Assembly Bill No. 680–Committee on Commerce and Labor
(On Behalf of Division of Insurance)
March 22, 1999
____________
Referred to Committee on Commerce and Labor
SUMMARY—Makes various changes to provisions relating to insurance. (BDR 57-651)
FISCAL NOTE: Effect on Local Government: No.
Effect on the State or on Industrial Insurance: No.
~
EXPLANATION – Matter in
bolded italics is new; matter between brackets
THE PEOPLE OF THE STATE OF NEVADA, REPRESENTED IN SENATE AND ASSEMBLY, DO ENACT AS FOLLOWS:
1-1
Section 1. Chapter 679A of NRS is hereby amended by adding thereto1-2
a new section to read as follows:1-3
The expiration or voluntary surrender of a license or certificate issued1-4
pursuant to the provisions of this code does not:1-5
1. Prohibit the commissioner from initiating or continuing a1-6
disciplinary proceeding against the holder of the license or certificate; or1-7
2. Prevent the imposition or collection of any fine or penalty1-8
authorized pursuant to the provisions of this code against the holder of1-9
the license or certificate.1-10
Sec. 2. NRS 679B.190 is hereby amended to read as follows: 679B.190 1. The commissioner shall carefully preserve in the1-12
division and in permanent form all papers and records relating to the2-1
business and transactions of the division and shall hand them over to his2-2
successor in office.2-3
2. Except as otherwise provided in subsections 3, 5 and 6 ,2-4
provisions of this code and NRS 616B.015, the papers and records must be2-5
open to public inspection.2-6
3. Any records or information in the possession of the division related2-7
to an investigation2-8
confidential2-9
(a) The commissioner releases, in the manner that he deems appropriate,2-10
all or any part of the records or information for public inspection after2-11
determining that the release of the records or information:2-12
(1) Will not harm his investigation2-13
who is being investigated ;2-14
(2) Serves the interests of a policyholder, the shareholders of the2-15
insurer or the public; or2-16
(b) A court orders the release of the records or information after2-17
determining that the production of the records or information will not2-18
damage any investigation being conducted by the commissioner.2-19
4. The commissioner may destroy unneeded or obsolete records and2-20
filings in the division in accordance with provisions and procedures2-21
applicable in general to administrative agencies of this state.2-22
5. The commissioner may classify as confidential certain records and2-23
information obtained from a governmental agency or other sources upon2-24
the express condition that they remain confidential.2-25
6. All information and documents in the possession of the division or2-26
any of its employees which are related to cases or matters under2-27
investigation2-28
confidential for the2-29
may not be made public unless the commissioner finds the existence of an2-30
imminent threat of harm to the safety or welfare of the policyholder,2-31
shareholders or the public and determines that the interests of the2-32
policyholder, shareholders or the public will be served by publication2-33
thereof, in which event he may make a record public or publish all or any2-34
part of the record in any manner he deems appropriate.2-35
Sec. 3. NRS 679B.440 is hereby amended to read as follows: 679B.440 1. The commissioner may require that reports submitted2-37
pursuant to NRS 679B.430 include, without limitation, information2-38
regarding:2-39
(a) Liability insurance provided to:2-40
(1) Governmental agencies and political subdivisions of this state,2-41
reported separately for:2-42
(I) Cities and towns;2-43
(II) School districts; and3-1
(III) Other political subdivisions;3-2
(2) Public officers;3-3
(3) Establishments where alcoholic beverages are sold;3-4
(4) Facilities for the care of children;3-5
(5) Labor, fraternal or religious organizations; and3-6
(6) Officers or directors of organizations formed pursuant to Title 73-7
of NRS, reported separately for nonprofit entities and entities organized for3-8
profit;3-9
(b) Liability insurance for:3-10
(1) Defective products;3-11
(2) Medical malpractice;3-12
(3) Malpractice of attorneys;3-13
(4) Malpractice of architects and engineers; and3-14
(5) Errors and omissions by other professionally qualified persons;3-15
3-16
(c) Vehicle insurance, reported separately for:3-17
(1) Private vehicles;3-18
(2) Commercial vehicles;3-19
(3) Liability insurance; and3-20
(4) Insurance for property damage3-21
(d) Workers’ compensation insurance.3-22
2. The commissioner may require that the report include, without3-23
limitation, information specifically pertaining to this state or to an insurer in3-24
its entirety, in the aggregate or by type of insurance, and for a previous or3-25
current year, regarding:3-26
(a) Premiums directly written;3-27
(b) Premiums directly earned;3-28
(c) Number of policies issued;3-29
(d) Net investment income, using appropriate estimates when necessary;3-30
(e) Losses paid;3-31
(f) Losses incurred;3-32
(g) Loss reserves, including:3-33
(1) Losses unpaid on reported claims; and3-34
(2) Losses unpaid on incurred but not reported claims;3-35
(h) Number of claims, including:3-36
(1) Claims paid; and3-37
(2) Claims that have arisen but are unpaid;3-38
(i) Expenses for adjustment of losses, including allocated and3-39
unallocated losses;3-40
(j) Net underwriting gain or loss;3-41
(k) Net operation gain or loss, including net investment income; and3-42
(l) Any other information requested by the commissioner.4-1
3. The commissioner may also obtain, based upon an insurer in its4-2
entirety, information regarding:4-3
(a) Recoverable federal income tax;4-4
(b) Net unrealized capital gain or loss; and4-5
(c) All other expenses not included in subsection 2.4-6
Sec. 4. NRS 680B.010 is hereby amended to read as follows: 680B.010 The commissioner shall collect in advance and receipt for,4-8
and persons so served must pay to the commissioner, fees and4-9
miscellaneous charges as follows:4-10
1. Insurer’s certificate of authority:4-11
(a) Filing initial application $2,4504-12
(b) Issuance of certificate:4-13
(1) For any one kind of insurance as defined in NRS4-14
681A.010 to 681A.080, inclusive 2834-15
(2) For two or more kinds of insurance as so defined 5784-16
(3) For a reinsurer 2,4504-17
(c) Each annual continuation of a certificate 2,4504-18
(d) Reinstatement pursuant to NRS 680A.180, 50 percent of4-19
the annual continuation fee otherwise required.4-20
(e) Registration of additional title pursuant to NRS 680A.240 504-21
(f) Annual renewal of the registration of additional title4-22
pursuant to NRS 680A.240 254-23
2. Charter documents, other than those filed with an4-24
application for a certificate of authority. Filing amendments to4-25
articles of incorporation, charter, bylaws, power of attorney and4-26
other constituent documents of the insurer, each document $104-27
3. Annual statement or report. For filing annual statement or4-28
report $254-29
4. Service of process:4-30
(a) Filing of power of attorney $54-31
(b) Acceptance of service of process 304-32
5. Agents’ licenses, appointments and renewals:4-33
(a) Resident agents and nonresident agents qualifying under4-34
subsection 3 of NRS 683A.340:4-35
(1) Application and license $784-36
(2) Appointment by each insurer 54-37
(3) Triennial renewal of each license 784-38
(4) Temporary license 104-39
(b) Other nonresident agents:4-40
(1) Application and license 1384-41
(2) Appointment by each insurer 254-42
(3) Triennial renewal of each license 1385-1
6. Brokers’ licenses and renewals:5-2
(a) Resident brokers and nonresident brokers qualifying under5-3
subsection 3 of NRS 683A.340:5-4
(1) Application and license $785-5
(2) Triennial renewal of each license 785-6
(b) Other nonresident brokers:5-7
(1) Application and license 2585-8
(2) Triennial renewal of each license 2585-9
(c)5-10
(1) Application and license 785-11
(2) Triennial renewal of each license 785-12
(d) Nonresident surplus lines brokers:5-13
(1) Application and license 2585-14
(2) Triennial renewal of each license 2585-15
7. Solicitors’ licenses, appointments and renewals:5-16
(a) Application and license $785-17
(b) Triennial renewal of each license 785-18
(c) Initial appointment 55-19
8. Managing general agents’ licenses, appointments and5-20
renewals:5-21
(a) Resident managing general agents:5-22
(1) Application and license $785-23
(2) Initial appointment, each insurer 55-24
(3) Triennial renewal of each license 785-25
(b) Nonresident managing general agents:5-26
(1) Application and license 1385-27
(2) Initial appointment, each insurer 255-28
(3) Triennial renewal of each license 1385-29
9. Adjusters’ licenses and renewals:5-30
(a) Independent and public adjusters:5-31
(1) Application and license $785-32
(2) Triennial renewal of each license 785-33
(b) Associate adjusters:5-34
(1) Application and license 785-35
(2) Initial appointment 55-36
(3) Triennial renewal of each license 785-37
10. Licenses and renewals for appraisers of physical damage5-38
to motor vehicles:5-39
(a) Application and license $785-40
(b) Triennial renewal of each license 785-41
11. Additional title and property insurers pursuant to NRS5-42
680A.240:6-1
(a) Original registration $506-2
(b) Annual renewal 256-3
12. Insurance vending machines:6-4
(a) Application and license, for each machine $786-5
(b) Triennial renewal of each license 786-6
13. Permit for solicitation for securities:6-7
(a) Application for permit $1006-8
(b) Extension of permit 506-9
14. Securities salesmen for domestic insurers:6-10
(a) Application and license $256-11
(b) Annual renewal of license 156-12
15. Rating organizations:6-13
(a) Application and license $5006-14
(b) Annual renewal 5006-15
16. Certificates and renewals for administrators licensed6-16
pursuant to chapter 683A of NRS:6-17
(a) Resident administrators:6-18
(1) Application and certificate of registration $786-19
(2) Triennial renewal 786-20
(b) Nonresident administrators:6-21
(1) Application and certificate of registration 1386-22
(2) Triennial renewal 1386-23
17. For copies of the insurance laws of Nevada, a fee which6-24
is not less than the cost of producing the copies.6-25
18. Certified copies of certificates of authority and licenses6-26
issued pursuant to the insurance code $106-27
19. For copies and amendments of documents on file in the6-28
division, a reasonable charge fixed by the commissioner,6-29
including charges for duplicating or amending the forms and for6-30
certifying the copies and affixing the official seal.6-31
20. Letter of clearance for an agent or broker $106-32
21. Certificate of status as a licensed agent or broker $106-33
22. Licenses, appointments and renewals for bail agents:6-34
(a) Application and license $786-35
(b) Initial appointment by each surety insurer 56-36
(c) Triennial renewal of each license 786-37
23. Licenses and renewals for bail enforcement agents:6-38
(a) Application and license $786-39
(b) Triennial renewal of each license 786-40
24. Licenses, appointments and renewals for general bail6-41
agents:6-42
(a) Application and license $786-43
(b) Initial appointment by each insurer 57-1
(c) Triennial renewal of each license $787-2
25. Licenses and renewals for bail solicitors:7-3
(a) Application and license $787-4
(b) Triennial renewal of each license 787-5
26. Licenses and renewals for title agents and escrow7-6
officers:7-7
(a) Resident title agents and escrow officers:7-8
(1) Application and license $787-9
(2) Triennial renewal of each license 787-10
(b) Nonresident title agents and escrow officers:7-11
(1) Application and license 1387-12
(2) Triennial renewal of each license 1387-13
(c) Change in name or location of business or in association 107-14
27. Certificate of authority and renewal for a seller of7-15
prepaid funeral contracts $787-16
28. Licenses and renewals for agents for prepaid funeral7-17
contracts:7-18
(a) Resident agents:7-19
(1) Application and license $787-20
(2) Triennial renewal of each license 787-21
(b) Nonresident agents:7-22
(1) Application and license 1387-23
(2) Triennial renewal of each license 1387-24
29. Licenses, appointments and renewals for agents for7-25
fraternal benefit societies:7-26
(a) Resident agents:7-27
(1) Application and license $787-28
(2) Appointment 57-29
(3) Triennial renewal of each license 787-30
(b) Nonresident agents:7-31
(1) Application and license 1387-32
(2) Triennial renewal of each license 1387-33
30. Reinsurance intermediary broker or manager:7-34
(a) Resident agents:7-35
(1) Application and license $787-36
(2) Triennial renewal of each license 787-37
(b) Nonresident agents:7-38
(1) Application and license 1387-39
(2) Triennial renewal of each license 1387-40
31. Agents for and sellers of prepaid burial contracts:7-41
(a) Resident agents and sellers:7-42
(1) Application and certificate or license $787-43
(2) Triennial renewal 788-1
(b) Nonresident agents and sellers:8-2
(1) Application and certificate or license $1388-3
(2) Triennial renewal 1388-4
32. Risk retention groups:8-5
(a) Initial registration and review of an application $2,4508-6
(b) Each annual continuation of a certificate of registration 2,4508-7
33. Required filing of forms:8-8
(a) For rates and policies $258-9
(b) For riders and endorsements 108-10
Sec. 5. NRS 681B.290 is hereby amended to read as follows: 681B.290 1.8-12
or before March 1 of each year, each domestic insurer, and each foreign8-13
insurer domiciled in a state which does not have requirements for reporting8-14
risk-based capital, that transacts property, casualty, life or health insurance8-15
in this state shall prepare and submit to the commissioner, and to each8-16
person designated by the commissioner, a report of the level of the risk-8-17
based capital of the insurer as of the end of the immediately preceding8-18
calendar year. The report must be in such form and contain such8-19
information as required by the regulations adopted by the commissioner8-20
pursuant to this section.8-21
2. The commissioner shall adopt regulations concerning the amount of8-22
risk-based capital required to be maintained by each insurer licensed to do8-23
business in this state that is transacting property, casualty, life or health8-24
insurance in this state. The regulations must be consistent with the8-25
instructions for reporting risk-based capital adopted by the National8-26
Association of Insurance Commissioners, as those instructions existed on8-27
January 1, 1997. If the instructions are amended, the commissioner may8-28
amend the regulations to maintain consistency with the instructions if he8-29
determines that the amended instructions are appropriate for use in this8-30
state.8-31
3. The commissioner may exempt from the provisions of this section8-32
a domestic insurer who:8-33
(a) Does not transact insurance in any other state; and8-34
(b) Does not assume reinsurance that is more than 5 percent of the8-35
direct premiums written by the insurer.8-36
Sec. 6. Chapter 683A of NRS is hereby amended by adding thereto the8-37
provisions set forth as sections 7 to 16, inclusive, of this act.8-38
Sec. 7. As used in NRS 683A.085 to 683A.0893, inclusive, and8-39
sections 7 to 16, inclusive, of this act, unless the context otherwise8-40
requires, the words and terms defined in sections 8 to 11, inclusive, of8-41
this act have the meanings ascribed to them in those sections.8-42
Sec. 8. "Affiliate" has the meaning ascribed to it in NRS 692C.030.8-43
Sec. 9. "Control" has the meaning ascribed to it in NRS 692C.050.9-1
Sec. 10. "Insurer" includes, without limitation:9-2
1. An insurance company licensed pursuant to the provisions of this9-3
code;9-4
2. A prepaid limited health service organization that has been issued9-5
a certificate of authority pursuant to chapter 695F of NRS;9-6
3. A health maintenance organization that has been issued a9-7
certificate of authority pursuant to chapter 695C of NRS;9-8
4. A multiple employer welfare arrangement as defined in 29 U.S.C.§ 1002;
9-9
5. An employer for whom a program of self-insurance is9-10
administered by an administrator; and9-11
6. An organization for dental care that has been issued a certificate9-12
of authority pursuant to chapter 695D of NRS.9-13
Sec. 11. "Underwrite" includes, without limitation:9-14
1. Accepting applications for insurance coverage in accordance with9-15
the written rules of an insurer;9-16
2. Planning and coordinating a program of insurance; and9-17
3. Procuring bonds and excess insurance.9-18
Sec. 12. The commissioner:9-19
1. Shall suspend or revoke the certificate of registration of an9-20
administrator if the commissioner has determined, after notice and a9-21
hearing, that the administrator:9-22
(a) Is in an unsound financial condition;9-23
(b) Uses methods or practices in the conduct of his business that are9-24
hazardous or injurious to insured persons or members of the general9-25
public; or9-26
(c) Has failed to pay any judgment against him in this state within 609-27
days after the judgment became final.9-28
2. May suspend or revoke the certificate of registration of an9-29
administrator if the commissioner determines, after notice and a hearing,9-30
that the administrator:9-31
(a) Has willfully violated or failed to comply with any provision of this9-32
code, any regulation adopted pursuant to this code or any order of the9-33
commissioner;9-34
(b) Has refused to be examined by the commissioner or has refused to9-35
produce accounts, records or files for examination upon the request of9-36
the commissioner;9-37
(c) Has, without just cause, refused to pay claims or perform services9-38
pursuant to his contracts or has, without just cause, caused persons to9-39
accept less than the amount of money owed to them pursuant to the9-40
contracts, or has caused persons to employ an attorney or bring a civil9-41
action against him to receive full payment or settlement of claims;10-1
(d) Is affiliated with, managed by or owned by another administrator10-2
or an insurer who transacts insurance in this state without a certificate of10-3
authority or a certificate of registration;10-4
(e) Fails to comply with any of the requirements for a certificate of10-5
registration;10-6
(f) Has been convicted of, or has entered a plea of guilty or nolo10-7
contendere to a felony, whether or not adjudication was withheld; or10-8
(g) Has had his authority to act as an administrator in another state10-9
limited, suspended or revoked.10-10
3. May, upon notice to the administrator, suspend the certificate of10-11
registration of the administrator pending a hearing if:10-12
(a) The administrator is impaired or insolvent;10-13
(b) A proceeding for receivership, conservatorship or rehabilitation10-14
has been commenced against the administrator in any state; or10-15
(c) The financial condition or the business practices of the10-16
administrator represent an imminent threat to the public health, safety or10-17
welfare of the residents of this state.10-18
4. May, in addition to or in lieu of the suspension or revocation of10-19
the certificate of registration of the administrator, impose a fine of10-20
$2,000 for each act or violation.10-21
Sec. 13. Each application for a certificate of registration as an10-22
administrator must include or be accompanied by:10-23
1. A financial statement that is certified by an officer of the applicant10-24
and must include:10-25
(a) The amount of money that the applicant expects to collect from or10-26
disburse to residents of this state during the next calendar year;10-27
(b) Financial information for the 90 days immediately preceding the10-28
date the application was filed with the commissioner; and10-29
(c) An income statement and balance sheet for the 2 years10-30
immediately preceding the application that are prepared in accordance10-31
with generally accepted accounting principles. The submission by the10-32
applicant of his consolidated income statement and balance sheet does10-33
not constitute compliance with the provisions of this paragraph.10-34
2. The documents used to create the business association of the10-35
administrator, including, without limitation, articles of incorporation,10-36
articles of association, a partnership agreement, a trust agreement and a10-37
shareholder agreement.10-38
3. The documents used to regulate the internal affairs of the10-39
administrator, including, without limitation, the bylaws, rules or10-40
regulations of the administrator.10-41
4. A certificate of registration issued pursuant to NRS 600.350 for a10-42
trade name or trade-mark used by the administrator.11-1
5. An organizational chart that identifies each person who directly or11-2
indirectly controls the administrator and each affiliate of the11-3
administrator.11-4
6. A notarized affidavit from each person who manages or controls11-5
the administrator, including, without limitation, each member of the11-6
board of directors or board of trustees, each officer, partner, and member11-7
of the business association of the administrator, and each shareholder of11-8
the administrator who holds not less than 10 percent of the voting stock11-9
of the administrator. The affidavit must include, without limitation:11-10
(a) The personal history, business record and insurance experience of11-11
the affiant;11-12
(b) Whether the affiant has been investigated by any regulatory11-13
authority or has had any license or certificate denied, suspended or11-14
revoked in any state; and11-15
(c) Any other information that the commissioner may require.11-16
7. The complete name and address of each office of the11-17
administrator, including, offices located outside this state.11-18
8. A statement that sets forth whether the administrator has:11-19
(a) Held a license or certificate to transact any kind of insurance in11-20
this state or any other state and whether that license or certificate has11-21
been refused, suspended or revoked;11-22
(b) Been indebted to any person and, if so, the circumstances of that11-23
debt; and11-24
(c) Had an administrative agreement canceled and, if so, the11-25
circumstances of that cancellation.11-26
9. A statement that describes the business plan of the administrator.11-27
The statement must include information:11-28
(a) Concerning the number of persons on the staff of the11-29
administrator and the activities proposed in this state or in any other11-30
state.11-31
(b) That demonstrates the capability of the administrator to provide a11-32
sufficient number of experienced and qualified persons for the11-33
processing of claims, the keeping of records and, if applicable,11-34
underwriting.11-35
10. If the applicant intends to solicit new or renewal business, proof11-36
that the applicant employs or has contracted with an agent licensed in11-37
this state to solicit and take applications. An applicant who intends to11-38
solicit insurance contracts directly or to act as an insurance agent must11-39
provide proof that he is licensed as an insurance agent in this state.11-40
Sec. 14. 1. Except as otherwise provided by subsection 2, the11-41
commissioner shall issue a certificate of registration as an administrator11-42
to an applicant who:11-43
(a) Submits an application on a form prescribed by the commissioner;12-1
(b) Has complied with the provisions of section 13 of this act; and12-2
(c) Pays the fee for the issuance of a certificate of registration12-3
prescribed in NRS 680B.010.12-4
2. The commissioner may refuse to issue a certificate of registration12-5
as an administrator to an applicant if the commissioner determines that12-6
the applicant or any person who has completed an affidavit pursuant to12-7
subsection 6 of section 13 of this act:12-8
(a) Is not competent to act as an administrator;12-9
(b) Is not trustworthy or financially responsible;12-10
(c) Does not have a good personal or business reputation;12-11
(d) Has had a license or certificate to transact insurance denied for12-12
cause, suspended or revoked in this state or any other state; or12-13
(e) Has failed to comply with any provision of this chapter.12-14
Sec. 15. 1. A certificate of registration as an administrator is valid12-15
for 3 years after the date the commissioner issues the certificate to the12-16
administrator.12-17
2. An administrator may renew a certificate of registration if he12-18
submits to the commissioner:12-19
(a) An application on a form prescribed by the commissioner; and12-20
(b) The fee for the renewal of the certificate of registration prescribed12-21
in NRS 680B.010.12-22
3. A certificate of registration that is suspended or revoked must be12-23
surrendered immediately to the commissioner.12-24
Sec. 16. Not later than March 1 of each year, each holder of a12-25
certificate of registration as an administrator shall file a financial12-26
statement with the commissioner on a form approved by the12-27
commissioner.12-28
Sec. 17. NRS 683A.025 is hereby amended to read as follows: 683A.025 1. Except as limited by this section, "administrator" means12-30
a person who:12-31
(a)12-32
premiums from or adjusts or settles claims of residents of this state or any12-33
other state from within this state in connection with workers’12-34
compensation insurance, life or health insurance coverage or annuities,12-35
including coverage or annuities provided by an employer for his12-36
employees;12-37
(b) Administers12-38
NRS 287.010;12-39
(c) Administers a program of self-insurance for an employer;12-40
(d) Administers a program which is funded by an employer and which12-41
provides pensions, annuities, health benefits, death benefits or other similar12-42
benefits for his employees13-1
(e) Is an insurance company that is licensed to do business in this13-2
state or is acting as an insurer with respect to a policy lawfully issued and13-3
delivered in a state where the insurer is authorized to do business, if the13-4
insurance company performs any act described in paragraphs (a) to (d),13-5
inclusive, for or on behalf of another insurer.13-6
2. "Administrator" does not include:13-7
(a) An employee authorized to act on behalf of an administrator who13-8
holds a certificate of registration from the commissioner.13-9
(b) An employer acting on behalf of his employees or the employees of13-10
a subsidiary or affiliated concern.13-11
(c) A labor union acting on behalf of its members.13-12
(d)13-13
1, an insurance company licensed to do business in this state or acting as an13-14
insurer with respect to a policy lawfully issued and delivered in a state in13-15
which the insurer was authorized to do business.13-16
(e) A life or health insurance agent or broker licensed in this state, when13-17
his activities are limited to the sale of insurance.13-18
(f) A creditor acting on behalf of his debtors with respect to insurance13-19
covering a debt between the creditor and debtor.13-20
(g) A trust and its trustees, agents and employees acting for it, if the trust13-21
was established under the provisions of 29 U.S.C. § 186.13-22
(h) A trust which is exempt from taxation under section 501(a) of the13-23
Internal Revenue Code, 26 U.S.C. § 501(2), its trustees and employees, and13-24
a custodian, his agents and employees acting under a custodial account13-25
which meets the requirements of section 401(f) of the Internal Revenue13-26
Code13-27
(i) A bank, credit union or other financial institution which is subject to13-28
supervision by federal or state banking authorities.13-29
(j) A company which issues credit cards, and which advances for and13-30
collects premiums or charges from credit card holders who have authorized13-31
it to do so, if the company does not adjust or settle claims.13-32
(k) An attorney at law who adjusts or settles claims in the normal course13-33
of his practice or employment, but who does not collect charges or13-34
premiums in connection with life or health insurance coverage or with13-35
annuities.13-36
Sec. 18. NRS 683A.085 is hereby amended to read as follows: 683A.08513-38
as or hold himself out to the public as an administrator, unless he has13-39
obtained a certificate of registration as an administrator from the13-40
commissioner13-41
13-42
13-43
14-1
14-2
14-3
14-4
14-5
14-6
14-7
14-8
14-9
14-10
pursuant to section 14 of this act.14-11
Sec. 19. NRS 683A.0857 is hereby amended to read as follows: 683A.0857 1.14-13
commissioner a bond with an authorized surety in favor of the State of14-14
Nevada, continuous in form and in an amount determined by the14-15
commissioner of not less than14-16
2. The commissioner shall establish schedules for the amount of the14-17
bond required, based on the amount of money received and distributed by14-18
an administrator.14-19
3. The bond must inure to the benefit of any person damaged by any14-20
fraudulent act or conduct of the administrator and must be conditioned14-21
upon faithful accounting and application of all money coming into the14-22
administrator’s possession in connection with his activities as an14-23
administrator.14-24
4. The bond remains in force until released by the commissioner or14-25
canceled by the surety. Without prejudice to any liability previously14-26
incurred, the surety may cancel the bond upon 90 days’ advance notice to14-27
the administrator and the commissioner. An administrator’s certificate is14-28
automatically suspended if he does not file with the commissioner a14-29
replacement bond before the date of cancellation of the previous bond. A14-30
replacement bond must meet all requirements of this section for the initial14-31
bond.14-32
Sec. 20. NRS 683A.086 is hereby amended to read as follows: 683A.086 1. No person may act as an administrator unless he has14-34
entered into a written agreement with an insurer, and the written agreement14-35
contains provisions to effectuate the requirements contained in NRS14-36
14-37
inclusive, of this act which apply to the duties of the administrator.14-38
2. The written agreement must set forth:14-39
(a) The duties the administrator will be required to perform on behalf14-40
of the insurer; and14-41
(b) The lines, classes or types of insurance that the administrator is14-42
authorized to administer on behalf of the insurer.15-1
3. A copy of an agreement entered into under the provisions of this15-2
section must be retained in the records of the administrator and of the15-3
insurer for a period of 5 years after the termination of the agreement.15-4
15-5
trust agreement and amendments must be obtained by the administrator and15-6
a copy forwarded to the insurer. Each agreement must be retained by the15-7
administrator and15-8
termination of the policy.15-9
15-10
functions an administrator may perform on behalf of an insurer.15-11
6. The insurer or administrator may, upon written notice to the other15-12
party to the agreement and to the commissioner, terminate the written15-13
agreement for any cause specified in the agreement. The insurer may15-14
suspend the authority of the administrator while any dispute regarding15-15
the cause for termination is pending. The insurer shall perform any15-16
obligations with respect to the policies affected by the agreement15-17
regardless of any dispute with the administrator.15-18
Sec. 21. NRS 683A.087 is hereby amended to read as follows: 683A.087 An administrator may advertise the insurance which he15-20
administers only15-21
underwrites the business involved.15-22
Sec. 22. NRS 683A.0873 is hereby amended to read as follows: 683A.0873 1. Each administrator shall maintain at his principal15-24
office adequate books and records of all transactions between himself, the15-25
insurer and the insured. The books and records must be maintained in15-26
accordance with prudent standards of recordkeeping for insurance and with15-27
regulations of the commissioner for a period of 5 years after the transaction15-28
to which they respectively relate. After the 5-year period the administrator15-29
may remove the books and records from the state, store their contents on15-30
microfilm or return them to the appropriate insurer.15-31
2. The commissioner may examine, audit and inspect books and15-32
records15-33
provisions of this section15-34
to 679B.300, inclusive.15-35
3. The names and addresses of insured persons and any other material15-36
which is in the books and records of an administrator are confidential15-37
except when used in proceedings against the administrator.15-38
4. The insurer may inspect and examine all books and records to the15-39
extent necessary to fulfill all contractual obligations to insured persons,15-40
subject to restrictions in the written agreement between the insurer and15-41
administrator.16-1
Sec. 23. NRS 683A.0877 is hereby amended to read as follows: 683A.0877 1. All insurance charges and premiums collected by an16-3
administrator on behalf of an insurer and return premiums received from an16-4
insurer are held by the administrator in a fiduciary capacity.16-5
2. Money16-6
persons entitled to it, or16-7
16-8
by the administrator16-9
state. The fiduciary accounts must be separate from the personal or16-10
business accounts of the administrator.16-11
3. If charges or premiums deposited in an account have been collected16-12
for or on behalf of more than one insurer, the administrator shall cause the16-13
16-14
maintained to record clearly the deposits and withdrawals from the account16-15
on behalf of each insurer.16-16
4. The administrator shall promptly obtain and keep copies of16-17
16-18
insurer with copies of the records which pertain to him upon demand of the16-19
insurer.16-20
5. The administrator16-21
money from his fiduciary account16-22
deposited.16-23
6. Withdrawals16-24
between the insurer and the administrator for:16-25
(a) Remittance to the insurer.16-26
(b) Deposit in an account maintained in the name of the insurer.16-27
(c) Transfer to and deposit in an account for the payment of claims.16-28
(d) Payment to a group policyholder for remittance to the insurer16-29
entitled to the money.16-30
(e) Payment to the administrator of his commission, fees or charges.16-31
(f) Remittance of return premiums to persons entitled to them.16-32
7. The administrator shall maintain copies of all records relating to16-33
deposits or withdrawals and, upon the request of an insurer, provide the16-34
insurer with copies of those records.16-35
Sec. 24. NRS 683A.088 is hereby amended to read as follows: 683A.088 Each claim paid by the administrator from16-37
collected for or on behalf of an insurer16-38
draft upon and as authorized by the insurer.16-39
Sec. 25. NRS 683A.0883 is hereby amended to read as follows: 683A.0883 1. The compensation paid to an administrator for his16-41
services may be based upon premiums or charges collected, on number of16-42
claims paid or processed or on16-43
the administrator and the insurer, except as provided in subsection 2.17-1
2. Compensation paid to an administrator may not be based upon or17-2
contingent upon :17-3
(a) The claim experience of the policies17-4
handles; or17-5
(b) The savings realized by the administrator by adjusting, settling or17-6
paying the losses covered by an insurer.17-7
Sec. 26. NRS 683A.0887 is hereby amended to read as follows: 683A.0887 1. Each administrator shall advise each insured, by means17-9
of a written notice approved by the insurer, of the identity of and17-10
relationship among the insurer, administrator and insured.17-11
2. An administrator who seeks to collect premiums or charges shall17-12
clearly17-13
charge set by the insurer for the insurance coverage17-14
the collection of the premium or charge. Each charge must be set forth17-15
separately from the premium.17-16
3. The administrator shall disclose to an insurer, in writing, all17-17
charges, fees and commissions the administrator receives in connection17-18
with the provision of administrative services for the insurer, including,17-19
without limitation, the fees and commissions paid by insurers providing17-20
reinsurance or excess of loss insurance.17-21
Sec. 27. NRS 685A.120 is hereby amended to read as follows: 685A.120 1. No person in this state may act as, hold himself out as,17-23
or be a surplus lines broker with respect to subjects of insurance resident,17-24
located or to be performed in this state or elsewhere unless he is licensed as17-25
such by the commissioner pursuant to this chapter.17-26
2. Any person who has been licensed by this state as a17-27
for general lines for at least 6 months , or has been licensed in another state17-28
as a surplus lines broker for at least 1 year and continues to be licensed in17-29
that state, and who is deemed by the commissioner to be competent and17-30
trustworthy with respect to the handling of surplus lines may be licensed as17-31
a surplus lines broker upon:17-32
(a) Application for a license and payment of the applicable fee for a17-33
license and a fee of $15 for deposit in the insurance recovery account17-34
created by NRS 679B.305;17-35
(b) Submitting the statement required pursuant to NRS 685A.127; and17-36
(c) Passing any examination prescribed by the commissioner on the17-37
subject of surplus lines.17-38
3. An application for a license must be submitted to the commissioner17-39
on a form designated and furnished by him. The application must include17-40
the social security number of the applicant.17-41
4. A license issued pursuant to this chapter continues in force for 317-42
years unless it is suspended, revoked or otherwise terminated. The license17-43
may be renewed upon submission of the statement required pursuant to18-1
NRS 685A.127 and payment of the applicable fee for renewal and a fee of18-2
$15 for deposit in the insurance recovery account created by NRS18-3
679B.305 to the commissioner on or before the last day of the month in18-4
which the license is renewable.18-5
5. A license which is not renewed expires at midnight on the last day18-6
specified for its renewal. The commissioner may accept a request for18-7
renewal received by him within 30 days after the expiration of the license if18-8
the request is accompanied by the statement required pursuant to NRS18-9
685A.127, a fee for renewal of 150 percent of the fee otherwise required18-10
and a fee of $15 for deposit in the insurance recovery account created by18-11
NRS 679B.305.18-12
Sec. 28. NRS 685A.140 is hereby amended to read as follows: 685A.140 1. In addition to other grounds therefor, the commissioner18-14
may suspend or revoke any surplus lines broker’s license:18-15
(a) If the broker fails to file the annual statement or to remit the tax as18-16
required by NRS 685A.170 and 685A.180;18-17
(b) If the broker fails to maintain an office in this state18-18
where he was issued a license as a resident broker, or to keep the records,18-19
or to allow the commissioner to examine his records as required by this18-20
chapter, or if he removes his records from the state; or18-21
(c) If the broker places a surplus lines coverage in an insurer other than18-22
as authorized under this chapter.18-23
2. Upon suspending or revoking the broker’s surplus lines license the18-24
commissioner may also suspend or revoke all other licenses of or as to the18-25
same individual under this code.18-26
Sec. 29. NRS 685A.160 is hereby amended to read as follows: 685A.160 1. Each broker shall keep in his office18-28
and true record of each surplus lines coverage procured by him, including a18-29
copy of each daily report, if any, a copy of each certificate of insurance18-30
issued by him, and such of the following items as may be applicable:18-31
(a)18-32
(b)18-33
(c)18-34
(d)18-35
property;18-36
(e)18-37
(f)18-38
the proportion of the entire risk assumed by18-39
the entire risk;18-40
(g)18-41
(h)18-42
where located or to be performed; and19-1
(i)19-2
commissioner.19-3
2. The record19-4
the office of the broker and must be open to examination by the19-5
commissioner or his representative at all times within 5 years after issuance19-6
of the coverage to which it relates.19-7
Sec. 30. NRS 686A.130 is hereby amended to read as follows: 686A.130 1. No property, casualty, surety or title insurer or19-9
underwritten title company or any employee or representative thereof, and19-10
no broker, agent or solicitor may pay, allow or give, or offer to pay, allow19-11
or give, directly or indirectly, as an inducement to insurance, or after19-12
insurance has been effected, any rebate, discount, abatement, credit or19-13
reduction of the premium named in a policy of insurance, or any special19-14
favor or advantage in the dividends or other benefits to accrue thereon, or19-15
any valuable consideration or inducement whatever, not specified or19-16
provided for in the policy, except to the extent provided for in an19-17
applicable filing with the commissioner.19-18
2. No title insurer or underwritten title company may:19-19
(a) Pay, directly or indirectly, to the insured or any person acting as19-20
agent, representative, attorney or employee of the owner, lessee,19-21
mortgagee, existing or prospective, of the real property or interest therein19-22
which is the subject matter of title insurance or as to which a service is to19-23
be performed, any commission , rebate or part of its fee or charges or other19-24
consideration as inducement or compensation for the placing of any order19-25
for a title insurance policy or for performance of any escrow or other19-26
service by the insurer or underwritten title company with respect thereto; or19-27
(b) Issue any policy or perform any service in connection with which it19-28
or any agent or other person has paid or contemplates paying any19-29
commission, rebate or inducement in violation of this section.19-30
3. No insured named in a policy or any employee of19-31
may knowingly receive or accept, directly or indirectly, any such rebate,19-32
discount, abatement, credit or reduction of premium, or any such special19-33
favor or advantage or valuable consideration or inducement.19-34
4. No such insurer may make or permit any unfair discrimination19-35
between insured or property having like insuring or risk characteristics, in19-36
the premium or rates charged for insurance, or in the dividends or other19-37
benefits payable thereon, or in any other of the terms and conditions of19-38
insurance.19-39
5. No casualty insurer may make or permit any unfair discrimination19-40
between persons legally qualified to provide a particular service, in the19-41
amount of the fee or charge for that service payable as a benefit under any19-42
policy or contract of casualty insurance.20-1
6.20-2
not prohibit:20-3
(a) The payment of commissions or other compensation to licensed20-4
agents, brokers or solicitors.20-5
(b) The extension of credit to an insured for the payment of any20-6
premium and for which credit a reasonable rate of interest is charged and20-7
collected.20-8
(c) Any insurer from allowing or returning to its participating20-9
policyholders, members or subscribers, dividends, savings or unabsorbed20-10
premium deposits.20-11
20-12
(d) With respect to title insurance, bulk rates or special rates for20-13
customers of prescribed classes if20-14
provided for in the20-15
title insurer or underwritten title company.20-16
7.20-17
wet marine and transportation insurance.20-18
Sec. 31. NRS 686C.035 is hereby amended to read as follows: 686C.035 1. This chapter does not provide coverage for:20-20
(a) Any portion of a policy or contract not guaranteed by the insurer, or20-21
under which the risk is borne by the20-22
contract.20-23
(b) Any policy or contract of reinsurance unless assumption certificates20-24
have been issued20-25
(c) Any portion of a policy or contract to the extent that the rate of20-26
interest on which it is based:20-27
(1) When averaged over the period of 4 years before the date20-28
on which the association becomes obligated with respect to the policy or20-29
contract, or averaged for the period since the policy or contract was issued20-30
if it was issued less than 4 years before the association became obligated,20-31
exceeds the rate of interest determined by subtracting 2 percentage points20-32
from Moody’s Corporate Bond Yield Average averaged for the same20-33
period; and20-34
(2) On or after the date on which the association becomes obligated20-35
with respect to the policy or contract, exceeds the rate of interest20-36
determined by subtracting 3 percentage points from the most recent20-37
Moody’s Corporate Bond Yield Average.20-38
(d) Any portion of a policy or contract issued to a plan or program of20-39
an employer, association or20-40
20-41
members or other persons to the extent that the plan or program is self-20-42
funded or uninsured, including, but not limited to, benefits payable by an20-43
employer, association or21-1
(1) A21-2
welfare arrangement as defined in 29 U.S.C. § 1002;21-3
(2) A minimum-premium group insurance plan;21-4
(3) A stop-loss group insurance plan; or21-5
(4) A contract for administrative services only.21-6
(e) Any portion of a policy or contract to the extent that it provides for21-7
dividends, credits for experience, voting rights or the payment of any fee21-8
or allowance to any person, including the21-9
policy or contract, for services or administration connected with the policy21-10
or contract.21-11
(f) Any policy or contract issued in this state by a member insurer at a21-12
time when the member insurer was not authorized to issue the policy or21-13
contract21-14
(g)21-15
21-16
21-17
21-18
21-19
21-20
21-21
21-22
portion of a policy or contract to the extent that the assessments required21-23
by NRS 686C.230 for the policy or contract are preempted by federal law.21-24
(h) An obligation that does not arise under the written terms of a21-25
policy or contract issued by the insurer.21-26
(i) An unallocated annuity contract.21-27
2. As used in this section, "Moody’s Corporate Bond Yield Average"21-28
means the monthly average for corporate bonds published by Moody’s21-29
Investors Service, Inc., or any successor average.21-30
Sec. 32. NRS 687B.440 is hereby amended to read as follows: 687B.440 1. An insurer offering an umbrella policy to an individual21-32
shall obtain a signed disclosure statement from the individual indicating21-33
whether the umbrella policy includes uninsured or underinsured vehicle21-34
coverage.21-35
2. The disclosure statement for an umbrella policy that includes21-36
uninsured or underinsured vehicle coverage must be on a form provided21-37
by the commissioner or in substantially the following form:21-38
UMBRELLA POLICY DISCLOSURE STATEMENT21-39
UNINSURED/UNDERINSURED VEHICLE COVERAGE21-40 ¨
Your Umbrella Policy does provide coverage in excess of the21-41
limits of the uninsured/underinsured vehicle coverage in your primary22-1
auto insurance only if the requirements for the uninsured/underinsured22-2
vehicle coverage in your underlying auto insurance are maintained.22-3
22-4
22-5
22-6
22-7
vehicle coverage provided by this umbrella policy is limited to22-8
$……… .22-9
I understand and acknowledge the above disclosure.22-10
22-11
Insured Date22-12
3. The disclosure statement for an umbrella policy that does not22-13
include uninsured or underinsured vehicle coverage must be on a form22-14
provided by the commissioner or in substantially the following form:22-15 ¨
Your Umbrella Liability Policy does not provide any22-16
uninsured/underinsured vehicle coverage.22-17
I understand and acknowledge the above disclosure.22-18
22-19
Insured Date22-20
22-21
protects a person against losses in excess of the underlying amount required22-22
to be covered by other policies.22-23
Sec. 33. NRS 689A.505 is hereby amended to read as follows: 689A.505 "Creditable coverage" means, with respect to a person,22-25
health benefits or coverage provided pursuant to:22-26
1. A group health plan;22-27
2. A health benefit plan;22-28
3. Part A or Part B of Title XVIII of the Social Security Act, 42 U.S.C.§§ 1395c et seq.,
also known as Medicare;22-29
4. Title XIX of the Social Security Act, 42 U.S.C. §§ 1396 et seq., also22-30
known as Medicaid, other than coverage consisting solely of benefits under22-31
section 1928 of that Title22-32
22-33
5. The Civilian Health and Medical Program of Uniformed Services22-34
22-35
6. A medical care program of the Indian Health Service or of a tribal22-36
organization;23-1
7. A state health benefit risk pool;23-2
8. A health plan offered pursuant to23-3
23-4
23-5
9. A public health plan as defined in federal regulations authorized by23-6
the Public Health Service Act,23-7
23-8
10. A health benefit plan under section 5(e) of the Peace Corps Act ,23-9
23-10
11. A short-term health insurance policy; or23-11
12. A blanket student accident and health insurance policy.23-12
Sec. 34. NRS 689A.515 is hereby amended to read as follows: 689A.515 "Eligible person" means:23-14
1. A person:23-15
(a) Who, as of the date on which he seeks coverage pursuant to this23-16
chapter, has an aggregate period of creditable coverage that is 18 months or23-17
more;23-18
(b) Whose most recent prior creditable coverage , other than coverage23-19
under a short-term health insurance policy, was under a group health23-20
plan, governmental plan, church plan or health insurance coverage offered23-21
in connection with any such plan;23-22
(c) Who is not eligible for coverage under a group health plan, Part A or23-23
Part B of Title XVIII of the Social Security Act, 42 U.S.C. §§ 1395c et23-24
seq., also known as Medicare, a state plan pursuant to Title XIX of the23-25
Social Security Act, 42 U.S.C. §§ 1396 et seq., also known as Medicaid, or23-26
any successor program, and who does not have any other health insurance23-27
coverage;23-28
(d) Whose most recent health insurance coverage within the period of23-29
aggregate creditable coverage was not terminated because of a failure to23-30
pay premiums or fraud;23-31
(e) Who has exhausted his continuation of coverage under the23-32
Consolidation Omnibus Budget Reconciliation Act of 198523-33
99-272, or under a similar state program, if any; and23-34
(f) Who has not had a break of more than 63 consecutive days in his23-35
creditable coverage.23-36
2. A person whose most recent prior creditable coverage was under a23-37
basic or standard health benefit plan and was not renewed by a carrier23-38
who discontinued offering and renewing individual health benefit plans23-39
in this state pursuant to NRS 689A.630.23-40
3. Notwithstanding the provisions of paragraph (a) of subsection 1, a23-41
newborn child or a child placed for adoption, if the child was enrolled23-42
timely and would have otherwise met the requirements of an eligible person23-43
as set forth in subsection 1.24-1
Sec. 35. NRS 689A.540 is hereby amended to read as follows: 689A.540 1. "Health benefit plan" means a policy, contract,24-3
certificate or agreement offered by a carrier to provide for, deliver payment24-4
for, arrange for the payment of, pay for or reimburse any of the costs of24-5
health care services. Except as otherwise provided in this section, the term24-6
includes24-7
policy that pays on a cost-incurred basis.24-8
2. The term does not include:24-9
(a) Coverage that is only for accident or disability income insurance, or24-10
any combination thereof;24-11
(b) Coverage issued as a supplement to liability insurance;24-12
(c) Liability insurance, including general liability insurance and24-13
automobile liability insurance;24-14
(d) Workers’ compensation or similar insurance;24-15
(e) Coverage for medical payments under a policy of automobile24-16
insurance;24-17
(f) Credit insurance;24-18
(g) Coverage for on-site medical clinics;24-19
(h) Other similar insurance coverage specified in federal regulations24-20
issued pursuant to Public Law 104-191 under which benefits for medical24-21
care are secondary or incidental to other insurance benefits24-22
(i) Coverage under a short-term health insurance policy; and24-23
(j) Coverage under a blanket student accident and health insurance24-24
policy.24-25
3. The term does not include the following benefits if the benefits are24-26
provided under a separate policy, certificate or contract of insurance or are24-27
otherwise not an integral part of a health benefit plan:24-28
(a) Limited-scope dental or vision benefits;24-29
(b) Benefits for long-term care, nursing home care, home health care or24-30
community-based care, or any combination thereof; and24-31
(c) Such other similar benefits as are specified in any federal regulations24-32
adopted pursuant to the Health Insurance Portability and Accountability24-33
Act of 1996, Public Law 104-191.24-34
4. The term does not include the following benefits if the benefits are24-35
provided under a separate policy, certificate or contract of insurance, there24-36
is no coordination between the provision of the benefits and any exclusion24-37
of benefits under any group health plan maintained by the same plan24-38
sponsor, and24-39
whether benefits are provided for such a claim under any group health plan24-40
maintained by the same plan sponsor:24-41
(a) Coverage that is only for a specified disease or illness; and24-42
(b) Hospital indemnity or other fixed indemnity insurance.25-1
5. The term does not include any of the following, if offered as a25-2
separate policy, certificate or contract of insurance:25-3
(a) Medicare supplemental health insurance as defined in section25-4
1882(g)(1) of the Social Security Act, 42 U.S.C. § 1395ss, as that section25-5
existed on July 16, 1997;25-6
(b) Coverage supplemental to the coverage provided pursuant to25-7
25-8
Medical Program of Uniformed Services25-9
10 U.S.C. §§ 1071 et seq.; and25-10
(c) Similar supplemental coverage provided under a group health plan.25-11
Sec. 36. NRS 689A.650 is hereby amended to read as follows: 689A.650 1. An individual carrier is not required to provide25-13
coverage to eligible persons pursuant to NRS 689A.640:25-14
(a) During any period in which the commissioner determines that25-15
requiring the individual carrier to provide such coverage would place the25-16
individual carrier in a financially impaired condition.25-17
(b) If the individual carrier elects not to offer any new coverage to any25-18
25-19
new coverage in accordance with this paragraph may maintain its existing25-20
policies issued to25-21
of NRS 689A.630.25-22
2. An individual carrier that elects not to offer new coverage pursuant25-23
to paragraph (b) of subsection 1 shall notify the commissioner forthwith of25-24
that election and shall not thereafter write any new business to individuals25-25
in this state for 5 years after the date of the notification.25-26
Sec. 37. NRS 689A.660 is hereby amended to read as follows: 689A.660 An individual carrier shall not:25-28
1. Impose on an eligible person who is covered under a basic or25-29
standard health benefit plan any exclusion because of a preexisting25-30
condition.25-31
2. Modify a health benefit plan, with respect to an eligible person,25-32
through riders, endorsements or otherwise, to restrict or exclude services25-33
otherwise covered by the plan.25-34
Sec. 38. NRS 689A.680 is hereby amended to read as follows: 689A.680 1. An individual carrier shall develop its rates for its25-36
individual health benefit plans pursuant to NRS 689A.470 to 689A.740,25-37
inclusive, based on rating characteristics. After any adjustments for rating25-38
characteristics and design of benefits, the rate for any block of business for25-39
an individual health benefit plan written on or after25-40
January 1, 2000, must not exceed the rate for any other block of business25-41
for an individual health benefit plan offered by the individual carrier by25-42
more than25-43
average rate charged to all the insureds in the block of business. In26-1
determining whether the rate of a block of business complies with the26-2
provisions of this subsection, any differences in rating factors between26-3
blocks of business must be considered.26-4
2. In determining the rating factors to establish premium rates for a26-5
health benefit plan, an individual carrier shall not use characteristics other26-6
than age, sex, occupation, geographic area, composition of the family of the26-7
individual and health status.26-8
3. If an individual carrier uses health status as a rating factor in26-9
establishing premium rates, the highest factor associated with any26-10
classification for health status may not exceed the lowest factor by more26-11
than 75 percent.26-12
4. For the purposes of this section, rating characteristics must not26-13
include durational or tier rating, or adverse changes in health status or26-14
claim experience after the policy is issued.26-15
5. As used in this section, "characteristics" means demographic or26-16
other information concerning individuals that is considered by a carrier in26-17
the determination of premium rates for individuals.26-18
Sec. 39. NRS 689B.027 is hereby amended to read as follows: 689B.027 1. The commissioner shall adopt regulations which require26-20
an insurer to file with the commissioner, for his approval, a disclosure26-21
summarizing the coverage provided by each policy of group health26-22
insurance offered by the insurer. The disclosure must include:26-23
(a) Any significant exception, reduction or limitation that applies to the26-24
policy;26-25
(b) Any restrictions on payments for emergency care, including related26-26
definitions of an emergency and medical necessity;26-27
(c) Any provisions concerning the insurer’s right to change premium26-28
rates and the characteristics, other than claim experience, that affect26-29
changes in premium rates;26-30
(d) Any provisions relating to renewability;26-31
(e) Any provisions relating to preexisting conditions; and26-32
(f) Any other information,26-33
that the commissioner finds necessary to provide for full and fair disclosure26-34
of the provisions of the policy.26-35
2. The disclosure must be written in language which is easily26-36
understood and26-37
of the policy only, and that the policy26-38
the governing contractual provisions.26-39
3. The commissioner shall not approve any proposed disclosure26-40
submitted to him pursuant to this section which does not comply with the26-41
requirements of this section and the applicable regulations.26-42
4. The insurer shall make available to an employer or a producer26-43
acting on behalf of an employer upon request a copy of the disclosure27-1
approved by the commissioner pursuant to this section for each policy of27-2
health insurance coverage for which that employer may be eligible.27-3
Sec. 40. NRS 689B.380 is hereby amended to read as follows: 689B.380 "Creditable coverage" means health benefits or coverage27-5
provided to a person pursuant to:27-6
1. A group health plan;27-7
2. A health benefit plan;27-8
3. Part A or Part B of Title XVIII of the Social Security Act, 42 U.S.C.§§ 1395c et seq.,
also known as Medicare;27-9
4. Title XIX of the Social Security Act, 42 U.S.C. §§ 1396 et seq., also27-10
known as Medicaid, other than coverage consisting solely of benefits under27-11
section 1928 of that Title27-12
27-13
5. The Civilian Health and Medical Program of Uniformed Services27-14
27-15
6. A medical care program of the Indian Health Service or of a tribal27-16
organization;27-17
7. A state health benefit risk pool;27-18
8. A health plan offered pursuant to27-19
27-20
27-21
9. A public health plan as defined in federal regulations authorized by27-22
the Public Health Service Act,27-23
27-24
10. A health benefit plan under section 5(e) of the Peace Corps Act ,27-25
27-26
11. A short-term health insurance policy; or27-27
12. A blanket student accident and health insurance policy.27-28
Sec. 41. NRS 689B.410 is hereby amended to read as follows: 689B.410 1. "Health benefit plan" means a policy, contract,27-30
certificate or agreement offered by a carrier to provide for, arrange for27-31
payment of, pay for or reimburse any of the costs of health care services.27-32
Except as otherwise provided in this section, the term includes27-33
27-34
incurred basis.27-35
2. The term does not include:27-36
(a) Coverage that is only for accident or disability income insurance, or27-37
any combination thereof;27-38
(b) Coverage issued as a supplement to liability insurance;27-39
(c) Liability insurance, including general liability insurance and27-40
automobile liability insurance;27-41
(d) Workers’ compensation or similar insurance;28-1
(e) Coverage for medical payments under a policy of automobile28-2
insurance;28-3
(f) Credit insurance;28-4
(g) Coverage for on-site medical clinics;28-5
(h) Other similar insurance coverage specified in federal regulations28-6
issued pursuant to the Health Insurance Portability and Accountability28-7
Act of 1996, Public Law 104-191 , under which benefits for medical care28-8
are secondary or incidental to other insurance benefits28-9
(i) Coverage under a short-term health insurance policy; and28-10
(j) Coverage under a blanket student accident and health insurance28-11
policy.28-12
3. If the benefits are provided under a separate policy, certificate or28-13
contract of insurance or are otherwise not an integral part of a health28-14
benefit plan, the term does not include the following benefits:28-15
(a) Limited-scope dental or vision benefits;28-16
(b) Benefits for long-term care, nursing home care, home health care or28-17
community-based care, or any combination thereof; and28-18
(c) Such other similar benefits as are specified in any federal regulations28-19
adopted pursuant to the Health Insurance Portability and Accountability28-20
Act of 1996, Public Law 104-191.28-21
4. For the purposes of NRS 689B.340 to 689B.600, inclusive, if the28-22
benefits are provided under a separate policy, certificate or contract of28-23
insurance, there is no coordination between the provision of the benefits28-24
and any exclusion of benefits under any group health plan maintained by28-25
the same plan sponsor, and28-26
regard to whether benefits are provided for such a claim under any group28-27
health plan maintained by the same plan sponsor, the term does not include:28-28
(a) Coverage that is only for a specified disease or illness; and28-29
(b) Hospital indemnity or other fixed indemnity insurance.28-30
5. For the purposes of NRS 689B.340 to 689B.600, inclusive, if28-31
offered as a separate policy, certificate or contract of insurance, the term28-32
does not include:28-33
(a) Medicare supplemental health insurance as defined in section28-34
1882(g)(1) of the Social Security Act, 42 U.S.C. § 1395ss, as that section28-35
existed on July 16, 1997;28-36
(b) Coverage supplemental to the coverage provided pursuant to28-37
28-38
Medical Program of Uniformed Services28-39
10 U.S.C. §§ 1071 et seq.; and28-40
(c) Similar supplemental coverage provided under a group health plan.28-41
Sec. 42. NRS 689B.460 is hereby amended to read as follows: 689B.460 "Waiting period" means the period established by a plan of28-43
health insurance that must pass before a person who is an eligible29-1
participant or beneficiary in a plan is covered for benefits under the terms29-2
of the plan. The term includes the period from the date a person submits29-3
an application to an individual carrier for coverage under a health29-4
benefit plan until the first day of coverage under that health benefit plan.29-5
Sec. 43. NRS 689B.500 is hereby amended to read as follows: 689B.500 1. Except as otherwise provided in this section, a carrier29-7
that issues a group health plan or coverage under group health insurance29-8
shall not deny, exclude or limit a benefit for a preexisting condition for:29-9
(a) More than 12 months after the effective date of coverage if the29-10
employee enrolls through open enrollment or after the first day of the29-11
waiting period for29-12
(b) More than 18 months after the effective date of coverage for a late29-13
enrollee.29-14
A carrier may not define a preexisting condition more restrictively than that29-15
term is defined in NRS 689B.450.29-16
2. The period of any exclusion for a preexisting condition imposed by29-17
a group health plan or coverage under group health insurance on a person29-18
to be insured in accordance with the provisions of this chapter must be29-19
reduced by the aggregate period of creditable coverage of that person, if the29-20
creditable coverage was continuous to a date not more than 63 days before29-21
the effective date of the coverage. The period of continuous coverage must29-22
not include:29-23
(a) Any waiting period for the effective date of the new coverage29-24
applied by the employer or the carrier; or29-25
(b) Any affiliation period not to exceed 60 days for a new enrollee and29-26
29-27
in the group health plan.29-28
3. A health maintenance organization authorized to transact insurance29-29
pursuant to chapter 695C of NRS that does not restrict coverage for a29-30
preexisting condition may require an affiliation period before coverage29-31
becomes effective under a plan of insurance if the affiliation period applies29-32
uniformly to all employees and without regard to any health status-related29-33
factors. During the affiliation period, the carrier shall not collect any29-34
premiums for coverage of the employee.29-35
4. An insurer that restricts coverage for preexisting conditions shall not29-36
impose an affiliation period.29-37
5. A carrier shall not impose any exclusion for a preexisting condition:29-38
(a) Relating to pregnancy.29-39
(b) In the case of a person who, as of the last day of the 30-day period29-40
beginning on the date of his birth, is covered under creditable coverage.29-41
(c) In the case of a child who is adopted or placed for adoption before29-42
attaining the age of 18 years and who, as of the last day of the 30-day29-43
period beginning on the date of adoption or placement for adoption,30-1
whichever is earlier, is covered under creditable coverage. The provisions30-2
of this paragraph do not apply to coverage before the date of adoption or30-3
placement for adoption.30-4
(d) In the case of a condition for which medical advice, diagnosis, care30-5
or treatment was recommended or received for the first time while the30-6
covered person held creditable coverage, and the medical advice, diagnosis,30-7
care or treatment was a benefit under the plan, if the creditable coverage30-8
was continuous to a date not more than 63 days before the effective date of30-9
the new coverage.30-10
The provisions of paragraphs (b) and (c) do not apply to a person after the30-11
end of the first 63-day period during all of which the person was not30-12
covered under any creditable coverage.30-13
6. As used in this section, "late enrollee" means an eligible employee,30-14
or his dependent, who requests enrollment in a group health plan following30-15
the initial period of enrollment, if that initial period of enrollment is at least30-16
30 days, during which the person is entitled to enroll under the terms of the30-17
health benefit plan. The term does not include an eligible employee or his30-18
dependent if:30-19
(a) The employee or dependent:30-20
(1) Was covered under creditable coverage at the time of the initial30-21
enrollment;30-22
(2) Lost coverage under creditable coverage as a result of cessation of30-23
contributions by his employer, termination of employment or eligibility,30-24
reduction in the number of hours of employment, involuntary termination30-25
of creditable coverage, or death of, or divorce or legal separation from, a30-26
covered spouse; and30-27
(3) Requests enrollment not later than 30 days after the date on which30-28
his creditable coverage was terminated or on which the change in30-29
conditions that gave rise to the termination of the coverage occurred.30-30
(b) The employee enrolls during the open enrollment period, as30-31
provided in the contract or as otherwise specifically provided by specific30-32
statute.30-33
(c) The employer of the employee offers multiple health benefit plans30-34
and the employee elected a different plan during an open enrollment period.30-35
(d) A court has ordered coverage to be provided to the spouse or a30-36
minor or dependent child of an employee under a health benefit plan of the30-37
employee and a request for enrollment is made within 30 days after the30-38
issuance of the court order.30-39
(e) The employee changes status from not being an eligible employee to30-40
being an eligible employee and requests enrollment, subject to any waiting30-41
period, within 30 days after the change in status.31-1
(f) The person has continued coverage in accordance with the31-2
Consolidated Omnibus Budget Reconciliation Act of 1985 , Public Law31-3
99-272, and31-4
Sec. 44. NRS 689B.590 is hereby amended to read as follows: 689B.590 1. Not later than 180 days after the date on which the basic31-6
and standard health benefit plans are approved pursuant to NRS 689C.77031-7
as part of the plan of operation of the program of reinsurance, each carrier31-8
required to offer to a person a converted policy pursuant to NRS 689B.12031-9
shall only offer as a converted policy a choice of the basic and standard31-10
health benefit plans.31-11
2. A person with a converted policy issued before the effective date of31-12
the requirement set forth in subsection 1 may, at each annual renewal of the31-13
converted policy elect a basic or standard health benefit plan as a substitute31-14
converted policy, except that the carrier may, if the person has not made an31-15
election within 3 years after first becoming eligible to do so, require the31-16
person to make such an election. Once a person has elected31-17
basic or standard health benefit plan as a substitute converted policy, he31-18
may not elect another converted policy.31-19
3. The premium for a converted policy may not exceed the small group31-20
index rate, as defined in paragraph (b) of subsection 3 of NRS 689C.230,31-21
applicable to the carrier by more than31-22
index rate used by a carrier that does not write insurance to small31-23
employers in this state must be the average small group index rate, as31-24
determined by the commissioner, of the five largest carriers that provide31-25
coverage to small employers pursuant to this chapter for their basic and31-26
standard health benefit plans. The commissioner shall annually determine31-27
the average small group index rate, as measured by the premium volume of31-28
the plans, of those five largest carriers.31-29
4. The rates for new and renewal converted policies for persons with31-30
the same converted policies whose case characteristics are similar must be31-31
the same.31-32
5. Any losses suffered by a carrier on its converted policies issued31-33
pursuant to this section must be spread across the entire book of the health31-34
benefit coverage of the carrier issued or delivered for issuance to small31-35
employers and large group employers in this state.31-36
6. The commissioner shall adopt such regulations as are necessary to31-37
carry out the provisions of this section.31-38
Sec. 45. Chapter 689C of NRS is hereby amended by adding thereto31-39
the provisions set forth as sections 46 and 47 of this act.31-40
Sec. 46. No member, agent or employee of the board may be held31-41
liable in a civil action for any act that he performs in good faith in the31-42
execution of his duties pursuant to the provisions of this chapter.32-1
Sec. 47. The provisions of this chapter apply to health benefit plans32-2
that provide coverage to the employees of small employers in this state32-3
and to carriers that offer those health benefit plans if:32-4
1. A portion of the premium or benefits are paid by or on behalf of32-5
the small employer;32-6
2. An eligible employee or his dependent is reimbursed for a portion32-7
of the premium, whether by wage adjustments or otherwise, by or on32-8
behalf of the small employer; or32-9
3. The health benefit plan is considered by the small employer or any32-10
of his eligible employees or dependents as part of a plan or program for32-11
the purposes of sections 106, 125 or 162 of the Internal Revenue Code,32-12
26 U.S.C. § 106, 125 or 162.32-13
Sec. 48. NRS 689C.053 is hereby amended to read as follows: 689C.053 "Creditable coverage" means health benefits or coverage32-15
provided to a person pursuant to:32-16
1. A group health plan;32-17
2. A health benefit plan;32-18
3. Part A or Part B of Title XVIII of the Social Security Act, 42 U.S.C.§§ 1395c et seq.,
also known as Medicare;32-19
4. Title XIX of the Social Security Act, 42 U.S.C. §§ 1396 et seq., also32-20
known as Medicaid, other than coverage consisting solely of benefits under32-21
section 1928 of that Title32-22
32-23
5. The Civilian Health and Medical Program of Uniformed Services32-24
32-25
6. A medical care program of the Indian Health Service or of a tribal32-26
organization;32-27
7. A state health benefit risk pool;32-28
8. A health plan offered pursuant to32-29
32-30
32-31
9. A public health plan as defined in federal regulations authorized by32-32
the Public Health Service Act,32-33
32-34
10. A health benefit plan under section 5(e) of the Peace Corps Act ,32-35
32-36
11. A short-term health insurance policy; or32-37
12. A blanket student accident and health insurance policy.32-38
Sec. 49. NRS 689C.075 is hereby amended to read as follows: 689C.075 1. "Health benefit plan" means a policy or certificate for32-40
hospital or medical expenses, a contract for dental, hospital or medical32-41
services, or a health care plan of a health maintenance organization32-42
available for use, offered or sold to a small employer. Except as otherwise33-1
provided in this section, the term includes short-term and catastrophic33-2
health insurance policies, and a policy that pays on a cost-incurred basis.33-3
2. The term does not include:33-4
(a) Coverage that is only for accident or disability income insurance, or33-5
any combination thereof;33-6
(b) Coverage issued as a supplement to liability insurance;33-7
(c) Liability insurance, including general liability insurance and33-8
automobile liability insurance;33-9
(d) Workers’ compensation or similar insurance;33-10
(e) Coverage for medical payments under a policy of automobile33-11
insurance;33-12
(f) Credit insurance;33-13
(g) Coverage for on-site medical clinics;33-14
(h) Coverage under a short-term health insurance policy;33-15
(i) Coverage under a blanket student accident and health insurance33-16
policy; and33-17
(j) Other similar insurance coverage specified in federal regulations33-18
issued pursuant to the Health Insurance Portability and Accountability33-19
Act of 1996, Public Law 104-191 , under which benefits for medical care33-20
are secondary or incidental to other insurance benefits.33-21
3. If the benefits are provided under a separate policy, certificate or33-22
contract of insurance or are otherwise not an integral part of a health33-23
benefit plan, the term does not include the following benefits:33-24
(a) Limited-scope dental or vision benefits;33-25
(b) Benefits for long-term care, nursing home care, home health care or33-26
community-based care, or any combination thereof; and33-27
(c) Such other similar benefits as are specified in any federal regulations33-28
adopted pursuant to the Health Insurance Portability and Accountability33-29
Act of 1996, Public Law 104-191.33-30
4. If the benefits are provided under a separate policy, certificate or33-31
contract of insurance, there is no coordination between the provision of the33-32
benefits and any exclusion of benefits under any group health plan33-33
maintained by the same plan sponsor, and33-34
claim without regard to whether benefits are provided for such a claim33-35
under any group health plan maintained by the same plan sponsor, the term33-36
does not include:33-37
(a) Coverage that is only for a specified disease or illness; and33-38
(b) Hospital indemnity or other fixed indemnity insurance.33-39
5. If offered as a separate policy, certificate or contract of insurance,33-40
the term does not include:33-41
(a) Medicare supplemental health insurance as defined in section33-42
1882(g)(1) of the Social Security Act, 42 U.S.C. § 1395ss, as that section33-43
existed on July 16, 1997;34-1
(b) Coverage supplemental to the coverage provided pursuant to34-2
34-3
Medical Program of Uniformed Services34-4
10 U.S.C. §§ 1071 et seq.; and34-5
(c) Similar supplemental coverage provided under a group health plan.34-6
Sec. 50. NRS 689C.095 is hereby amended to read as follows: 689C.095 1. "Small employer" means ,34-8
34-9
34-10
who employed on business days during the preceding calendar year an34-11
average of at least 234-12
34-13
of 30 hours or more, and34-14
first day of the plan year .34-15
34-16
34-17
34-18
34-19
employees, organizations which are affiliated or which are eligible to file a34-20
combined tax return for the purposes of taxation constitute one employer.34-21
2. For the purposes of this section, organizations are "affiliated" if one34-22
directly, or indirectly, through one or more intermediaries, controls or is34-23
controlled by, or is under common control with, the other, as determined34-24
pursuant to the provisions of NRS 692C.050.34-25
Sec. 51. NRS 689C.106 is hereby amended to read as follows: 689C.106 "Waiting period" means the period established by a plan of34-27
health insurance that must pass before a person who is an eligible34-28
participant or beneficiary in a plan is covered for benefits under the terms34-29
of the plan. The term includes the period from the date a person submits34-30
an application to an individual carrier for coverage under a health34-31
benefit plan until the first day of coverage under that health benefit plan.34-32
Sec. 52. NRS 689C.210 is hereby amended to read as follows: 689C.210 1. Except as otherwise provided in subsection 3, a carrier34-34
shall not increase the premium rate charged to a small employer for a new34-35
rating period by a percentage greater than the sum of:34-36
(a) The percentage of change in the premium rate for new business for34-37
the policy under which the small employer is covered, measured from the34-38
first day of the previous rating period to the first day of the new rating34-39
period;34-40
(b) An adjustment, not to exceed 15 percent annually, adjusted pro rata34-41
for rating periods of less than 1 year, on account of the claim experience,34-42
health status, or duration of coverage of the employees or dependents of the35-1
small employer as determined from the carrier’s rate manual for the class of35-2
business; and35-3
(c) Any adjustment on account of change in coverage or change in the35-4
characteristics of the small employer as determined from the carrier’s rate35-5
manual for the class of business.35-6
2. If the carrier no longer issues new policies for that class of business,35-7
the carrier shall use the percentage of change in the premium rate for new35-8
business for the class of business which is most similar to the closed class35-9
of business and for which the carrier is issuing new policies.35-10
3. In the case of health benefit plans delivered or issued for delivery35-11
before January 1, 1996, for groups with35-12
and35-13
with35-14
employees, a premium rate for a rating period may exceed the ranges set35-15
forth in35-16
period of 3 years following that date. In that case, the percentage of35-17
increase in the premium rate charged to a small employer for a new rating35-18
period may not exceed the sum of:35-19
(a) The percentage of change in the premium rate for new business35-20
measured from the first day of the previous rating period to the first day of35-21
the new rating period. In the case of a health benefit plan into which the35-22
carrier is no longer enrolling new small employers, the carrier shall use the35-23
percentage of change in the base premium rate if that change does not35-24
exceed, on a percentage basis, the change in the premium rate for new35-25
business for the most similar health benefit plan into which the carrier is35-26
actively enrolling new small employers.35-27
(b) Any adjustment on account of change in coverage or change in the35-28
characteristics of the small employer as determined from the carrier’s rate35-29
manual for the class of business.35-30
Sec. 53. NRS 689C.270 is hereby amended to read as follows: 689C.270 1. The commissioner shall adopt regulations which require35-32
a carrier to file with the commissioner, for his approval, a disclosure35-33
offered by the carrier to a small employer. The disclosure must include:35-34
(a) Any significant exception, reduction or limitation that applies to the35-35
policy;35-36
(b) Any restrictions on payments for emergency care, including, without35-37
limitation, related definitions of an emergency and medical necessity;35-38
(c) The provision of the health benefit plan concerning the carrier’s right35-39
to change premium rates and the characteristics, other than claim35-40
experience, that affect changes in premium rates;35-41
(d) The provisions relating to renewability of policies and contracts;35-42
(e) The provisions relating to any preexisting condition; and36-1
(f) Any other information that the commissioner finds necessary to36-2
provide for full and fair disclosure of the provisions of a policy or contract36-3
of insurance issued pursuant to this chapter.36-4
2. The disclosure must be written in language which is easily36-5
understood and must include a statement that the disclosure is a summary36-6
of the policy only, and that the policy itself should be read to determine the36-7
governing contractual provisions.36-8
3. The commissioner shall not approve any proposed disclosure36-9
submitted to him pursuant to this section which does not comply with the36-10
requirements of this section and the applicable regulations.36-11
4. The carrier shall make available to a small employer or a producer36-12
acting on behalf of a small employer, upon request a copy of the36-13
disclosure approved by the commissioner pursuant to this section for36-14
policies of health insurance for which that employer may be eligible.36-15
Sec. 54. NRS 689C.310 is hereby amended to read as follows: 689C.310 1. Except as otherwise provided in subsections 2 and 3, a36-17
carrier shall renew a health benefit plan at the option of the small employer36-18
who purchased the plan.36-19
2. A carrier may refuse to issue or to renew a health benefit plan if:36-20
(a) The carrier discontinues transacting insurance in this state or in the36-21
geographic area of this state where the employer is located;36-22
(b) The employer fails to pay the premiums or contributions required by36-23
the terms of the plan;36-24
(c) The employer misrepresents any information regarding the36-25
employees covered under the plan or other information regarding eligibility36-26
for coverage under the plan;36-27
(d) The plan sponsor has engaged in an act or practice that constitutes36-28
fraud to obtain or maintain coverage under the plan;36-29
(e) The employer is not in compliance with the minimum requirements36-30
for participation or employer contribution as set forth in the plan; or36-31
(f) The employer fails to comply with any of the provisions of this36-32
chapter.36-33
3.36-34
36-35
36-36
36-37
36-38
36-39
a small employer if the commissioner finds that the continuation of the36-40
coverage would not be in the best interests of the policyholders or36-41
certificate holders of the carrier in this state or would impair the ability of36-42
the carrier to meet its contractual obligations. If the commissioner makes37-1
such a finding, the commissioner shall assist the affected small employers37-2
in finding replacement coverage.37-3
37-4
a product of a health benefit plan offered to small employers pursuant to37-5
this chapter if the commissioner finds that the form of the product offered37-6
by the carrier is obsolete and is being replaced with comparable coverage.37-7
A form of a product of a health benefit plan may be discontinued by a37-8
carrier pursuant to this subsection only if:37-9
(a) The carrier notifies the commissioner and the chief regulatory officer37-10
for insurance in each state in which it is licensed of its decision pursuant to37-11
this subsection to discontinue the issuance and renewal of the form of the37-12
product at least 60 days before the carrier notifies the affected small37-13
employers pursuant to paragraph (b).37-14
(b) The carrier notifies each affected small employer and the37-15
commissioner and the chief regulatory officer for insurance in each state in37-16
which any affected small employer is located or eligible employee resides37-17
of the decision of the carrier to discontinue offering the form of the37-18
product. The notice must be made at least 180 days before the date on37-19
which the carrier will discontinue offering the form of the product.37-20
(c) The carrier offers to each affected small employer the option to37-21
purchase any other health benefit plan currently offered by the carrier to37-22
small employers in this state.37-23
(d) In exercising the option to discontinue the particular form of the37-24
product and in offering the option to purchase other coverage pursuant to37-25
paragraph (c), the carrier acts uniformly without regard to the claims37-26
experience of the affected small employers or any health status-related37-27
factor relating to any participant or beneficiary covered by the discontinued37-28
product or any new participant or beneficiary who may become eligible for37-29
37-30
37-31
5. A carrier may discontinue the issuance and renewal of a health37-32
benefit plan offered to a small employer or an eligible employee pursuant37-33
to this chapter only through a bona fide association if:37-34
(a) The membership of the small employer or eligible employee in the37-35
association was the basis for the provision of coverage;37-36
(b) The membership of the small employer or eligible employee in the37-37
association ceases; and37-38
(c) The coverage is terminated pursuant to this subsection uniformly37-39
without regard to any health status-related factor relating to the small37-40
employer or eligible employee or his dependent.37-41
37-42
service area of this state, the provisions of this section apply only to the37-43
operations of the carrier in that service area.38-1
Sec. 55. NRS 689C.610 is hereby amended to read as follows: 689C.610 As used in NRS 689C.610 to 689C.980, inclusive, and38-3
section 46 of this act, unless the context otherwise requires, the words and38-4
terms defined in NRS 689C.620 to 689C.730, inclusive, have the meanings38-5
ascribed to them in those sections.38-6
Sec. 56. NRS 689C.870 is hereby amended to read as follows: 689C.870 1. If, in each of 2 consecutive years, the board determines38-8
that the amount of the assessment needed exceeds 5 percent of the total38-9
premiums earned in the previous calendar year from health benefit plans38-10
delivered or issued for delivery to small employers by reinsuring carriers,38-11
the program of reinsurance is eligible for additional funding pursuant to this38-12
section.38-13
2. If, in each of 2 consecutive years, the board determines that the38-14
amount of the assessment needed exceeds 5 percent of the total premiums38-15
earned in the previous calendar year from health benefit plans delivered or38-16
issued for delivery to individuals by individual reinsuring carriers, the38-17
program of reinsurance is eligible for additional funding pursuant to this38-18
section.38-19
3. To raise38-20
formula pursuant to which additional assessments may be made on all38-21
carriers that offer a health benefit plan or provide stop-loss coverage for a38-22
health benefit plan which is an38-23
plan or a plan established pursuant to the Labor-Management Relations38-24
Act, 1947, as amended. The total additional assessments on all such38-25
carriers combined may not exceed one-half of 1 percent of the total38-26
premiums earned from all health benefit plans and stop-loss coverage38-27
issued in this state in the previous calendar year.38-28
Sec. 57. NRS 690B.042 is hereby amended to read as follows: 690B.042 1. Except as otherwise provided in subsection 2, any party38-30
against whom a claim is asserted for compensation or damages for personal38-31
injury under a policy of motor vehicle insurance covering a private38-32
passenger car may require any attorney representing the claimant to provide38-33
to the party and his insurer or attorney, not more than once every 90 days,38-34
all medical reports38-35
2. In lieu of providing medical reports38-36
to subsection 1, the claimant or any attorney representing the claimant may38-37
38-38
38-39
party, his insurer or his attorney a written authorization to receive the38-40
reports, records and bills from the provider of health care. At the written38-41
request of the claimant or his attorney, copies of all reports, records and38-42
bills obtained pursuant to the authorization must be provided to the38-43
claimant or his attorney within 30 days after the date they are received. If39-1
the claimant or his attorney makes a written request for the reports,39-2
records and bills, the claimant or his attorney shall pay for the39-3
reasonable costs of copying the reports, records and bills.39-4
3. Upon receipt of any photocopies of medical reports39-5
and bills , or a written authorization pursuant to subsection 2, the insurer39-6
who issued the policy specified in subsection 1 shall, upon request,39-7
immediately disclose to the insured or the claimant all pertinent facts or39-8
provisions of the policy relating to any coverage at issue.39-9
Sec. 58. NRS 692A.105 is hereby amended to read as follows: 692A.105 1. The commissioner may refuse to license any title agent39-11
or escrow officer or may suspend or revoke any license or impose a fine of39-12
not more than $500 for each violation by entering an order to that effect,39-13
with his findings in respect thereto, if upon a hearing, it is determined that39-14
the applicant or licensee:39-15
(a) In the case of a title agent, is insolvent or in such a financial39-16
condition that he cannot continue in business with safety to his customers;39-17
(b) Has violated any provision of this chapter or any regulation adopted39-18
pursuant thereto or has aided and abetted another to do so;39-19
(c) Has committed fraud in connection with any transaction governed by39-20
this chapter;39-21
(d) Has intentionally or knowingly made any misrepresentation or false39-22
statement to, or concealed any essential or material fact known to him from,39-23
any principal or designated agent of the principal in the course of the39-24
escrow business;39-25
(e) Has intentionally or knowingly made or caused to be made to the39-26
commissioner any false representation of a material fact or has suppressed39-27
or withheld from him any information which the applicant or licensee39-28
possesses;39-29
(f) Has failed without reasonable cause to furnish to the parties of an39-30
escrow their respective statements of the settlement within a reasonable39-31
time after the close of escrow;39-32
(g) Has failed without reasonable cause to deliver, within a reasonable39-33
time after the close of escrow, to the respective parties of an escrow39-34
transaction any money, documents or other properties held in escrow in39-35
violation of the provisions of the escrow instructions;39-36
(h) Has refused to permit an examination by the commissioner of his39-37
books and affairs or has refused or failed, within a reasonable time, to39-38
furnish any information or make any report that may be required by the39-39
commissioner pursuant to the provisions of this chapter;39-40
(i) Has been convicted of a felony or any misdemeanor of which an39-41
essential element is fraud;39-42
(j) In the case of a title agent, has failed to maintain complete and39-43
accurate records of all transactions within the last 7 years;40-1
(k) Has commingled the money of40-2
or converted the money of40-3
(l) Has failed, before the close of escrow, to obtain written instructions40-4
concerning any essential or material fact or intentionally failed to follow40-5
the written instructions which have been agreed upon by the parties and40-6
accepted by the holder of the escrow;40-7
(m) Has failed to disclose in writing that he is acting in the dual capacity40-8
of escrow agent or agency and undisclosed principal in any transaction;40-9
(n) In the case of an escrow officer, has been convicted of, or entered a40-10
plea of guilty or nolo contendere to, any crime involving moral turpitude40-11
; or40-12
(o) Has failed to obtain and maintain a copy of the executed40-13
agreement or contract that establishes the conditions for the sale of real40-14
property.40-15
2. It is sufficient cause for the imposition of a fine or the refusal,40-16
suspension or revocation of the license of a partnership, corporation or any40-17
other association if any member of the partnership or any officer or director40-18
of the corporation or association has been guilty of any act or omission40-19
directly arising from the business activities of a title agent which would be40-20
cause for such action had the applicant or licensee been a natural person.40-21
3. The commissioner may suspend or revoke the license of a title agent,40-22
or impose a fine, if the commissioner finds that the title agent:40-23
(a) Failed to maintain adequate supervision of an escrow officer title40-24
agent he has appointed or employed.40-25
(b) Instructed an escrow officer to commit an act which would be cause40-26
for the revocation of the escrow officer’s license and the escrow officer40-27
committed the act. An escrow officer is not subject to disciplinary action40-28
for committing such an act under instruction by the title agent.40-29
4. The commissioner may refuse to issue a license to any person who,40-30
within 10 years before the date of applying for a current license, has had40-31
suspended or revoked a license issued pursuant to this chapter or a40-32
comparable license issued by any other state, district or territory of the40-33
United States or any foreign country.40-34
Sec. 59. Chapter 695C of NRS is hereby amended by adding thereto a40-35
new section to read as follows:40-36
1. To the extent authorized by federal law, the commissioner shall40-37
adopt regulations for the licensing of provider-sponsored organizations40-38
in this state.40-39
2. As used in this section, "provider-sponsored organization" has the40-40
meaning ascribed to it in 42 U.S.C. § 1395w-25(d).40-41
Sec. 60. NRS 695C.350 is hereby amended to read as follows: 695C.350 1. The commissioner may, in lieu of suspension or40-43
revocation of a certificate of authority under NRS 695C.330, levy an41-1
administrative penalty in an amount not less than $1,000 nor more than41-2
$2,50041-3
of the intent to levy the penalty .41-4
41-5
41-6
2. Any person who violates the provisions of this chapter is guilty of a41-7
misdemeanor.41-8
3. If the commissioner or the state board of health for any reason have41-9
cause to believe that any violation of this chapter has occurred or is41-10
threatened, the commissioner or the state board of health may give notice to41-11
the health maintenance organization and to the representatives, or other41-12
persons who appear to be involved in41-13
arrange a conference with the alleged violators or their authorized41-14
representatives41-15
determine the facts relating to41-16
41-17
at an adequate and effective means of correcting or preventing41-18
violation.41-19
4.41-20
pursuant to the provisions of subsection 3 must not be governed by any41-21
formal procedural requirements, and may be conducted in such manner as41-22
the commissioner or the state board of health may deem appropriate under41-23
the circumstances.41-24
5. The commissioner may issue an order directing a health maintenance41-25
organization or a representative of a health maintenance organization to41-26
cease and desist from engaging in any act or practice in violation of the41-27
provisions of this chapter.41-28
6. Within 30 days after service of the order41-29
respondent may request a hearing on the question of whether acts or41-30
practices in violation of this chapter have occurred.41-31
41-32
41-33
provisions of chapter 233B of NRS and judicial review must be available41-34
as provided therein.41-35
7. In the case of any violation of the provisions of this chapter, if the41-36
commissioner elects not to issue a cease and desist order, or in the event of41-37
noncompliance with a cease and desist order issued pursuant to subsection41-38
5, the commissioner may institute a proceeding to obtain injunctive relief,41-39
or seek other appropriate relief in the district court of the judicial district of41-40
the county in which the violator resides.41-41
Sec. 61. NRS 696B.415 is hereby amended to read as follows: 696B.415 1. Upon the issuance of an order of liquidation with a41-43
finding of insolvency against a domestic insurer, the commissioner shall42-1
apply to the district court for authority to disburse money to the Nevada42-2
insurance guaranty association or the Nevada life and health insurance42-3
guaranty association out of the42-4
insurer, as money becomes available, in amounts equal to disbursements42-5
made or to be made by the association for claims-handling expense and42-6
covered-claims obligations upon the presentation of evidence that42-7
disbursements have been made by the association. The commissioner shall42-8
apply to the district court for authority to make similar disbursements to42-9
insurance guaranty associations in other jurisdictions if one of the Nevada42-10
associations is entitled to like payment42-11
relating to insolvent insurers in the jurisdiction in which the organization is42-12
domiciled.42-13
2. The commissioner, in determining the amounts available for42-14
disbursement to the Nevada insurance guaranty association, the Nevada life42-15
and health insurance guaranty association, and similar organizations in42-16
other jurisdictions, shall reserve sufficient assets for the payment of the42-17
expenses of administration.42-18
3. The commissioner shall establish procedures for the ratable42-19
allocation of disbursements to the Nevada insurance guaranty association,42-20
the Nevada life and health insurance guaranty association, and similar42-21
organizations in other jurisdictions, and shall secure from each organization42-22
to which money is paid as a condition to advances in reimbursement of42-23
covered-claims obligations an agreement to return to the commissioner, on42-24
demand, amounts previously advanced which are required to pay claims of42-25
secured creditors and claims falling within the priorities established in42-26
paragraph (a) or (b) of subsection 1 of NRS 696B.420 .42-27
42-28
42-29
Sec. 62. NRS 696B.420 is hereby amended to read as follows: 696B.420 1. The order of distribution of claims from the42-31
estate of the insurer on liquidation of the insurer must be as42-32
forth in this section.42-33
42-34
42-35
42-36
42-37
each class must be paid in full or adequate money retained for the payment42-38
before the members of the next class receive any payment. No subclasses42-39
may be established within any class. Except as otherwise provided in42-40
subsection 2, the order of distribution and of priority must be as follows:42-41
(a) Administration costs and expenses, including, but not limited to, the42-42
following:43-1
(1) The actual and necessary costs of preserving or recovering the43-2
assets of the insurer;43-3
(2) Compensation for43-4
(3) Any necessary filing fees;43-5
(4) The fees and mileage payable to witnesses; and43-6
(5) Reasonable attorney’s fees.43-7
(b) Loss claims, including43-8
incurred, including third party claims,43-9
for liability for bodily injury or for injury to or destruction of tangible43-10
property which are not under policies, and43-11
insurance guaranty association, the Nevada life and health insurance43-12
guaranty association, and other similar statutory organizations in other43-13
jurisdictions .43-14
43-15
annuity policies, whether for death proceeds, annuity proceeds or43-16
investment values, must be treated as loss claims.43-17
43-18
43-19
by other benefits or advantages recovered or recoverable by the claimant43-20
may not be included in this class, other than benefits or advantages43-21
recovered or recoverable in discharge of familial obligations of support or43-22
43-23
as gratuities. No payment made by an employer to his employee may be43-24
treated as a gratuity.43-25
(c) Unearned premiums and small loss claims, including claims under43-26
nonassessable policies for unearned premiums or other premium refunds .43-27
43-28
43-29
(d) Claims of the Federal Government .43-30
(e) Claims of any state or local government, including, but not limited43-31
to, a claim of43-32
penalty or forfeiture.43-33
43-34
exceed $1,000 to each employee, that have been earned within 1 year43-35
before the filing of the petition for liquidation. Officers of the insurer are43-36
not entitled to the benefit of this priority. The priority set forth in this43-37
paragraph must be in lieu of any other similar priority authorized by law as43-38
to wages or compensation of employees.43-39
43-40
within other classes43-41
Claims for a penalty or forfeiture must be allowed in this class only to the43-42
extent of the pecuniary loss sustained from the act, transaction or43-43
proceeding out of which the penalty or forfeiture arose, with reasonable and44-1
actual costs occasioned thereby. The remainder of44-2
be postponed to the class of claims44-3
44-4
(h) Judgment claims based solely on judgments. If a claimant files a44-5
claim and bases44-6
facts, the claim must be considered by the liquidator, who shall give the44-7
judgment such weight as he deems appropriate. The claim as allowed must44-8
receive the priority it would receive in the absence of the judgment. If the44-9
judgment is larger than the allowance on the underlying claim, the44-10
remaining portion of the judgment must be treated as if it were a claim44-11
based solely on a judgment.44-12
44-13
legal rate compounded annually on44-14
specified in paragraphs (a) to44-15
petition for liquidation or the date on which the claim becomes due,44-16
whichever is later, until the date on which the dividend is declared. The44-17
liquidator, with the approval of the court, may44-18
(1) Make reasonable classifications of claims for purposes of44-19
computing interest44-20
(2) Make approximate computations ; and44-21
(3) Ignore certain classifications and periods as de minimis.44-22
44-23
44-24
paragraph44-25
44-26
44-27
44-28
(1) Claims subordinated by NRS 696B.430;44-29
44-30
44-31
44-32
(4) Claims or portions of claims the payment of which is provided by44-33
other benefits or advantages recovered or recoverable by the claimant; and44-34
44-35
44-36
notes, or similar obligations, and premium refunds on assessable policies.44-37
Interest at the legal rate must be added to each claim, as provided in44-38
paragraphs44-39
44-40
(l) Proprietary claims of shareholders or other owners.44-41
2. If there are no existing or potential claims of the government against44-42
the estate, claims for wages have priority over44-43
paragraphs (c) to45-1
subsection must not be construed to require the45-2
accumulation of interest for claims as described in paragraph45-3
subsection 1.45-4
Sec. 63. NRS 697.090 is hereby amended to read as follows: 697.090 1. A person in this state shall not act in the capacity of a bail45-6
agent, bail enforcement agent or bail solicitor, or perform any of the45-7
functions, duties or powers prescribed for a bail agent, bail enforcement45-8
agent or bail solicitor under the provisions of this chapter, unless that45-9
person is qualified and licensed as provided in this chapter. The45-10
commissioner may, after notice and a hearing, impose a fine of not more45-11
than $1,000 for each act or violation of the provisions of this subsection.45-12
2. A person, whether or not located in this state, shall not act as or hold45-13
himself out to be a general agent unless qualified and licensed as such45-14
under the provisions of this chapter.45-15
3. For the protection of the people of this state, the commissioner shall45-16
not issue or renew, or permit to exist, any license except in compliance with45-17
this chapter. The commissioner shall not issue or renew, or permit to exist,45-18
a license for any person found to be untrustworthy or incompetent, or who45-19
has not established to the satisfaction of the commissioner that he is45-20
qualified therefor in accordance with this chapter.45-21
Sec. 64. NRS 697.184 is hereby amended to read as follows: 697.184 1. An application for a license as a general agent must be45-23
accompanied by:45-24
(a) Proof of the completion of a 6-hour course of instruction in bail45-25
bonds that is:45-26
(1) Offered by a state or national organization of bail agents or45-27
another organization that administers training programs for general agents;45-28
and45-29
(2) Approved by the commissioner.45-30
(b) A written appointment by an authorized insurer as general agent,45-31
subject to the issuance of the license.45-32
(c) A letter from a local law enforcement agency in the applicant’s45-33
county of residence which indicates that the applicant:45-34
(1) Has not been convicted of a felony in this state or of any offense45-35
committed in another state which would be a felony if committed in this45-36
state; and45-37
(2) Has not been convicted of an offense involving moral turpitude or45-38
the unlawful use, sale or possession of a controlled substance.45-39
(d) A copy of the contract or agreement that authorizes the general45-40
agent to act as general agent for the insurer.45-41
(e) Any other information the commissioner may require.45-42
2. If the applicant for a license as a general agent is a firm or45-43
corporation, the application must include the names of the members,46-1
officers and directors and designate each natural person who is to exercise46-2
the authority granted by the license. Each person so designated must furnish46-3
information about himself as though the application were for an individual46-4
license.46-5
Sec. 65. NRS 697.190 is hereby amended to read as follows: 697.190 1.46-7
46-8
with the application, and thereafter maintain in force while so licensed, a46-9
bond in favor of the people of the State of Nevada executed by an46-10
authorized surety insurer. The bond may be continuous in form with total46-11
aggregate liability limited to payment as follows:46-12
(a) Bail agent $25,00046-13
(b) Bail solicitor 10,00046-14
(c) General agent 50,00046-15
2. The bond must be conditioned upon full accounting and payment to46-16
the person entitled thereto of money, property or other matters coming into46-17
the licensee’s possession through bail bond transactions under the license.46-18
3. The bond must remain in force until released by the commissioner,46-19
or canceled by the surety. Without prejudice to any liability previously46-20
incurred under the bond, the surety may cancel the bond upon 30 days’46-21
advance written notice to the licensee and the commissioner.46-22
Sec. 66. NRS 616B.500 is hereby amended to read as follows: 616B.500 1. An insurer may enter into a contract to have his plan of46-24
insurance administered by a third-party administrator.46-25
2. An insurer shall not enter into a contract with any person for the46-26
administration of any part of the plan of insurance unless that person46-27
maintains an office in this state and has a46-28
commissioner pursuant to46-29
system may, as a part of a contract entered into with an organization for46-30
managed care pursuant to NRS 616B.515, require the organization to act as46-31
its third-party administrator.46-32
Sec. 67. NRS 616B.503 is hereby amended to read as follows: 616B.503 1. A person shall not act as a third-party administrator for46-34
an insurer without a certificate issued by the commissioner pursuant to46-35
46-36
2. A person who acts as a third-party administrator pursuant to chapters46-37
616A to 616D, inclusive, of NRS shall:46-38
(a) Administer from one or more offices located in this state all of the46-39
claims arising under each plan of insurance that he administers and46-40
maintain in those offices all of the records concerning those claims;46-41
(b) Administer each plan of insurance directly, without subcontracting46-42
with another third-party administrator; and47-1
(c) Upon the termination of his contract with an insurer, transfer47-2
forthwith to a certified third-party administrator chosen by the insurer all of47-3
the records in his possession concerning claims arising under the plan of47-4
insurance.47-5
3. The commissioner may, under exceptional circumstances, waive the47-6
requirements of subsection 2.47-7
Sec. 68. NRS 683A.0867, 686C.060 and 686C.085 are hereby47-8
repealed.
47-9
TEXT OF REPEALED SECTIONS683A.0867 Standards to be provided in agreement. The
47-11
agreement between the administrator and the insurer shall provide for47-12
underwriting and other standards pertaining to the business underwritten by47-13
the insurer.47-14
686C.060 "Board" defined. "Board" means the board of directors47-15
of the Nevada Life and Health Insurance Guaranty Association. 686C.085 "Domiciliary state" defined. "Domiciliary state" has the47-17
meaning ascribed to it in NRS 696B.070.~