EXPLANATION – Matter in bolded italics is new; matter between brackets [omitted material] is material to be omitted. Green numbers along left margin indicate location on the printed bill (e.g., 5-15 indicates page 5, line 15).

1-1 Section 1. NRS 679B.130 is hereby amended to read as follows:

1-2 679B.130 1. The commissioner may adopt reasonable regulations for

1-11 with any such regulation, notwithstanding that the regulation may, after the

2-1 act or omission, be amended, rescinded or determined by a judicial or other

2-2 authority to be invalid for any reason.

2-3 Sec. 2. Chapter 689A of NRS is hereby amended by adding thereto the

2-4 provisions set forth as sections 3 and 4 of this act.

2-5 Sec. 3. An insurer shall, at the request of an insured or provider of

2-6 health care with whom it has a contract for the provision of health care

2-7 services, promptly provide the insured or provider of health care with an

2-8 estimate of the rate at which the provider of health care will be

2-9 reimbursed for providing a health care service to the insured and the

2-10 amount of money for which the insured will be responsible for the health

2-11 care service.

2-12 Sec. 4. 1. If an insured requires health care services that may be

2-13 provided only by a specialist and his insurer does not have a contract for

2-14 the provision of health care services with such a specialist who is located

2-15 within 75 miles from the residence of the insured, the insurer shall

2-16 reimburse a specialist who is located within 75 miles from the residence

2-17 of the insured for specialized health care services that are provided to the

2-18 insured by that specialist.

2-19 2. An insurer shall reimburse a specialist pursuant to the provisions

2-20 of this section in a reasonable amount that is not less than the amount

2-21 the insurer would reimburse a specialist with whom it has a contract for

2-22 the provision of health care services.

2-23 Sec. 5. Chapter 689B of NRS is hereby amended by adding thereto

2-24 the provisions set forth as sections 6 and 7 of this act.

2-25 Sec. 6. An insurer that issues a policy of group health insurance

2-26 shall, at the request of an insured or provider of health care with whom it

2-27 has a contract for the provision of health care services, promptly provide

2-28 the insured or provider of health care with an estimate of the rate at

2-29 which the provider of health care will be reimbursed for providing a

2-30 health care service to the insured and the amount of money for which the

2-31 insured will be responsible for the health care service.

2-32 Sec. 7. 1. If an insured requires health care services that may be

2-33 provided only by a specialist and his insurer that issues a policy of group

2-34 health insurance does not have a contract for the provision of health care

2-35 services with such a specialist who is located within 75 miles from the

2-36 residence of the insured, the insurer shall reimburse a specialist who is

2-37 located within 75 miles from the residence of the insured for specialized

2-38 health care services that are provided to the insured by that specialist.

2-39 2. An insurer that issues a policy of group health insurance shall

2-40 reimburse a specialist pursuant to the provisions of this section in a

2-41 reasonable amount that is not less than the amount the insurer would

2-42 reimburse a specialist with whom it has a contract for the provision of

2-43 health care services.

3-1 Sec. 8. Chapter 695A of NRS is hereby amended by adding thereto

3-2 the provisions set forth as sections 9 and 10 of this act.

3-3 Sec. 9. A society shall, at the request of an insured or provider of

3-4 health care with whom it has a contract for the provision of health care

3-5 services, promptly provide the insured or provider of health care with an

3-6 estimate of the rate at which the provider of health care will be

3-7 reimbursed for providing a health care service to the insured and the

3-8 amount of money for which the insured will be responsible for the health

3-9 care service.

3-10 Sec. 10. 1. If an insured requires health care services that may be

3-11 provided only by a specialist and his society does not have a contract for

3-12 the provision of health care services with such a specialist who is located

3-13 within 75 miles from the residence of the insured, the society shall

3-14 reimburse a specialist who is located within 75 miles from the residence

3-15 of the insured for specialized health care services that are provided to the

3-16 insured by that specialist.

3-17 2. A society shall reimburse a specialist pursuant to the provisions of

3-18 this section in a reasonable amount that is not less than the amount the

3-19 society would reimburse a specialist with whom it has a contract for the

3-20 provision of health care services.

3-21 Sec. 11. Chapter 695B of NRS is hereby amended by adding thereto

3-22 the provisions set forth as sections 12 and 13 of this act.

3-23 Sec. 12. A corporation subject to the provisions of this chapter shall,

3-24 at the request of an insured or provider of health care with whom it has a

3-25 contract for the provision of health care services, promptly provide the

3-26 insured or provider of health care with an estimate of the rate at which

3-27 the provider of health care will be reimbursed for providing a health care

3-28 service to the insured and the amount of money for which the insured

3-29 will be responsible for the health care service.

3-30 Sec. 13. 1. If an insured requires health care services that may be

3-31 provided only by a specialist and his corporation, subject to the

3-32 provisions of this chapter, does not have a contract for the provision of

3-33 health care services with such a specialist who is located within 75 miles

3-34 from the residence of the insured, the corporation shall reimburse a

3-35 specialist who is located within 75 miles from the residence of the insured

3-36 for specialized health care services that are provided to the insured by

3-37 that specialist.

3-38 2. A corporation subject to the provisions of this chapter shall

3-39 reimburse a specialist pursuant to the provisions of this section in a

3-40 reasonable amount that is not less than the amount the corporation

3-41 would reimburse a specialist with whom it has a contract for the

3-42 provision of health care services.

4-1 Sec. 14. Chapter 695C of NRS is hereby amended by adding thereto

4-2 the provisions set forth as sections 15 and 16 of this act.

4-3 Sec. 15. A health maintenance organization shall, at the request of

4-4 an enrollee or provider of health care with whom it has a contract for the

4-5 provision of health care services, promptly provide the enrollee or

4-6 provider of health care with an estimate of the rate at which the provider

4-7 of health care will be reimbursed for providing a health care service to

4-8 the enrollee and the amount of money for which the enrollee will be

4-9 responsible for the health care service.

4-10 Sec. 16. 1. If an enrollee requires health care services that may be

4-11 provided only by a specialist and his health maintenance organization

4-12 does not have a contract for the provision of health care services with

4-13 such a specialist who is located within 75 miles from the residence of the

4-14 enrollee, the health maintenance organization shall reimburse a

4-15 specialist who is located within 75 miles from the residence of the

4-16 enrollee for specialized health care services that are provided to the

4-17 enrollee by that specialist.

4-18 2. A health maintenance organization shall reimburse a specialist

4-19 pursuant to the provisions of this section in a reasonable amount that is

4-20 not less than the amount the health maintenance organization would

4-21 reimburse a specialist with whom it has a contract for the provision of

4-22 health care services.

4-23 Sec. 17. NRS 695C.050 is hereby amended to read as follows:

4-24 695C.050 1. Except as otherwise provided in this chapter or in

4-43 This subsection does not exempt a health maintenance organization from

5-1 any provision of this chapter for services provided pursuant to any other

5-2 contract.

5-3 Sec. 18. NRS 695F.090 is hereby amended to read as follows:

5-4 695F.090 Prepaid limited health service organizations are subject to

5-28 11. Chapter 692C of NRS, concerning holding companies.

5-29 Sec. 19. Chapter 287 of NRS is hereby amended by adding thereto a

5-30 new section to read as follows:

5-31 Any health insurance provided by the committee on benefits through a

5-32 plan of self-insurance must comply with the provisions of NRS 689B.255,

5-33 695G.150, 695G.160, 695G.170, 695G.200 to 695G.230, inclusive, and

5-34 sections 6 and 7 of this act in the same manner as an insurer subject to

5-35 the provisions of Title 57 of NRS.

5-36 Sec. 20. NRS 287.043 is hereby amended to read as follows:

5-37 287.043 The committee on benefits shall:

5-42 persons who participate in the state’s program of group insurance.

6-1 2. Except as otherwise provided in this subsection, negotiate and

6-2 contract with the governing body of any public agency enumerated in NRS

6-3 287.010 which is desirous of obtaining group insurance for its officers,

6-4 employees and retired employees by participation in the state’s program of

6-5 group insurance. The committee shall establish separate rates and coverage

6-6 for those officers, employees and retired employees based on actuarial

6-7 reports.

6-8 3. Give public notice in writing of proposed changes in rates or

6-9 coverage to each participating public employer who may be affected by the

6-10 changes. Notice must be provided at least 30 days before the effective date

6-11 of the changes.

6-12 4. Purchase policies of life, accident or health insurance, or any

6-13 combination of these, or a program to reduce the amount of taxable

6-14 compensation pursuant to 26 U.S.C. § 125, from any company qualified to

6-15 do business in this state or provide similar coverage through a plan of self-

6-16 insurance for the benefit of all eligible public officers, employees and

6-17 retired employees who participate in the state’s program.

6-18 5. Consult the state risk manager and obtain his advice in the

6-19 performance of the duties set forth in this section.

6-20 6. Except as otherwise provided in this Title, develop and establish

6-21 other employee benefits as necessary.

6-22 7. Adopt such regulations and perform such other duties as are

6-23 necessary to carry out the provisions of NRS 287.041 to 287.049,

6-24 inclusive, and section 19 of this act, including the establishment of:

6-25 (a) Fees for applications for participation in the state’s program and for

6-26 the late payment of premiums;

6-27 (b) Conditions for entry and reentry into the state’s program by public

6-28 agencies enumerated in NRS 287.010; and

6-29 (c) The levels of participation in the state’s program required for

6-30 employees of participating public agencies.

6-31 8. Appoint an independent certified public accountant. The accountant

6-32 shall provide an annual audit of the plan and report to the committee and

6-33 the legislative commission.

6-34 For the purposes of this section, "employee benefits" includes any form of

6-35 compensation provided to a state employee pursuant to this Title except

6-36 federal benefits, wages earned, legal holidays, deferred compensation and

6-37 benefits available pursuant to chapter 286 of NRS.

6-38 Sec. 21. NRS 287.0432 is hereby amended to read as follows:

6-39 287.0432 The committee on benefits shall by regulation provide for