NRS689C.191. Determination of applicable creditable coverage of person; determining period of creditable coverage of person; required statement; applicability. [Effective January 1, 2014.]

      1.  In determining the applicable creditable coverage of a person, a period of creditable coverage must not be included if, after the expiration of that period but before the enrollment date, there was a 63-day period during all of which the person was not covered under any creditable coverage. To establish a period of creditable coverage, an eligible employee must present any certificates of coverage provided to the eligible employee in accordance with NRS 689C.192 and such other evidence of coverage as required by regulations adopted by the Commissioner. For the purposes of this subsection, any waiting period for coverage or an affiliation period must not be considered in determining the applicable period of creditable coverage.

      2.  In determining the period of creditable coverage of a person, a carrier shall include each applicable period of creditable coverage without regard to the specific benefits covered during that period, except that the carrier may elect to include applicable periods of creditable coverage based on coverage of specific benefits as specified by the United States Department of Health and Human Services by regulation, if such an election is made on a uniform basis for all participants and beneficiaries of the health benefit plan or coverage. Pursuant to such an election, the carrier shall include each applicable period of creditable coverage with respect to any class or category of benefits if any level of benefits is covered within that class or category, as specified by those regulations.

      3.  Regardless of whether coverage is actually provided, if a carrier elects in accordance with subsection 2 to determine creditable coverage based on specified benefits, a statement that such an election has been made and a description of the effect of the election must be:

      (a) Included prominently in any disclosure statement concerning the health benefit plan; and

      (b) Provided to each eligible employee at the time of enrollment in the health benefit plan.

      4.  The provisions of this section apply only to grandfathered plans.

      (Added to NRS by 1997, 2926; A 2013, 3630, effective January 1, 2014)