There is a newer version of the Nevada Revised Statutes
2010 Nevada Code
TITLE 57 INSURANCE
Chapter 689C Health Insurance for Small Employers
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HEALTH BENEFIT PLANS
- NRS 689C.015 Definitions.
- NRS 689C.017 "Affiliated" defined.
- NRS 689C.019 "Affiliation period" defined.
- NRS 689C.021 "Basic health benefit plan" defined.
- NRS 689C.023 "Bona fide association" defined.
- NRS 689C.025 "Carrier" defined.
- NRS 689C.035 "Characteristics" defined.
- NRS 689C.045 "Class of business" defined.
- NRS 689C.047 "Control" defined.
- NRS 689C.051 "Converted policy" defined.
- NRS 689C.053 "Creditable coverage" defined.
- NRS 689C.055 "Dependent" defined.
- NRS 689C.065 "Eligible employee" defined.
- NRS 689C.067 "Established geographic service area" defined.
- NRS 689C.071 "Geographic area" defined.
- NRS 689C.073 "Group health plan" defined.
- NRS 689C.075 "Health benefit plan" defined.
- NRS 689C.076 "Health status-related factor" defined.
- NRS 689C.077 "Network plan" defined.
- NRS 689C.078 "Open enrollment" defined.
- NRS 689C.079 "Plan for coverage of a bona fide association" defined.
- NRS 689C.081 "Plan sponsor" defined.
- NRS 689C.082 "Preexisting condition" defined.
- NRS 689C.083 "Producer" defined.
- NRS 689C.084 "Program of Reinsurance" defined.
- NRS 689C.085 "Rating period" defined.
- NRS 689C.089 "Risk-assuming carrier" defined.
- NRS 689C.095 "Small employer" defined.
- NRS 689C.099 "Standard health benefit plan" defined.
- NRS 689C.105 "Supplemental coverage" defined.
- NRS 689C.106 "Waiting period" defined.
- NRS 689C.1065 Applicability.
- NRS 689C.107 Affiliated carriers deemed one carrier in certain circumstances; affiliated carrier that is health maintenance organization considered separate carrier; ceding arrangement prohibited in certain circumstances.
- NRS 689C.109 Certain plan, fund or program to be treated as employee welfare benefit plan which is group health plan; partnership deemed employer of each partner.
- NRS 689C.111 Determination of whether employer is small or large; applicability of provisions after employer is deemed large.
- NRS 689C.113 Requirements for employee welfare benefit plan for providing benefits for employees of more than one employer.
- NRS 689C.115 Mandatory and optional coverage.
- NRS 689C.125 Rating factors for determining premiums.
- NRS 689C.135 Effect of provision in health benefit plan for restricted network on determination of rates.
- NRS 689C.143 Offering of policy of health insurance for purposes of establishing health savings account.
- NRS 689C.145 Characteristics that carrier may use to determine rating factors for establishing premiums.
- NRS 689C.155 Regulations.
- NRS 689C.156 Each health benefit plan marketed in this State required to be offered to small employers.
- NRS 689C.1565 Coverage to small employers not required under certain circumstances; notice to Commissioner of and prohibition on writing new business after election not to offer new coverage required.
- NRS 689C.157 Requirement to file basic and standard health benefit plans with Commissioner; disapproval of plan.
- NRS 689C.158 Producer may only sign up small employers and eligible employees in bona fide associations if employers and employees are actively engaged in or related to bona fide association.
- NRS 689C.159 Certain provisions inapplicable to plan that carrier makes available only through bona fide association.
- NRS 689C.160 Carrier must uniformly apply requirements to determine whether to provide coverage.
- NRS 689C.165 Carrier prohibited from modifying plan to restrict or exclude coverage for certain services.
- NRS 689C.1655 Coverage for autism spectrum disorders. [Effective January 1, 2011.]
- NRS 689C.166 Coverage for abuse of alcohol or drugs: Required.
- NRS 689C.167 Coverage for abuse of alcohol or drugs: Benefits.
- NRS 689C.168 Coverage for prescription drug previously approved for medical condition of insured.
- NRS 689C.169 Coverage for severe mental illness.
- NRS 689C.170 Authorized variation of minimum participation and contributions; denial of coverage based on industry prohibited.
- NRS 689C.180 Carrier to offer same coverage to all eligible employees; denial of coverage to otherwise eligible employee.
- NRS 689C.183 Plan and carrier required to permit employee or dependent of employee to enroll for coverage under certain circumstances.
- NRS 689C.187 Manner and period for enrolling dependent of covered employee; period of special enrollment.
- NRS 689C.190 Coverage of preexisting conditions; period of exclusion for preexisting condition; when health maintenance organization may require affiliation period.
- NRS 689C.191 Determination of applicable creditable coverage of person; determining period of creditable coverage of person; required statement.
- NRS 689C.192 Written certification of coverage required for purpose of determining period of creditable coverage accumulated by person.
- NRS 689C.193 Carrier prohibited from imposing restriction on participation inconsistent with certain sections; restrictions on rules of eligibility that may be established; premiums to be equitable.
- NRS 689C.194 Plan that includes coverage for maternity and pediatric care: Required to allow minimum stay in hospital in connection with childbirth; prohibited acts.
- NRS 689C.196 Insurer prohibited from denying coverage solely because person was victim of domestic violence.
- NRS 689C.197 Carrier prohibited from denying coverage because insured was intoxicated or under influence of controlled substance; exceptions.
- NRS 689C.198 Insurer prohibited from requiring or using information concerning genetic testing; exceptions.
- NRS 689C.200 When carrier is not required to offer coverage.
- NRS 689C.203 Denial of application for coverage from small employer; regulations.
- NRS 689C.207 Regulations concerning reissuance of health benefit plan.
- NRS 689C.210 Procedure for increasing premium rates.
- NRS 689C.220 Adjustment in rates to be applied uniformly.
- NRS 689C.230 Determination and application of index rate.
- NRS 689C.240 Use of industry classifications as rating factor.
- NRS 689C.250 Required disclosures to Commissioner; when disclosures constitute trade secret.
- NRS 689C.260 Manner in which carrier may establish separate class of business; transferring small employer into or out of class of business.
- NRS 689C.265 Carrier authorized to modify coverage for insurance product under certain circumstances.
- NRS 689C.270 Regulations concerning disclosures by carrier to small employer; copy of disclosure to be made available to small employer.
- NRS 689C.280 Carrier to provide required disclosures to small employer before issuing policy of insurance.
- NRS 689C.281 Coverage for prescription drugs: Provision of notice and information regarding use of formulary.
- NRS 689C.283 Election to operate as risk-assuming carrier or reinsuring carrier: Notice to Commissioner; effective date; change in status.
- NRS 689C.287 Election to act as risk-assuming carrier: Suspension by Commissioner; applicable statutes.
- NRS 689C.290 Commissioner authorized to suspend restriction on increase of premiums for new rating period based on new business for policy.
- NRS 689C.300 Carrier to file actuarial certification annually with Commissioner.
- NRS 689C.310 Renewal of health benefit plan; discontinuing issuance and renewal of coverage, plan or form of product of health benefit plan.
- NRS 689C.320 Required notification when carrier discontinues transacting insurance in this State; restrictions on carrier that discontinues transacting insurance.
- NRS 689C.325 Coverage offered through network plan not required to be offered to eligible employee who does not reside or work in established geographic service area or if carrier lacks capacity to deliver adequate service to additional employers and employees.
- NRS 689C.327 Carrier that offers network plan: Contracts with certain federally qualified health centers.
- NRS 689C.330 When insurer is required to allow employee to continue coverage after employee is no longer covered by health benefit plan.
- NRS 689C.340 Required provisions in health benefit plan of employer who employs less than 20 employees related to continuation of coverage.
- NRS 689C.342 Notice of election and payment of premium.
- NRS 689C.344 Amount of premium for continuation of coverage; change in rates; payment to insurer; termination.
- NRS 689C.346 Effect of change in insurer during period of continued coverage.
- NRS 689C.348 Continued coverage ceases before end of established period under certain circumstances.
- NRS 689C.350 Health benefit plan with preferred providers of health care: Deductible; percentage rate of payment; when coinsurance is no longer required; when service is deemed to be provided by preferred provider; processing claims of provider who is not preferred.
- NRS 689C.355 Prohibited acts of carrier or producer; denial of application for coverage; violation may constitute unfair trade practice; applicability of section. VOLUNTARY PURCHASING GROUPS
- NRS 689C.360 Definitions.
- NRS 689C.380 "Contract" defined.
- NRS 689C.390 "Dependent" defined.
- NRS 689C.420 "Voluntary purchasing group" defined.
- NRS 689C.425 Applicability of other provisions.
- NRS 689C.430 Entities which are authorized to offer contracts to voluntary purchasing groups.
- NRS 689C.435 Contracts between carrier and providers of health care: Prohibiting carrier from charging provider of health care fee for inclusion on list of providers given to insureds; form to obtain information on provider of health care; modification; schedule of fees.
- NRS 689C.440 Regulations regarding required disclosures by carrier.
- NRS 689C.450 Carrier to provide disclosure before issuing contract.
- NRS 689C.455 Coverage for prescription drugs: Provision of notice and information regarding use of formulary.
- NRS 689C.460 Carrier to offer same coverage to all eligible employees; denial of coverage to otherwise eligible employee.
- NRS 689C.470 Renewal of contract; discontinuing issuance and renewal of form of product of health benefit plan or health benefit plan.
- NRS 689C.480 Required notification when carrier ceases to renew all contracts; restrictions on carrier that ceases to renew all contracts.
- NRS 689C.485 Approval or denial of claims; payment of claims and interest; requests for additional information; award of costs and attorney's fees; compliance with requirements.
- NRS 689C.490 Formation of voluntary purchasing group by small employers; requirements when affiliate of group ceases to qualify as small employer.
- NRS 689C.500 Requirements for registration as voluntary purchasing group; application.
- NRS 689C.510 Fee for application; response to application.
- NRS 689C.520 Additional requirements for registration.
- NRS 689C.530 Filing reports; annual renewal fee.
- NRS 689C.540 Duties.
- NRS 689C.550 Collection of premiums; trust account for deposit of premiums.
- NRS 689C.560 Regulations governing security to be maintained by voluntary purchasing group.
- NRS 689C.570 Organizer prohibited from acquiring financial interest in group's business.
- NRS 689C.580 Prohibited acts.
- NRS 689C.590 Disciplinary action for violation of provisions.
- NRS 689C.600 Regulations. REINSURANCE General Provisions
- NRS 689C.610 Definitions.
- NRS 689C.620 "Board" defined.
- NRS 689C.630 "Church plan" defined.
- NRS 689C.640 "Committee" defined.
- NRS 689C.650 "Eligible person" defined.
- NRS 689C.660 "Individual carrier" defined.
- NRS 689C.670 "Individual health benefit plan" defined.
- NRS 689C.680 "Individual reinsuring carrier" defined.
- NRS 689C.690 "Individual risk-assuming carrier" defined.
- NRS 689C.700 "Plan of operation" defined.
- NRS 689C.710 "Program of Reinsurance" defined.
- NRS 689C.720 "Reinsuring carrier" defined.
- NRS 689C.730 "Risk-assuming carrier" defined. Program of Reinsurance for Small Employers and Eligible Persons
- NRS 689C.740 Creation.
- NRS 689C.750 Board of Directors: Creation; members; term; vacancy.
- NRS 689C.760 Meetings of Board; Chair of Board.
- NRS 689C.770 Plan of operation: Submission by Board; approval by Commissioner; temporary plan when plan not suitable or not submitted.
- NRS 689C.780 Requirements of plan of operation and temporary plan of operation.
- NRS 689C.790 Program deemed to have powers and authority of insurance companies and health maintenance organizations; exceptions; powers.
- NRS 689C.800 Amount of coverage to be reinsured; time within which reinsurance may begin; limitation on reimbursement to reinsuring carrier; termination of reinsurance; premium rate charged to federally qualified health maintenance organization; manner of handling managed care and claims by reinsuring carrier.
- NRS 689C.810 Premium rates: Methodology for determining; minimum rates; review of methodology.
- NRS 689C.820 Premiums for certain health benefit plans that are reinsured with program required to meet established requirements for premium rates.
- NRS 689C.830 Board required to determine, account for and report to Commissioner net loss.
- NRS 689C.840 Net loss from reinsuring small employers and eligible employees and dependents required to be recouped by assessments against reinsuring carriers.
- NRS 689C.850 Net loss from reinsuring individual eligible persons and dependents required to be recouped by assessments against individual reinsuring carriers.
- NRS 689C.860 Board required to determine, account for and report to Commissioner estimate of assessments needed to pay for losses; evaluation of operation of Program.
- NRS 689C.870 Additional funding: Eligibility based on amount of assessment needed; Board to establish formula for additional assessments on all carriers.
- NRS 689C.880 Use of excess assessments.
- NRS 689C.890 Assessment against reinsuring carrier to be determined annually; penalty for late payment of assessments; deferment of assessment.
- NRS 689C.900 Insurer to receive certificate of contribution for paying additional assessment; certain amount of contribution may be shown as asset and may offset liability for premium tax.
- NRS 689C.910 Adjustment of assessment on federally qualified health maintenance organizations.
- NRS 689C.920 Immunity from liability of Program and reinsuring carriers for certain acts.
- NRS 689C.930 Board to develop standards setting forth manner and levels of compensation paid to producers for sale of health benefit plans.
- NRS 689C.940 Regulations concerning determination of status of stop-loss policy.
- NRS 689C.950 Certain provisions inapplicable to certain basic health benefit plan delivered to small employers or eligible persons.
- NRS 689C.955 Member, agent or employee of Board immune from liability in certain circumstances. Committee on Health Benefit Plans
- NRS 689C.960 Creation; members; term; vacancy.
- NRS 689C.970 Meetings; Chair; duties.
- NRS 689C.980 Board and Committee to study and submit report concerning effectiveness of certain provisions.
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