2005 Nevada Revised Statutes - Chapter 695A — Fraternal Benefit Societies

CHAPTER 695A - FRATERNAL BENEFIT SOCIETIES

NRS 695A.001 Definitions.

NRS 695A.003 Benefitcontract defined.

NRS 695A.004 Benefitmember defined.

NRS 695A.006 Certificatedefined.

NRS 695A.010 Fraternalbenefit society defined.

NRS 695A.014 Insurerdefined.

NRS 695A.016 Lawsdefined.

NRS 695A.018 Lodgedefined.

NRS 695A.020 Lodgesystem defined.

NRS 695A.023 Medicaiddefined.

NRS 695A.027 Orderfor medical coverage defined.

NRS 695A.030 Premiumsdefined.

NRS 695A.040 Representativeform of government defined.

NRS 695A.042 Rulesdefined.

NRS 695A.044 Societydefined.

NRS 695A.050 Organization:Preparation and contents of articles of incorporation.

NRS 695A.060 Organization:Filing of documents and bond with Commissioner; preliminary certificate ofauthority.

NRS 695A.070 Organization:Solicitation of members; collection of advance premiums; reports toCommissioner.

NRS 695A.080 Certificateof authority: Issuance and renewal; effect; record; copies; fees.

NRS 695A.090 Generalpowers and duties of society.

NRS 695A.095 Contractsbetween society and provider of health care: Prohibiting society from chargingprovider of health care fee for inclusion on list of providers given toinsureds; form to obtain information on provider of health care; modification;schedule of fees.

NRS 695A.110 Unincorporatedor voluntary association prohibited.

NRS 695A.120 Locationof principal office; meetings of supreme governing body; minutes of certainproceedings; official publications; grievances by benefit members.

NRS 695A.130 Consolidation;merger.

NRS 695A.140 Conversionof fraternal benefit society into mutual life insurer.

NRS 695A.150 Qualificationsfor and rights and privileges of membership.

NRS 695A.151 Effectof eligibility for medical assistance under Medicaid on eligibility forcoverage; assignment of rights to state agency.

NRS 695A.152 Societyrequired to comply with certain provisions concerning portability andavailability of health insurance.

NRS 695A.153 Societyprohibited from asserting certain grounds to deny enrollment of child ofinsured pursuant to order.

NRS 695A.155 Certainaccommodations to be made when child is covered under policy of noncustodialparent.

NRS 695A.157 Societyto authorize enrollment of child of parent who is required by order to providemedical coverage under certain circumstances; termination of coverage of child.

NRS 695A.159 Societyprohibited from restricting coverage of child based on preexisting conditionwhen person who is eligible for group coverage adopts or assumes legalobligation for child.

NRS 695A.160 Amendmentof laws of society.

NRS 695A.180 Scopeof contractual benefits.

NRS 695A.184 Coveragefor prescription drug previously approved for medical condition of insured.

NRS 695A.188 Approvalor denial of claim; interest on unpaid claim; request for additionalinformation; payment of claim; costs and attorneys fees.

NRS 695A.195 Societyprohibited from denying coverage solely because person was victim of domesticviolence.

NRS 695A.197 Societyprohibited from denying coverage solely because insured was intoxicated orunder the influence of controlled substance; exceptions. [Effective July 1,2006.]

NRS 695A.200 Nonforfeiturebenefits, cash surrender values, certificate loans and other options.

NRS 695A.210 Beneficiaries;funeral benefits.

NRS 695A.220 Benefitsnot liable to attachment, garnishment or other process.

NRS 695A.230 Termsand conditions of benefit contracts.

NRS 695A.235 Offeringpolicy of health insurance for purposes of establishing health savings account.

NRS 695A.240 Approvaland contents of certificates.

NRS 695A.255 Coveragefor prescription drugs: Provision of notice and information regarding use offormulary.

NRS 695A.270 Waiverof provisions of societys laws.

NRS 695A.280 Reinsurance.

NRS 695A.300 Admissionof foreign or alien society.

NRS 695A.310 Injunctionagainst, liquidation of or appointment of receiver for domestic society.

NRS 695A.320 Suspension,revocation or refusal of license of foreign or alien society.

NRS 695A.330 Licensingof insurance agents of society; persons exempt from licensing.

NRS 695A.400 Serviceof process on society.

NRS 695A.410 Injunctionsagainst societies.

NRS 695A.420 Judicialreview of Commissioners findings and decisions.

NRS 695A.430 Assets,funds and accounts of society.

NRS 695A.440 Investments.

NRS 695A.450 Annualstatement of financial condition, transactions and affairs.

NRS 695A.460 Penaltiesfor failure to file statement properly.

NRS 695A.475 Liabilityof directors, officers, employees, members and volunteers; indemnification andreimbursement of directors, officers, employees and agents.

NRS 695A.490 Standardsof valuation for certificates.

NRS 695A.500 Examinationof societies transacting business in State.

NRS 695A.530 Applicabilityof statutory provisions relating to trade practices and frauds.

NRS 695A.550 Exemptionof societies from certain taxes.

NRS 695A.555 Fees:Applicability of certain provisions.

NRS 695A.560 Exemptionof societies from other insurance laws.

NRS 695A.570 Applicability.

NRS 695A.580 Penalties.

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NRS 695A.001 Definitions. As used in this chapter, unless the context otherwiserequires, the words and terms defined in NRS695A.003 to 695A.044, inclusive,have the meanings ascribed to them in those sections.

(Added to NRS by 1991, 221; A 1995, 2432)

NRS 695A.003 Benefitcontract defined. Benefit contract means anagreement for the provision of any contractual benefit authorized by NRS 695A.180.

(Added to NRS by 1991, 221)

NRS 695A.004 Benefitmember defined. Benefit member means amember of a society who is an adult and who is designated by the laws or rulesof the society to be a benefit member under a benefit contract.

(Added to NRS by 1991, 221)

NRS 695A.006 Certificatedefined. Certificate means the documentissued as written evidence of the benefit contract.

(Added to NRS by 1991, 221)

NRS 695A.010 Fraternalbenefit society defined. Fraternal benefit societymeans any incorporated society, order or supreme lodge, without capital stock,including one exempted under the provisions of paragraph (b) of subsection 1 ofNRS 695A.570 whether incorporated ornot, which:

1. Is conducted solely for the benefit of its membersand their beneficiaries and not for profit;

2. Operates on a lodge system with ritualistic form ofwork;

3. Has a representative form of government; and

4. Provides benefits in accordance with this chapter.

(Added to NRS by 1971, 1835; A 1991, 222)

NRS 695A.014 Insurerdefined. Insurer includes every personengaged as principal and as indemnitor, surety or contractor in the business ofentering into contracts of insurance.

(Added to NRS by 1991, 221)

NRS 695A.016 Lawsdefined. Laws means the articles of incorporation,charter, constitution and bylaws of the society.

(Added to NRS by 1991, 221)

NRS 695A.018 Lodgedefined. Lodge means a subordinate unit of asociety, and includes a camp, court, council, branch or any similar entity bywhatever name designated.

(Added to NRS by 1991, 221)

NRS 695A.020 Lodgesystem defined. Lodge system means thesystem under which a society is operating if:

1. The society has a supreme governing body andsubordinate lodges into which members are elected, initiated or admitted inaccordance with its laws, ritual and rules; and

2. The subordinate lodges are required by the laws ofthe society to hold regular meetings at least once in each month.

(Added to NRS by 1971, 1835; A 1991, 223)

NRS 695A.023 Medicaiddefined. Medicaid means a program establishedin any state pursuant to Title XIX of the Social Security Act (42 U.S.C. 1396 et seq.) to provide assistance for part or all of the cost of medical carerendered on behalf of indigent persons.

(Added to NRS by 1995, 2431)

NRS 695A.027 Orderfor medical coverage defined. Order formedical coverage means an order of a court or administrative tribunal toprovide coverage under a certificate for health benefits to a child pursuant tothe provisions of 42 U.S.C. 1396g-1.

(Added to NRS by 1995, 2431)

NRS 695A.030 Premiumsdefined. Premiums means premiums, rates,dues or other required contributions by whatever name known, which are payableunder the certificate.

(Added to NRS by 1971, 1835; A 1991, 223)

NRS 695A.040 Representativeform of government defined. Representativeform of government means that form of government which a society has when:

1. It has a supreme governing body which is:

(a) An assembly composed of delegates elected eitherdirectly by the members of the society or at intermediate assemblies orconventions of members or their representatives, and such other delegates asprescribed in the laws of the society; or

(b) A board composed of persons elected by the membersof the society, either directly or by their representatives in intermediateassemblies, and such other persons as prescribed in the laws of the society.

2. If its supreme governing body is an assembly:

(a) The elected delegates constitute a majority innumber, have a majority of the votes and have not less than the number of votesnecessary to amend the laws of the society;

(b) The election of delegates is done in person or bymail, as prescribed in the laws of the society;

(c) The assembly is elected and meets not less thanonce every 4 years;

(d) A board of directors is elected by the assembly toconduct the business of the society in the interim between meetings of theassembly; and

(e) Vacancies on the board of directors are filled inthe manner prescribed in the laws of the society.

3. If its supreme governing body is a board:

(a) The persons elected to the board constitute amajority in number, have a majority of the votes and have not less than thenumber of votes necessary to amend the laws of the society;

(b) The election of the members of the board is done inperson or by mail, as prescribed in the laws of the society;

(c) The term of any member of the board does not exceed4 years;

(d) The board meets not less than quarterly to conductthe business of the society;

(e) Vacancies on the board are filled in the mannerprescribed in the laws of the society; and

(f) A person filling the unexpired term of an electedmember of the board is considered to be an elected member.

4. The officers of the society are elected either bythe supreme governing body or by the board of directors.

5. Only benefit members are eligible for election tothe supreme governing body, the board of directors or any intermediateassembly.

6. Each member who is entitled to vote has only onevote, and votes are not cast by proxy.

(Added to NRS by 1971, 1836; A 1991, 223)

NRS 695A.042 Rulesdefined. Rules includes all rules,regulations and resolutions adopted by the supreme governing body or board ofdirectors of a society and which generally apply to the members of the society.

(Added to NRS by 1991, 221)

NRS 695A.044 Societydefined. Society means a fraternal benefitsociety.

(Added to NRS by 1991, 221)

NRS 695A.050 Organization:Preparation and contents of articles of incorporation.Ten or more citizens of the United States, a majority of whom arecitizens of this state, who desire to form a fraternal benefit society, maymake, sign and acknowledge before some person competent to take acknowledgmentof deeds, articles of incorporation, in which must be stated:

1. The proposed corporate name of the society, whichmust not so closely resemble the name of any society or insurer as to bemisleading or confusing;

2. The purposes for which it is being formed, whichmust not include more liberal powers than are granted by this chapter;

3. The mode in which its corporate powers are to beexercised; and

4. The names and residences of the incorporators andthe names, residences and official titles of all the officers, trustees,directors or other persons who are to have and exercise the general control ofthe management of the affairs and money of the society for the first year oruntil the ensuing election at which all officers must be elected by the supremegoverning body, which election must be held not later than 1 year after thedate of the issuance of the permanent certificate of authority.

(Added to NRS by 1971, 1836; A 1991, 224)

NRS 695A.060 Organization:Filing of documents and bond with Commissioner; preliminary certificate ofauthority.

1. Duly certified copies of the laws and rules of thesociety, copies of all proposed forms of certificates, applications therefor,circulars to be issued by the society and a bond conditioned upon the return toapplicants of the advanced payments if the organization is not completed within1 year must be filed with the Commissioner, who may require such furtherinformation as he deems necessary. The bond with sureties approved by theCommissioner must be in such amount, not less than $300,000 nor more than$1,500,000, as required by the Commissioner. All documents filed must be in theEnglish language. If the purposes of the society conform to the requirements ofthis chapter and all applicable provisions of the law of this state have beencomplied with, the Commissioner shall so certify, retain and file the articlesof incorporation and furnish the incorporators a preliminary certificate of authorityfor the society to solicit members as provided in this chapter.

2. No preliminary certificate of authority grantedunder the provisions of this section is valid after 1 year from its date orafter such further period, not exceeding 1 year, as may be authorized by theCommissioner upon cause shown, unless 500 applicants have been secured and theorganization has been completed as provided in this chapter. The articles ofincorporation and all proceedings thereunder are void 1 year after the date ofthe preliminary certificate of authority, or at the expiration of the extendedperiod, unless the society has completed its organization and received acertificate of authority to do business.

(Added to NRS by 1971, 1837; A 1991, 225)

NRS 695A.070 Organization:Solicitation of members; collection of advance premiums; reports toCommissioner.

1. Upon receipt of a preliminary certificate ofauthority from the Commissioner, the society:

(a) May solicit members for the purpose of completingits organization;

(b) Shall collect from each applicant the amount of notless than one regular monthly premium in accordance with its table of rates;and

(c) Shall issue to each applicant a receipt for theamount collected.

2. A society shall not incur any liability other thanfor the return of an advance premium, or issue any certificate, or pay, allow,or offer or promise to pay or allow, any death or disability benefit to anyperson until:

(a) Actual bona fide applications for benefits havebeen secured aggregating at least $500,000 on not less than 500 applicants, andall required evidence of insurability has been furnished to and approved by thesociety;

(b) Not less than 10 subordinate lodges have beenestablished into which the 500 applicants have been admitted;

(c) There has been submitted to the Commissioner, underoath of the president or secretary, or corresponding officer of the society, alist of the applicants, giving their names and addresses, the date each wasadmitted, the name and number of the subordinate lodge of which each applicantis a member, the amount of benefits to be granted and the premiums therefor;and

(d) It has been shown to the Commissioner, by swornstatement of the treasurer or corresponding officer of the society, that atleast 500 applicants have each paid in cash at least one regular monthlypremium as provided in this chapter, which premiums in the aggregate mustamount to at least $150,000.

3. The advance premiums provided for in subsection 2must be held in trust during the period of organization and if the society hasnot qualified for a permanent certificate of authority within 1 year, asprovided in this chapter, the premiums must be returned to the applicants.

(Added to NRS by 1971, 1837; A 1991, 225)

NRS 695A.080 Certificateof authority: Issuance and renewal; effect; record; copies; fees.

1. The Commissioner may make such examination andrequire such further information as he deems advisable. Upon presentation ofsatisfactory evidence that the society has complied with all applicableprovisions of law, he shall issue to the society a certificate of authorityindicating that the society may transact business pursuant to the provisions ofthis chapter.

2. The certificate of authority is prima facie evidenceof the existence of the society on the date of the certificate.

3. The Commissioner shall cause a record of thecertificate of authority to be made. A certified copy of the record may begiven in evidence with like effect as the original certificate of authority.

4. For the issuance or renewal of a certificate ofauthority, a society must pay to the Commissioner:

(a) A fee of $250 if the number of outstanding benefitcontracts within Nevada of the society is 600 or less;

(b) A fee of $500 if the number of outstanding benefitcontracts within Nevada of the society is more than 600 but less than 1,200;and

(c) A fee of $2,450 if the number of outstandingbenefit contracts within Nevada of the society is 1,200 or more.

Each suchcertificate or renewal expires on March 1 following its issuance.

5. If a society properly applies for the renewal ofits certificate of authority but does not receive approval of its applicationby March 1, it may continue to transact business pursuant to this chapter unlessit receives notice that the application for renewal is specifically denied.

6. A certified copy or duplicate of a certificate ofauthority is prima facie evidence that the society may lawfully transactbusiness in this state pursuant to the provisions of this chapter during theperiod stated on the license.

(Added to NRS by 1971, 1838; A 1991, 226, 1633; 1993,2304)

NRS 695A.090 Generalpowers and duties of society. A society shalloperate for the benefit of its members and their beneficiaries by providingbenefits as specified in NRS 695A.180and may:

1. Operate for any lawful social, intellectual,educational, charitable, benevolent, moral, fraternal, patriotic or religious purpose.

2. Carry out its purposes directly or throughsubsidiary corporations or affiliated organizations.

3. Create, maintain and operate, or establishorganizations to operate, nonprofit institutions to further the societyspurposes. Such institutions may charge a reasonable amount for their services.

4. Organize and operate lodges for children under theminimum age for adult membership. Membership and initiation in local lodgesmust not be required of children, and they must not have a voice or vote in themanagement of the society.

5. Adopt laws and rules for the government of thesociety, the admission of its members and the management of its affairs.

6. Amend its laws and rules.

7. Exercise any other power which is necessary andincidental to carrying into effect the objects and purposes of the society andwhich is not inconsistent with the provisions of this chapter.

(Added to NRS by 1971, 1838; A 1991, 227)

NRS 695A.095 Contractsbetween society and provider of health care: Prohibiting society from chargingprovider of health care fee for inclusion on list of providers given toinsureds; form to obtain information on provider of health care; modification;schedule of fees.

1. A society shall not charge a provider of healthcare a fee to include the name of the provider on a list of providers of healthcare given by the society to its insureds.

2. A society shall not contract with a provider ofhealth care to provide health care to an insured unless the society uses theform prescribed by the Commissioner pursuant to NRS 629.095 to obtain any informationrelated to the credentials of the provider of health care.

3. A contract between a society and a provider ofhealth care may be modified:

(a) At any time pursuant to a written agreementexecuted by both parties.

(b) Except as otherwise provided in this paragraph, bythe society upon giving to the provider 30 days written notice of themodification. If the provider fails to object in writing to the modificationwithin the 30-day period, the modification becomes effective at the end of thatperiod. If the provider objects in writing to the modification within the30-day period, the modification must not become effective unless agreed to byboth parties as described in paragraph (a).

4. If a society contracts with a provider of healthcare to provide health care to an insured, the society shall:

(a) If requested by the provider of health care at thetime the contract is made, submit to the provider of health care the scheduleof payments applicable to the provider of health care; or

(b) If requested by the provider of health care at anyother time, submit to the provider of health care the schedule of paymentsspecified in paragraph (a) within 7 days after receiving the request.

5. As used in this section, provider of health caremeans a provider of health care who is licensed pursuant to chapter 630, 631,632 or 633 ofNRS.

(Added to NRS by 1999, 1649; A 2001, 2732; 2003, 3362)

NRS 695A.110 Unincorporatedor voluntary association prohibited. Nounincorporated or voluntary association may transact business in this state asa fraternal benefit society.

(Added to NRS by 1971, 1839; A 1991, 227)

NRS 695A.120 Locationof principal office; meetings of supreme governing body; minutes of certainproceedings; official publications; grievances by benefit members.

1. The principal office of any domestic society mustbe located in this state.

2. The meetings of its supreme governing body may beheld in any state, district, province or territory in which the society has atleast five subordinate lodges, and all business transacted at those meetings isas valid in all respects as if the meetings were held in this state.

3. The minutes of the proceedings of the supremegoverning body and the board of directors must be written in the Englishlanguage.

4. A society may provide in its laws for an officialpublication in which any notice, report or statement which is required by lawto be given to a member, including a notice of election, may be published. Sucha report, notice or statement must be printed conspicuously in the publication.

5. If the records of a society indicate that two ormore benefit members have the same mailing address, an official publicationmailed to one member shall be deemed to be mailed to all members at the sameaddress unless a member requests a separate copy.

6. A society may provide in its laws or rules aprocedure by which a benefit member may pursue a grievance or complaint againstthe society, its supreme governing body, officers, directors or other members.

(Added to NRS by 1971, 1839; A 1991, 227)

NRS 695A.130 Consolidation;merger.

1. A domestic society that wishes to consolidate ormerge with any other society must file with the Commissioner:

(a) A certified copy of the written contract containingin full the terms and conditions of the consolidation or merger;

(b) A sworn statement by the president and secretary orcorresponding officers of each society showing the financial condition thereofon a date fixed by the Commissioner, but not earlier than December 31, nextpreceding the date of the contract;

(c) The certification of such officers, duly verifiedby their respective oaths, that the consolidation or merger has been approvedby a two-thirds vote of the supreme governing body of each society at a regularor special meeting of such bodies or, if permitted by the laws of the society,by mail; and

(d) Evidence that at least 60 days before the action ofthe supreme governing body of each society, the text of the contract wasfurnished to all members of each society either by mail or by publication infull in the official publication of each society.

2. If the Commissioner finds that the contractcontaining in full the terms and conditions of the consolidation or merger isin conformity with the provisions of this section, that the financialstatements are correct and that the consolidation or merger is just andequitable to the members of each society, he shall approve the contract andissue a certification of that fact.

3. The contract becomes effective upon approval by theCommissioner unless any society which is a party to the contract isincorporated under the laws of any other state or territory, in which case theconsolidation or merger does not become effective unless:

(a) It is approved as provided by the laws of the otherstate or territory and a certificate of such approval has been filed with theCommissioner of this state; or

(b) If the laws of the other state or territory do notprovide for such approval, it is approved by the officer responsible forsupervising the business of insurance in the other state or territory and acertificate of such approval has been filed with the Commissioner of thisstate.

4. Upon the consolidation or merger becoming effectiveas provided in this chapter, all the rights, franchises and interests of theconsolidated or merged societies in and to every species of property, real,personal or mixed, and things in action belonging thereto are vested in thesociety resulting from or remaining after the consolidation or merger withoutany other instrument, except that conveyances of real property may be evidencedby proper deeds. The title to any real property or interest therein, vestedunder the laws of this state in any of the societies consolidated or merged,does not revert and is not in any way impaired by the consolidation or mergerbut vests absolutely in the society resulting from or remaining after the consolidationor merger.

5. The affidavit of any officer of the society or ofanyone authorized by it to mail any notice or document, stating that the noticeor document has been duly addressed and mailed, is prima facie evidence thatthe notice or document has been furnished the addressees.

(Added to NRS by 1971, 1839; A 1991, 228)

NRS 695A.140 Conversionof fraternal benefit society into mutual life insurer.Any domestic fraternal benefit society may be converted to and licensedas a mutual life insurer by compliance with all the applicable requirements of chapter 693A of NRS if a plan of conversion is:

1. Prepared by the board of directors of the societyin writing setting forth in full the terms and conditions of the conversion;

2. Approved by the affirmative vote of two-thirds ofall members of the supreme governing body of the society at a regular orspecial meeting; and

3. Approved by the Commissioner, who may give suchapproval if he finds that the proposed change is in conformity with the laws ofthis state and not prejudicial to the certificate holders of the society.

(Added to NRS by 1971, 1840; A 1991, 229; A 1991,229)

NRS 695A.150 Qualificationsfor and rights and privileges of membership.

1. Subject to the limitations set forth in subsections2, 3 and 4, a society shall specify in its laws or rules for each class ofmembership:

(a) The standards of eligibility and the process foradmission to membership in that class; and

(b) The rights and privileges of membership in thatclass, provided that only benefit members may have the right to vote on themanagement of the business of the society relating to insurance.

2. If benefits are provided on the lives of children,the minimum age for membership as an adult must be not less than 15 and notgreater than 21 years of age.

3. A society may also admit social members, who haveno voice or vote in the management of its affairs relating to insurance.

4. Membership rights in the society must not beassignable.

(Added to NRS by 1971, 1841; A 1973, 1582; 1991, 229)

NRS 695A.151 Effectof eligibility for medical assistance under Medicaid on eligibility forcoverage; assignment of rights to state agency.

1. A society shall not, when considering eligibilityfor coverage or making payments under a certificate for health benefits,consider the availability of, or eligibility of a person for, medicalassistance under Medicaid.

2. To the extent that payment has been made byMedicaid for health care, a society:

(a) Shall treat Medicaid as having a valid and enforceableassignment of an insureds benefits regardless of any exclusion of Medicaid orthe absence of a written assignment; and

(b) May, as otherwise allowed by its certificate forhealth benefits, evidence of coverage or contract and applicable law or regulationconcerning subrogation, seek to enforce any reimbursement rights of a recipientof Medicaid against any other liable party if:

(1) It is so authorized pursuant to a contractwith Medicaid for managed care; or

(2) It has reimbursed Medicaid in full for thehealth care provided by Medicaid to its insured.

3. If a state agency is assigned any rights of aperson who is:

(a) Eligible for medical assistance under Medicaid; and

(b) Covered by a certificate for health benefits,

the societythat issued the health policy shall not impose any requirements upon the stateagency except requirements it imposes upon the agents or assignees of otherpersons covered by the certificate.

(Added to NRS by 1995, 2431)

NRS 695A.152 Societyrequired to comply with certain provisions concerning portability andavailability of health insurance.

1. To the extent reasonably applicable, a fraternalbenefit society shall comply with the provisions of NRS 689B.340 to 689B.590, inclusive, and chapter 689C of NRS relating to the portabilityand availability of health insurance offered by the society to its members. Ifthere is a conflict between the provisions of this chapter and the provisionsof NRS 689B.340 to 689B.590, inclusive, and chapter 689C of NRS, the provisions of NRS 689B.340 to 689B.590, inclusive, and chapter 689C of NRS control.

2. For the purposes of subsection 1, unless thecontext requires that a provision apply only to a group health plan or acarrier that provides coverage under a group health plan, any reference inthose sections to group health plan or carrier must be replaced byfraternal benefit society.

(Added to NRS by 1997, 2954; A 2001, 1923)

NRS 695A.153 Societyprohibited from asserting certain grounds to deny enrollment of child ofinsured pursuant to order. A society shall notdeny the enrollment of a child pursuant to an order for medical coverage undera certificate for health benefits pursuant to which a parent of the child isinsured, on the ground that the child:

1. Was born out of wedlock;

2. Has not been claimed as a dependent on the parentsfederal income tax return; or

3. Does not reside with the parent or within thesocietys geographic area of service.

(Added to NRS by 1995, 2431)

NRS 695A.155 Certainaccommodations to be made when child is covered under policy of noncustodialparent. If a child has coverage under acertificate for health benefits pursuant to which a noncustodial parent of thechild is insured, the society issuing that certificate shall:

1. Provide to the custodial parent such information asnecessary for the child to obtain any benefits under that coverage.

2. Allow the custodial parent or, with the approval ofthe custodial parent, a provider of health care to submit claims for coveredservices without the approval of the noncustodial parent.

3. Make payments on claims submitted pursuant tosubsection 2 directly to the custodial parent, the provider of health care oran agency of this or another state responsible for the administration ofMedicaid.

(Added to NRS by 1995, 2432)

NRS 695A.157 Societyto authorize enrollment of child of parent who is required by order to providemedical coverage under certain circumstances; termination of coverage of child. If a parent is required by an order for medical coverageto provide coverage under a certificate for health benefits for a child and theparent is eligible for coverage of members of his family under a certificatefor health benefits, the society that issued the certificate:

1. Shall, if the child is otherwise eligible for thatcoverage, allow the parent to enroll the child in that coverage without regardto any restrictions upon periods for enrollment.

2. Shall, if:

(a) The child is otherwise eligible for that coverage;and

(b) The parent is enrolled in that coverage but failsto apply for enrollment of the child,

enroll thechild in that coverage upon application by the other parent of the child, or byan agency of this or another state responsible for the administration of Medicaidor a state program for the enforcement of child support established pursuant to42 U.S.C. 651 et seq., without regard to any restrictions upon periods forenrollment.

3. Shall not terminate the enrollment of the child inthat coverage or otherwise eliminate that coverage of the child unless thesociety has written proof that:

(a) The order for medical coverage is no longer ineffect; or

(b) The child is or will be enrolled in comparablecoverage through another insurer on or before the effective date of thetermination of enrollment or elimination of coverage.

(Added to NRS by 1995, 2432)

NRS 695A.159 Societyprohibited from restricting coverage of child based on preexisting conditionwhen person who is eligible for group coverage adopts or assumes legalobligation for child.

1. If a person:

(a) Adopts a dependent child;or

(b) Assumes and retains alegal obligation for the total or partial support of a dependent child inanticipation of adopting the child,

while the person is eligible for group coverage under acertificate for health benefits, the society issuing that certificate shall notrestrict the coverage, in accordance with NRS689B.340 to 689B.590, inclusive,and chapter 689C of NRS relating to theportability and availability of health insurance, of the child solely becauseof a preexisting condition the child has at the time he would otherwise becomeeligible for coverage pursuant to that policy.

2. For the purposes of thissection, child means a person who is under 18 years of age at the time of hisadoption or the assumption of a legal obligation for his support inanticipation of his adoption.

(Added to NRS by 1995, 2432; A 1997, 2954)

NRS 695A.160 Amendmentof laws of society.

1. A domestic society may amend its laws in accordancewith the provisions thereof by action of its supreme governing body at anyregular or special meeting thereof or, if its laws so provide, by referendum.Such a referendum may be held in accordance with the provisions of its laws bythe vote of the voting members of the society, by the vote of delegates orrepresentatives of voting members or by the vote of local lodges. A society mayprovide for voting by mail. No amendment submitted for adoption by referendummay be adopted unless, within 6 months after the date of submission thereof, amajority of all of the voting members of the society have signified theirconsent to the amendment by one of the methods specified in this section.

2. No amendment to the laws of any domestic societybecomes effective unless approved by the Commissioner, who shall approve theamendment if he finds that it has been duly adopted and is not inconsistentwith any requirement of the laws of this state or with the character, objectsand purposes of the society. Unless the Commissioner disapproves an amendmentwithin 60 days after it is filed, such amendment shall be deemed approved. Theapproval or disapproval of the Commissioner must be in writing and mailed tothe secretary or corresponding officer of the society at its principal office.If the Commissioner disapproves an amendment, the reasons therefor must bestated in the written notice.

3. Within 90 days after their approval by thecommissioner, all the amendments, or a synopsis thereof, must be furnished toall members of the society either by mail or by publication in full in theofficial publication of the society. The affidavit of any officer of thesociety or of anyone authorized by it to mail any amendments or synopsisthereof, stating facts which show that the amendments or synopsis thereof havebeen duly addressed and mailed, is prima facie evidence that the amendments orsynopsis thereof have been furnished the addressee.

4. Every foreign or alien society authorized to dobusiness in this state shall file with the Commissioner a duly certified copyof all amendments of, or additions to, its laws within 90 days after theirenactment.

5. Printed copies of the laws as amended, certified bythe secretary or corresponding officer of the society, are prima facie evidenceof the legal adoption thereof.

(Added to NRS by 1971, 1841; A 1991, 230)

NRS 695A.180 Scopeof contractual benefits.

1. A society authorized to do business in this statemay provide the following contractual benefits in any form:

(a) Death benefits;

(b) Endowment benefits;

(c) Annuity benefits;

(d) Temporary or permanent disability benefits;

(e) Hospital, medical or nursing benefits;

(f) Monument or tombstone benefits to the memory ofdeceased members; and

(g) Any other benefits which life insurance companiesare authorized to pay which are not inconsistent with the provisions of thischapter.

2. A society shall specify in its laws or rules thosepersons who may be issued, or covered by, the contractual benefits set forth insubsection 1, consistent with the purpose of providing benefits to members andtheir dependents. A society may provide benefits on the lives of children underthe minimum age for adult membership upon the application of an adult.

(Added to NRS by 1971, 1842; A 1991, 231)

NRS 695A.184 Coveragefor prescription drug previously approved for medical condition of insured.

1. Except as otherwise provided in this section, abenefit contract which provides coverage for prescription drugs must not limitor exclude coverage for a drug if the drug:

(a) Had previously been approved for coverage by thesociety for a medical condition of an insured and the insureds provider ofhealth care determines, after conducting a reasonable investigation, that noneof the drugs which are otherwise currently approved for coverage are medicallyappropriate for the insured; and

(b) Is appropriately prescribed and considered safe andeffective for treating the medical condition of the insured.

2. The provisions of subsection 1 do not:

(a) Apply to coverage for any drug that is prescribedfor a use that is different from the use for which that drug has been approvedfor marketing by the Food and Drug Administration;

(b) Prohibit:

(1) The society from charging a deductible,copayment or coinsurance for the provision of benefits for prescription drugsto the insured or from establishing, by contract, limitations on the maximumcoverage for prescription drugs;

(2) A provider of health care from prescribinganother drug covered by the benefit contract that is medically appropriate forthe insured; or

(3) The substitution of another drug pursuant toNRS 639.23286 or 639.2583 to 639.2597, inclusive; or

(c) Require any coverage for a drug after the term ofthe benefit contract.

3. Any provision of a benefit contract subject to theprovisions of this chapter that is delivered, issued for delivery or renewed onor after October 1, 2001, which is in conflict with this section is void.

(Added to NRS by 2001, 861; A 2003, 2299)

NRS 695A.188 Approvalor denial of claim; interest on unpaid claim; request for additionalinformation; payment of claim; costs and attorneys fees.

1. Except as otherwise provided in subsection 2, asociety shall approve or deny a claim relating to a certificate of healthinsurance within 30 days after the society receives the claim. If the claim isapproved, the society shall pay the claim within 30 days after it is approved.If the approved claim is not paid within that period, the society shall pay intereston the claim at the rate of interest established pursuant to NRS 99.040 unless a different rate ofinterest is established pursuant to an express written contract between thesociety and the provider of health care. The interest must be calculated from30 days after the date on which the claim is approved until the claim is paid.

2. If the society requires additional information todetermine whether to approve or deny the claim, it shall notify the claimant ofits request for the additional information within 20 days after it receives theclaim. The society shall notify the provider of health care of all the specificreasons for the delay in approving or denying the claim. The society shallapprove or deny the claim within 30 days after receiving the additionalinformation. If the claim is approved, the society shall pay the claim within30 days after it receives the additional information. If the approved claim isnot paid within that period, the society shall pay interest on the claim in themanner prescribed in subsection 1.

3. A society shall not request a claimant to resubmitinformation that the claimant has already provided to the society, unless thesociety provides a legitimate reason for the request and the purpose of therequest is not to delay the payment of the claim, harass the claimant ordiscourage the filing of claims.

4. A society shall not pay only part of a claim thathas been approved and is fully payable.

5. A court shall award costs and reasonable attorneysfees to the prevailing party in an action brought pursuant to this section.

(Added to NRS by 1991, 1330; A 1999, 1649)

NRS 695A.195 Societyprohibited from denying coverage solely because person was victim of domesticviolence. A society shall not deny a claim,refuse to issue a benefit contract or cancel a benefit contract solely becausethe claim involves an act that constitutes domestic violence pursuant to NRS 33.018, or because the person applyingfor or covered by the benefit contract was the victim of such an act ofdomestic violence, regardless of whether the insured or applicant contributedto any loss or injury.

(Added to NRS by 1997, 1096)

NRS 695A.197 Societyprohibited from denying coverage solely because insured was intoxicated orunder the influence of controlled substance; exceptions. [Effective July 1,2006.]

1. Except as otherwise provided in subsection 2, asociety that provides health benefits shall not:

(a) Deny a claim under a benefit contract solelybecause the claim involves an injury sustained by an insured as a consequenceof being intoxicated or under the influence of a controlled substance.

(b) Cancel a benefit contract solely because an insuredhas made a claim involving an injury sustained by the insured as a consequenceof being intoxicated or under the influence of a controlled substance.

(c) Refuse to issue a benefit contract to an eligibleapplicant solely because the applicant has made a claim involving an injurysustained by the applicant as a consequence of being intoxicated or under theinfluence of a controlled substance.

2. Theprovisions of this section do not prohibit a society from enforcing a provisionincluded in a benefit contract to:

(a) Deny a claim which involves an injury to which acontributing cause was the insureds commission of or attempt to commit afelony;

(b) Cancel a benefit contract solely because of such aclaim; or

(c) Refuse to issue a benefit contract to an eligibleapplicant solely because of such a claim.

(Added to NRS by 2005, 2345,effective July 1, 2006)

NRS 695A.200 Nonforfeiturebenefits, cash surrender values, certificate loans and other options.

1. A society may grant paid-up nonforfeiture benefits,cash surrender values, certificate loans and such other options as its laws maypermit.

2. In the case of certificates for which reserves arecomputed on the Commissioners 1980 Standard Ordinary Mortality Table or suchother table of mortality as may be specified by the society and approved by theCommissioner, every paid-up nonforfeiture benefit and the amount of any cashsurrender value, loan or other option granted must not be less than thecorresponding amount ascertained in accordance with the provisions of the lawsof this state applicable to life insurance companies issuing policiescontaining like insurance benefits based upon those tables.

(Added to NRS by 1971, 1843; A 1985, 1185; 1991, 231)

NRS 695A.210 Beneficiaries;funeral benefits.

1. The owner of a benefit contract has the right atall times to change any beneficiary in accordance with the laws or rules of thesociety, unless the owner waives that right by requesting in writing that hisdesignation of a beneficiary be irrevocable. Every society by its laws or rulesmay limit the scope of a designation of a beneficiary and shall provide that arevocable beneficiary does not have or obtain any vested interest in theproceeds of any certificate until the certificate has become due and payable inconformity with the provisions of the benefit contract.

2. A society may provide for the payment of funeralbenefits to the extent of such portion of any payment under a certificate asmight reasonably appear to be due to any person equitably entitled thereto byreason of having incurred expense occasioned by the burial of a member, but theportion so paid must not exceed $1,000.

3. If, at the death of any person insured under abenefit contract, there is no lawful beneficiary to whom the insurance benefitsare payable, the amount of such benefits, except to the extent that funeralbenefits may be paid as provided in subsection 2, are payable:

(a) To the estate of the deceased insured; or

(b) To the owner of the certificate if he is not theperson insured under the benefit contract.

(Added to NRS by 1971, 1844; A 1991, 232)

NRS 695A.220 Benefitsnot liable to attachment, garnishment or other process. No money or other benefit, charity, relief or aid to bepaid, provided or rendered by any society is liable to attachment, garnishmentor other process, or to be seized, taken, appropriated or applied by any legalor equitable process or operation of law to pay any debt or liability of abenefit member or beneficiary, or any other person who may have a rightthereunder, either before or after payment by the society.

(Added to NRS by 1971, 1844; A 1991, 233)

NRS 695A.230 Termsand conditions of benefit contracts.

1. Every society authorized to do business in thisstate shall issue to each owner of a benefit contract a certificate specifyingthe amount of benefits provided thereby. The certificate, together with anyriders or endorsements attached thereto, the laws of the society, theapplication for membership, the application for insurance and the declarationof insurability, if any, signed by the applicant, and all amendments to eachthereof, constitute the agreement, as of the date of issuance, between thesociety and the member, and the certificate must so state. A copy of theapplication for insurance and the declaration of insurability, if any, must beendorsed upon or attached to the certificate.

2. All statements on an application for insurance arerepresentations and not warranties. Any waiver of this provision is void.

3. Except with regard to contracts providing benefitspayable in variable amounts, any changes, additions or amendments to the laws ofthe society duly made or enacted after the issuance of the certificate bind theowner and the beneficiaries, and govern and control the benefit contract asthough the changes, additions or amendments were in force at the time of theapplication for insurance, except that no change, addition or amendment maydestroy or diminish benefits which the society contracted to give the owner asof the date of issuance.

4. Any person upon whose life a benefit contract isissued before he attains the age of majority is bound by the terms of theapplication and certificate and by all the laws and rules of the society asthough the age of majority had been attained at the time of application.

5. Copies of any of the documents mentioned in thissection, certified by the secretary or corresponding officer of the society,must be received in evidence of the terms and conditions thereof.

6. Except with regard to contracts providing benefitspayable in variable amounts, a society shall provide in its laws that if its reservesas to all or any class of certificates become impaired, its supreme governingbody or board of directors may require each owner of such certificates to payto the society the amount of his equitable proportion of such deficiency asascertained by its board, and that if the payment is not made, the owner mayelect to:

(a) Let it stand as an indebtedness against thecertificate and draw interest at a rate not to exceed that specified for loansmade pursuant to the certificates; or

(b) In lieu of, or in combination with paragraph (a),accept a proportionate reduction in benefits under the certificate.

The societymay specify the manner of the election and which alternative is to be presumedif no election is made by the owner.

(Added to NRS by 1971, 1844; A 1991, 233)

NRS 695A.235 Offeringpolicy of health insurance for purposes of establishing health savings account. A society may, subject to regulation by the Commissioner,offer a policy of health insurance that has a high deductible and is in compliancewith 26 U.S.C. 223 for the purposes of establishing a health savings account.

(Added to NRS by 2005, 2158)

NRS 695A.240 Approvaland contents of certificates.

1. No certificate may be delivered or issued fordelivery in this state unless a copy of the form of the certificate has beenfiled with and approved by the Commissioner in conformity with the requirementsof NRS 687B.120.

2. The certificate must contain:

(a) A provision stating the amount of premiums whichare payable under the certificate;

(b) A provision setting forth the societys laws orrules which, if violated, will result in the termination or reduction ofbenefits payable under the certificate;

(c) If the laws of the society provide for theexpulsion or suspension of a member, a provision that any member who isexpelled or suspended, except for nonpayment of a premium or, during the periodof contestability, for material misrepresentation in the application formembership or insurance, may maintain the certificate in force by continuingpayment of the required premium; and

(d) All standard contractual provisions which are requiredby the provisions of chapters 687B, 688A, 688B, 689, 689A and 689B of NRS to be included in similar policiesissued by life or health insurers in this state, and which are not inconsistentwith the provisions of this chapter.

3. The certificate may contain:

(a) A provision that the member is entitled to a graceperiod of 1 month in which the payment of any premium after the first may bemade.

(b) For a benefit contract issued on the life of aperson under the societys minimum age for membership as an adult, a provisiongoverning the transfer of ownership to the insured at an age specified in thecertificate. A society may require approval of an application for membership inorder to make the transfer, and may provide for the regulation, government andcontrol of such a certificate and all rights, obligations and liabilitiesincident to the certificate, including rights of ownership before the transfer.

(c) The terms and conditions governing theassignability of the benefit contract.

(Added to NRS by 1971, 1845; A 1991, 234)

NRS 695A.255 Coveragefor prescription drugs: Provision of notice and information regarding use offormulary.

1. A society that offers or issues a benefit contractwhich provides coverage for prescription drugs shall include with anycertificate for such a contract provided to a benefit member, notice of whethera formulary is used and, if so, of the opportunity to secure informationregarding the formulary from the society pursuant to subsection 2. The noticerequired by this subsection must:

(a) Be in a language that is easily understood and in aformat that is easy to understand;

(b) Include an explanation of what a formulary is; and

(c) If a formulary is used, include:

(1) An explanation of:

(I) How often the contents of theformulary are reviewed; and

(II) The procedure and criteria fordetermining which prescription drugs are included in and excluded from theformulary; and

(2) The telephone number of the society formaking a request for information regarding the formulary pursuant to subsection2.

2. If a society offers or issues a benefit contractwhich provides coverage for prescription drugs and a formulary is used, thesociety shall:

(a) Provide to any insured or participating provider ofhealth care, upon request:

(1) Information regarding whether a specificdrug is included in the formulary.

(2) Access to the most current list of prescriptiondrugs in the formulary, organized by major therapeutic category, with anindication of whether any listed drugs are preferred over other listed drugs.If more than one formulary is maintained, the society shall notify therequester that a choice of formulary lists is available.

(b) Notify each person who requests informationregarding the formulary, that the inclusion of a drug in the formulary does notguarantee that a provider of health care will prescribe that drug for aparticular medical condition.

(Added to NRS by 2001, 860)

NRS 695A.270 Waiverof provisions of societys laws. The laws ofthe society may provide that no subordinate body or any of its subordinateofficers or members may waive any of the provisions of the laws of the society.Such a provision is binding on the society and every member and beneficiary ofa member.

(Added to NRS by 1971, 1849; A 1991, 237)

NRS 695A.280 Reinsurance.

1. Except as otherwise provided in subsection 3, adomestic society may, by a reinsurance agreement, cede any individual risk orrisks in whole or in part to an insurer, other than another fraternal benefitsociety, authorized to provide reinsurance in this state, or if not soauthorized, one which is approved in writing by the Commissioner, but no suchsociety may reinsure substantially all of its insurance in force without thewritten permission of the Commissioner.

2. A society may take credit for the reserves on suchceded risks to the extent reinsured, but no credit may be allowed as anadmitted asset or as a deduction from liability to a ceding society forreinsurance made, ceded, renewed or otherwise becoming effective after July 1,1963, unless the reinsurance is payable by the assuming insurer on the basis ofthe liability of the ceding society under the benefit contract or contractsreinsured without diminution because of the insolvency of the ceding society.

3. A society may reinsure the risks of another societyin a consolidation or merger which is approved by the Commissioner pursuant to NRS 695A.130.

(Added to NRS by 1971, 1849; A 1987, 649; 1991, 237)

NRS 695A.300 Admissionof foreign or alien society.

1. A foreign or alien society shall not transactbusiness in this state without a license issued by the Commissioner.

2. A foreign or alien society may be licensed totransact business in this state upon a showing that its assets are invested inaccordance with the provisions of this chapter and upon filing with theCommissioner:

(a) A duly certified copy of its laws, certified by itssecretary or corresponding officer;

(b) A power of attorney to the Commissioner asprescribed in NRS 695A.400;

(c) A statement of its business under oath of itspresident and secretary or corresponding officers in a form prescribed by theCommissioner, duly verified by an examination made by the supervising insuranceofficer of its home state or other state, territory, province or country,satisfactory to the Commissioner of this state;

(d) Certification from the proper officer of its homestate, territory, province or country that the society is legally incorporatedand licensed to transact business therein;

(e) Copies of its certificate forms; and

(f) Such other information as the Commissioner may deemnecessary.

3. Any foreign or alien society desiring admission tothis state must comply substantially with the requirements and limitations ofthis chapter applicable to domestic societies.

(Added to NRS by 1971, 1849; A 1991, 237)

NRS 695A.310 Injunctionagainst, liquidation of or appointment of receiver for domestic society.

1. When the Commissioner upon investigation finds thata domestic society:

(a) Has exceeded its powers;

(b) Has failed to comply with any provision of thischapter;

(c) Is not fulfilling its contracts in good faith;

(d) Has a membership of less than 400 after anexistence of 1 year or more; or

(e) Is conducting business fraudulently or in a mannerhazardous to its members, creditors, the public or the business,

he shallnotify the society of his findings, state in writing the reasons for his dissatisfaction,and issue a written order requiring the society to make the necessarycorrections. If the Commissioner finds that the society has failed to complywith the order within 30 days after receiving it, he shall notify the societyof his finding of noncompliance and require the society to show cause on a datenamed why it should not be enjoined from carrying on any business until theviolation complained of has been corrected, or why an action in quo warrantoshould not be commenced against the society.

2. If on that date the society does not present goodand sufficient reasons why it should not be so enjoined or why such actionshould not be commenced, the Commissioner may present the facts relatingthereto to the Attorney General, who shall, if he deems the circumstanceswarrant, commence an action to enjoin the society from transacting business oran action in quo warranto.

3. The court shall thereupon notify the officers ofthe society of a hearing. If, after a full hearing, it appears that the societyshould be so enjoined or liquidated or a receiver appointed, the court shallenter the necessary order.

4. A society that is so enjoined shall not do businessuntil:

(a) The Commissioner finds that the violationcomplained of has been corrected;

(b) The costs of the action have been paid by thesociety, if the court finds that the society was in default as charged;

(c) The court has dissolved its injunction; and

(d) The Commissioner has reinstated the certificate ofauthority.

5. If the court orders the society liquidated, it mustbe enjoined from carrying on any further business, whereupon the receiver ofthe society shall proceed at once to take possession of the books, papers,money and other assets of the society and, under the direction of the court,proceed forthwith to close the affairs of the society and to distribute itsfunds to those entitled thereto.

6. No action under this section may be recognized inany court of this state unless brought by the Attorney General upon request ofthe Commissioner. Whenever a receiver is to be appointed for a domesticsociety, the court shall appoint the Commissioner as the receiver.

7. The provisions of this section relating to hearingby the Commissioner, action by the Attorney General at the request of theCommissioner, hearing by the court, injunction and receivership apply to asociety which voluntarily determines to discontinue business.

(Added to NRS by 1971, 1850; A 1991, 238)

NRS 695A.320 Suspension,revocation or refusal of license of foreign or alien society.

1. When the Commissioner upon investigation finds thata foreign or alien society transacting or applying to transact business in thisstate:

(a) Has exceeded its powers;

(b) Has failed to comply with any provision of this chapter;

(c) Is not fulfilling its contracts in good faith; or

(d) Is conducting its business fraudulently or in amanner hazardous to its members or creditors or the public,

he shallnotify the society of his findings, state in writing the reasons for his dissatisfactionand issue a written order requiring the society to make the necessarycorrections. If the Commissioner finds that the society has failed to complywith the order within 30 days after receiving it, he shall notify the societyof his finding of noncompliance and require the society to show cause on a datenamed why its license should not be suspended, revoked or refused.

2. If on that date the society does not present goodand sufficient reason why its authority to do business in this state should notbe suspended, revoked or refused, the Commissioner may suspend or refuse thelicense of the society to do business in this state until satisfactory evidenceis furnished to him that the suspension or refusal should be withdrawn, or hemay revoke the authority of the society to do business in this state.

3. Nothing contained in this section prevents asociety from continuing in good faith all contracts made in this state duringthe time the society was legally authorized to transact business in this state.

(Added to NRS by 1971, 1851; A 1991, 239)

NRS 695A.330 Licensingof insurance agents of society; persons exempt from licensing.

1. Every insurance agent of a society must be licensedpursuant to chapter 683A of NRS and anyregulations adopted by the Commissioner which apply to health and lifeinsurance agents.

2. No written or other examination is required of aperson who held a license as an insurance agent on July 1, 1977, for renewalsof his license.

3. No examination or license is required of:

(a) Any regular salaried officer or employee of alicensed society who devotes substantially all of his services to activitiesother than the solicitation of fraternal insurance contracts from the public,and who does not receive for the solicitation of such contracts any commissionor other compensation directly dependent upon the amount of business obtained;or

(b) Any member of the society who does not writeinsurance contracts, and whose solicitation or negotiation is incidental tosecuring new members for his society, and whose only remuneration consists ofprizes in the form of merchandise or payments of a nominal amount of money.

(Added to NRS by 1971, 1851; A 1977, 693; 1991, 239)

NRS 695A.400 Serviceof process on society.

1. Every society authorized to do business in thisstate shall appoint in writing the Commissioner and each successor in office tobe its true and lawful attorney upon whom all lawful process in any action orproceeding against it must be served, and shall agree in the writing that anylawful process against it which is served on the Commissioner is of the samelegal force and validity as if served upon the society, and that the authoritycontinues in force so long as any liability remains outstanding in this state.A copy of the appointment, certified by the Commissioner, constitutessufficient evidence of the appointment and must be admitted in evidence withthe same validity as the original.

2. Service must be made only upon the Commissioner, orif absent, upon the person in charge of his office. It must be made induplicate and constitutes sufficient service upon the society. When legalprocess against a society is served upon the Commissioner, he shall forthwithforward one of the duplicate copies by registered mail, prepaid, directed tothe secretary or corresponding officer.

3. No such service may require a society to file itsanswer, pleading or defense in less than 30 days from the date of mailing thecopy of the service to a society.

4. Legal process must not be served upon a societyexcept in the manner provided in this section.

5. At the time of serving any process upon theCommissioner, the plaintiff or complainant in the action shall pay to theCommissioner a fee of $5.

6. For the purposes of this section, processincludes only the summons or the initial documents served in an action. TheCommissioner is not required to serve any documents after the initial serviceof process.

(Added to NRS by 1971, 1854; A 1971, 1956; 1985, 612;1991, 240)

NRS 695A.410 Injunctionsagainst societies. No application or petitionfor injunction against any domestic, foreign or alien society, or any of itslodges, may be recognized in any court of this state unless made by theAttorney General upon request of the Commissioner.

(Added to NRS by 1971, 1855; A 1991, 240)

NRS 695A.420 Judicialreview of Commissioners findings and decisions. Alldecisions and findings of the Commissioner made under the provisions of thischapter are subject to review by proper proceedings in any court of competentjurisdiction in this state.

(Added to NRS by 1971, 1855; A 1991, 241)

NRS 695A.430 Assets,funds and accounts of society.

1. All assets must be held, invested and disbursed forthe use and benefit of the society and no member or beneficiary may have oracquire individual rights therein or become entitled to any apportionment orthe surrender of any part thereof, except as provided in the benefit contract.

2. A society may create, maintain, invest, disburseand apply any special fund necessary to carry out any purpose permitted by thelaws of the society.

3. A society may, pursuant to a resolution of itssupreme governing body and subject to the provisions of NRS 688A.390, establish and operate oneor more separate accounts and issue contracts providing benefits payable invariable amounts. For the purposes of NRS688A.390, a society shall be deemed to be a domestic life insurer.

(Added to NRS by 1971, 1855; A 1991, 241)

NRS 695A.440 Investments.

1. A society shall invest its money only in suchinvestments as are authorized by the laws of this state for the investment ofassets of life insurers and subject to the limitations thereon.

2. Any foreign or alien society permitted or seekingto do business in this state which invests its money in accordance with the lawsof the state, district, territory, country or province in which it isincorporated shall be deemed to meet the requirements of this section for theinvestment of money.

(Added to NRS by 1971, 1855; A 1991, 241)

NRS 695A.450 Annualstatement of financial condition, transactions and affairs.

1. Every society transacting business in this stateshall annually, on or before the first day of March, unless for cause shown thetime has been extended by the Commissioner, file with the Commissioner a truestatement of its financial condition, transactions and affairs for thepreceding calendar year and pay a filing fee of $25. The statement must be insuch general form and context as approved by the National Association ofInsurance Commissioners for fraternal benefit societies and as supplemented byadditional information required by the Commissioner. The statement must includeseparately from the societys admitted assets all real or personal propertyowned, held or leased by the society for the purposes of its nonprofitinstitutions operated pursuant to NRS695A.090.

2. A synopsis of its annual statement providing anexplanation of the facts concerning the condition of the society thereby disclosedmust be printed and mailed to each benefit member of the society not later thanJune 1 of each year, or, in lieu thereof, the synopsis may be published in thesocietys official publication established pursuant to NRS 695A.120.

3. As a part of the annual statement required bysubsection 1, each society shall, on or before the first day of March, filewith the Commissioner a valuation of its certificates in force on the precedingDecember 31. The Commissioner may, in his discretion for cause shown, extendthe time for filing the valuation for not more than 2 calendar months. Thevaluation must be done pursuant to NRS695A.490. The valuation and supporting data must be certified by aqualified actuary or, at the expense of the society, verified by the actuary ofthe department of insurance of the state in which the society is domiciled.

(Added to NRS by 1971, 1856; A 1987, 466; 1991, 241)

NRS 695A.460 Penaltiesfor failure to file statement properly. If asociety fails to file the annual statement in the form and within the timeprovided by NRS 695A.450, it shall payto the Commissioner $100 for each day that the statement remains unfiled ordeficient, and, upon notice by the Commissioner to that effect, its authorityto do business in this state ceases until the statement is properly filed.

(Added to NRS by 1971, 1857; A 1991, 242)

NRS 695A.475 Liabilityof directors, officers, employees, members and volunteers; indemnification andreimbursement of directors, officers, employees and agents.

1. The officers and members of the supreme governing bodyor any subordinate body of a society are not personally liable for payment ofany benefits provided by the society.

2. A person may be indemnified and reimbursed by asociety for expenses reasonably incurred by, and liabilities imposed upon, himin connection with or arising out of any action, suit or proceeding, whethercivil, criminal, administrative or investigative, or threat thereof, in whichthe person may be involved because he is or was a director, officer, employeeor agent of the society or of any firm, corporation or organization which heserved in any capacity at the request of the society.

3. A person may not be so indemnified or reimbursed asto any matter in an action, suit or proceeding, or threat thereof, in which heis finally adjudged to be guilty of a breach of a duty as a director, officer,employee or agent of the society, or which is made the subject of a compromisesettlement, unless:

(a) He acted in good faith for a purpose he reasonablybelieved to be in the best interests of the society; and

(b) If a criminal action, he had no reasonable cause tobelieve that his conduct was unlawful.

4. The determination of whether the conduct of aperson meets the standard required for indemnification and reimbursement mayonly be made by:

(a) The supreme governing body or board of directors bya majority vote of a quorum consisting of persons who were not parties to theaction, suit or proceeding; or

(b) A court of competent jurisdiction.

5. The termination of any action, suit or proceedingby judgment, order, settlement or conviction, or upon a plea of nolocontendere, does not create a conclusive presumption that the person does notmeet the standard of conduct required for indemnification and reimbursement.

6. The right of indemnification and reimbursement doesnot exclude other rights to which the person may be entitled as a matter oflaw, and inures to the benefit of his heirs, executors and administrators.

7. A society may purchase and maintain insurance onbehalf of any person who is or was a director, officer, employee or agent ofthe society, or who is serving or has served at the request of the society as adirector, officer, employee or agent of any other firm, corporation ororganization, against any liability asserted against and incurred by him inthat capacity or arising out of his status as such, whether or not the societymay indemnify the person against liability pursuant to this section.

8. A director, officer, employee, member or volunteerof a society who serves without compensation is not liable, and no cause ofaction may be brought for damages resulting from his exercise of judgment ordiscretion in carrying out his duties or responsibilities on behalf of thesociety, unless the act or omission involved willful or wanton misconduct.

(Added to NRS by 1991, 221)

NRS 695A.490 Standardsof valuation for certificates.

1. The minimum standards of valuation for certificatesissued before July 1, 1964, are those provided by the law applicableimmediately before July 1, 1963, but not lower than the standards used in thecalculating of rates for those certificates.

2. Except as otherwise provided in subsection 4, theminimum standard of valuation for certificates issued on or after July 1, 1964,but before January 1, 1993, is 3.5 percent interest and the following:

(a) For certificates of life insurance, American MenUltimate Table of Mortality, with Bowermans or Davis Extension thereof orwith the consent of the Commissioner, the Commissioners 1941 Standard OrdinaryMortality Table, the Commissioners 1941 Standard Industrial Mortality Table orthe Commissioners 1958 Standard Ordinary Mortality Table, using the actual ageof the insured for male risks and an age not more than 3 years younger than theactual age of the insured for female risks.

(b) For annuity and pure endowment certificates,excluding any disability and accidental death benefits in those certificates,the 1937 Standard Annuity Mortality Table or the Annuity Mortality Table for1949, Ultimate, or any modification of either of these tables approved by theCommissioner.

(c) For total and permanent disability benefits in orsupplementary to life insurance certificates, Hunters Disability Table, or theClass III Disability Table (1926) modified to conform to the contractualwaiting period, or the tables of Period 2 disablement rates and the 1930 to1950 termination rates of the 1952 Disability Study of the Society of Actuarieswith due regard to the type of benefit. Any such table must, for active lives,be combined with a mortality table permitted for calculating the reserves forlife insurance certificates.

(d) For accidental death benefits in or supplementaryto life insurance certificates, the Inter-Company Double Indemnity MortalityTable or the 1959 Accidental Death Benefits Table. Either table must becombined with a mortality table permitted for calculating the reserves for lifeinsurance certificates.

(e) For noncancellable accident and health benefits,the Class III Disability Table (1926) with conference modifications or, withthe consent of the Commissioner, tables based upon the societys ownexperience.

3. Except as otherwise provided in subsection 4, theminimum standard of valuation for certificates issued on or after January 1,1993, is:

(a) For certificates of life insurance, theCommissioners 1980 Standard Ordinary Mortality Table or any more recent tablemade applicable to life insurance companies; and

(b) For annuity and pure endowment certificates, totaland permanent disability benefits, accidental death benefits and noncancellableaccident and health benefits, such tables as are authorized for use by lifeinsurance companies in this state.

4. A society may value its certificates in accordancewith the valuation standards used for policies containing comparable benefitswhich are issued in this state by life insurance companies.

5. The Commissioner may:

(a) Accept other standards for valuation if he findsthat the reserves produced thereby will not be less in the aggregate thanreserves computed in accordance with the minimum valuation standard prescribedin this section.

(b) Vary the standards of mortality applicable to allbenefit contracts on substandard lives or other extra-hazardous lives by anysociety authorized to do business in this state.

6. Any society, with the consent of the commissionerof insurance of the state of domicile of the society and under such conditions,if any, as he may impose, may establish and maintain reserves on itscertificates in excess of the reserves required thereunder, but the contractualrights of any benefit member are not affected thereby.

(Added to NRS by 1971, 1858; A 1985, 1186; 1991, 242)

NRS 695A.500 Examinationof societies transacting business in State. TheCommissioner, or any person he may appoint, may examine any domestic, foreignor alien society which is transacting business or applying for admission totransact business in this state in the same manner as authorized for theexamination of domestic, foreign or alien insurers. For the purposes of thissection, the provisions of NRS 679B.230to 679B.300, inclusive, are applicableto societies.

(Added to NRS by 1971, 1859; A 1991, 244)

NRS 695A.530 Applicabilityof statutory provisions relating to trade practices and frauds. A society authorized to do business in this state and itsagents are subject to the provisions of chapter686A of NRS relating to trade practices and frauds, except that nothing inthat chapter applies to or affects:

1. The right of a society to determine its eligibilityrequirements for membership; or

2. The offering of benefits exclusively to members orpersons eligible for membership in the society by a subsidiary corporation oraffiliated organization of the society.

(Added to NRS by 1971, 1860; A 1991, 245)

NRS 695A.550 Exemptionof societies from certain taxes. Every societyorganized or licensed under this chapter is hereby declared to be a charitableand benevolent institution, and is exempt from every state, county, district,municipal and school tax other than taxes on real property and officeequipment.

(Added to NRS by 1971, 1861; A 1991, 245)

NRS 695A.555 Fees:Applicability of certain provisions. Societiesare not exempt from the provisions of NRS679B.700. If a society is an admitted health insurer, as that term isdefined in NRS 449.450, it is not exemptfrom the fees imposed pursuant to NRS449.465.

(Added to NRS by 1985, 1071)

NRS 695A.560 Exemptionof societies from other insurance laws. Exceptas otherwise provided in this chapter or by specific statute, societies aregoverned by this chapter and are exempt from all other provisions of theinsurance laws of this state.

(Added to NRS by 1971, 1861; A 1991, 246)

NRS 695A.570 Applicability.

1. Nothing contained in this chapter shall beconstrued to affect or apply to:

(a) Grand or subordinate lodges of societies, orders orassociations now doing business in this state which provide benefitsexclusively through local or subordinate lodges;

(b) Orders, societies or associations which admit tomembership only persons engaged in one or more crafts or hazardous occupations,in the same or similar lines of business, insuring only their own members andtheir families and the ladies societies or ladies auxiliaries to such orders,societies or associations;

(c) Domestic societies which limit their membership toemployees of a particular city or town, designated firm, business house orcorporation which provide for a death benefit of not more than $400 ordisability benefits of not more than $350 to any person in any 1 year, or both;or

(d) Domestic societies or associations of a purelyreligious, charitable or benevolent description, which provide for a deathbenefit of not more than $400 or for disability benefits of not more than $350to any one person in any 1 year, or both.

2. Any society or association described in paragraphs(c) or (d) of subsection 1 which provides for death or disability benefits forwhich benefit certificates are issued, and any such society or associationincluded in paragraph (d) of subsection 1 which has more than 1,000 members,shall not be exempted from the provisions of this chapter but shall comply withall requirements thereof.

3. No society which, by the provisions of thissection, is exempt from the requirements of this chapter, except any societydescribed in paragraph (b) of subsection 1, shall give or allow, or promise togive or allow, to any person any compensation for procuring new members.

4. Every society which provides for benefits in caseof death or disability resulting solely from accident and which does notobligate itself to pay natural death or sick benefits shall have all of theprivileges and be subject to all the applicable provisions and regulations ofthis chapter, except that the provisions thereof relating to medicalexamination, valuations of benefit certificates and incontestability shall notapply to such society.

5. The Commissioner may require from any society orassociation, by examination or otherwise, such information as will enable himto determine whether such society or association is exempt from the provisionsof this chapter.

6. Societies, exempted under the provisions of thissection, shall also be exempt from all other provisions of the insurance lawsof this state.

(Added to NRS by 1971, 1861)

NRS 695A.580 Penalties.

1. Any person who makes a false or fraudulentstatement in or relating to an application for membership or for the purpose ofobtaining money from or a benefit in any society is guilty of a grossmisdemeanor.

2. Any person who solicits membership for, or in anymanner assists in procuring membership in, any society not licensed to dobusiness in this State is subject to an administrative fine, imposed by theCommissioner, of not less than $25 nor more than $500 for each violation. Inaddition if the person is an insurance agent of the society, the Commissionermay suspend, revoke, limit or refuse to continue his license in the mannerprovided in NRS 683A.451 and 683A.461.

3. Any person convicted of a willful violation of, orneglect or refusal to comply with, any provision of this chapter for which apenalty is not otherwise prescribed shall be punished by a fine of not morethan $1,000 for each violation, and not more than $10,000 for all relatedviolations.

(Added to NRS by 1971, 1862; A 1977, 695; 1979, 1493;2001, 2248)

 

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