GENERAL PROVISIONS

NRS 695B.010. Short title.

NRS 695B.020. Scope.

NRS 695B.030. Definitions.

NRS 695B.035. Contract between corporation and provider of health care: Prohibiting corporation from charging provider of health care fee for inclusion on list of providers given to insureds; form for obtaining information on provider of health care; modification; schedule of fees.

ORGANIZATION

NRS 695B.040. Corporations authorized to undertake and operate plans.

NRS 695B.050. Manner of incorporation.

NRS 695B.060. Directors: Qualifications.

NRS 695B.070. Merger and consolidation: Procedure.

NRS 695B.080. Merger and consolidation: Continuance of contracts and contribution certificates.

NRS 695B.090. Merger and consolidation: Withdrawal of prior deposit of securities.

LICENSING; REGULATION

NRS 695B.110. Certificate of authority required; fees.

NRS 695B.120. Certificate of authority: Qualifications.

NRS 695B.130. Certificate of authority: Application; issuance.

NRS 695B.135. Certificate of authority: Expiration; renewal.

NRS 695B.140. Reserve fund: Minimum amounts; computation; contracts with hospitals; participation of physicians.

NRS 695B.150. Insolvency; determination of financial condition.

NRS 695B.160. Annual statement of condition and affairs; fees; examination by Commissioner.

NRS 695B.170. Acquisition costs and administrative expenses; effect of finding of excess costs.

NRS 695B.172. Summary of coverage: Contents of disclosure; approval by Commissioner.

NRS 695B.174. Summary of coverage: Copy to be provided before policy issued; policy not to be offered unless summary approved by Commissioner.

NRS 695B.176. Coverage for prescription drugs: Provision of notice and information regarding use of formulary.

CONTRACTS

General Provisions

NRS 695B.180. Required provisions.

NRS 695B.181. Provision in contract requiring binding arbitration authorized; procedures for arbitration; declaratory relief.

NRS 695B.182. Required procedure for arbitration of disputes concerning independent medical evaluations.

NRS 695B.185. Limitations on deductibles and copayments charged under group contract which offers difference of payment between preferred providers of health care and providers who are not preferred.

NRS 695B.187. Group contract issued to replace discontinued policy or coverage: Requirements; notice of reduction of benefits; statement of benefits; applicability to self-insured employer. [Effective through December 31, 2013.]

NRS 695B.187. Group contract issued to replace discontinued policy or coverage: Requirements; notice of reduction of benefits; statement of benefits; applicability to self-insured employer. [Effective January 1, 2014.]

NRS 695B.189. Continuation of coverage under group contract: Required provision. [Effective through December 31, 2013.]

NRS 695B.189. Continuation of coverage under group contract: Required provision. [Effective January 1, 2014.]

NRS 695B.190. Family contracts.

Coverage

NRS 695B.1901. Required provision concerning coverage for continued medical treatment.

NRS 695B.1903. Required provision concerning coverage for treatment as part of clinical trial or study.

NRS 695B.1905. Required provision concerning coverage for prescription drug previously approved for medical condition of insured.

NRS 695B.1907. Required provision concerning coverage for screening for colorectal cancer.

NRS 695B.1908. Required provision concerning coverage for certain drugs for treatment of cancer.

NRS 695B.1909. Required provision concerning coverage for orally administered chemotherapy.

NRS 695B.191. Required provision concerning coverage relating to mastectomy.

NRS 695B.1912. Required provision concerning coverage for cytologic screening tests and mammograms for certain women.

NRS 695B.1914. Required provision concerning coverage of certain gynecological and obstetrical services without authorization or referral from primary care physician.

NRS 695B.1916. Required provision concerning coverage of drug or device for contraception and of hormone replacement therapy in certain circumstances; prohibited actions by insurer; exceptions.

NRS 695B.1918. Required provision concerning coverage of health care services related to contraceptives and hormone replacement therapy in certain circumstances; prohibited actions by insurer; exceptions.

NRS 695B.192. Required provision concerning coverage relating to complications of pregnancy. [Effective through December 31, 2013.]

NRS 695B.192. Required provision concerning coverage relating to complications of pregnancy. [Effective January 1, 2014.]

NRS 695B.1923. Required provision concerning coverage for treatment of certain inherited metabolic diseases.

NRS 695B.1925. Required provision concerning coverage for human papillomavirus vaccine.

NRS 695B.1927. Required provision concerning coverage for management and treatment of diabetes.

NRS 695B.193. Required provision concerning coverage for newly born and adopted children and children placed for adoption.

NRS 695B.1931. Required provision concerning coverage relating to treatment of temporomandibular joint.

NRS 695B.1942. Required provision concerning coverage for prostate cancer screening.

NRS 695B.1944. Required provision concerning coverage for employee or member on leave without pay as result of total disability.

Reimbursement

NRS 695B.1951. Reimbursement for treatment by podiatrist.

NRS 695B.1955. Reimbursement for treatment by licensed clinical alcohol and drug abuse counselor.

NRS 695B.196. Reimbursement for acupuncture.

NRS 695B.197. Reimbursement for treatment by licensed psychologist.

NRS 695B.1973. Reimbursement for treatment by licensed marriage and family therapist or licensed clinical professional counselor.

NRS 695B.1975. Reimbursement for treatment by licensed associate in social work, social worker, independent social worker or clinical social worker.

NRS 695B.198. Reimbursement for treatment by chiropractor.

NRS 695B.199. Reimbursement for services provided by certain nurses; prohibited limitations; exception.

NRS 695B.1995. Reimbursement to provider of medical transportation.

Miscellaneous Provisions

NRS 695B.200. Group contracts written under master contract: Conditions required for issuance.

NRS 695B.210. Group master service contract: Required provisions.

NRS 695B.220. Blanket service contracts: Issuance to college, school or school personnel; pupils not to be compelled to accept service.

NRS 695B.225. Policies of group insurance: Order of benefits.

NRS 695B.230. Filing and approval of forms and schedules of premium rates.

NRS 695B.240. Provision of group service coverage before approval of forms.

NRS 695B.250. Extensions of time; automatic approval.

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.

CONVERSION OF GROUP CONTRACTS TO INDIVIDUAL CONTRACTS

NRS 695B.251. Group subscriber contracts to contain provision for conversion to individual contracts; exceptions. [Effective through December 31, 2013.]

NRS 695B.251. Group subscriber contracts to contain provision for conversion to individual contracts; exceptions. [Effective January 1, 2014.]

NRS 695B.252. Conversion privilege available to spouse and children; conditions.

NRS 695B.253. Denial of converted contract because of overinsurance; notice concerning cancellation of other coverage.

NRS 695B.254. Choice of types of contracts must be offered.

NRS 695B.255. Benefits exceeding those provided under group contract not required; exclusions and limitations.

NRS 695B.2555. Benefits payable under converted contract may be reduced by amount payable under group contract.

NRS 695B.256. Issuance and effective date of converted contract; premiums; persons covered.

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.

NRS 695B.257. Notice of conversion privilege.

NRS 695B.2575. Converted contract delivered outside Nevada: Form.

NRS 695B.258. Extension of coverage under existing group contract.

NRS 695B.2585. Group coverage may be provided in lieu of converted individual contract.

NRS 695B.259. Medical service corporation may continue identical coverage in lieu of converting contract. [Effective through December 31, 2013.]

NRS 695B.259. Medical service corporation may continue identical coverage in lieu of converting contract. [Effective January 1, 2014.]

MISCELLANEOUS PROVISIONS

NRS 695B.260. Suspension or revocation of permission to provide coverage before approval of forms.

NRS 695B.270. Disapproval of forms; issuance unlawful.

NRS 695B.280. Regulations; limitations.

NRS 695B.285. Use of Uniform Billing and Claims Forms authorized.

NRS 695B.290. Agent’s license required.

NRS 695B.300. Contracts with agencies or political subdivisions of United States or State of Nevada; acceptance of money; subcontracts.

NRS 695B.310. Corporation subject to same fees, licenses and supervision as domestic mutual insurer.

NRS 695B.315. Insurer to provide certain information regarding renewal of insurance policy upon request; fee.

NRS 695B.316. Corporation prohibited from denying coverage solely because person was victim of domestic violence.

NRS 695B.3165. Corporation prohibited from denying coverage solely because insured was intoxicated or under the influence of controlled substance; exceptions.

NRS 695B.317. Corporation that provides health insurance prohibited from requiring or using information concerning genetic testing; exceptions.

NRS 695B.318. Corporations are subject to certain provisions concerning portability and availability of health insurance. [Effective through December 31, 2013.]

NRS 695B.318. Corporations are subject to certain provisions concerning portability and availability of health insurance. [Effective January 1, 2014.]

NRS 695B.319. Offering policy of health insurance for purposes of establishing health savings account.

NRS 695B.320. Applicability of other provisions. [Effective through December 31, 2013.]

NRS 695B.320. Applicability of other provisions. [Effective January 1, 2014.]

ELIGIBILITY FOR COVERAGE

NRS 695B.330. Definitions.

NRS 695B.340. Effect of eligibility for medical assistance under Medicaid; assignment of rights to state agency.

NRS 695B.350. Corporation prohibited from asserting certain grounds to deny enrollment of child of insured pursuant to order.

NRS 695B.360. Certain accommodations to be made when child is covered under policy of noncustodial parent.

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

SYSTEM FOR RESOLVING COMPLAINTS OF INSUREDS

NRS 695B.380. Approval; requirements; examination.

NRS 695B.390. Annual report; insurer to maintain records of complaints concerning something other than health care services.

NRS 695B.400. Written notice to insured explaining right to file complaint; notice to insured required when insurer denies coverage of health care service.