Title 57

NRS 695B.220 Blanket service contracts: Issuance to college, school or school personnel; pupils not to be compelled to accept service. Blanket hospital or blanket medical or dental service contracts may be issued to a college or school or to the head or principal thereof or to th…

NRS 695B.225 Policies of group insurance: Order of benefits. A policy of group insurance determines its order of benefits using the first of the following which applies: 1. A policy that does not coordinate with other policies is always the primary policy. 2. The benefits of the …

NRS 695B.230 Filing and approval of forms and schedules of premium rates. If more than one class of risk is included: 1. A hospital or medical or dental service contract or evidence of coverage under a group or nongroup contract must not be issued or delivered in this state until…

NRS 695B.240 Provision of group service coverage before approval of forms. 1. A corporation subject to the provisions of this chapter is permitted to provide group hospital or group medical or dental service coverage prior to the approval of the form of the contract or certificat…

NRS 695B.250 Extensions of time; automatic approval. 1. Upon written request from the corporation subject to the provisions of this chapter filed within 50 days after the date on which the coverage is provided or agreed to be provided and upon proof satisfactory to the Commission…

NRS 695B.2505 Approval or denial of claims; payment of claims and interest; requests 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…

NRS 695B.251 Group subscriber contracts required to contain provision for conversion to individual contracts; exceptions. 1. Except as otherwise provided in the provisions of this section, NRS 689B.340 to 689B.580, inclusive, and chapter 689C of NRS relating to the portability an…

NRS 695B.252 Conversion privilege available to spouse and children; conditions. Subject to the conditions set forth in NRS 695B.251 to 695B.259, inclusive, the conversion privilege must also be made available: 1. To the surviving spouse, if any, upon the death of the employee or …

NRS 695B.253 Denial of converted contract because of overinsurance; notice concerning cancellation of other coverage. 1. The medical service corporation is not required to issue a converted contract to any person who: (a) Is covered for similar benefits by another hospital, surgi…

NRS 695B.254 Choice of types of contracts required to be offered. 1. A person who is entitled to a converted contract must be given a choice of at least three types of contracts offering benefits on a service basis or an expense-incurred basis, or both. 2. The converted contract …

NRS 695B.255 Benefits exceeding those provided under group contract not required; exclusions and limitations. A medical service corporation is not required to issue a converted contract which provides benefits in excess of those provided under the group contract from which conver…

NRS 695B.2555 Benefits payable under converted contract authorized to be reduced by amount payable under group contract; limitation. A converted contract may provide that any hospital, surgical or medical benefits payable under it may be reduced by the amount of any benefits paya…

NRS 695B.256 Issuance and effective date of converted contract; premiums; persons covered. The medical service corporation shall: 1. Issue the converted contract without evidence of insurability; 2. Base the premium on the converted policies for the first 12 months, and subsequen…

NRS 695B.2565 Renewal of converted contract: Request for information on sources of other benefits; grounds for refusal to renew; notice concerning cancellation of other coverage. 1. A converted contract issued under NRS 695B.251 may include a provision permitting the medical serv…

NRS 695B.257 Notice of conversion privilege. A notification of the conversion privilege must be included in each certificate of coverage. A written notice of the existence of the conversion privilege must also be given to the employee or member at least 15 days before the expirat…

NRS 695B.2575 Converted contract delivered outside Nevada: Form. A converted contract which is to be delivered outside this state must be in such form as would be deliverable in the other jurisdiction as a converted contract if the group contract had been issued in that jurisdict…

NRS 695B.258 Extension of coverage under existing group contract. The medical service corporation may elect to extend coverage of a subscriber under the existing group contract for a period not to exceed 6 months following the day of the person’s eligibility for a converted contr…

NRS 695B.2585 Provision of group coverage in lieu of converted individual contract. The medical service corporation may elect to provide group coverage in lieu of the issuance of a converted individual contract. (Added to NRS by 1979, 1089)

NRS 695B.259 Continuation of identical coverage in lieu of converted contract. The medical service corporation may continue coverage identical to that provided under the group contract instead of issuing a converted contract. Coverage may be offered by amending the group certific…

NRS 695B.260 Suspension or revocation of permission to provide coverage before approval of forms. The Commissioner may suspend or revoke the permission granted by NRS 695B.240 if, after notice and hearing, the Commissioner finds that the corporation has: 1. Misrepresented the con…

NRS 695B.270 Disapproval of forms; issuance unlawful. If the Commissioner notifies the corporation, in writing, that the filed form does not comply with the requirements of law, specifying the reasons for his or her opinion, it is unlawful for the corporation thereafter to issue …

NRS 695B.280 Regulations; limitations. The Commissioner may adopt such reasonable regulations, not inconsistent with the provisions of this chapter, relating to the substance, form and issuance of any contract covering the furnishing of hospital or medical or dental services and …

NRS 695B.285 Use of Uniform Billing and Claims Forms authorized. Every nonprofit hospital or medical or dental service corporation may utilize the Uniform Billing and Claims Forms established by the American Hospital Association. (Added to NRS by 1975, 897)

NRS 695B.290 Agent’s license required. Any agent of a nonprofit hospital or medical or dental service corporation who acts as such in the solicitation, negotiation, procurement or making of a hospital service or medical or dental care contract shall be qualified, examined and lic…

NRS 695B.300 Contracts with agencies or political subdivisions of United States or State of Nevada; acceptance of money; subcontracts. Any nonprofit hospital or medical or dental service corporation organized and created under the provisions of this chapter and engaged in the ope…

NRS 695B.310 Corporation subject to same taxes, licenses, fees and supervision as domestic mutual insurer. Any nonprofit hospital or medical or dental service corporation subject to the provisions of this chapter shall be subject to the same taxes, licenses, fees and, to the exte…

NRS 695B.315 Provision of information regarding claims by policyholder for renewal of insurance policy required upon request; fee; regulations. 1. If a policyholder requests information for the renewal of the policy of the policyholder, an insurer shall provide to the policyholde…

NRS 695B.316 Corporation prohibited from denying coverage solely because claim involves act that constitutes domestic violence or applicant or insured was victim of domestic violence. A corporation shall not deny a claim, refuse to issue a contract for hospital, medical or dental…

NRS 695B.3165 Corporation prohibited from denying coverage solely because applicant or insured was intoxicated or under the influence of controlled substance; exceptions. 1. Except as otherwise provided in subsection 2, a medical services corporation that issues contracts for hos…

NRS 695B.3167 Corporation prohibited from discriminating against person with respect to participation or coverage on basis of gender identity or expression. A hospital or medical services corporation that issues a policy of health insurance shall not discriminate against any pers…

NRS 695B.317 Corporation that provides health insurance prohibited from requiring or using information concerning genetic testing; exceptions. 1. Except as otherwise provided in subsection 2, a corporation that provides health insurance shall not: (a) Require an insured person or…

NRS 695B.318 Applicability of certain provisions concerning portability and availability of health insurance. 1. Nonprofit hospital, medical or dental service corporations are subject to the provisions of NRS 689B.340 to 689B.580, inclusive, and chapter 689C of NRS relating to th…

NRS 695B.319 Offering policy of health insurance for purposes of establishing health savings account. A corporation may, subject to regulation by the Commissioner, offer a policy of health insurance that has a high deductible and is in compliance with 26 U.S.C. § 223 for the purp…

NRS 695B.320 Applicability of other provisions. 1. Nonprofit hospital and medical or dental service corporations are subject to the provisions of this chapter, and to the provisions of chapters 679A and 679B of NRS, subsections 2, 4, 17, 18 and 30 of NRS 680B.010, NRS 680B.025 to…

NRS 695B.330 Definitions. As used in NRS 695B.330 to 695B.370, inclusive, unless the context otherwise requires: 1. “Contract” means a contract for hospital, medical or dental services issued pursuant to this chapter. 2. “Corporation” means a corporation organized pursuant to thi…

NRS 695B.340 Effect of eligibility for medical assistance under Medicaid; assignment of rights to state agency. 1. A corporation shall not, when considering eligibility for coverage or making payments under a contract, consider the availability of, or any eligibility of a person …

NRS 695B.350 Corporation prohibited from asserting certain grounds to deny enrollment of child of insured pursuant to order. A corporation shall not deny the enrollment of a child pursuant to an order for medical coverage under a contract pursuant to which a parent of the child i…

NRS 695B.360 Certain accommodations required to be made when child is covered under policy of noncustodial parent. If a child has coverage under a contract pursuant to which a noncustodial parent of the child is insured, the corporation issuing that contract shall: 1. Provide to …

NRS 695B.370 Corporation required to authorize enrollment of child of parent who is required by order to provide medical coverage under certain circumstances; termination of coverage of child. If a parent is required by an order for medical coverage to provide coverage for a chil…

NRS 695B.380 Establishment; approval; requirements; examination. 1. Except as otherwise provided in subsection 4, each insurer that issues a contract for hospital or medical services in this State shall establish a system for resolving any complaints of an insured concerning heal…

NRS 695B.390 Annual report; insurer required to maintain records of complaints concerning something other than health care services. 1. Each insurer that issues a contract for hospital or medical services in this State shall submit to the Commissioner an annual report regarding i…

NRS 695B.400 Written notice to insured required to be provided by insurer explaining right to file complaint; written notice to insured required when insurer denies coverage of health care service. 1. Following approval by the Commissioner, each insurer that issues a contract for…

NRS 695C.010 Short title. This chapter may be cited as the Nevada Health Maintenance Organization Act. (Added to NRS by 1973, 1246)

NRS 695C.020 Legislative declaration. The Legislature hereby declares that the rising cost of health services in recent years has led government agencies, private organizations, and legislative bodies to seek alternatives to the traditional medical delivery system which would pro…

NRS 695C.030 Definitions. As used in this chapter, unless the context otherwise requires: 1. “Comprehensive health care services” means medical services, dentistry, drugs, psychiatric and optometric and all other care necessary for the delivery of services to the consumer. 2. “En…

NRS 695C.050 Applicability of certain provisions. 1. Except as otherwise provided in this chapter or in specific provisions of this title, the provisions of this title are not applicable to any health maintenance organization granted a certificate of authority under this chapter.…