NRS689B.590. Converted policies: Carrier may only offer choice of basic and standard plans; election of basic or standard plan; premium; rates must be same for persons with similar case characteristics; losses must be spread across book. [Effective through December 31, 2013.]

      1.  Not later than 180 days after the date on which the basic and standard health benefit plans are approved pursuant to NRS 689C.770 as part of the plan of operation of the Program of Reinsurance, each carrier required to offer to a person a converted policy pursuant to NRS 689B.120 shall only offer as a converted policy a choice of the basic and standard health benefit plans.

      2.  A person with a converted policy issued before the effective date of the requirement set forth in subsection 1 may, at each annual renewal of the converted policy elect a basic or standard health benefit plan as a substitute converted policy, except that the carrier may, if the person has not made an election within 3 years after first becoming eligible to do so, require the person to make such an election. Once a person has elected the basic or standard health benefit plan as a substitute converted policy, the person may not elect another converted policy.

      3.  The premium for a converted policy may not exceed the small group index rate, as defined in paragraph (b) of subsection 3 of NRS 689C.230, applicable to the carrier by more than 75 percent. The small group index rate used by a carrier that does not write insurance to small employers in this state must be the average small group index rate, as determined by the Commissioner, of the five largest carriers that provide coverage to small employers pursuant to this chapter for their basic and standard health benefit plans. The Commissioner shall annually determine the average small group index rate, as measured by the premium volume of the plans, of those five largest carriers.

      4.  The rates for new and renewal converted policies for persons with the same converted policies whose case characteristics are similar must be the same.

      5.  Any losses suffered by a carrier on its converted policies issued pursuant to this section must be spread across the entire book of the health benefit coverage of the carrier issued or delivered for issuance to small employers and large group employers in this state.

      6.  The Commissioner shall adopt such regulations as are necessary to carry out the provisions of this section.

      (Added to NRS by 1997, 2911; A 1999, 2810; R 2013, 3661, effective January 1, 2014)