Nevada Administrative Code

NAC 689C.117 Carrier prohibited from requiring purchase of other insurance as prerequisite to purchase or renewal of group health plan. (NRS 679B.130, 689C.155, 689C.203) A carrier serving small employers shall not require a small employer to purchase a group life insurance polic…

NAC 689C.120 Compliance required. (NRS 679B.130, 689C.155) A carrier that provides health benefit plans to small employers in this State shall comply with the provisions of this chapter and: 1. Chapter 689C of NRS; 2. NRS 689B.033 and 689B.290 to 689B.330, inclusive, to the exten…

NAC 689C.130 Notice of cancellation, nonrenewal or renewal with altered terms. (NRS 679B.130, 689C.155, 689C.203) A notice of cancellation, nonrenewal or renewal with altered terms issued by a carrier to a small employer must comply with the provisions of NRS 687B.310 to 687B.420…

NAC 689C.150 Notification of conversion privilege; coverage of eligible dependent. (NRS 679B.130, 689C.203, 689C.330) 1. A certificate of coverage for a health benefit plan must include notification of the conversion privilege provided by NRS 689C.330. 2. An eligible dependent is…

NAC 689C.155 Evidence of creditable coverage. (NRS 679B.130, 689C.155, 689C.191, 689C.203) If a person is unable to obtain a certificate of creditable coverage pursuant to NRS 689C.192, a carrier shall accept from the person other evidence of creditable coverage if it determines …

NAC 689C.170 Contents of disclosure form. (NRS 679B.130, 689C.203, 689C.270) The disclosure required to be filed with the Commissioner pursuant to NRS 689C.270 must be on a form which is in at least 10-point type and include: 1. The name, address and telephone number of the carri…

NAC 689C.172 Disclosures in advertising and sales materials; inclusion of certain information in health benefit plan. (NRS 679B.130, 689C.203, 689C.270) 1. As part of the disclosure required by NRS 689C.270, a carrier serving small employers shall disclose in the advertising and …

NAC 689C.175 Request for copy of disclosure. (NRS 679B.130, 689C.203) On behalf of a small employer, a producer may request a copy of the disclosure required to be filed with the Commissioner pursuant to NRS 689C.270. (Added to NAC by Comm’r of Insurance by R224-97, eff. 11-16-98…

NAC 689C.180 Filing of forms required by NRS 687B.120. (NRS 679B.130, 687B.120, 689C.203) A form required to be filed pursuant to NRS 687B.120 for a health benefit plan must: 1. Be in a format prescribed by the Commissioner; 2. Include an affidavit signed by an officer of the car…

NAC 689C.190 Coverage under different plan constituting passage of fixed period. (NRS 679B.130, 689C.190, 689C.203) A carrier serving small employers shall, with regard to employees that had existing coverage continuously under a different health plan in the 90-day period immedia…

NAC 689C.195 Restrictions on rules of eligibility and on contribution rates. (NRS 679B.130, 689C.155, 689C.193, 689C.203) 1. A group health plan and a carrier that issues group health insurance pursuant to chapter 689C of NRS shall not include or establish any rule of eligibility…

NAC 689C.200 Development of rate manual; calculation of rates. (NRS 679B.130, 689C.155, 689C.203) 1. A carrier serving small employers shall develop a rate manual for each class of business established by the carrier. Base premium rates and new business premium rates charged to s…

NAC 689C.202 Limitation on frequency of increases in premium rates; exceptions. (NRS 679B.130, 689C.155, 689C.203) 1. Except as otherwise provided in this section, a carrier serving small employers shall not increase the premium rates for a group health benefit plan more frequent…

NAC 689C.205 Disclosure of variance in premium rate. (NRS 679B.130, 689C.155, 689C.203) If a carrier serving small employers quotes a premium rate for a health benefit plan to a producer or a small employer who seeks health insurance coverage from the carrier, the carrier shall d…

NAC 689C.210 Marketing in established geographic area. (NRS 679B.130, 689C.203) A carrier serving small employers shall, in accordance with the provisions of NRS 689C.200, take reasonable steps to market its health benefit plans to small employers located in the carrier’s establi…

NAC 689C.220 Requirement upon denial of coverage. (NRS 679B.130, 689C.155, 689C.203) If a carrier serving small employers denies coverage in a health benefit plan to a small employer on the basis of a risk characteristic, the denial must be in writing and state the reasons for th…

NAC 689C.230 Determination of reduction in liability of carrier because of benefits under other group coverage. (NRS 679B.130) A reduction in the liability of a carrier serving small employers because of benefits under other valid group coverage must be determined in the manner p…

NAC 689C.250 Policies for stop-loss insurance: General requirements for policy; determination of number of persons in group health plan; effect of policy failing to meet general requirements; requirements specific to policy for group health plan with small employer; provision of …

NAC 689C.300 Application for registration; submission of proposed material changes to business plan. (NRS 679B.130, 689C.500, 689C.510, 689C.560, 689C.600) 1. In addition to the requirements of NRS 689C.500, the application for registration must include: (a) A statement authorizi…

NAC 689C.310 Grounds for denial of application or suspension, revocation or refusal to renew certificate. (NRS 679B.130, 689C.600) The Commissioner may deny the application of a voluntary purchasing group or suspend, revoke or refuse to renew the certificate of registration of a …

NAC 689C.320 Annual renewal fee. (NRS 679B.130, 689C.530, 689C.600) The voluntary purchasing group must pay an annual renewal fee of $1,000 to the Commissioner on or before March 1 of each year. (Added to NAC by Comm’r of Insurance, eff. 3-5-96)

NAC 689C.330 Disclosure by carrier. (NRS 679B.130, 689C.440) In addition to the requirements of NRS 689C.440, the disclosure offered by a carrier must: 1. Be printed in at least 10-point type; 2. Include the name, address and telephone number of the insurer; 3. Include the name, …

NAC 689C.340 Accessibility of coverage: Prohibited activity; enrollment of all eligible employees and dependents. (NRS 679B.130, 689C.460) 1. A participating carrier, agent or broker shall not engage in any activity that would encourage an eligible employee to decline coverage of…

NAC 689C.350 Annual report. (NRS 679B.130, 689C.530, 689C.600) Each voluntary purchasing group shall submit to the Commissioner no later than March 1, 1997, and annually thereafter, a report concerning: 1. The progress achieved by the group in providing affordable coverage to eli…

NAC 689C.360 General powers. (NRS 679B.130, 689C.600) A voluntary purchasing group may: 1. Offer other benefit plans approved by the Commissioner, such as group coverage for vision care, dental care and other limited contracts for other care; 2. Exclude or temporarily suspend the…

NAC 689C.370 Prohibited acts. (NRS 679B.130, 689C.600) A voluntary purchasing group shall not: 1. Purchase health care services for its enrollees or otherwise assume the related financial risk; 2. Exclude any eligible small employer that is willing to accept the rules and bylaws …

NAC 689C.380 Provisions of contract with participating carrier: Payment of premiums. (NRS 679B.130, 689C.600) Each contract between a voluntary purchasing group and a participating carrier must include a provision which sets forth: 1. A statement of how the premiums are to be pai…

NAC 689C.390 Provisions of contract with participating small employer: Group as policyholder of record; issuance of certificates of coverage; coverage through group required. (NRS 679B.130, 689C.600) Each contract between a voluntary purchasing group and a participating small emp…

NAC 689C.400 Establishment of standards and guidelines for insurers. (NRS 679B.130, 689C.600) A voluntary purchasing group shall establish standards and guidelines for compliance by insurers which will enable the group to conduct its business, meet its reporting obligations and o…

NAC 689C.410 Establishment of marketing standards and approval of marketing materials. (NRS 679B.130, 689C.600) The voluntary purchasing group shall establish marketing standards for participating carriers and approve all marketing materials before use. (Added to NAC by Comm’r of…

NAC 689C.420 Board of directors and management personnel: Duties. (NRS 679B.130, 689C.600) The board of directors and management personnel of a voluntary purchasing group shall: 1. Operate the voluntary purchasing group; 2. Publish the requirements that carriers must meet to part…

NAC 689C.430 Board members and management personnel: Prohibited acts. (NRS 679B.130, 689C.600) No board members or management personnel of the voluntary purchasing group and their immediate families may, in any capacity: 1. Receive remuneration of any kind from any carrier; 2. Pr…

NAC 689C.440 Report of suspected violation. (NRS 679B.130, 689C.600) A voluntary purchasing group shall report to the Commissioner any suspected violation of law or regulation relating to any transaction between the group and insurers who offer policies for group health insurance…

NAC 689C.450 Insolvency of voluntary purchasing group: Jurisdiction of Commissioner. (NRS 679B.130, 689C.600) If a voluntary purchasing group becomes insolvent, the Commissioner will maintain jurisdiction over the group to protect the interests of the enrollees in the group. (Add…

NAC 690A.002 Definitions. (NRS 679B.130, 690A.277) As used in this chapter, unless the context otherwise requires, the words and terms defined in NAC 690A.005 to 690A.018, inclusive, have the meanings ascribed to them in those sections. (Added to NAC by Comm’r of Insurance by R01…

NAC 690A.005 “Actuarially consistent” defined. (NRS 679B.130, 690A.277) “Actuarially consistent” means the present value of two patterns of cash flow that when measured using the same assumptions are approximately equivalent. (Added to NAC by Comm’r of Insurance by R014-06, 3-23-…

NAC 690A.010 “Full-time” defined. (NRS 679B.130, 690A.277) “Full-time” means a workweek of 30 hours or more. (Added to NAC by Comm’r of Insurance by R131-05, eff. 10-31-2005)

NAC 690A.012 “Indebtedness” defined. (NRS 679B.130, 690A.277) “Indebtedness” means the total amount payable by a debtor to a creditor in connection with a loan or other credit transaction and includes the finance charge that is or will be assigned to the transaction. (Added to NA…

NAC 690A.014 “Outstanding balance basis” defined. (NRS 679B.130, 690A.277) “Outstanding balance basis” means premiums that are paid monthly using a rate per $1,000 of monthly outstanding insured indebtedness. (Added to NAC by Comm’r of Insurance by R014-06, 3-23-2007, eff. 4-1-20…

NAC 690A.016 “Prima facie rate” defined. (NRS 679B.130, 690A.277) “Prima facie rate” means a rate that is deemed to be reasonable in relation to the benefits provided for credit insurance and may be used without filing additional actuarial information with the Commissioner. (Adde…

NAC 690A.018 “Single premium basis” defined. (NRS 679B.130, 690A.277) “Single premium basis” means the present value of the monthly premiums that are charged over the term of a policy. (Added to NAC by Comm’r of Insurance by R014-06, 3-23-2007, eff. 4-1-2007)

NAC 690A.020 Disclosures to debtors: Requirement; filing of form for approval. (NRS 679B.130, 690A.073, 690A.087, 690A.277) Before a debtor elects to purchase consumer credit insurance in connection with a credit transaction, the information found in the form NDOI-915, as specifi…

NAC 690A.025 Disclosures to debtors: Approved form. (NRS 679B.130, 690A.073, 690A.087, 690A.277) 1. Except as otherwise provided in NAC 690A.020, an insurer that issues a policy of consumer credit insurance must disclose the limitations set forth in subsection 2 in the manner set…

NAC 690A.030 Disclosures to debtors: Notice concerning benefits payable under truncated consumer credit insurance coverage; application of adjustment factors to rates. (NRS 679B.130, 690A.087, 690A.093, 690A.277) 1. In addition to any disclosure required pursuant to NAC 690A.020 …

NAC 690A.040 Credit unemployment insurance: Benefits; eligibility for coverage. (NRS 679B.130, 690A.277) 1. Credit unemployment insurance policies must contain benefits at least as favorable to insureds as the following provisions: (a) A provision for coverage for unemployment fo…

NAC 690A.050 Credit life insurance: Written standards for processing claims; records substantiating compliance. (NRS 679B.130) 1. Each insurer issuing a policy of credit life insurance shall adopt a written standard for processing a claim for a benefit under a policy of credit li…

NAC 690A.055 Credit life insurance: Written certification. (NRS 679B.130, 690A.277) 1. Each insurer wishing to provide coverage under a policy of credit life insurance shall, before offering that coverage in this State, certify in writing that the policy: (a) Complies with the pr…