Nevada Administrative Code

NAC 694C.100 Qualifying investigation or examination of applicant. (NRS 679B.130, 694C.170) The Commissioner may perform a qualifying investigation or examination of an applicant either before or after the applicant is issued a certificate of authority. Such an investigation or e…

NAC 694C.110 Authority of Commissioner to establish review panel for applications. (NRS 679B.130, 694C.170, 694C.220) In contracting with outside resources, including attorneys, accountants and actuaries, for the review of the applications for licenses for captive insurers pursua…

NAC 694C.200 Annual and quarterly reports of financial condition; request for extension of filing date. (NRS 679B.130, 694C.170, 694C.390, 694C.400) 1. A report of financial condition filed by an association captive insurer, an agency captive insurer or a rental captive insurer p…

NAC 694C.210 Annual audit; request for extension of filing date; application for exemption. (NRS 679B.130, 694C.170, 694C.390, 694C.400) 1. Except as otherwise provided in subsection 2 or 7, a captive insurer shall have an annual audit by an independent certified public accountan…

NAC 694C.220 Independent certified public accountant: Report of retention by insurer; acknowledgment of applicable requirements. (NRS 679B.130, 694C.170, 694C.400) 1. A captive insurer shall report to the Commissioner in writing the name and address of the independent certified p…

NAC 694C.222 Criteria for recognition as qualified independent certified public accountant by Commissioner. (NRS 679B.130, 694C.170, 694C.400) 1. Except as otherwise provided in subsection 2, the Commissioner will recognize an independent certified public accountant as a qualifie…

NAC 694C.224 Hearing to determine whether independent certified public accountant is qualified; determination that accountant is not qualified. (NRS 679B.130, 694C.170, 694C.400) 1. The Commissioner will, if he or she deems it necessary, hold a hearing to determine whether an ind…

NAC 694C.226 Reporting of determination that insurer misstated its financial condition or does not meet minimum requirements for capital and surplus; procedure upon discovery of additional facts. (NRS 679B.130, 694C.170, 694C.400) 1. An independent certified public accountant of …

NAC 694C.228 Reporting of significant deficiency in insurer’s structure for internal control. (NRS 679B.130, 694C.170, 694C.400) If, following the audit of the financial statements of a captive insurer, an independent certified public accountant notes any significant deficiency i…

NAC 694C.230 Availability and maintenance of work papers of independent certified public accountant. (NRS 679B.130, 694C.170, 694C.400) 1. A captive insurer shall ensure that its independent certified public accountant makes available for review by the Commissioner or a designee …

NAC 694C.235 Procedure upon dismissal or resignation of independent certified public accountant. (NRS 679B.130, 694C.170, 694C.400) 1. If the independent certified public accountant who was the accountant for the most recent filing of the annual audited financial report of a capt…

NAC 694C.240 Security deposit or letter of credit; return upon discontinuation of business. (NRS 679B.130, 694C.170) 1. If the Commissioner determines that the financial condition of a captive insurer warrants additional security, the Commissioner may require the captive insurer …

NAC 694C.245 Requirements for material service provider contract. (NRS 679B.130, 694C.170) 1. A material service provider contract between a captive insurer and a service provider: (a) Must be for a period of not more than 5 years; (b) Requires the approval of the majority of the…

NAC 694C.250 Reinsurance and excess insurance agreements. (NRS 679B.130, 694C.170) 1. Except as approved by the Commissioner, a captive insurer shall not: (a) Enter into any agreement to cede reinsurance; (b) Enter into any agreement to assume reinsurance; or (c) Terminate an exi…

NAC 694C.260 Notification of certain changes in operations or organizational structure. (NRS 679B.130, 694C.170) If any material change occurs in the operations of a captive insurer or in the organizational structure within the captive insurer: 1. The manager, certified public ac…

NAC 694C.270 Prior approval required for material change in nature of business; circumstances constituting material change; filing of certain other changes in application information with Commissioner. (NRS 679B.130, 694C.170, 694C.240) 1. A captive insurer shall not, without the…

NAC 694C.280 Officers and directors. (NRS 679B.130, 694C.170) 1. Within 30 days after any change in the executive officers and directors of a captive insurer, the captive insurer shall report the change to the Commissioner. The report must include a statement of the business and …

NAC 694C.290 Conflict of interest policy: Adoption; contents; required disclosures. (NRS 679B.130, 694C.170) 1. A captive insurer chartered in this State shall adopt a conflict of interest policy for its attorneys-in-fact, trustees, managers, officers and directors. The policy mu…

NAC 694C.295 Reasonable and proper expenses incurred in examination conducted pursuant to NRS 694C.410. (NRS 679B.130, 694C.170, 694C.410) Reasonable and proper expenses incurred in an examination conducted pursuant to NRS 694C.410 may include, without limitation: 1. For a financ…

NAC 694C.300 Acting as manager, broker or agent without authorization of Commissioner prohibited. (NRS 679B.130, 694C.170) A person shall not act as a manager, a broker or an agent in this State for a captive insurer without authorization of the Commissioner. An application for a…

NAC 694C.310 Acquisition of control of or merger with captive insurer. (NRS 679B.130, 694C.170) 1. A person other than an issuer shall not: (a) Make a tender offer for, make a request or invitation for tenders of, or enter into any agreement to exchange securities for, any voting…

NAC 695A.100 Capital account. (NRS 679B.130, 681B.550) Each society shall maintain a capital account with a net worth in an amount which is not less than the amount of risk-based capital determined in the manner set forth in NRS 681B.550 and the regulations adopted pursuant there…

NAC 695B.002 Definitions. (NRS 679B.130) As used in this chapter, unless the context otherwise requires, the words and terms defined in NAC 695B.004 and 695B.006 have the meanings ascribed to them in those sections. (Added to NAC by Comm’r of Insurance by R132-98, eff. 3-30-99)

NAC 695B.004 “Commissioner” defined. (NRS 679B.130) “Commissioner” means the Commissioner of Insurance. (Added to NAC by Comm’r of Insurance by R132-98, eff. 3-30-99)

NAC 695B.006 “Division” defined. (NRS 679B.130) “Division” means the Division of Insurance of the Department of Business and Industry. (Added to NAC by Comm’r of Insurance by R132-98, eff. 3-30-99) USE OF PREFERRED PROVIDERS OF HEALTH CARE

NAC 695B.010 Disclosure of points at which insured’s payment for coinsurance is no longer required; sample calculation of claim; limitation on approval of contract. (NRS 679B.130, 695B.185) 1. The point at which an insured’s payment for coinsurance is no longer required to be pai…

NAC 695B.020 General requirements for program. (NRS 679B.130, 695B.185) Any nonprofit corporation for hospital, medical or dental services wishing to offer a program using preferred providers of health care pursuant to NRS 695B.185 shall comply with the provisions of NAC 689B.120…

NAC 695B.030 Filing, contents and delivery of disclosure. (NRS 679B.130, 695B.172, 695B.174, 695B.280) 1. Each corporation shall file with the Commissioner, for his or her approval, a disclosure summarizing the coverage provided by a group contract for hospital or medical service…

NAC 695B.035 Disclosures in advertising and sales materials; inclusion of certain information in contract for hospital or medical service. (NRS 679B.130, 695B.172, 695B.280) 1. As part of the disclosure required by NRS 695B.172, an insurer shall disclose in the advertising and sa…

NAC 695B.050 Limitation on frequency of increases; exceptions. (NRS 679B.130, 695B.280) 1. Except as otherwise provided in this section, a nonprofit corporation for hospital, medical or dental services shall not increase the premium rates under a group contract for hospital, medi…

NAC 695B.100 Subrogation: Right to recover from third party; lien against recovery; subrogation not basis for denial of payment of benefits. (NRS 679B.130, 695B.280) 1. Except as otherwise provided by specific federal or state statute or regulation, a nonprofit corporation for ho…

NAC 695B.120 Restrictions on group benefits payable by more than one insurer to provider. (NRS 679B.130, 695B.280) When the benefits of a group contract for hospital, medical or dental service issued pursuant to chapter 695B of NRS are payable by more than one insurer to a provid…

NAC 695B.125 Consideration of coverage under another policy prohibited to determine or pay benefits. (NRS 679B.130, 695B.280) A group contract for hospital, medical or dental service issued pursuant to chapter 695B of NRS: 1. Must not, for the determination of benefits payable fo…

NAC 695B.200 Requirements for approval. (NRS 679B.130, 695B.380) To obtain approval of a system for resolving complaints of insureds concerning health care services covered by an insurer from the Commissioner as required pursuant to NRS 695B.380, an insurer must: 1. Demonstrate t…

NAC 695B.210 Annual report. (NRS 679B.130, 695B.390) 1. An insurer shall submit its annual report regarding its system for resolving complaints as required pursuant to NRS 695B.390 on or before June 1 of each year. The insurer shall retain a copy of the annual report for at least…

NAC 695B.250 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 disclosure to small employer; subm…

NAC 695B.300 Maintenance of reserve fund. (NRS 679B.130, 695B.140) All reserves maintained by a nonprofit corporation pursuant to NRS 695B.140: 1. Must be deposited in a trust account in a federally insured financial institution located in this State. All income earned by the acc…

NAC 695B.305 Capital account. (NRS 679B.130, 681B.550) Each nonprofit corporation shall maintain a capital account with a net worth in an amount which is not less than the amount of risk-based capital determined in the manner set forth in NRS 681B.550 and the regulations adopted …

NAC 695B.310 Annual statement of condition and affairs; financial statements; quarterly statement of domestic nonprofit organization; extension of time for filing statement; disciplinary action for failure to file statement. (NRS 679B.130, 680A.265, 695B.110, 695B.160) 1. As a co…

NAC 695B.320 Conduct of examinations. (NRS 679B.130, 695B.160) Each examination of a nonprofit corporation which establishes, maintains or operates a hospital, medical or dental service plan, including, without limitation, an examination conducted pursuant to NRS 695B.160, must b…

NAC 695C.010 Definitions. (NRS 679B.130) As used in this chapter, unless the context otherwise requires, the words and terms defined in NAC 695C.025 to 695C.090, inclusive, have the meanings ascribed to them in those sections. (Supplied in codification; A by Comm’r of Insurance, …

NAC 695C.019 “Commissioner” defined. (NRS 679B.130) “Commissioner” means the Commissioner of Insurance. (Added to NAC by Comm’r of Insurance by R132-98, eff. 3-30-99)

NAC 695C.025 “Delivery system intermediary” defined. (NRS 679B.130) 1. “Delivery system intermediary” means a partnership, association, corporation or other legal entity which enters into a contract with an organization to provide health care services. The term includes: (a) An e…

NAC 695C.040 “Division” defined. (NRS 679B.130) “Division” means the Division of Insurance of the Department of Business and Industry. [Comm’r of Insurance, LH-4 part § II, eff. 7-1-74]—(NAC A 5-27-92)

NAC 695C.041 “Division of Public and Behavioral Health” defined. (NRS 439.200) “Division of Public and Behavioral Health” means the Division of Public and Behavioral Health of the Department of Human Services. (Added to NAC by Bd. of Health, eff. 11-1-95)

NAC 695C.042 “Group practice” defined. (NRS 679B.130) “Group practice” has the meaning ascribed to it in NRS 439B.425. (Added to NAC by Comm’r of Insurance by R129-96, eff. 10-29-97)

NAC 695C.043 “Health care services” defined. (NRS 679B.130) “Health care services” has the meaning ascribed to it in NRS 695C.030. (Added to NAC by Comm’r of Insurance by R129-96, eff. 10-29-97)