Nevada Revised Statutes (Last Updated: December 24, 2014) |
TITLE57 INSURANCE |
CHAPTER695B. Nonprofit Corporations for Hospital, Medical and Dental Service |
GENERAL PROVISIONS |
NRS 695B.010. Short title. |
NRS 695B.020. Scope. |
NRS 695B.030. Definitions. |
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.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.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. |