Title 57

NRS 695D.050 “Member” defined. “Member” includes the person enrolled in a plan for dental care and the person’s dependents who may also be enrolled in the plan. (Added to NRS by 1983, 2021)

NRS 695D.060 “Organization for dental care” defined. “Organization for dental care” means any person who agrees to provide coverage for dental care through one or more plans for dental care. (Added to NRS by 1983, 2021)

NRS 695D.070 “Plan for dental care” defined. “Plan for dental care” means any agreement in which a person agrees to provide or arrange for dental care or pay for or reimburse any part of the cost of that care and the member agrees to prepay, make periodic payments or pay through …

NRS 695D.080 “Policy” defined. “Policy” means the document given to a member which describes the dental care to which the member is entitled under a plan for dental care and the obligations of the member to the organization for dental care. (Added to NRS by 1983, 2021)

NRS 695D.090 Applicability of title to organizations for dental care; applicability of chapter. 1. Except as otherwise specifically provided in this chapter or elsewhere in this title, the provisions of this title other than this chapter do not apply to organizations for dental c…

NRS 695D.095 Applicability of chapter and certain other provisions to organizations for dental care. 1. An organization for dental care is subject to the provisions of this chapter and to the provisions set forth in this section, to the extent reasonably applicable. Organizations…

NRS 695D.100 Regulations. The Commissioner may adopt any regulations necessary to carry out the provisions of this chapter. (Added to NRS by 1983, 2022)

NRS 695D.102 Summary of coverage: Contents of disclosure; approval by Commissioner; regulations. 1. The Commissioner shall adopt regulations which require an organization for dental care to file with the Commissioner, for approval by the Commissioner, a disclosure summarizing the…

NRS 695D.104 Summary of coverage: Copy required to be provided to group policyholder before issuance of policy; organization prohibited from offering plan unless disclosure approved by Commissioner. An organization for dental care shall provide to the group policyholder to whom i…

NRS 695D.110 Certificate of authority: Required for establishing, operating, acting as administrator of, selling or offering to sell plan for dental care. No person may establish or operate a plan for dental care, act as an administrator of such a plan or sell or offer to sell su…

NRS 695D.120 Certificate of authority: Application. Each application for a certificate of authority must be filed with the Commissioner on a form prescribed by the Commissioner, must be verified by an officer or authorized representative of the organization for dental care and mu…

NRS 695D.130 Certificate of authority: Issuance; fees. The Commissioner shall issue a certificate of authority to an organization for dental care after the organization has paid an application fee of $2,450 and, in addition to any other fee or charge, all applicable fees required…

NRS 695D.140 Certificate of authority: Notice of change of information; application for amendment; fee; approval. 1. Except as otherwise provided in subsection 2, every organization issued a certificate of authority by the Commissioner shall notify the Commissioner of any change …

NRS 695D.150 Certificate of authority: Expiration; renewal; fees. A certificate of authority expires at midnight on March 1 following the date it was issued or previously renewed. The Commissioner shall renew the certificate of any organization for dental care which: 1. Continues…

NRS 695D.153 Capital account: Minimum amount; requirements. 1. Each organization for dental care which receives a certificate of authority shall maintain a capital account with a net worth of not less than $500,000 unless a lesser amount is permitted in writing by the Commissione…

NRS 695D.157 Hazardous financial condition: Regulations; determination; powers of Commissioner. 1. The Commissioner may adopt regulations to define when an organization for dental care is considered to be in a hazardous financial condition and to set forth the standards to be con…

NRS 695D.160 Composition of board of directors for organization for dental care that is corporation. If an organization for dental care is a corporation, its board of directors must include: 1. Dentists who have contracted with the organization to provide dental care to its membe…

NRS 695D.170 Bond or deposit: Required; amount; creation of Fund for Bonds of Organizations for Dental Care; judgment as lien; disposition upon dissolution, liquidation or other termination of organization. 1. Except as otherwise provided in this section, before a certificate of …

NRS 695D.180 Requirements concerning bond. An organization for dental care or its officers under this chapter shall file a bond with the Commissioner. The bond must comply with NRS 679B.175. (Added to NRS by 1983, 2024; A 2021, 2995)

NRS 695D.190 Certain persons in organization for dental care in fiduciary relationship to members; dentist subject to disciplinary action for breaches of fiduciary or contractual obligations. Any director, officer, partner or employee of an organization for dental care who receiv…

NRS 695D.200 Policy: Review by prospective members at meeting; provision of copy to members; approval by Commissioner; form and contents; notice of change. 1. An organization for dental care shall: (a) Hold a meeting for all prospective members to review fully the policy being of…

NRS 695D.203 Group plan issued to replace discontinued policy or coverage: Requirements; notice of reduction of benefits; statement of benefits; applicability to self-insured employer. 1. A group plan for dental care issued by an organization for dental care to replace any discon…

NRS 695D.205 Copayments and deductibles: Reasonableness; approval of Commissioner; regulations. 1. Each copayment and deductible required to be paid by a member must be reasonable and reasonably related to the cost of the particular service. 2. Every organization for dental care …

NRS 695D.210 Policy covering dependent of member required to include coverage for member’s newly born and adopted children and children placed with member for adoption to same extent as other dependents. 1. Any policy which provides coverage for a dependent of a member must provi…

NRS 695D.215 Claims: Approval or denial; payment of claim and interest; request 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 c…

NRS 695D.2153 Claims: Organization for dental care or administrator prohibited from denying claim for which prior authorization has been granted; exceptions. 1. An organization for dental care or an administrator of a dental plan shall not refuse to pay a claim for dental care fo…

NRS 695D.2157 Recovery of overpayments: Notice; procedures for challenging attempted recovery; limitation of period for recovery; exception. 1. An organization for dental care or an administrator who recovers overpayments under a plan for dental care shall provide written notice …

NRS 695D.216 Required provision concerning coverage for services provided through telehealth to same extent as though provided in person or by other means; required provision concerning reimbursement for certain services provided through telehealth in same amount as though provid…

NRS 695D.2165 Required provision concerning coverage for dental service provided by qualified dental hygienist in certain circumstances. 1. An organization for dental care that offers or issues a plan for dental care which includes coverage for a dental service that a qualified d…

NRS 695D.217 Organization for dental care prohibited from denying coverage solely because claim involves act that constitutes domestic violence or applicant or insured was victim of domestic violence. An organization for dental care shall not deny a claim, refuse to issue a polic…

NRS 695D.219 Organization for dental care prohibited from denying coverage solely because applicant or member was intoxicated or under the influence of controlled substance; exceptions. 1. Except as otherwise provided in subsection 2, an organization for dental care shall not: (a…

NRS 695D.220 Licensing of agents. 1. The provisions of chapter 683A of NRS apply to the licensing of agents for an organization for dental care. 2. As used in this section, “agent” means any person who is associated, directly or indirectly, with the organization and engages in so…

NRS 695D.225 Contracts between organization for dental care and dentist: Modification; submission of schedule of payments upon request; exceptions. 1. Except as otherwise provided in NRS 695D.227, a contract between an organization for dental care and a dentist may be modified: (…

NRS 695D.227 Prohibitions related to setting of fees by plan or organization for dental care other than covered services to members. 1. No plan for dental care and no contract between an organization for dental care and a dentist may require, directly or indirectly, that the dent…

NRS 695D.230 Advertising or materials used to enroll or solicit members: Approval of Commissioner; penalties. 1. Every organization for dental care must submit any advertising, or other materials to be used to enroll or solicit members, to the Commissioner for approval by the Com…

NRS 695D.240 Limitation on use of charges or premiums for marketing and administrative expenses; regulations. 1. The organization for dental care shall use not more than 25 percent of its prepaid charges or premiums for marketing and administrative expenses, including all costs t…

NRS 695D.250 Reserves: Maintenance; exception; held in fiduciary capacity; deposit; penalty for diversion or appropriation; regulations. 1. An organization for dental care shall set aside a reserve equal to 3 percent of the premiums collected from its members up to a total of $50…

NRS 695D.260 Annual report; financial statement; quarterly statement; administrative penalty for failure to file timely report or statement; extension of time; payment of premium tax and filing fee. 1. Every organization for dental care shall file with the Commissioner on or befo…

NRS 695D.270 Examination by Commissioner. 1. The Commissioner shall, not less frequently than once every 3 years, conduct an examination of an organization for dental care pursuant to NRS 679B.250 to 679B.300, inclusive. 2. The Commissioner may examine any organization which hold…

NRS 695D.280 Rehabilitation, liquidation or conservation: Conduct. Any rehabilitation, liquidation or conservation of an organization for dental care shall be deemed to be the rehabilitation, liquidation or conservation of an insurer and must be conducted pursuant to chapter 696B…

NRS 695D.290 Trade practices and frauds: Applicability of provisions to organizations for dental care. The provisions of NRS 686A.010 to 686A.310, inclusive, relating to trade practices and frauds apply to organizations for dental care. (Added to NRS by 1983, 2027; A 2023, 22)

NRS 695D.300 Disciplinary action: Grounds; penalties. 1. The Commissioner may suspend or revoke any certificate of authority issued to an organization for dental care or impose a fine of not more than $500 for each violation if the Commissioner finds that: (a) The organization is…

NRS 695D.310 Disciplinary or other action: Notice; hearing; order. 1. If the Commissioner believes that grounds for denying a certificate of authority or for suspending or revoking a certificate exist, the Commissioner shall notify the organization for dental care in writing, spe…