Nevada Administrative Code

NAC 687B.0684 Delivery of policy summary or contract summary. (NRS 679B.130) 1. A policy summary must be delivered to an applicant for an individual policy of life insurance at the time of policy delivery if the policy provides long-term care benefits, whether by rider, endorseme…

NAC 687B.0685 Offer of nonforfeiture benefit required. (NRS 679B.130) 1. Except as otherwise provided in subsection 2, an insurer shall not deliver or issue for delivery in this State a long-term care insurance contract or certificate unless the policyholder or certificate holder…

NAC 687B.0686 Requirements for nonforfeiture benefits; contingent benefit upon lapse. (NRS 679B.130) 1. The provisions of this section do not apply to a policy of life insurance or a rider or endorsement to a policy of life insurance that contains accelerated benefits for long-te…

NAC 687B.0687 Applicability of provisions regarding nonforfeiture benefits and contingent benefit upon lapse. (NRS 679B.130) 1. Except as otherwise provided in this section, the provisions of NAC 687B.0686 apply to any long-term care insurance contract or certificate issued in th…

NAC 687B.0689 Rescission or denial of claim upon showing of misrepresentation material to acceptance for coverage; field issuance of contract or certificate. (NRS 679B.130) 1. For a long-term care insurance contract or certificate that has been in force for less than 6 months, an…

NAC 687B.069 Record of rescissions. (NRS 679B.130) An insurer or other entity selling or issuing benefits for long-term care insurance shall maintain a record of all rescissions of its long-term care insurance contracts or certificates in this State or in any other state, except …

NAC 687B.070 Certificate of insurance: Contents. (NRS 679B.130) A certificate issued pursuant to a group long-term care insurance contract which is delivered or issued for delivery in this State must include: 1. A description of the principal benefits and coverage provided in the…

NAC 687B.075 Outline of coverage: Format; delivery; contents. (NRS 679B.130) 1. An outline of coverage must be delivered to a prospective applicant for a long-term care insurance contract or certificate at the time of initial solicitation through means that prominently direct the…

NAC 687B.076 Offer to purchase protection from inflation required. (NRS 679B.130) 1. An insurer shall not offer a long-term care insurance contract unless the insurer also offers to the policyholder, in addition to any other protection from inflation, the option to purchase a lon…

NAC 687B.077 Requirements for marketing. (NRS 679B.130) An insurer, health care plan or other entity who markets, directly or through its agents or other producers, long-term care insurance in this State shall: 1. Establish procedures regarding marketing to assure that any compar…

NAC 687B.0775 Approval of advertisement by Commissioner. (NRS 679B.130) 1. Except as otherwise provided in subsection 2, every insurer or other organization that markets or offers long-term care insurance contracts or certificates in this State shall: (a) Provide to the Commissio…

NAC 687B.078 Restriction on use of certain terms in marketing. (NRS 679B.130) An insurer, health care plan or other entity marketing long-term care insurance in this State, directly or through its agents or other producers, shall not use the terms “noncancellable” or “level premi…

NAC 687B.079 Prohibition of certain marketing practices. (NRS 679B.130) 1. An insurer, health care plan or other entity marketing long-term care insurance in this State, directly or through its agents or other producers, shall not engage in the following acts or practices: (a) Hi…

NAC 687B.080 Definition of terms in contracts. (NRS 679B.130) A long-term care insurance contract delivered or issued for delivery in this State may not use the following terms unless the terms are defined in the long-term care insurance contract as follows: 1. “Activities of dai…

NAC 687B.081 Notification of availability of new series of contracts. (NRS 679B.130) 1. The provisions of this section do not apply to a policy of life insurance or a rider or endorsement to a policy of life insurance that contains accelerated benefits for long-term care. 2. Exce…

NAC 687B.082 Notification regarding partnership status. (NRS 679B.130) 1. Except as otherwise provided in subsection 3, after the Division approves a filing associated with the partnership status of a form, the insurer or similar organization issuing the form shall notify each po…

NAC 687B.0825 Activities of daily living and cognitive impairment to be used to measure needs of insured and to be described in contract or certificate; benefit triggers. (NRS 679B.130) 1. Activities of daily living and cognitive impairment must be used to measure the needs of an…

NAC 687B.083 Contract or certificate to condition payment of benefits on insured’s ability to perform daily activities and cognitive impairment. (NRS 679B.130) 1. A long-term care insurance contract or certificate must condition the payment of benefits on a determination of the a…

NAC 687B.084 Requirements relating to qualified long-term care insurance contract. (NRS 679B.130) 1. A qualified long-term care insurance contract must pay only for qualified long-term care services: (a) Received by a chronically ill individual; and (b) Provided pursuant to a pla…

NAC 687B.0845 Required statement as to whether contract intended to be qualified long-term care insurance contract under federal provisions. (NRS 679B.130) 1. A qualified long-term care insurance contract must include a disclosure statement in the qualified long-term care insuran…

NAC 687B.085 Terms for renewal of contracts. (NRS 679B.130) 1. The terms “guaranteed renewable” and “noncancellable” may not be used in any individual long-term care insurance contract without further explanatory language conforming to the disclosure requirements of NAC 687B.100.…

NAC 687B.090 Exclusions from and limitations on coverage. (NRS 679B.130) 1. A long-term care insurance contract may not be delivered or issued for delivery in this State as long-term care insurance if the long-term care insurance contract limits or excludes coverage by type of il…

NAC 687B.095 Extension of benefits; continuation or conversion of coverage. (NRS 679B.130) 1. Any termination of long-term care insurance must be without prejudice to any benefits payable for institutionalization if the institutionalization began while the long-term care insuranc…

NAC 687B.100 Required disclosures. (NRS 679B.130, 679B.136) 1. An individual long-term care insurance contract must contain a provision for renewability unless the long-term care insurance contract provides that the right not to renew is reserved solely to the policyholder. Such …

NAC 687B.105 Prohibited provisions. (NRS 679B.130) No long-term care insurance contract may: 1. Be cancelled, nonrenewed or otherwise terminated on the grounds of the age or the deterioration of the mental or physical health of the insured or the certificate holder; 2. Contain a …

NAC 687B.106 Required provisions for reducing coverage and lowering premium; notice. (NRS 679B.130) 1. The provisions of this section do not apply to a policy of life insurance or a rider or endorsement to a policy of life insurance that contains accelerated benefits for long-ter…

NAC 687B.1065 Insurer to file for approval any increase in a premium rate schedule for certain contracts. (NRS 679B.130) 1. The provisions of this section do not apply to: (a) A long-term care insurance contract or certificate issued before October 1, 2008; (b) A policy of life i…

NAC 687B.107 Insurer to request approval of any increase in premium rate schedule for contracts and certificates issued on or after October 1, 2011. (NRS 679B.130) 1. An insurer shall request approval of any increase in a premium rate schedule, including an exceptional increase, …

NAC 687B.1075 Exceptional increases. (NRS 679B.130) 1. Except as otherwise provided in NAC 687B.107, an exceptional increase is subject to the same requirements as other premium rate schedule increases. 2. The Commissioner may request a review by an independent actuary or a profe…

NAC 687B.108 Prohibited increases in premiums. (NRS 679B.130) 1. The premium charged to an insured for long-term care insurance must not increase because of: (a) The increasing age of the insured beyond 65 years of age; or (b) The duration the insured has been covered under the p…

NAC 687B.111 Coverage for preexisting conditions. (NRS 679B.130) 1. A long-term care insurance contract or certificate, other than a long-term care insurance contract or certificate issued to a group described in subsection 1 of NAC 687B.025, may not: (a) Define “preexisting cond…

NAC 687B.112 Monthly report to certain insureds. (NRS 679B.130) If an insured is receiving benefits for long-term care through the acceleration of benefits under a group or individual policy of life insurance, a rider to that policy or an annuity contract, the insurer shall provi…

NAC 687B.113 Delivery of shopper’s guide to long-term care insurance. (NRS 679B.130) 1. Except as otherwise provided in this section, a shopper’s guide to long-term care insurance must be furnished to each prospective applicant. In the case of a group contract, the guide may be d…

NAC 687B.114 Responsibilities of professional, trade or occupational association which endorses or sells contracts or certificates to members. (NRS 679B.130) 1. A professional, trade or occupational association, as described in subsection 2 of NAC 687B.025, which endorses or sell…

NAC 687B.115 Filing and certification requirements for insurer issuing contract or certificate to professional, trade or occupational association. (NRS 679B.130) 1. An insurer shall not issue a group long-term care insurance contract or certificate to a professional, trade or occ…

NAC 687B.116 Limitations on conditioning of benefits. (NRS 679B.130) 1. A long-term care insurance contract delivered or issued for delivery in this State may not: (a) Condition any benefit upon the hospitalization of the insured; (b) Condition any benefit for an insured who is i…

NAC 687B.117 Restrictions on limitation or exclusion of benefits. (NRS 679B.130) 1. A long-term care insurance contract or certificate that provides benefits for services related to home health care or community care must not limit or exclude benefits: (a) By requiring that the i…

NAC 687B.118 Statement of limitations or conditions upon receipt of benefits. (NRS 679B.130) Each long-term care insurance contract which provides coverage for postconfinement care, postacute care or recuperative services, and each certificate issued under such a contract, must c…

NAC 687B.1185 Requirements for denied claims. (NRS 679B.130) If a claim under a long-term care insurance contract or certificate is denied, the issuer shall, not later than 60 days after the date of a written request by the policyholder, certificate holder or a representative the…

NAC 687B.119 Required reserves for policy, rider or endorsement. (NRS 679B.130) 1. When benefits for long-term care are provided through the acceleration of benefits under a group or an individual policy of life insurance or a rider or endorsement to that policy, the reserves for…

NAC 687B.121 Evaluation of expected loss ratio. (NRS 679B.130) 1. For a long-term care insurance contract or certificate to which subsection 2 does not apply, the Commissioner shall deem the benefits reasonable in relation to premiums charged if the expected loss ratio is at leas…

NAC 687B.122 General requirements for converted policy. (NRS 679B.130) 1. A written application by an insured for a converted policy must be made, and the first premium due, if any, must be paid as directed by the insurer within 31 days of the date of termination of coverage unde…

NAC 687B.125 Replacement of contract: Questions on applications. (NRS 679B.130) Application forms for individual long-term care insurance contracts must include the following questions designed to elicit information as to whether the proposed long-term care insurance contract is …

NAC 687B.127 Replacement of contract or certificate: Waiver of time applicable to preexisting conditions and probationary period; notice to existing insurer. (NRS 679B.130) 1. If a long-term care insurance contract or certificate replaces another long-term care insurance contract…

NAC 687B.130 Replacement of contract: Notice from insurer not using direct-response solicitation. (NRS 679B.130) 1. Upon determining that a sale will involve the replacement of a long-term care insurance contract, an insurer, other than an insurer using direct-response solicitati…

NAC 687B.135 Replacement of policy: Notice from insurer using direct-response solicitation. (NRS 679B.130) 1. Insurers using a direct-response solicitation shall deliver a notice regarding the replacement of a policy for accident and sickness or a long-term care insurance contrac…

NAC 687B.140 Replacement of contract: Restrictions concerning group policies for long-term care. (NRS 679B.130) If a group long-term care insurance contract is replaced by another group long-term care insurance contract issued to the same policyholder, the succeeding insurer shal…