GENERAL PROVISIONS

NRS 689A.010. Short title.

NRS 689A.020. Scope. [Effective through December 31, 2013.]

NRS 689A.020. Scope. [Effective January 1, 2014.]

NRS 689A.030. General requirements. [Effective through December 31, 2013.]

NRS 689A.030. General requirements. [Effective January 1, 2014.]

NRS 689A.035. Contracts between insurer and provider of health care: Prohibiting insurer from charging provider of health care fee for inclusion on list of providers given to insureds; form to obtain information on provider of health care; modification; providing schedule of fees.

REQUIRED PROVISIONS

NRS 689A.040. Contents of policy; substitution of provisions; captions; omission or modification of provisions. [Effective through December 31, 2013.]

NRS 689A.040. Contents of policy; substitution of provisions; captions; omission or modification of provisions. [Effective January 1, 2014.]

NRS 689A.0403. Procedure for arbitration of disputes concerning independent medical evaluations.

NRS 689A.04033. Coverage for treatment received as part of clinical trial or study.

NRS 689A.04036. Coverage for continued medical treatment.

NRS 689A.0404. Coverage for use of certain drugs for treatment of cancer.

NRS 689A.04042. Coverage for screening for colorectal cancer.

NRS 689A.04045. Coverage for prescription drug previously approved for medical condition of insured.

NRS 689A.0405. Coverage for cytologic screening test and mammograms for certain women.

NRS 689A.041. Coverage relating to mastectomy.

NRS 689A.0413. Coverage for certain gynecological or obstetrical services without authorization or referral from primary care physician.

NRS 689A.0415. Coverage for drug or device for contraception and for hormone replacement therapy in certain circumstances; prohibited actions by insurer; exceptions.

NRS 689A.0417. Coverage for health care services related to contraceptives and hormone replacement therapy in certain circumstances; prohibited actions by insurer; exceptions.

NRS 689A.042. Coverage relating to complications of pregnancy.

NRS 689A.0423. Coverage for treatment of certain inherited metabolic diseases.

NRS 689A.0425. Individual health benefit plan that includes coverage for maternity care and pediatric care: Requirement to allow minimum stay in hospital in connection with childbirth; prohibited acts.

NRS 689A.0427. Coverage for management and treatment of diabetes.

NRS 689A.043. Coverage of newly born and adopted children and children placed for adoption.

NRS 689A.0435. Coverage for autism spectrum disorders.

NRS 689A.044. Coverage for human papillomavirus vaccine. [Effective through December 31, 2013.]

NRS 689A.044. Coverage for human papillomavirus vaccine. [Effective January 1, 2014.]

NRS 689A.0445. Coverage for prostate cancer screening.

NRS 689A.0447. Coverage for orally administered chemotherapy.

NRS 689A.045. Termination of coverage on dependent child. [Effective through December 31, 2013.]

NRS 689A.0455. Coverage for treatment of conditions relating to severe mental illness. [Effective through December 31, 2013.]

NRS 689A.0455. Coverage for treatment of conditions relating to severe mental illness. [Effective January 1, 2014.]

NRS 689A.046. Benefits for treatment of abuse of alcohol or drugs.

NRS 689A.0465. Coverage of treatment of temporomandibular joint.

REIMBURSEMENT FOR CERTAIN MEDICALLY RELATED TREATMENT AND SERVICES

NRS 689A.0475. Acupuncture.

NRS 689A.048. Treatment by licensed psychologist.

NRS 689A.0483. Treatment by licensed marriage and family therapist or licensed clinical professional counselor.

NRS 689A.0485. Treatment by licensed associate in social work, social worker, independent social worker or clinical social worker.

NRS 689A.0487. Treatment by licensed podiatrist.

NRS 689A.049. Treatment by licensed chiropractor; restriction on policy limitations.

NRS 689A.0493. Treatment by licensed clinical alcohol and drug abuse counselor.

NRS 689A.0495. Services provided by certain registered nurses; restriction on policy limitations; exception.

NRS 689A.0497. Provider of medical transportation.

MISCELLANEOUS PROVISIONS

NRS 689A.050. Entire contract; changes.

NRS 689A.060. Time limit on certain defenses.

NRS 689A.070. Grace period.

NRS 689A.080. Reinstatement.

NRS 689A.090. Notice of claim.

NRS 689A.100. Claim forms: Required provision.

NRS 689A.105. Claim forms: Uniform billing, claims forms.

NRS 689A.110. Claim forms: Acceptance of uniform forms.

NRS 689A.120. Time of payment of claims.

NRS 689A.130. Payment of claims.

NRS 689A.135. Assignment of benefits to provider of health care.

NRS 689A.140. Physical examination and autopsy.

NRS 689A.150. Legal actions.

NRS 689A.160. Change of beneficiary.

NRS 689A.170. Right to examine and return policy.

NRS 689A.180. Optional provisions.

NRS 689A.190. Extended disability benefit.

NRS 689A.200. Change of occupation.

NRS 689A.210. Misstatement of age.

NRS 689A.220. Coordination of benefits: Same insurer.

NRS 689A.230. Coordination of benefits: All coverages. [Effective through December 31, 2013.]

NRS 689A.230. Coordination of benefits: All coverages. [Effective January 1, 2014.]

NRS 689A.240. Relation of earnings to insurance.

NRS 689A.250. Unpaid premiums.

NRS 689A.260. Conformity with state statutes.

NRS 689A.270. Illegal occupation.

NRS 689A.290. Renewability.

NRS 689A.300. Order of certain provisions.

NRS 689A.310. Ownership of policy by person other than insured.

NRS 689A.320. Requirements of other jurisdictions.

NRS 689A.330. Policies issued for delivery in another state.

NRS 689A.340. Limitation on provisions not subject to chapter; effect of violation.

NRS 689A.350. Age limit.

NRS 689A.370. Health insurance on franchise plan. [Effective through December 31, 2013.]

NRS 689A.380. Definitions of terms used in policies.

NRS 689A.390. Summary of coverage: Contents of disclosure; approval by Commissioner.

NRS 689A.400. Summary of coverage: Copy to be provided before policy issued; policy may not be offered unless summary approved by Commissioner.

NRS 689A.405. Coverage for prescription drugs: Provision of notice and information regarding use of formulary.

NRS 689A.410. Approval or denial of claims; payment of claims and interest; requests for additional information; award of costs and attorney’s fees; compliance with requirements.

NRS 689A.413. Insurer prohibited from denying coverage solely because person was victim of domestic violence.

NRS 689A.415. Insurer prohibited from denying coverage solely because insured was intoxicated or under influence of controlled substance; exceptions.

NRS 689A.417. Insurer prohibited from requiring or using information concerning genetic testing; exceptions.

NRS 689A.419. Offering policy of health insurance for purposes of establishing health savings account.

ELIGIBILITY FOR COVERAGE

NRS 689A.420. Definitions.

NRS 689A.430. Effect of eligibility for medical assistance under Medicaid; assignment of rights to state agency.

NRS 689A.440. Insurer prohibited from asserting certain grounds to deny enrollment of child of insured pursuant to order.

NRS 689A.450. Certain accommodations to be made when child is covered under policy of noncustodial parent.

NRS 689A.460. Insurer to authorize enrollment of child of parent who is required by order to provide medical coverage under certain circumstances; termination of coverage of child.

PORTABILITY AND ACCOUNTABILITY

General Provisions

NRS 689A.470. Definitions. [Effective through December 31, 2013.]

NRS 689A.470. Definitions. [Effective January 1, 2014.]

NRS 689A.475. “Affiliated” defined.

NRS 689A.480. “Basic health benefit plan” defined. [Effective through December 31, 2013.]

NRS 689A.485. “Bona fide association” defined.

NRS 689A.490. “Church plan” defined.

NRS 689A.495. “Control” defined.

NRS 689A.500. “Converted policy” defined. [Effective through December 31, 2013.]

NRS 689A.505. “Creditable coverage” defined.

NRS 689A.510. “Dependent” defined.

NRS 689A.515. “Eligible person” defined. [Effective through December 31, 2013.]

NRS 689A.520. “Established geographic service area” defined. [Effective through December 31, 2013.]

NRS 689A.523. “Exclusion for a preexisting condition” defined.

NRS 689A.525. “Geographic area” defined. [Effective through December 31, 2013.]

NRS 689A.525. “Geographic rating area” defined. [Effective January 1, 2014.]

NRS 689A.527. “Geographic service area” defined. [Effective January 1, 2014.]

NRS 689A.530. “Governmental plan” defined.

NRS 689A.535. “Group health plan” defined.

NRS 689A.540. “Health benefit plan” defined.

NRS 689A.545. “Health status-related factor” defined. [Effective through December 31, 2013.]

NRS 689A.550. “Individual carrier” defined.

NRS 689A.555. “Individual health benefit plan” defined.

NRS 689A.560. “Individual reinsuring carrier” defined. [Effective through December 31, 2013.]

NRS 689A.565. “Individual risk-assuming carrier” defined. [Effective through December 31, 2013.]

NRS 689A.570. “Plan for coverage of a bona fide association” defined.

NRS 689A.575. “Plan of operation” defined. [Effective through December 31, 2013.]

NRS 689A.580. “Plan sponsor” defined.

NRS 689A.585. “Preexisting condition” defined.

NRS 689A.590. “Producer” defined.

NRS 689A.595. “Program of Reinsurance” defined. [Effective through December 31, 2013.]

NRS 689A.600. “Provision for a restricted network” defined.

NRS 689A.605. “Standard health benefit plan” defined. [Effective through December 31, 2013.]

NRS 689A.610. Applicability; ceding arrangement prohibited in certain circumstances. [Effective through December 31, 2013.]

NRS 689A.615. Certain plan, fund or program to be treated as employee welfare benefit plan which is group health plan; partnership deemed employer of each partner.

NRS 689A.620. Certain person with break in coverage deemed eligible person. [Effective through December 31, 2013.]

Individual Carriers

NRS 689A.630. Requirement to renew coverage at option of individual; exceptions; discontinuation of form of product of health benefit plan; discontinuation of health benefit plan available through bona fide association. [Effective through December 31, 2013.]

NRS 689A.630. Requirement to renew coverage at option of individual; exceptions; discontinuation of form of product of health benefit plan; discontinuation of health benefit plan available through bona fide association. [Effective January 1, 2014.]

NRS 689A.635. Coverage offered through network plan not required to be offered to eligible person who does not reside or work in established geographic service area. [Effective through December 31, 2013.]

NRS 689A.635. Coverage offered through network plan not required to be offered to person who does not reside or work in geographic service area or geographic rating area. [Effective January 1, 2014.]

NRS 689A.637. Coverage offered through plan that provides for restricted network: Contracts with certain federally qualified health centers. [Effective through December 31, 2013.]

NRS 689A.637. Coverage offered through plan that provides for restricted network: Contracts with certain federally qualified health centers. [Effective January 1, 2014.]

NRS 689A.640. Each health benefit plan marketed in this State required to be offered to eligible persons. [Effective through December 31, 2013.]

NRS 689A.645. Coverage to eligible person who does not reside in established geographic service area not required; coverage within certain areas not required. [Effective through December 31, 2013.]

NRS 689A.650. Coverage to eligible persons not required under certain circumstances; notice to Commissioner of and prohibition on writing new business after election not to offer new coverage required. [Effective through December 31, 2013.]

NRS 689A.655. Requirement to file basic and standard health benefit plans with Commissioner; disapproval of plan. [Effective through December 31, 2013.]

NRS 689A.660. Prohibited acts concerning preexisting conditions and modification of health benefit plan. [Effective through December 31, 2013.]

NRS 689A.665. Certain health carriers not required to offer health benefit insurance coverage to individuals. [Effective through December 31, 2013.]

NRS 689A.670. Election to operate as individual risk-assuming carrier or individual reinsuring carrier: Notice to Commissioner; effective date; change in status. [Effective through December 31, 2013.]

NRS 689A.675. Election to act as individual risk-assuming carrier: Suspension by Commissioner; applicable statutes. [Effective through December 31, 2013.]

NRS 689A.680. Rates for individual health benefit plans to be developed based on rating characteristics: Prohibited characteristics; health status as rating factor. [Effective through December 31, 2013.]

NRS 689A.685. Amount of change in rate of single block of business; plan with provision for restricted network; involuntary transfer of individual or dependent prohibited; premiums adjusted for block of business. [Effective through December 31, 2013.]

NRS 689A.690. Information required to be disclosed as part of solicitation and sales materials; information required to be maintained at place of business; actuarial certification required to be filed with Commissioner. [Effective through December 31, 2013.]

NRS 689A.690. Information required to be disclosed as part of solicitation and sales materials; information required to be maintained at place of business. [Effective January 1, 2014.]

NRS 689A.695. Information and documents to be made available to Commissioner; proprietary information. [Effective through December 31, 2013.]

NRS 689A.695. Information and documents to be made available to Commissioner; proprietary information. [Effective January 1, 2014.]

NRS 689A.700. Regulations regarding rates. [Effective through December 31, 2013.]

NRS 689A.700. Regulations regarding rates. [Effective January 1, 2014.]

NRS 689A.705. Regulations concerning reissuance of health benefit plan.

NRS 689A.710. Prohibited acts; denial of application for coverage; regulations; violation may constitute unfair trade practice; applicability of section. [Effective through December 31, 2013.]

NRS 689A.710. Prohibited acts; denial of application for coverage; regulations; violation may constitute unfair trade practice; applicability of section. [Effective January 1, 2014.]

Individual Health Insurance Coverage

NRS 689A.715. Requirements for employee welfare benefit plan for providing benefits for employees of more than one employer.

NRS 689A.720. Written certification of coverage required for determining period of creditable coverage accumulated by person; provision of certificate to insured.

Bona Fide Associations

NRS 689A.725. Requirements for plan for coverage. [Effective through December 31, 2013.]

NRS 689A.725. Requirements for plan for coverage. [Effective January 1, 2014.]

NRS 689A.730. Producer may only sign up eligible persons if eligible persons are actively engaged in or related to association. [Effective through December 31, 2013.]

Miscellaneous Provisions

NRS 689A.740. Regulations.

SYSTEM FOR RESOLVING COMPLAINTS OF INSUREDS

NRS 689A.745. Approval; requirements; examination.

NRS 689A.750. Annual report; insurer to maintain records of complaints concerning something other than health care services.

NRS 689A.755. Written notice to insured explaining right to file complaint; notice to insured required when insurer denies coverage of health care service.