nonpayment of premium.
Nevada Administrative Code › Chapter 687B - Contracts of Insurance › CONTRACTS FOR LONG-TERM CARE › Section 687B.0682 - Verification of enrollment in group policy; satisfaction of any requirement for signature of insured

Current through June 11, 2024
1. For the
			 enrollment of an insured in a long-term care insurance contract that applies to
			 a group described in subsection 1 of NAC 687B.025, any requirement that the
			 signature of an insured be obtained by an agent or insurer shall be deemed
			 satisfied if:
(a) The necessary consent to
			 enrollment is obtained from the insured by telephonic or electronic enrollment
			 by the group policyholder or insurer;
(b) The enrollment provides necessary and
			 reasonable safeguards to ensure the accuracy, retention and prompt retrieval of
			 records; and
(c) The enrollment
			 provides necessary and reasonable safeguards to ensure the confidentiality of
			 individually identifiable and privileged information.
Nevada Administrative Code › Chapter 687B - Contracts of Insurance › CONTRACTS FOR LONG-TERM CARE › Section 687B.0683 - Delivery of contract or certificate

Current through June 11, 2024
If an insurer approves an application for long-term care
				insurance, the insurer shall deliver the long-term care insurance contract or
				certificate to the applicant not later than 30 days after the date on which the
				application is approved.
Added to NAC by Comm'r of
				Insurance by R121-07, 9-18-2008, eff. 10-1-2008; A by R028-10, 12-16-2010, eff.
				10-1-2011
NRS
				  679B.130
Nevada Administrative Code › Chapter 687B - Contracts of Insurance › CONTRACTS FOR LONG-TERM CARE › Section 687B.0684 - Delivery of policy summary or contract summary

Current through June 11, 2024
1. A
			 policy summary must be delivered to an applicant for an individual policy of
			 life insurance at the time of policy delivery if the policy provides long-term
			 care benefits, whether by rider, endorsement or within the policy. In the case
			 of direct-response solicitations, the insurer shall deliver the policy summary
			 upon the applicant's request, or not later than the time the policy is
			 delivered. The policy summary must include:
(a) An explanation of how the long-term care
			 benefit interacts with other components of the policy, including deductions
			 from death benefits;
(b) An
			 illustration of the amount of benefits, the length of benefit and the
			 guaranteed lifetime benefits, if any, for each covered person;
(c) Any exclusions, reductions and
			 limitations on benefits for long-term care;
(d) A statement that the protection against
			 inflation required by NAC 687B.076 is not available under this policy;
			 and
(e) If applicable to the policy
			 type:
(1) A disclosure of the effects of
			 exercising other rights under the policy;
(2) A disclosure of guarantees related to
			 long-term care costs of insurance charges; and
(3) Current and projected lifetime
			 benefits.
Nevada Administrative Code › Chapter 687B - Contracts of Insurance › CONTRACTS FOR LONG-TERM CARE › Section 687B.0685 - Offer of nonforfeiture benefit required

Current through June 11, 2024
1. Except as
			 otherwise provided in subsection 2, an insurer shall not deliver or issue for
			 delivery in this State a long-term care insurance contract or certificate
			 unless the policyholder or certificate holder has been offered the option to
			 purchase a long-term care insurance contract or certificate that includes a
			 nonforfeiture benefit. The offer of a nonforfeiture benefit may be in the form
			 of a rider or endorsement that is attached to the policy. If the policyholder
			 or certificate holder declines the nonforfeiture benefit, the insurer shall
			 provide a contingent benefit upon lapse that must be available to the
			 policyholder or certificate holder for the period following a substantial
			 increase in premium rates specified in NAC 687B.0686.
2. Except as otherwise provided in subsection
			 3, if an insurer offers a group long-term care insurance contract, the offer
			 required by subsection 1 must be made only to the group policyholder.
3. If an insurer offers a group long-term
			 care insurance contract to a group described in subsection 4 of NAC 687B.025,
			 other than a continuing-care retirement community or other similar entity, the
			 offer required by subsection 1 must be made to each certificate
			 holder.
Added to NAC by Comm'r of
				Insurance by R121-07, 9-18-2008, eff. 10-1-2008; A by R028-10, 12-16-2010, eff.
				10-1-2011
NRS
				  679B.130
Nevada Administrative Code › Chapter 687B - Contracts of Insurance › CONTRACTS FOR LONG-TERM CARE › Section 687B.0686 - Requirements for nonforfeiture benefits; contingent benefit upon lapse

Current through June 11, 2024
1. The provisions of this section do not
			 apply to a policy of life insurance or a rider or endorsement to a policy of
			 life insurance that contains accelerated benefits for long-term care.
2. To satisfy the requirements of NAC
			 687B.0685:
(a) A long-term care insurance
			 contract or certificate offered with nonforfeiture benefits must include the
			 elements of the coverage, requirements for eligibility, benefit triggers and
			 length of benefits that are the same as the coverage issued without
			 nonforfeiture benefits;
(b) If the
			 offer of a nonforfeiture benefit required by NAC 687B.0685 is not otherwise
			 described in the outline of coverage or other materials provided to the
			 applicant, the offer must be set out separately and be in writing;
			 and
(c) The nonforfeiture benefit
			 included in the offer must conform to the requirements of this
			 section.