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2022 Nevada Revised Statutes
Chapter 689B - Group and Blanket Health Insurance
GENERAL PROVISIONS
General Provisions
- NRS 689B.010 - Short title; scope.
- NRS 689B.015 - Contracts between insurer and provider of health care: Prohibiting insurer from charging provider of health care fee for inclusion on list of providers given to insureds; insurer required to use form to obtain information on provider of health care; modification; submission by insurer of schedule of payments to providers.
General Provisions
- NRS 689B.020 - "Group health insurance" defined; authority to provide in certain policies for continuation of certain benefit provisions after death of person in insured group; authority of Commissioner to require filing of form of certificate proposed for delivery in this state of policy made under laws of another state.
- NRS 689B.026 - Delivery of policy to group formed to purchase health insurance prohibited; exception; applicable provisions for review of marketed insurance products by Commissioner; applicability to policy issued in another state.
- NRS 689B.0265 - Policy to guaranteed association.
- NRS 689B.0283 - Policy covering prescription drugs: Provision of notice and information regarding use of formulary.
- NRS 689B.0285 - System for resolving complaints of insureds: Establishment; approval; requirements; examination; exception.
- NRS 689B.029 - Annual report regarding system for resolving complaints of insureds; insurer required to maintain records of and report complaints concerning something other than health care services.
- NRS 689B.0295 - Written notice required to be provided by insurer to insured explaining right to file complaint; written notice to insured required when insurer denies coverage of health care service.
- NRS 689B.030 - Required provisions.
- NRS 689B.0303 - Required provision in certain policies concerning coverage for continued medical treatment; exceptions; regulations.
- NRS 689B.0304 - Policy covering prescription drugs: Required actions by insurer related to acquisition of prescription drugs for certain insureds residing in area for which emergency or disaster has been declared.
- NRS 689B.0305 - Policy covering prescription drug for treatment of cancer or cancer symptom that is part of step therapy protocol: Insurer required to allow insured or attending physician to apply for exemption from step therapy protocol in certain circumstances; procedure for applying for and granting exemption. [Effective January 1, 2022.]
- NRS 689B.0306 - Required provision concerning coverage for certain treatment received as part of clinical trial or study for treatment of cancer or chronic fatigue syndrome; authority of insurer to require certain information; immunity from liability.
- NRS 689B.031 - Required provision concerning coverage of certain gynecological or obstetrical services without authorization or referral from primary care physician.
- NRS 689B.0312 - Required provision concerning coverage for drugs, laboratory testing and certain services related to human immunodeficiency virus; reimbursement of pharmacist for certain services.
- NRS 689B.0313 - Required coverage for certain tests and vaccines relating to human papillomavirus; prohibited acts.
- NRS 689B.0314 - Required provision concerning coverage for screening, genetic counseling and testing related to BRCA gene in certain circumstances. [Effective January 1, 2022.]
- NRS 689B.0315 - Required provision concerning coverage for examination of person who is pregnant for certain diseases.
- NRS 689B.0317 - Required provision in policy covering treatment of prostate cancer concerning coverage for prostate cancer screening; prohibited act.
- NRS 689B.033 - Certain policies covering family members required to include certain coverage for insured’s newly born and adopted children and children placed with insured for adoption.
- NRS 689B.0335 - Required provision concerning coverage for autism spectrum disorders for certain persons; prohibited acts.
- NRS 689B.034 - Required provision concerning effect of benefits under other valid group coverage; subrogation; prohibited act.
- NRS 689B.0345 - Required provision concerning continuing coverage for employee or member on leave without pay as result of total disability.
- NRS 689B.035 - Required provision in certain policies concerning termination of coverage on dependent child.
- NRS 689B.0353 - Required provision concerning coverage for treatment of certain inherited metabolic diseases.
- NRS 689B.0357 - Required provision in policy covering hospital, medical or surgical expenses concerning coverage for management and treatment of diabetes.
- NRS 689B.0358 - Required provision concerning coverage for management and treatment of sickle cell disease and its variants; required provision in policy covering prescription drugs concerning coverage for medically necessary prescription drugs to treat sickle cell disease and its variants.
- NRS 689B.0362 - Policy covering treatment of cancer through use of chemotherapy: Prohibited acts related to orally administered chemotherapy.
- NRS 689B.0365 - Required provision in certain policies concerning coverage for use of certain drugs and related services for treatment of cancer.
- NRS 689B.0367 - Required provision in policy covering treatment of colorectal cancer concerning coverage for colorectal cancer screening.
- NRS 689B.0368 - Policy covering prescription drugs prohibited from limiting or excluding coverage for certain prescription drugs previously approved for medical condition of insured; exceptions.
- NRS 689B.0369 - Required provision concerning coverage for services provided through telehealth to same extent and in same amount as though provided in person or by other means; exception; prohibited acts. [Effective through 1 year after the date on which the Governor terminates the emergency described in the Declaration of Emergency for COVID-19 issued on March 12, 2020, if the Governor terminates that emergency before July 1, 2022, or June 29, 2023, if the Governor terminates that emergency on or after July 1, 2022.] Required provision concerning coverage for services provided through telehealth to same extent and in same amount as though provided in person or by other means; exception; prohibited acts. [Effective on the date 1 year after the date on which the Governor terminates the emergency described in the Declaration of Emergency for COVID-19 issued on March 12, 2020, and through June 30, 2023, only if the Governor terminates that emergency before July 1, 2022.] Required provision concerning coverage for services provided through telehealth to same extent as though provided in person or by other means; prohibited acts. [Effective July 1, 2023, only if the Governor terminates the emergency described in the Declaration of Emergency for COVID-19 issued on March 12, 2020, before July 1, 2022.] Required provision concerning coverage for services provided through telehealth to same extent as though provided in person or by other means; prohibited acts. [Effective June 30, 2023, only if the Governor terminates the emergency described in the Declaration of Emergency for COVID-19 issued on March 12, 2020, on or after July 1, 2022.]
- NRS 689B.0374 - Required provision concerning coverage for mammograms for certain women; prohibited acts.
- NRS 689B.0375 - Required provision in policy covering mastectomies concerning coverage relating to mastectomy; prohibited acts.
- NRS 689B.0376 - Required provision in policy covering prescription drugs or devices concerning coverage of hormone replacement therapy in certain circumstances; prohibited acts; exception.
- NRS 689B.03762 - Required provision in policy covering prescription drugs concerning coverage for drugs irregularly dispensed for purpose of synchronization of chronic medications; prohibited acts; exception.
- NRS 689B.03764 - Policy covering prescription drugs: Denial of coverage for early refills of otherwise covered topical ophthalmic products prohibited.
- NRS 689B.03766 - Policy covering maternity care: Prohibited acts by insurer if insured is acting as gestational carrier; child deemed child of intended parent for purposes of policy.
- NRS 689B.0377 - Required provision in policy covering outpatient care concerning coverage for health care services related to hormone replacement therapy; prohibited acts.
- NRS 689B.0378 - Required provision concerning coverage for drug or device for contraception and related health services; prohibited acts; exceptions. [Effective through December 31, 2021.] Required provision concerning coverage for drug or device for contraception and related health services; prohibited acts; exceptions. [Effective January 1, 2022.]
- NRS 689B.03785 - Required provisions concerning coverage for certain services, screenings and tests relating to wellness; prohibited acts.
- NRS 689B.0379 - Policy prohibited from excluding coverage for treatment of temporomandibular joint; exception.
- NRS 689B.038 - Reimbursement for treatments by licensed psychologist.
- NRS 689B.0383 - Reimbursement for treatments by licensed marriage and family therapist or licensed clinical professional counselor.
- NRS 689B.0385 - Reimbursement for treatments by licensed associate in social work, social worker, master social worker, independent social worker or clinical social worker.
- NRS 689B.039 - Reimbursement for treatments by chiropractor. [Effective through December 31, 2021.] Reimbursement for treatments by chiropractic physician. [Effective January 1, 2022.]
- NRS 689B.0393 - Reimbursement for treatments by podiatrist.
- NRS 689B.0397 - Reimbursement for treatment by licensed clinical alcohol and drug counselor.
- NRS 689B.040 - Direct payment for hospital and medical services and home health care; payment to assignee.
- NRS 689B.045 - Reimbursement for services provided by certain nurses.
- NRS 689B.047 - Reimbursement to provider of medical transportation.
- NRS 689B.049 - Reimbursement for acupuncture.
- NRS 689B.050 - Extended disability benefit.
- NRS 689B.060 - Readjustment of premiums; dividends.
- NRS 689B.061 - Limitations on deductibles and copayments charged under policy which offers difference of payment between preferred providers of health care and providers who are not preferred.
- NRS 689B.063 - Primary and secondary policies: Determination of benefits.
- NRS 689B.064 - Primary and secondary policies: Order of benefits.
- NRS 689B.065 - Policy issued to replace discontinued policy or coverage: Requirements; notice of reduction of benefits; statement of benefits; applicability of section.
- NRS 689B.067 - Provision in policy requiring binding arbitration for disputes with insurer authorized; procedure for arbitration; declaratory relief.
- NRS 689B.068 - Insurer prohibited from denying coverage solely because claim involves act that constitutes domestic violence or applicant or insured was victim of domestic violence.
- NRS 689B.069 - Insurer prohibited from requiring or using information concerning genetic testing; exceptions.
- NRS 689B.070 - "Blanket accident and health insurance" defined.
- NRS 689B.080 - Authority to issue; required provisions.
- NRS 689B.090 - Application and certificates.
- NRS 689B.100 - Payment of benefits.
- NRS 689B.110 - Legal liability of policyholders for death of or injury to insured member unaffected.
- NRS 689B.250 - Acceptance of uniform forms for billing and claims.
- NRS 689B.255 - Approval or denial of claims; payment of claims and interest; requests for additional information; award of costs and attorney’s fees; compliance with requirements; imposition of administrative fine or suspension or revocation of certificate of authority for failure to comply.
- NRS 689B.260 - Group health or blanket health policy containing exclusion, reduction or limitation of coverage relating to complications of pregnancy prohibited; exception.
- NRS 689B.265 - Policy covering anatomical gifts, organ transplants or treatments or services related to organ transplants: Prohibited acts by insurer if insured is person with disability.
- NRS 689B.270 - Required procedure for arbitration of disputes concerning independent medical, dental or chiropractic evaluations. [Effective through December 31, 2021.] Required procedure for arbitration of disputes concerning independent medical, dental or chiropractic evaluations. [Effective January 1, 2022.]
- NRS 689B.275 - Contents, approval and provision of summary of coverage; provision of information about guaranteed availability of certain plans for benefits.
- NRS 689B.280 - Disclosure of information concerning medication of insured prohibited.
- NRS 689B.285 - Offering policy of health insurance for purposes of establishing health savings account.
- NRS 689B.287 - Insurer prohibited from denying coverage solely because applicant or insured was intoxicated or under influence of controlled substance; exceptions.
- NRS 689B.290 - Definitions.
- NRS 689B.300 - Effect of eligibility for medical assistance under Medicaid; assignment of rights to state agency.
- NRS 689B.310 - Insurer prohibited from asserting certain grounds to deny enrollment of child of insured pursuant to order.
- NRS 689B.320 - Certain accommodations required to be made when child is covered under policy of noncustodial parent.
- NRS 689B.330 - Insurer required to authorize enrollment of child of parent who is required by order to provide medical coverage for child in certain circumstances.
- NRS 689B.340 - Definitions.
- NRS 689B.350 - "Affiliation period" defined.
- NRS 689B.355 - "Blanket accident and health insurance" defined.
- NRS 689B.360 - "Carrier" defined.
- NRS 689B.370 - "Contribution" defined.
- NRS 689B.380 - "Creditable coverage" defined.
- NRS 689B.390 - "Group health plan" defined.
- NRS 689B.400 - "Group participation" defined.
- NRS 689B.430 - "Open enrollment" defined.
- NRS 689B.440 - "Plan sponsor" defined.
- NRS 689B.450 - "Preexisting condition" defined.
- NRS 689B.460 - "Waiting period" defined.
- NRS 689B.480 - Determination of applicable creditable coverage of person; determination of period of creditable coverage of person; required statement.
- NRS 689B.490 - Written certification of coverage required for purpose of determining period of creditable coverage accumulated by person.
- NRS 689B.500 - Carrier required to offer and issue plan regardless of health status of members; prohibited acts; authority to include wellness program in plan that offers discounts based on health status under certain circumstances.
- NRS 689B.510 - Carrier authorized to modify coverage for insurance product under certain circumstances.
- NRS 689B.520 - Group plan or coverage covering maternity care and pediatric care: Required to allow minimum stay in hospital in connection with childbirth; exception; prohibited acts.
- NRS 689B.530 - Carrier required to permit eligible employee or dependent of employee to enroll for coverage under certain circumstances.
- NRS 689B.540 - Manner and period for enrollment of dependent of covered employee; period of special enrollment.
- NRS 689B.550 - Carrier prohibited from imposing restriction on participation inconsistent with chapter; restrictions on rules of eligibility that may be established.
- NRS 689B.560 - Carrier required to renew coverage at option of plan sponsor; exceptions; discontinuation of product; discontinuation of group health insurance through bona fide association.
- NRS 689B.570 - Carrier that offers coverage through network plan not required to offer coverage to employer that does not employ enrollees who reside or work in geographic service area for which carrier is authorized to transact insurance.
- NRS 689B.580 - Plan sponsor of governmental plan authorized to elect to exclude governmental plan from compliance with certain statutes; duties of plan sponsor.
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