Chapter 44 — INSURANCE
2,728 sections in this chapter.
Neb. Rev. Stat. § 44-4412 Insurance coverage; prohibitions.
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A risk retention group may not offer insurance coverage prohibited by Chapter 44 or declared unlawful by the Supreme Court.
Neb. Rev. Stat. § 44-4413 Financial impairment; compliance with order.
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A risk retention group which is not chartered and licensed in this state and which is doing business in this state shall comply with a lawful order issued in a voluntary dissolution proceeding or in a delinquency proceeding commenced by the director or the commissioner of any oth…
Neb. Rev. Stat. § 44-4414 Guaranty fund; membership; coverage.
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(1) A risk retention group shall not join or contribute financially to any insurance insolvency guaranty fund or similar mechanism in this state nor shall any risk retention group or its insureds receive any benefit from any such fund for claims arising out of operations of such …
Repealed. Laws 1999, LB 260, § 17.
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[Repealed or reserved.]
Neb. Rev. Stat. § 44-4416 Purchasing group; exemption from insurance laws; when.
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Any purchasing group meeting the criteria established under the federal Liability Risk Retention Act of 1986 shall be exempt from any law of this state relating to the creation of groups for the purchase of insurance or to the prohibition of group purchasing or any law that would…
Neb. Rev. Stat. § 44-4417 Purchasing group; notice; requirements; registration fees.
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(1) A purchasing group which intends to do business in this state shall, prior to doing business, furnish notice to the director which shall: (a) Identify the state in which the purchasing group is domiciled; (b) Identify all other states in which the purchasing group intends to …
Neb. Rev. Stat. § 44-4418 Purchasing group; purchase of insurance; authorized; when.
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(1) A purchasing group shall not purchase insurance from a risk retention group that is not chartered and licensed in a state or from an insurer not admitted in the state in which the purchasing group is located, unless the purchase is effected through a licensed agent or broker …
Neb. Rev. Stat. § 44-4418.01 Purchasing group; premium taxes.
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Premium taxes and taxes on premiums paid for coverage of risks resident or located in this state by a purchasing group or any members of the purchasing group shall be: (1) Imposed at the same rate and subject to the same interest, fines, and penalties as applicable to premium tax…
Neb. Rev. Stat. § 44-4419 Director; administrative powers.
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The director may make use of any of the powers established under Chapter 44 to enforce the laws of this state if those powers are not specifically preempted by the federal Product Liability Risk Retention Act of 1981 as amended by the Risk Retention Amendments of 1986. Such power…
Neb. Rev. Stat. § 44-4420 Violations; penalties.
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A risk retention group which violates any provision of the Risk Retention Act shall be subject to fines and penalties applicable to licensed insurers generally, including revocation of its license to do business in this state.
Neb. Rev. Stat. § 44-4421 Sale or purchase of insurance; requirements.
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(1) Any person other than a licensed surplus lines licensee acting or offering to act as an insurance producer for a risk retention group or purchasing group which solicits members, sells insurance coverage, purchases coverage for its members located within this state, or otherwi…
Neb. Rev. Stat. § 44-4422 Federal order; enforceable.
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An order issued by any district court of the United States enjoining a risk retention group from soliciting or selling insurance or operating in any state, in all states, or in any territory or possession of the United States upon a finding that such group is in a hazardous finan…
Neb. Rev. Stat. § 44-4423 Rules and regulations.
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The director shall adopt and promulgate rules and regulations relating to risk retention groups necessary to carry out the Risk Retention Act.
Neb. Rev. Stat. § 44-4501 Act, how cited.
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Sections 44-4501 to 44-4521 shall be known and may be cited as the Long-Term Care Insurance Act.
Neb. Rev. Stat. § 44-4502 Purpose of act.
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The purposes of the Long-Term Care Insurance Act are to promote the public interest, to promote the availability of long-term care insurance policies, to protect applicants for long-term care insurance from unfair or deceptive sales or enrollment practices, to establish standards…
Neb. Rev. Stat. § 44-4503 Long-term care insurance; applicability of acts.
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The Long-Term Care Insurance Act shall apply to policies delivered or issued for delivery in this state on or after May 30, 1987, and shall not supersede the obligations of entities subject to the act to comply with the provisions of Chapter 44 insofar as such provisions do not c…
Neb. Rev. Stat. § 44-4504 Definitions, sections found.
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As used in the Long-Term Care Insurance Act, unless the context otherwise requires, the definitions found in sections 44-4505 to 44-4510 shall be used.
Neb. Rev. Stat. § 44-4505 Applicant, defined.
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Applicant shall mean (1) in the case of an individual policy, the person who seeks to contract for such benefits and (2) in the case of a group policy, the proposed certificate holder.
Neb. Rev. Stat. § 44-4506 Certificate, defined.
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Certificate shall mean any certificate issued under a group policy, which policy has been delivered or issued for delivery in this state.
Neb. Rev. Stat. § 44-4507 Director, defined.
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Director shall mean the Director of Insurance.
Neb. Rev. Stat. § 44-4508 Group policy, defined.
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Group policy shall mean a long-term care insurance policy which is delivered or issued for delivery in this state and issued to: (1) One or more employers or labor organizations or a trust or the trustees of a fund established by one or more employers or labor organizations, or a…
Neb. Rev. Stat. § 44-4509 Long-term care insurance, defined.
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Long-term care insurance shall mean any insurance policy or rider advertised, marketed, offered, or designed to provide coverage for not less than twelve consecutive months for each covered person on an expense-incurred, indemnity, prepaid, or other basis for one or more necessar…
Neb. Rev. Stat. § 44-4510 Policy, defined.
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Policy shall mean any individual or group policy, contract, subscriber agreement, rider, or endorsement delivered or issued for delivery in this state by an insurer, fraternal benefit society, prepaid health plan, health maintenance organization, or any similar organization.
Neb. Rev. Stat. § 44-4511 Insurance; offer; restrictions.
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No group long-term care insurance coverage may be offered to a resident of this state under a group policy issued in another state to a group described in subdivision (4) of section 44-4508 unless this state or another state having statutory and regulatory long-term care insuranc…
Neb. Rev. Stat. § 44-4512 Rules and regulations for disclosure.
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The director may adopt and promulgate reasonable rules and regulations in accordance with the Administrative Procedure Act that include standards for full and fair disclosure setting forth the manner, content, and required disclosures for the sale of long-term care insurance poli…
Neb. Rev. Stat. § 44-4513 Policy; certificate; restrictions.
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(1) No long-term care insurance policy may: (a) Be canceled, refused renewal, or otherwise terminated on the grounds of the age or the deterioration of the mental or physical health of the insured individual or certificate holder; (b) Contain a provision establishing a new waitin…
Neb. Rev. Stat. § 44-4514 Rules and regulations for loss-ratio standards.
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The director may adopt and promulgate rules and regulations establishing loss-ratio standards for long-term care insurance policies if a specific reference to long-term care insurance policies is contained in such rules or regulations.
Neb. Rev. Stat. § 44-4515 Applicants; rights.
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Long-term care insurance applicants shall have the right to return the policy or certificate within thirty days of its delivery and to have the premium refunded if, after examination of the policy or certificate, the applicant is not satisfied for any reason. Long-term care insur…
Neb. Rev. Stat. § 44-4516 Outline of coverage; required; contents.
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(1)(a) An outline of coverage shall be delivered to a prospective applicant at the time of initial solicitation through means which prominently direct the attention of the recipient to the document and its purpose. (b) The director shall prescribe a standard format, including sty…
Neb. Rev. Stat. § 44-4517 Compliance with act.
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Any policy or rider advertised, marketed, or offered as long-term care insurance or nursing home insurance shall comply with the Long-Term Care Insurance Act.
Neb. Rev. Stat. § 44-4517.01 Policy or certificate; claim denial; grounds; exception; issuance restriction.
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(1) For a policy or certificate that has been in force for less than six months, an insurer may rescind a long-term care insurance policy or certificate or deny an otherwise valid long-term care insurance claim upon a showing of misrepresentation that is material to the acceptanc…
Neb. Rev. Stat. § 44-4517.02 Policy or certificate; nonforfeiture benefits.
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(1) Except as provided in subsection (2) of this section, a long-term care insurance policy may not be delivered or issued for delivery in this state unless the policyholder or certificate holder has been offered the option of purchasing a policy or certificate including a nonfor…
Neb. Rev. Stat. § 44-4518 Director; duties.
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The director shall adopt and promulgate rules and regulations to promote premium adequacy, to protect the policyholder in the event of substantial rate increases, and to establish minimum standards for marketing practices, agent compensation, agent testing, penalties, and reporti…
Neb. Rev. Stat. § 44-4519 Rules and regulations.
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The director may adopt and promulgate rules and regulations to carry out the Long-Term Care Insurance Act, including minimum standards for insurance producer training.
Neb. Rev. Stat. § 44-4520 Violations; administrative penalty.
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In addition to any other penalties provided by the laws of this state, any insurer or agent found by the director to have violated the Long-Term Care Insurance Act or any rule or regulation shall be subject to an administrative penalty of up to three times the amount of any commi…
Neb. Rev. Stat. § 44-4521 Sale, solicitation, or negotiation of long-term care insurance; license required; training course; insurer; duties; records.
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(1) On or after August 1, 2008, an individual may not sell, solicit, or negotiate long-term care insurance unless the individual is licensed as an insurance producer for health or sickness and accident insurance and has completed a one-time training course and ongoing training ev…
Neb. Rev. Stat. § 44-4601 Pharmacy Benefit Manager Licensure and Regulation Act, how cited.
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Sections 44-4601 to 44-4617 shall be known and may be cited as the Pharmacy Benefit Manager Licensure and Regulation Act.
Neb. Rev. Stat. § 44-4602 Act; purposes.
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(1) The Pharmacy Benefit Manager Licensure and Regulation Act establishes the standards and criteria for the licensure and regulation of pharmacy benefit managers providing a claims processing service or other prescription drug or device service for a health benefit plan. (2) The…
Neb. Rev. Stat. § 44-4603 Terms, defined.
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For purposes of the Pharmacy Benefit Manager Licensure and Regulation Act: (1) Auditing entity means a pharmacy benefit manager or any person that represents a pharmacy benefit manager in conducting an audit for compliance with a contract between the pharmacy benefit manager and …
Neb. Rev. Stat. § 44-4604 Act; applicability; how construed; licensure conditions; contract requirements.
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(1) The Pharmacy Benefit Manager Licensure and Regulation Act applies to any contract or health benefit plan issued, renewed, recredentialed, amended, or extended on or after January 1, 2023, including any claims processing service or other prescription drug or device service per…
Neb. Rev. Stat. § 44-4605 License, required; application; fee; refusal to issue or renew; grounds; renewal; application; fee; failure to comply; fine; extension; notice of material change, required.
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(1) A person shall not establish or operate as a pharmacy benefit manager in this state for a health benefit plan without first obtaining a license from the director under the Pharmacy Benefit Manager Licensure and Regulation Act. (2) The director may adopt and promulgate rules a…
Neb. Rev. Stat. § 44-4606 Participation contract; requirements; disclosure of information; limitations; contract termination; grounds; pharmacy benefit manager, prohibited acts.
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(1) A participation contract between a pharmacy benefit manager and any pharmacist or pharmacy providing prescription drug coverage for a health benefit plan shall not prohibit or restrict any pharmacy or pharmacist from or penalize any pharmacy or pharmacist for disclosing to an…
Neb. Rev. Stat. § 44-4607 Pharmacy audit; auditing entity; requirements; recoupment; terms and conditions; documentation requirements; appeal process; audit reports.
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(1) Unless otherwise prohibited by federal law, an auditing entity conducting a pharmacy audit shall: (a) Give any pharmacy notice fifteen business days prior to conducting an initial onsite audit; (b) For any audit that involves clinical or professional judgment, conduct such au…
Neb. Rev. Stat. § 44-4608 Contract; pharmacy benefit manager; cost price list; duties; disputes; procedures.
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(1) With respect to each contract and contract renewal between a pharmacy benefit manager and a pharmacy, the pharmacy benefit manager shall: (a) Update any maximum allowable cost price list at least every seven business days, noting any price change from the previous list, and p…
Neb. Rev. Stat. § 44-4609 Pharmacy benefit manager; 340B entity; 340B contract pharmacy; treatment; discrimination, prohibited.
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(1) A pharmacy benefit manager that reimburses a 340B entity or a 340B contract pharmacy for a drug that is subject to an agreement under 42 U.S.C. 256b shall not reimburse the 340B entity or the 340B contract pharmacy for the pharmacy-dispensed drug at a rate lower than that pai…
Neb. Rev. Stat. § 44-4610 Pharmacy benefit manager; specialty pharmacy network; exclusions; specialty pharmacy; terms and conditions.
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(1) A pharmacy benefit manager shall not exclude a Nebraska pharmacy from participation in the pharmacy benefit manager's specialty pharmacy network if: (a) The pharmacy holds a specialty pharmacy accreditation from a nationally recognized independent accrediting organization; an…
Neb. Rev. Stat. § 44-4611 Act; enforcement; director; powers and duties; monetary penalty.
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(1) The director shall enforce compliance with the requirements of the Pharmacy Benefit Manager Licensure and Regulation Act. (2)(a) Pursuant to the Insurers Examination Act, the director may examine or audit the books and records of a pharmacy benefit manager providing a claims …
Neb. Rev. Stat. § 44-4612 Rules and regulations.
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The director may adopt and promulgate rules and regulations to carry out the Pharmacy Benefit Manager Licensure and Regulation Act.
Neb. Rev. Stat. § 44-4613 Clinician-administered drug; specialty pharmacy; shipping; requirements; dispensing; delivery requirements; exceptions; prohibited acts.
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(1) A specialty pharmacy that ships a clinician-administered drug to a health care provider or pharmacy shall: (a) Comply with all federal laws regulating the shipment of drugs, including, but not limited to, general chapter 800 of the United States Pharmacopeia; (b) In response …
Neb. Rev. Stat. § 44-4614 Choice of pharmacy services; prohibited acts.
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(1) A health benefit plan, health carrier, or pharmacy benefit manager shall not: (a) Require a covered person, as a condition of payment or reimbursement, to obtain pharmacist services exclusively through the mail-order pharmacy or pharmacy benefit manager affiliate; (b) Prohibi…