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; or2-1
2. Prevent the imposition or collection of any fine or penalty2-2
authorized pursuant to the provisions of this code against the holder of2-3
the license or certificate.2-4
Sec. 2. NRS 679B.190 is hereby amended to read as follows: 679B.190 1. The commissioner shall carefully preserve in the2-6
division and in permanent form all papers and records relating to the2-7
business and transactions of the division and shall hand them over to his2-8
successor in office.2-9
2. Except as otherwise provided in subsections 3, 5 and 6 ,2-10
provisions of this code and NRS 616B.015, the papers and records must be2-11
open to public inspection.2-12
3. Any records or information in the possession of the division related2-13
to an investigation2-14
confidential2-15
(a) The commissioner releases, in the manner that he deems appropriate,2-16
all or any part of the records or information for public inspection after2-17
determining that the release of the records or information:2-18
(1) Will not harm his investigation2-19
who is being investigated ;2-20
(2) Serves the interests of a policyholder, the shareholders of the2-21
insurer or the public; or2-22
(b) A court orders the release of the records or information after2-23
determining that the production of the records or information will not2-24
damage any investigation being conducted by the commissioner.2-25
4. The commissioner may destroy unneeded or obsolete records and2-26
filings in the division in accordance with provisions and procedures2-27
applicable in general to administrative agencies of this state.2-28
5. The commissioner may classify as confidential certain records and2-29
information obtained from a governmental agency or other sources upon2-30
the express condition that they remain confidential.2-31
6. All information and documents in the possession of the division or2-32
any of its employees which are related to cases or matters under2-33
investigation2-34
confidential for the2-35
may not be made public unless the commissioner finds the existence of an2-36
imminent threat of harm to the safety or welfare of the policyholder,2-37
shareholders or the public and determines that the interests of the2-38
policyholder, shareholders or the public will be served by publication2-39
thereof, in which event he may make a record public or publish all or any2-40
part of the record in any manner he deems appropriate.3-1
Sec. 3. NRS 679B.440 is hereby amended to read as follows: 679B.440 1. The commissioner may require that reports submitted3-3
pursuant to NRS 679B.430 include, without limitation, information3-4
regarding:3-5
(a) Liability insurance provided to:3-6
(1) Governmental agencies and political subdivisions of this state,3-7
reported separately for:3-8
(I) Cities and towns;3-9
(II) School districts; and3-10
(III) Other political subdivisions;3-11
(2) Public officers;3-12
(3) Establishments where alcoholic beverages are sold;3-13
(4) Facilities for the care of children;3-14
(5) Labor, fraternal or religious organizations; and3-15
(6) Officers or directors of organizations formed pursuant to Title 73-16
of NRS, reported separately for nonprofit entities and entities organized for3-17
profit;3-18
(b) Liability insurance for:3-19
(1) Defective products;3-20
(2) Medical malpractice;3-21
(3) Malpractice of attorneys;3-22
(4) Malpractice of architects and engineers; and3-23
(5) Errors and omissions by other professionally qualified persons;3-24
3-25
(c) Vehicle insurance, reported separately for:3-26
(1) Private vehicles;3-27
(2) Commercial vehicles;3-28
(3) Liability insurance; and3-29
(4) Insurance for property damage3-30
(d) Workers’ compensation insurance.3-31
2. The commissioner may require that the report include, without3-32
limitation, information specifically pertaining to this state or to an insurer in3-33
its entirety, in the aggregate or by type of insurance, and for a previous or3-34
current year, regarding:3-35
(a) Premiums directly written;3-36
(b) Premiums directly earned;3-37
(c) Number of policies issued;3-38
(d) Net investment income, using appropriate estimates when necessary;3-39
(e) Losses paid;3-40
(f) Losses incurred;3-41
(g) Loss reserves, including:3-42
(1) Losses unpaid on reported claims; and3-43
(2) Losses unpaid on incurred but not reported claims;4-1
(h) Number of claims, including:4-2
(1) Claims paid; and4-3
(2) Claims that have arisen but are unpaid;4-4
(i) Expenses for adjustment of losses, including allocated and4-5
unallocated losses;4-6
(j) Net underwriting gain or loss;4-7
(k) Net operation gain or loss, including net investment income; and4-8
(l) Any other information requested by the commissioner.4-9
3. The commissioner may also obtain, based upon an insurer in its4-10
entirety, information regarding:4-11
(a) Recoverable federal income tax;4-12
(b) Net unrealized capital gain or loss; and4-13
(c) All other expenses not included in subsection 2.4-14
Sec. 4. NRS 680B.010 is hereby amended to read as follows: 680B.010 The commissioner shall collect in advance and receipt for,4-16
and persons so served must pay to the commissioner, fees and4-17
miscellaneous charges as follows:4-18
1. Insurer’s certificate of authority:4-19
(a) Filing initial application $2,4504-20
(b) Issuance of certificate:4-21
(1) For any one kind of insurance as defined in NRS4-22
681A.010 to 681A.080, inclusive 2834-23
(2) For two or more kinds of insurance as so defined 5784-24
(3) For a reinsurer 2,4504-25
(c) Each annual continuation of a certificate 2,4504-26
(d) Reinstatement pursuant to NRS 680A.180, 50 percent of4-27
the annual continuation fee otherwise required.4-28
(e) Registration of additional title pursuant to NRS 680A.240 504-29
(f) Annual renewal of the registration of additional title4-30
pursuant to NRS 680A.240 254-31
2. Charter documents, other than those filed with an4-32
application for a certificate of authority. Filing amendments to4-33
articles of incorporation, charter, bylaws, power of attorney and4-34
other constituent documents of the insurer, each document $104-35
3. Annual statement or report. For filing annual statement or4-36
report $254-37
4. Service of process:4-38
(a) Filing of power of attorney $54-39
(b) Acceptance of service of process 304-40
5. Agents’ licenses, appointments and renewals:4-41
(a) Resident agents and nonresident agents qualifying under4-42
subsection 3 of NRS 683A.340:4-43
(1) Application and license $785-1
(2) Appointment by each insurer $55-2
(3) Triennial renewal of each license 785-3
(4) Temporary license 105-4
(b) Other nonresident agents:5-5
(1) Application and license 1385-6
(2) Appointment by each insurer 255-7
(3) Triennial renewal of each license 1385-8
6. Brokers’ licenses and renewals:5-9
(a) Resident brokers and nonresident brokers qualifying under5-10
subsection 3 of NRS 683A.340:5-11
(1) Application and license $785-12
(2) Triennial renewal of each license 785-13
(b) Other nonresident brokers:5-14
(1) Application and license 2585-15
(2) Triennial renewal of each license 2585-16
(c)5-17
(1) Application and license 785-18
(2) Triennial renewal of each license 785-19
(d) Nonresident surplus lines brokers:5-20
(1) Application and license 2585-21
(2) Triennial renewal of each license 2585-22
7. Solicitors’ licenses, appointments and renewals:5-23
(a) Application and license $785-24
(b) Triennial renewal of each license 785-25
(c) Initial appointment 55-26
8. Managing general agents’ licenses, appointments and5-27
renewals:5-28
(a) Resident managing general agents:5-29
(1) Application and license $785-30
(2) Initial appointment, each insurer 55-31
(3) Triennial renewal of each license 785-32
(b) Nonresident managing general agents:5-33
(1) Application and license 1385-34
(2) Initial appointment, each insurer 255-35
(3) Triennial renewal of each license 1385-36
9. Adjusters’ licenses and renewals:5-37
(a) Independent and public adjusters:5-38
(1) Application and license $785-39
(2) Triennial renewal of each license 785-40
(b) Associate adjusters:5-41
(1) Application and license 785-42
(2) Initial appointment 55-43
(3) Triennial renewal of each license 786-1
10. Licenses and renewals for appraisers of physical damage6-2
to motor vehicles:6-3
(a) Application and license $786-4
(b) Triennial renewal of each license 786-5
11. Additional title and property insurers pursuant to NRS6-6
680A.240:6-7
(a) Original registration $506-8
(b) Annual renewal 256-9
12. Insurance vending machines:6-10
(a) Application and license, for each machine $786-11
(b) Triennial renewal of each license 786-12
13. Permit for solicitation for securities:6-13
(a) Application for permit $1006-14
(b) Extension of permit 506-15
14. Securities salesmen for domestic insurers:6-16
(a) Application and license $256-17
(b) Annual renewal of license 156-18
15. Rating organizations:6-19
(a) Application and license $5006-20
(b) Annual renewal 5006-21
16. Certificates and renewals for administrators licensed6-22
pursuant to chapter 683A of NRS:6-23
(a) Resident administrators:6-24
(1) Application and certificate of registration $786-25
(2) Triennial renewal 786-26
(b) Nonresident administrators:6-27
(1) Application and certificate of registration 1386-28
(2) Triennial renewal 1386-29
17. For copies of the insurance laws of Nevada, a fee which6-30
is not less than the cost of producing the copies.6-31
18. Certified copies of certificates of authority and licenses6-32
issued pursuant to the insurance code $106-33
19. For copies and amendments of documents on file in the6-34
division, a reasonable charge fixed by the commissioner,6-35
including charges for duplicating or amending the forms and for6-36
certifying the copies and affixing the official seal.6-37
20. Letter of clearance for an agent or broker $106-38
21. Certificate of status as a licensed agent or broker $106-39
22. Licenses, appointments and renewals for bail agents:6-40
(a) Application and license $786-41
(b) Initial appointment by each surety insurer 56-42
(c) Triennial renewal of each license 786-43
23. Licenses and renewals for bail enforcement agents:7-1
(a) Application and license $787-2
(b) Triennial renewal of each license 787-3
24. Licenses, appointments and renewals for general bail7-4
agents:7-5
(a) Application and license $787-6
(b) Initial appointment by each insurer 57-7
(c) Triennial renewal of each license $787-8
25. Licenses and renewals for bail solicitors:7-9
(a) Application and license $787-10
(b) Triennial renewal of each license 787-11
26. Licenses and renewals for title agents and escrow7-12
officers:7-13
(a) Resident title agents and escrow officers:7-14
(1) Application and license $787-15
(2) Triennial renewal of each license 787-16
(b) Nonresident title agents and escrow officers:7-17
(1) Application and license 1387-18
(2) Triennial renewal of each license 1387-19
(c) Change in name or location of business or in association 107-20
27. Certificate of authority and renewal for a seller of7-21
prepaid funeral contracts $787-22
28. Licenses and renewals for agents for prepaid funeral7-23
contracts:7-24
(a) Resident agents:7-25
(1) Application and license $787-26
(2) Triennial renewal of each license 787-27
(b) Nonresident agents:7-28
(1) Application and license 1387-29
(2) Triennial renewal of each license 1387-30
29. Licenses, appointments and renewals for agents for7-31
fraternal benefit societies:7-32
(a) Resident agents:7-33
(1) Application and license $787-34
(2) Appointment 57-35
(3) Triennial renewal of each license 787-36
(b) Nonresident agents:7-37
(1) Application and license 1387-38
(2) Triennial renewal of each license 1387-39
30. Reinsurance intermediary broker or manager:7-40
(a) Resident agents:7-41
(1) Application and license $787-42
(2) Triennial renewal of each license 787-43
(b) Nonresident agents:8-1
(1) Application and license $1388-2
(2) Triennial renewal of each license 1388-3
31. Agents for and sellers of prepaid burial contracts:8-4
(a) Resident agents and sellers:8-5
(1) Application and certificate or license $788-6
(2) Triennial renewal 788-7
(b) Nonresident agents and sellers:8-8
(1) Application and certificate or license $1388-9
(2) Triennial renewal 1388-10
32. Risk retention groups:8-11
(a) Initial registration and review of an application $2,4508-12
(b) Each annual continuation of a certificate of registration 2,4508-13
33. Required filing of forms:8-14
(a) For rates and policies $258-15
(b) For riders and endorsements 108-16
Sec. 5. NRS 681B.290 is hereby amended to read as follows: 681B.290 1.8-18
or before March 1 of each year, each domestic insurer, and each foreign8-19
insurer domiciled in a state which does not have requirements for reporting8-20
risk-based capital, that transacts property, casualty, life or health insurance8-21
in this state shall prepare and submit to the commissioner, and to each8-22
person designated by the commissioner, a report of the level of the risk-8-23
based capital of the insurer as of the end of the immediately preceding8-24
calendar year. The report must be in such form and contain such8-25
information as required by the regulations adopted by the commissioner8-26
pursuant to this section.8-27
2. The commissioner shall adopt regulations concerning the amount of8-28
risk-based capital required to be maintained by each insurer licensed to do8-29
business in this state that is transacting property, casualty, life or health8-30
insurance in this state. The regulations must be consistent with the8-31
instructions for reporting risk-based capital adopted by the National8-32
Association of Insurance Commissioners, as those instructions existed on8-33
January 1, 1997. If the instructions are amended, the commissioner may8-34
amend the regulations to maintain consistency with the instructions if he8-35
determines that the amended instructions are appropriate for use in this8-36
state.8-37
3. The commissioner may exempt from the provisions of this section8-38
a domestic insurer who:8-39
(a) Does not transact insurance in any other state; and8-40
(b) Does not assume reinsurance that is more than 5 percent of the8-41
direct premiums written by the insurer.9-1
Sec. 5.2. NRS 682A.100 is hereby amended to read as follows: 682A.100 1. An insurer may invest in preferred or guaranteed stocks9-3
or shares of any solvent institution existing under the laws of the United9-4
States of America, Canada or Mexico, or of any state or province thereof, if9-5
all of the prior obligations and prior preferred stocks, if any, of9-6
institution at the date of acquisition of the investment by the insurer are9-7
eligible as investments under this chapter and if the net earnings of9-8
the institution available for its fixed charges during either of the last 2 years9-9
have been, and during each of the last 5 years have averaged, not less than9-10
1 1/2 times the sum of its average annual fixed charges, if any, its average9-11
annual maximum contingent interest, if any, and its average annual9-12
preferred dividend requirements. For the purposes of this section , such9-13
computation9-14
preceding the date of acquisition of the investment by the insurer, and the9-15
term "preferred dividend9-16
mean cumulative or noncumulative dividends, whether paid or not.9-17
2. No insurer9-18
stocks in an amount in excess of9-19
guaranteed or preferred stocks or, subject to subsection 1 of NRS9-20
682A.050 ,9-21
the insurer’s admitted assets in any one issue.9-22
Sec. 5.4. NRS 682A.110 is hereby amended to read as follows: 682A.110 An insurer may invest up to9-24
nonassessable (except as to bank or trust company stocks, and except for9-25
taxes) common stocks, other than insurance stocks, of any solvent9-26
corporation organized and existing under the laws of the United States of9-27
America, Canada or Mexico, or of any state or province thereof, if9-28
that corporation has had net earnings available for dividends on such stock9-29
in each of the 5 fiscal years next preceding acquisition by the insurer. If the9-30
issuing corporation has not been in legal existence for the whole of9-31
the 5 fiscal years , but was formed as a consolidation or merger of two or9-32
more businesses of which at least one was in operation on a date 5 years9-33
9-34
9-35
pro forma statements of the predecessor or constituent institutions.9-36
Sec. 5.6. NRS 682A.130 is hereby amended to read as follows: 682A.130 1. An insurer may invest in the stock of its subsidiary9-38
insurance corporation formed or acquired by it, or in the stock of its9-39
subsidiary business corporation or corporations formed and engaged solely9-40
in any one or more of the following businesses:9-41
(a) In any business necessary and incidental to the convenient operation9-42
of the insurer’s insurance business or to the administration of any of its9-43
lawful affairs;10-1
(b) Providing any actuarial, computer, data processing, accounting,10-2
claims, appraisal, collection, sales, loss prevention or safety engineering10-3
and similar services;10-4
(c) Real property management and development;10-5
(d) Premium financing;10-6
(e) Financing of agents of the insurer;10-7
(f) Acting as investment adviser and principal underwriter or investment10-8
adviser or principal underwriter of a management company or management10-9
companies (mutual funds), registered as such under the Investment10-10
Company Act of 1940;10-11
(g) Financial and investment counseling services;10-12
(h) Administration of self-insurance plans;10-13
(i) Administration of self-insured pension and similar plans, or the self-10-14
insured portions of such plans;10-15
(j) Securities broker-dealer;10-16
(k) Escrow services;10-17
(l) Trust services with respect to10-18
under its insurance contracts10-19
10-20
10-21
10-22
(m) A bank, thrift company, savings and loan association, or credit10-23
union; or10-24
(n) An insurance agency.10-25
2. All of the insurer’s investments under this section shall be deemed to10-26
be common stocks for the purposes of the10-27
imposed by NRS 682A.110.10-28
3. For the purposes of this section, a "subsidiary" is a corporation of10-29
which the insurer owns sufficient stock to give it effective control.10-30
Sec. 5.8. NRS 682A.190 is hereby amended to read as follows:10-31
682A.190 An insurer may invest in share or savings accounts of10-32
savings and loan associations, or in savings accounts of banks, and in any10-33
one such institution only to the extent that the investment is insured .10-34
10-35
Sec. 6. Chapter 683A of NRS is hereby amended by adding thereto the10-36
provisions set forth as sections 7 to 16, inclusive, of this act.10-37
Sec. 7. As used in NRS 683A.085 to 683A.0893, inclusive, and10-38
sections 7 to 16, inclusive, of this act, unless the context otherwise10-39
requires, the words and terms defined in sections 8 to 11, inclusive, of10-40
this act have the meanings ascribed to them in those sections.10-41
Sec. 8. "Affiliate" has the meaning ascribed to it in NRS 692C.030.10-42
Sec. 9. "Control" has the meaning ascribed to it in NRS 692C.050.11-1
Sec. 10. "Insurer" includes, without limitation:11-2
1. An insurance company licensed pursuant to the provisions of this11-3
code;11-4
2. A prepaid limited health service organization that has been issued11-5
a certificate of authority pursuant to chapter 695F of NRS;11-6
3. A health maintenance organization that has been issued a11-7
certificate of authority pursuant to chapter 695C of NRS;11-8
4. A multiple employer welfare arrangement as defined in 29 U.S.C.§ 1002;
11-9
5. An employer for whom a program of self-insurance is11-10
administered by an administrator; and11-11
6. An organization for dental care that has been issued a certificate11-12
of authority pursuant to chapter 695D of NRS.11-13
Sec. 11. "Underwrite" includes, without limitation:11-14
1. Accepting applications for insurance coverage in accordance with11-15
the written rules of an insurer;11-16
2. Planning and coordinating a program of insurance; and11-17
3. Procuring bonds and excess insurance.11-18
Sec. 12. The commissioner:11-19
1. Shall suspend or revoke the certificate of registration of an11-20
administrator if the commissioner has determined, after notice and a11-21
hearing, that the administrator:11-22
(a) Is in an unsound financial condition;11-23
(b) Uses methods or practices in the conduct of his business that are11-24
hazardous or injurious to insured persons or members of the general11-25
public; or11-26
(c) Has failed to pay any judgment against him in this state within 6011-27
days after the judgment became final.11-28
2. May suspend or revoke the certificate of registration of an11-29
administrator if the commissioner determines, after notice and a hearing,11-30
that the administrator:11-31
(a) Has willfully violated or failed to comply with any provision of this11-32
code, any regulation adopted pursuant to this code or any order of the11-33
commissioner;11-34
(b) Has refused to be examined by the commissioner or has refused to11-35
produce accounts, records or files for examination upon the request of11-36
the commissioner;11-37
(c) Has, without just cause, refused to pay claims or perform services11-38
pursuant to his contracts or has, without just cause, caused persons to11-39
accept less than the amount of money owed to them pursuant to the11-40
contracts, or has caused persons to employ an attorney or bring a civil11-41
action against him to receive full payment or settlement of claims;12-1
(d) Is affiliated with, managed by or owned by another administrator12-2
or an insurer who transacts insurance in this state without a certificate of12-3
authority or a certificate of registration;12-4
(e) Fails to comply with any of the requirements for a certificate of12-5
registration;12-6
(f) Has been convicted of, or has entered a plea of guilty or nolo12-7
contendere to a felony, whether or not adjudication was withheld; or12-8
(g) Has had his authority to act as an administrator in another state12-9
limited, suspended or revoked.12-10
3. May, upon notice to the administrator, suspend the certificate of12-11
registration of the administrator pending a hearing if:12-12
(a) The administrator is impaired or insolvent;12-13
(b) A proceeding for receivership, conservatorship or rehabilitation12-14
has been commenced against the administrator in any state; or12-15
(c) The financial condition or the business practices of the12-16
administrator represent an imminent threat to the public health, safety or12-17
welfare of the residents of this state.12-18
4. May, in addition to or in lieu of the suspension or revocation of12-19
the certificate of registration of the administrator, impose a fine of12-20
$2,000 for each act or violation.12-21
Sec. 13. Each application for a certificate of registration as an12-22
administrator must include or be accompanied by:12-23
1. A financial statement that is certified by an officer of the applicant12-24
and must include:12-25
(a) The amount of money that the applicant expects to collect from or12-26
disburse to residents of this state during the next calendar year;12-27
(b) Financial information for the 90 days immediately preceding the12-28
date the application was filed with the commissioner; and12-29
(c) An income statement and balance sheet for the 2 years12-30
immediately preceding the application that are prepared in accordance12-31
with generally accepted accounting principles. The submission by the12-32
applicant of his consolidated income statement and balance sheet does12-33
not constitute compliance with the provisions of this paragraph.12-34
2. The documents used to create the business association of the12-35
administrator, including, without limitation, articles of incorporation,12-36
articles of association, a partnership agreement, a trust agreement and a12-37
shareholder agreement.12-38
3. The documents used to regulate the internal affairs of the12-39
administrator, including, without limitation, the bylaws, rules or12-40
regulations of the administrator.12-41
4. A certificate of registration issued pursuant to NRS 600.350 for a12-42
trade name or trade-mark used by the administrator.13-1
5. An organizational chart that identifies each person who directly or13-2
indirectly controls the administrator and each affiliate of the13-3
administrator.13-4
6. A notarized affidavit from each person who manages or controls13-5
the administrator, including, without limitation, each member of the13-6
board of directors or board of trustees, each officer, partner, and member13-7
of the business association of the administrator, and each shareholder of13-8
the administrator who holds not less than 10 percent of the voting stock13-9
of the administrator. The affidavit must include, without limitation:13-10
(a) The personal history, business record and insurance experience of13-11
the affiant;13-12
(b) Whether the affiant has been investigated by any regulatory13-13
authority or has had any license or certificate denied, suspended or13-14
revoked in any state; and13-15
(c) Any other information that the commissioner may require.13-16
7. The complete name and address of each office of the13-17
administrator, including, offices located outside this state.13-18
8. A statement that sets forth whether the administrator has:13-19
(a) Held a license or certificate to transact any kind of insurance in13-20
this state or any other state and whether that license or certificate has13-21
been refused, suspended or revoked;13-22
(b) Been indebted to any person and, if so, the circumstances of that13-23
debt; and13-24
(c) Had an administrative agreement canceled and, if so, the13-25
circumstances of that cancellation.13-26
9. A statement that describes the business plan of the administrator.13-27
The statement must include information:13-28
(a) Concerning the number of persons on the staff of the13-29
administrator and the activities proposed in this state or in any other13-30
state.13-31
(b) That demonstrates the capability of the administrator to provide a13-32
sufficient number of experienced and qualified persons for the13-33
processing of claims, the keeping of records and, if applicable,13-34
underwriting.13-35
10. If the applicant intends to solicit new or renewal business, proof13-36
that the applicant employs or has contracted with an agent licensed in13-37
this state to solicit and take applications. An applicant who intends to13-38
solicit insurance contracts directly or to act as an insurance agent must13-39
provide proof that he is licensed as an insurance agent in this state.13-40
Sec. 14. 1. Except as otherwise provided by subsection 2, the13-41
commissioner shall issue a certificate of registration as an administrator13-42
to an applicant who:13-43
(a) Submits an application on a form prescribed by the commissioner;14-1
(b) Has complied with the provisions of section 13 of this act; and14-2
(c) Pays the fee for the issuance of a certificate of registration14-3
prescribed in NRS 680B.010.14-4
2. The commissioner may refuse to issue a certificate of registration14-5
as an administrator to an applicant if the commissioner determines that14-6
the applicant or any person who has completed an affidavit pursuant to14-7
subsection 6 of section 13 of this act:14-8
(a) Is not competent to act as an administrator;14-9
(b) Is not trustworthy or financially responsible;14-10
(c) Does not have a good personal or business reputation;14-11
(d) Has had a license or certificate to transact insurance denied for14-12
cause, suspended or revoked in this state or any other state; or14-13
(e) Has failed to comply with any provision of this chapter.14-14
Sec. 15. 1. A certificate of registration as an administrator is valid14-15
for 3 years after the date the commissioner issues the certificate to the14-16
administrator.14-17
2. An administrator may renew a certificate of registration if he14-18
submits to the commissioner:14-19
(a) An application on a form prescribed by the commissioner; and14-20
(b) The fee for the renewal of the certificate of registration prescribed14-21
in NRS 680B.010.14-22
3. A certificate of registration that is suspended or revoked must be14-23
surrendered immediately to the commissioner.14-24
Sec. 16. Not later than March 1 of each year, each holder of a14-25
certificate of registration as an administrator shall file a financial14-26
statement with the commissioner on a form approved by the14-27
commissioner.14-28
Sec. 17. NRS 683A.025 is hereby amended to read as follows: 683A.025 1. Except as limited by this section, "administrator" means14-30
a person who:14-31
(a)14-32
premiums from or adjusts or settles claims of residents of this state or any14-33
other state from within this state in connection with workers’14-34
compensation insurance, life or health insurance coverage or annuities,14-35
including coverage or annuities provided by an employer for his14-36
employees;14-37
(b) Administers14-38
NRS 287.010;14-39
(c) Administers a program of self-insurance for an employer;14-40
(d) Administers a program which is funded by an employer and which14-41
provides pensions, annuities, health benefits, death benefits or other similar14-42
benefits for his employees15-1
(e) Is an insurance company that is licensed to do business in this15-2
state or is acting as an insurer with respect to a policy lawfully issued and15-3
delivered in a state where the insurer is authorized to do business, if the15-4
insurance company performs any act described in paragraphs (a) to (d),15-5
inclusive, for or on behalf of another insurer.15-6
2. "Administrator" does not include:15-7
(a) An employee authorized to act on behalf of an administrator who15-8
holds a certificate of registration from the commissioner.15-9
(b) An employer acting on behalf of his employees or the employees of15-10
a subsidiary or affiliated concern.15-11
(c) A labor union acting on behalf of its members.15-12
(d)15-13
1, an insurance company licensed to do business in this state or acting as an15-14
insurer with respect to a policy lawfully issued and delivered in a state in15-15
which the insurer was authorized to do business.15-16
(e) A life or health insurance agent or broker licensed in this state, when15-17
his activities are limited to the sale of insurance.15-18
(f) A creditor acting on behalf of his debtors with respect to insurance15-19
covering a debt between the creditor and debtor.15-20
(g) A trust and its trustees, agents and employees acting for it, if the trust15-21
was established under the provisions of 29 U.S.C. § 186.15-22
(h) A trust which is exempt from taxation under section 501(a) of the15-23
Internal Revenue Code, 26 U.S.C. § 501(2), its trustees and employees, and15-24
a custodian, his agents and employees acting under a custodial account15-25
which meets the requirements of section 401(f) of the Internal Revenue15-26
Code15-27
(i) A bank, credit union or other financial institution which is subject to15-28
supervision by federal or state banking authorities.15-29
(j) A company which issues credit cards, and which advances for and15-30
collects premiums or charges from credit card holders who have authorized15-31
it to do so, if the company does not adjust or settle claims.15-32
(k) An attorney at law who adjusts or settles claims in the normal course15-33
of his practice or employment, but who does not collect charges or15-34
premiums in connection with life or health insurance coverage or with15-35
annuities.15-36
Sec. 18. NRS 683A.085 is hereby amended to read as follows: 683A.08515-38
as or hold himself out to the public as an administrator, unless he has15-39
obtained a certificate of registration as an administrator from the15-40
commissioner15-41
15-42
15-43
16-1
16-2
16-3
16-4
16-5
16-6
16-7
16-8
16-9
16-10
pursuant to section 14 of this act.16-11
Sec. 19. NRS 683A.0857 is hereby amended to read as follows: 683A.0857 1.16-13
commissioner a bond with an authorized surety in favor of the State of16-14
Nevada, continuous in form and in an amount determined by the16-15
commissioner of not less than16-16
2. The commissioner shall establish schedules for the amount of the16-17
bond required, based on the amount of money received and distributed by16-18
an administrator.16-19
3. The bond must inure to the benefit of any person damaged by any16-20
fraudulent act or conduct of the administrator and must be conditioned16-21
upon faithful accounting and application of all money coming into the16-22
administrator’s possession in connection with his activities as an16-23
administrator.16-24
4. The bond remains in force until released by the commissioner or16-25
canceled by the surety. Without prejudice to any liability previously16-26
incurred, the surety may cancel the bond upon 90 days’ advance notice to16-27
the administrator and the commissioner. An administrator’s certificate is16-28
automatically suspended if he does not file with the commissioner a16-29
replacement bond before the date of cancellation of the previous bond. A16-30
replacement bond must meet all requirements of this section for the initial16-31
bond.16-32
Sec. 20. NRS 683A.086 is hereby amended to read as follows: 683A.086 1. No person may act as an administrator unless he has16-34
entered into a written agreement with an insurer, and the written agreement16-35
contains provisions to effectuate the requirements contained in NRS16-36
16-37
Bill No. 145 of this16-38
act which apply to the duties of the administrator.16-39
2. The written agreement must set forth:16-40
(a) The duties the administrator will be required to perform on behalf16-41
of the insurer; and16-42
(b) The lines, classes or types of insurance that the administrator is16-43
authorized to administer on behalf of the insurer.17-1
3. A copy of an agreement entered into under the provisions of this17-2
section must be retained in the records of the administrator and of the17-3
insurer for a period of 5 years after the termination of the agreement.17-4
17-5
trust agreement and amendments must be obtained by the administrator and17-6
a copy forwarded to the insurer. Each agreement must be retained by the17-7
administrator and17-8
termination of the policy.17-9
17-10
functions an administrator may perform on behalf of an insurer.17-11
6. The insurer or administrator may, upon written notice to the other17-12
party to the agreement and to the commissioner, terminate the written17-13
agreement for any cause specified in the agreement. The insurer may17-14
suspend the authority of the administrator while any dispute regarding17-15
the cause for termination is pending. The insurer shall perform any17-16
obligations with respect to the policies affected by the agreement17-17
regardless of any dispute with the administrator.17-18
Sec. 21. NRS 683A.087 is hereby amended to read as follows: 683A.087 An administrator may advertise the insurance which he17-20
administers only17-21
underwrites the business involved.17-22
Sec. 22. NRS 683A.0873 is hereby amended to read as follows: 683A.0873 1. Each administrator shall maintain at his principal17-24
office adequate books and records of all transactions between himself, the17-25
insurer and the insured. The books and records must be maintained in17-26
accordance with prudent standards of recordkeeping for insurance and with17-27
regulations of the commissioner for a period of 5 years after the transaction17-28
to which they respectively relate. After the 5-year period the administrator17-29
may remove the books and records from the state, store their contents on17-30
microfilm or return them to the appropriate insurer.17-31
2. The commissioner may examine, audit and inspect books and17-32
records17-33
provisions of this section17-34
to 679B.300, inclusive.17-35
3. The names and addresses of insured persons and any other material17-36
which is in the books and records of an administrator are confidential17-37
except when used in proceedings against the administrator.17-38
4. The insurer may inspect and examine all books and records to the17-39
extent necessary to fulfill all contractual obligations to insured persons,17-40
subject to restrictions in the written agreement between the insurer and17-41
administrator.18-1
Sec. 23. NRS 683A.0877 is hereby amended to read as follows: 683A.0877 1. All insurance charges and premiums collected by an18-3
administrator on behalf of an insurer and return premiums received from an18-4
insurer are held by the administrator in a fiduciary capacity.18-5
2. Money18-6
persons entitled to it, or18-7
18-8
by the administrator18-9
state. The fiduciary accounts must be separate from the personal or18-10
business accounts of the administrator.18-11
3. If charges or premiums deposited in an account have been collected18-12
for or on behalf of more than one insurer, the administrator shall cause the18-13
18-14
maintained to record clearly the deposits and withdrawals from the account18-15
on behalf of each insurer.18-16
4. The administrator shall promptly obtain and keep copies of18-17
18-18
insurer with copies of the records which pertain to him upon demand of the18-19
insurer.18-20
5. The administrator18-21
money from his fiduciary account18-22
deposited.18-23
6. Withdrawals18-24
between the insurer and the administrator for:18-25
(a) Remittance to the insurer.18-26
(b) Deposit in an account maintained in the name of the insurer.18-27
(c) Transfer to and deposit in an account for the payment of claims.18-28
(d) Payment to a group policyholder for remittance to the insurer18-29
entitled to the money.18-30
(e) Payment to the administrator of his commission, fees or charges.18-31
(f) Remittance of return premiums to persons entitled to them.18-32
7. The administrator shall maintain copies of all records relating to18-33
deposits or withdrawals and, upon the request of an insurer, provide the18-34
insurer with copies of those records.18-35
Sec. 24. NRS 683A.088 is hereby amended to read as follows: 683A.088 Each claim paid by the administrator from18-37
collected for or on behalf of an insurer18-38
draft upon and as authorized by the insurer.18-39
Sec. 25. NRS 683A.0883 is hereby amended to read as follows: 683A.0883 1. The compensation paid to an administrator for his18-41
services may be based upon premiums or charges collected, on number of18-42
claims paid or processed or on18-43
the administrator and the insurer, except as provided in subsection 2.19-1
2. Compensation paid to an administrator may not be based upon or19-2
contingent upon :19-3
(a) The claim experience of the policies19-4
handles; or19-5
(b) The savings realized by the administrator by adjusting, settling or19-6
paying the losses covered by an insurer.19-7
Sec. 26. NRS 683A.0887 is hereby amended to read as follows: 683A.0887 1. Each administrator shall advise each insured, by means19-9
of a written notice approved by the insurer, of the identity of and19-10
relationship among the insurer, administrator and insured.19-11
2. An administrator who seeks to collect premiums or charges shall19-12
clearly19-13
charge set by the insurer for the insurance coverage19-14
the collection of the premium or charge. Each charge must be set forth19-15
separately from the premium.19-16
3. The administrator shall disclose to an insurer, in writing, all19-17
charges, fees and commissions the administrator receives in connection19-18
with the provision of administrative services for the insurer, including,19-19
without limitation, the fees and commissions paid by insurers providing19-20
reinsurance or excess of loss insurance.19-21
Sec. 26.5. NRS 685A.070 is hereby amended to read as follows: 685A.070 1. A broker shall not knowingly place surplus lines19-23
insurance with an insurer which is unsound financially or ineligible19-24
pursuant to this section.19-25
2.19-26
eligible for the acceptance of surplus lines risks pursuant to this chapter19-27
unless it has surplus as to policyholders in an amount of not less than19-28
$5,000,000 and, if an alien insurer, unless it has and maintains in a bank or19-29
trust company which is a member of the United States Federal Reserve19-30
System a trust fund established pursuant to terms reasonably adequate for19-31
the protection of all of its policyholders in the United States in an amount19-32
of not less than $1,500,000. Such a trust fund must not have an expiration19-33
date which is at any time less than 5 years in the future, on a continuing19-34
basis. In the case of:19-35
(a) A group of insurers which includes individual unincorporated19-36
insurers, such a trust fund must not be less than $100,000,000.19-37
(b) A group of incorporated insurers under common administration,19-38
such a trust fund must not be less than $100,000,000. The group of19-39
incorporated insurers must:19-40
(1) Operate under the supervision of the Department of Trade and19-41
Industry of the United Kingdom;19-42
(2) Possess aggregate policyholders surplus of $10,000,000,000,19-43
which must consist of money in trust in an amount not less than the20-1
assuming insurers’ liabilities attributable to insurance written in the United20-2
States; and20-3
(3) Maintain a joint trusteed surplus of which $100,000,000 must be20-4
held jointly for the benefit of United States ceding insurers of any member20-5
of the group.20-6
(c) An insurance exchange created by the laws of a state,20-7
insurance exchange shall have and maintain a trust fund20-8
an amount of not less than $50,000,00020-9
policyholders in an amount of not less than $50,000,000. If an insurance20-10
exchange maintains money for the protection of all policyholders, each20-11
syndicate shall maintain minimum capital and surplus of not less than20-12
$5,000,000 and must qualify separately to be eligible for the acceptance of20-13
surplus lines risks pursuant to this chapter.20-14
The commissioner may require larger trust funds or surplus as to20-15
policyholders than those set forth in this section if, in his judgment, the20-16
volume of business being transacted or proposed to be transacted warrants20-17
larger amounts.20-18
3. No insurer is eligible to write surplus lines of insurance unless it has20-19
established a reputation for financial integrity and satisfactory practices in20-20
underwriting and handling claims. In addition, a foreign insurer must be20-21
authorized in the state of its domicile to write the kinds of insurance which20-22
it intends to write in Nevada.20-23
4. The commissioner may from time to time compile or approve a list20-24
of all surplus lines insurers deemed by him to be eligible currently, and may20-25
mail a copy of the list to each broker at his office last of record with the20-26
commissioner. To be placed on the list, a surplus lines insurer must file an20-27
application with the commissioner. The application must be accompanied20-28
by a nonrefundable fee of $2,450. This subsection does not require the20-29
commissioner to determine the actual financial condition or claims20-30
practices of any unauthorized insurer. The status of eligibility, if granted by20-31
the commissioner, indicates only that the insurer appears to be sound20-32
financially and to have satisfactory claims practices, and that the20-33
commissioner has no credible evidence to the contrary. While any such list20-34
is in effect, the broker shall restrict to the insurers so listed all surplus lines20-35
business placed by him.20-36
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,20-38
or be a surplus lines broker with respect to subjects of insurance resident,20-39
located or to be performed in this state or elsewhere unless he is licensed as20-40
such by the commissioner pursuant to this chapter.20-41
2. Any person who has been licensed by this state as a20-42
for general lines for at least 6 months , or has been licensed in another state20-43
as a surplus lines broker for at least 1 year and continues to be licensed in21-1
that state, and who is deemed by the commissioner to be competent and21-2
trustworthy with respect to the handling of surplus lines may be licensed as21-3
a surplus lines broker upon:21-4
(a) Application for a license and payment of the applicable fee for a21-5
license and a fee of $15 for deposit in the insurance recovery account21-6
created by NRS 679B.305;21-7
(b) Submitting the statement required pursuant to NRS 685A.127; and21-8
(c) Passing any examination prescribed by the commissioner on the21-9
subject of surplus lines.21-10
3. An application for a license must be submitted to the commissioner21-11
on a form designated and furnished by him. The application must include21-12
the social security number of the applicant.21-13
4. A license issued pursuant to this chapter continues in force for 321-14
years unless it is suspended, revoked or otherwise terminated. The license21-15
may be renewed upon submission of the statement required pursuant to21-16
NRS 685A.127 and payment of the applicable fee for renewal and a fee of21-17
$15 for deposit in the insurance recovery account created by NRS21-18
679B.305 to the commissioner on or before the last day of the month in21-19
which the license is renewable.21-20
5. A license which is not renewed expires at midnight on the last day21-21
specified for its renewal. The commissioner may accept a request for21-22
renewal received by him within 30 days after the expiration of the license if21-23
the request is accompanied by the statement required pursuant to NRS21-24
685A.127, a fee for renewal of 150 percent of the fee otherwise required21-25
and a fee of $15 for deposit in the insurance recovery account created by21-26
NRS 679B.305.21-27
Sec. 28. NRS 685A.140 is hereby amended to read as follows: 685A.140 1. In addition to other grounds therefor, the commissioner21-29
may suspend or revoke any surplus lines broker’s license:21-30
(a) If the broker fails to file the annual statement or to remit the tax as21-31
required by NRS 685A.170 and 685A.180;21-32
(b) If the broker fails to maintain an office in this state21-33
where he was issued a license as a resident broker, or to keep the records,21-34
or to allow the commissioner to examine his records as required by this21-35
chapter, or if he removes his records from the state; or21-36
(c) If the broker places a surplus lines coverage in an insurer other than21-37
as authorized under this chapter.21-38
2. Upon suspending or revoking the broker’s surplus lines license the21-39
commissioner may also suspend or revoke all other licenses of or as to the21-40
same individual under this code.21-41
Sec. 29. NRS 685A.160 is hereby amended to read as follows: 685A.160 1. Each broker shall keep in his office21-43
and true record of each surplus lines coverage procured by him, including a22-1
copy of each daily report, if any, a copy of each certificate of insurance22-2
issued by him, and such of the following items as may be applicable:22-3
(a)22-4
(b)22-5
(c)22-6
(d)22-7
property;22-8
(e)22-9
(f)22-10
the proportion of the entire risk assumed by22-11
the entire risk;22-12
(g)22-13
(h)22-14
where located or to be performed; and22-15
(i)22-16
commissioner.22-17
2. The record22-18
the office of the broker and must be open to examination by the22-19
commissioner or his representative at all times within 5 years after issuance22-20
of the coverage to which it relates.22-21
Sec. 30. NRS 686A.130 is hereby amended to read as follows: 686A.130 1. No property, casualty, surety or title insurer or22-23
underwritten title company or any employee or representative thereof, and22-24
no broker, agent or solicitor may pay, allow or give, or offer to pay, allow22-25
or give, directly or indirectly, as an inducement to insurance, or after22-26
insurance has been effected, any rebate, discount, abatement, credit or22-27
reduction of the premium named in a policy of insurance, or any special22-28
favor or advantage in the dividends or other benefits to accrue thereon, or22-29
any valuable consideration or inducement whatever, not specified or22-30
provided for in the policy, except to the extent provided for in an22-31
applicable filing with the commissioner.22-32
2. No title insurer or underwritten title company may:22-33
(a) Pay, directly or indirectly, to the insured or any person acting as22-34
agent, representative, attorney or employee of the owner, lessee,22-35
mortgagee, existing or prospective, of the real property or interest therein22-36
which is the subject matter of title insurance or as to which a service is to22-37
be performed, any commission , rebate or part of its fee or charges or other22-38
consideration as inducement or compensation for the placing of any order22-39
for a title insurance policy or for performance of any escrow or other22-40
service by the insurer or underwritten title company with respect thereto; or22-41
(b) Issue any policy or perform any service in connection with which it22-42
or any agent or other person has paid or contemplates paying any22-43
commission, rebate or inducement in violation of this section.23-1
3. No insured named in a policy or any employee of23-2
may knowingly receive or accept, directly or indirectly, any such rebate,23-3
discount, abatement, credit or reduction of premium, or any such special23-4
favor or advantage or valuable consideration or inducement.23-5
4. No such insurer may make or permit any unfair discrimination23-6
between insured or property having like insuring or risk characteristics, in23-7
the premium or rates charged for insurance, or in the dividends or other23-8
benefits payable thereon, or in any other of the terms and conditions of23-9
insurance.23-10
5. No casualty insurer may make or permit any unfair discrimination23-11
between persons legally qualified to provide a particular service, in the23-12
amount of the fee or charge for that service payable as a benefit under any23-13
policy or contract of casualty insurance.23-14
6.23-15
not prohibit:23-16
(a) The payment of commissions or other compensation to licensed23-17
agents, brokers or solicitors.23-18
(b) The extension of credit to an insured for the payment of any23-19
premium and for which credit a reasonable rate of interest is charged and23-20
collected.23-21
(c) Any insurer from allowing or returning to its participating23-22
policyholders, members or subscribers, dividends, savings or unabsorbed23-23
premium deposits.23-24
23-25
(d) With respect to title insurance, bulk rates or special rates for23-26
customers of prescribed classes if23-27
provided for in the23-28
title insurer or underwritten title company.23-29
7.23-30
wet marine and transportation insurance.23-31
Sec. 31. NRS 686C.035 is hereby amended to read as follows: 686C.035 1. This chapter does not provide coverage for:23-33
(a) Any portion of a policy or contract not guaranteed by the insurer, or23-34
under which the risk is borne by the23-35
contract.23-36
(b) Any policy or contract of reinsurance unless assumption certificates23-37
have been issued23-38
(c) Any portion of a policy or contract to the extent that the rate of23-39
interest on which it is based:23-40
(1) When averaged over the period of 4 years before the date23-41
on which the association becomes obligated with respect to the policy or23-42
contract, or averaged for the period since the policy or contract was issued23-43
if it was issued less than 4 years before the association became obligated,24-1
exceeds the rate of interest determined by subtracting 2 percentage points24-2
from Moody’s Corporate Bond Yield Average averaged for the same24-3
period; and24-4
(2) On or after the date on which the association becomes obligated24-5
with respect to the policy or contract, exceeds the rate of interest24-6
determined by subtracting 3 percentage points from the most recent24-7
Moody’s Corporate Bond Yield Average.24-8
(d) Any portion of a policy or contract issued to a plan or program of24-9
an employer, association or24-10
24-11
members or other persons to the extent that the plan or program is self-24-12
funded or uninsured, including, but not limited to, benefits payable by an24-13
employer, association or24-14
(1) A24-15
welfare arrangement as defined in 29 U.S.C. § 1002;24-16
(2) A minimum-premium group insurance plan;24-17
(3) A stop-loss group insurance plan; or24-18
(4) A contract for administrative services only.24-19
(e) Any portion of a policy or contract to the extent that it provides for24-20
dividends, credits for experience, voting rights or the payment of any fee24-21
or allowance to any person, including the24-22
policy or contract, for services or administration connected with the policy24-23
or contract.24-24
(f) Any policy or contract issued in this state by a member insurer at a24-25
time when the member insurer was not authorized to issue the policy or24-26
contract24-27
(g)24-28
24-29
24-30
24-31
24-32
24-33
24-34
24-35
portion of a policy or contract to the extent that the assessments required24-36
by NRS 686C.230 for the policy or contract are preempted by federal law.24-37
(h) An obligation that does not arise under the written terms of a24-38
policy or contract issued by the insurer.24-39
(i) An unallocated annuity contract.24-40
2. As used in this section, "Moody’s Corporate Bond Yield Average"24-41
means the monthly average for corporate bonds published by Moody’s24-42
Investors Service, Inc., or any successor average.25-1
Sec. 32. NRS 687B.440 is hereby amended to read as follows: 687B.440 1. An insurer offering an umbrella policy to an individual25-3
shall obtain a signed disclosure statement from the individual indicating25-4
whether the umbrella policy includes uninsured or underinsured vehicle25-5
coverage.25-6
2. The disclosure statement for an umbrella policy that includes25-7
uninsured or underinsured vehicle coverage must be on a form provided25-8
by the commissioner or in substantially the following form:25-9
UMBRELLA POLICY DISCLOSURE STATEMENT25-10
UNINSURED/UNDERINSURED VEHICLE COVERAGE25-11 ¨
Your Umbrella Policy does provide coverage in excess of the25-12
limits of the uninsured/underinsured vehicle coverage in your primary25-13
auto insurance only if the requirements for the uninsured/underinsured25-14
vehicle coverage in your underlying auto insurance are maintained.25-15
25-16
25-17
25-18
25-19
vehicle coverage provided by this umbrella policy is limited to25-20
$……… .25-21
I understand and acknowledge the above disclosure.25-22
25-23
Insured Date25-24
3. The disclosure statement for an umbrella policy that does not25-25
include uninsured or underinsured vehicle coverage must be on a form25-26
provided by the commissioner or in substantially the following form:25-27 ¨
Your Umbrella Liability Policy does not provide any25-28
uninsured/underinsured vehicle coverage.25-29
I understand and acknowledge the above disclosure.25-30
25-31
Insured Date25-32
25-33
protects a person against losses in excess of the underlying amount required25-34
to be covered by other policies.26-1
Sec. 33. NRS 689A.505 is hereby amended to read as follows: 689A.505 "Creditable coverage" means, with respect to a person,26-3
health benefits or coverage provided pursuant to:26-4
1. A group health plan;26-5
2. A health benefit plan;26-6
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;26-7
4. Title XIX of the Social Security Act, 42 U.S.C. §§ 1396 et seq., also26-8
known as Medicaid, other than coverage consisting solely of benefits under26-9
section 1928 of that Title26-10
26-11
5. The Civilian Health and Medical Program of Uniformed Services26-12
26-13
6. A medical care program of the Indian Health Service or of a tribal26-14
organization;26-15
7. A state health benefit risk pool;26-16
8. A health plan offered pursuant to26-17
26-18
26-19
9. A public health plan as defined in federal regulations authorized by26-20
the Public Health Service Act,26-21
26-22
10. A health benefit plan under section 5(e) of the Peace Corps Act ,26-23
26-24
11. A short-term health insurance policy; or26-25
12. A blanket student accident and health insurance policy.26-26
Sec. 34. NRS 689A.515 is hereby amended to read as follows: 689A.515 "Eligible person" means:26-28
1. A person:26-29
(a) Who, as of the date on which he seeks coverage pursuant to this26-30
chapter, has an aggregate period of creditable coverage that is 18 months or26-31
more;26-32
(b) Whose most recent prior creditable coverage , other than coverage26-33
under a short-term health insurance policy, was under a group health26-34
plan, governmental plan, church plan or health insurance coverage offered26-35
in connection with any such plan;26-36
(c) Who is not eligible for coverage under a group health plan, Part A or26-37
Part B of Title XVIII of the Social Security Act, 42 U.S.C. §§ 1395c et26-38
seq., also known as Medicare, a state plan pursuant to Title XIX of the26-39
Social Security Act, 42 U.S.C. §§ 1396 et seq., also known as Medicaid, or26-40
any successor program, and who does not have any other health insurance26-41
coverage;27-1
(d) Whose most recent health insurance coverage within the period of27-2
aggregate creditable coverage was not terminated because of a failure to27-3
pay premiums or fraud;27-4
(e) Who has exhausted his continuation of coverage under the27-5
Consolidation Omnibus Budget Reconciliation Act of 198527-6
99-272, or under a similar state program, if any; and27-7
(f) Who has not had a break of more than 63 consecutive days in his27-8
creditable coverage.27-9
2. A person whose most recent prior creditable coverage was under a27-10
basic or standard health benefit plan and was not renewed by a carrier27-11
who discontinued offering and renewing individual health benefit plans27-12
in this state pursuant to NRS 689A.630.27-13
3. Notwithstanding the provisions of paragraph (a) of subsection 1, a27-14
newborn child or a child placed for adoption, if the child was enrolled27-15
timely and would have otherwise met the requirements of an eligible person27-16
as set forth in subsection 1.27-17
Sec. 35. NRS 689A.540 is hereby amended to read as follows: 689A.540 1. "Health benefit plan" means a policy, contract,27-19
certificate or agreement offered by a carrier to provide for, deliver payment27-20
for, arrange for the payment of, pay for or reimburse any of the costs of27-21
health care services. Except as otherwise provided in this section, the term27-22
includes27-23
policy that pays on a cost-incurred basis.27-24
2. The term does not include:27-25
(a) Coverage that is only for accident or disability income insurance, or27-26
any combination thereof;27-27
(b) Coverage issued as a supplement to liability insurance;27-28
(c) Liability insurance, including general liability insurance and27-29
automobile liability insurance;27-30
(d) Workers’ compensation or similar insurance;27-31
(e) Coverage for medical payments under a policy of automobile27-32
insurance;27-33
(f) Credit insurance;27-34
(g) Coverage for on-site medical clinics;27-35
(h) Other similar insurance coverage specified in federal regulations27-36
issued pursuant to Public Law 104-191 under which benefits for medical27-37
care are secondary or incidental to other insurance benefits27-38
(i) Coverage under a short-term health insurance policy; and27-39
(j) Coverage under a blanket student accident and health insurance27-40
policy.27-41
3. The term does not include the following benefits if the benefits are27-42
provided under a separate policy, certificate or contract of insurance or are27-43
otherwise not an integral part of a health benefit plan:28-1
(a) Limited-scope dental or vision benefits;28-2
(b) Benefits for long-term care, nursing home care, home health care or28-3
community-based care, or any combination thereof; and28-4
(c) Such other similar benefits as are specified in any federal regulations28-5
adopted pursuant to the Health Insurance Portability and Accountability28-6
Act of 1996, Public Law 104-191.28-7
4. The term does not include the following benefits if the benefits are28-8
provided under a separate policy, certificate or contract of insurance, there28-9
is no coordination between the provision of the benefits and any exclusion28-10
of benefits under any group health plan maintained by the same plan28-11
sponsor, and28-12
whether benefits are provided for such a claim under any group health plan28-13
maintained by the same plan sponsor:28-14
(a) Coverage that is only for a specified disease or illness; and28-15
(b) Hospital indemnity or other fixed indemnity insurance.28-16
5. The term does not include any of the following, if offered as a28-17
separate policy, certificate or contract of insurance:28-18
(a) Medicare supplemental health insurance as defined in section28-19
1882(g)(1) of the Social Security Act, 42 U.S.C. § 1395ss, as that section28-20
existed on July 16, 1997;28-21
(b) Coverage supplemental to the coverage provided pursuant to28-22
28-23
Medical Program of Uniformed Services28-24
10 U.S.C. §§ 1071 et seq.; and28-25
(c) Similar supplemental coverage provided under a group health plan.28-26
Sec. 36. NRS 689A.650 is hereby amended to read as follows: 689A.650 1. An individual carrier is not required to provide28-28
coverage to eligible persons pursuant to NRS 689A.640:28-29
(a) During any period in which the commissioner determines that28-30
requiring the individual carrier to provide such coverage would place the28-31
individual carrier in a financially impaired condition.28-32
(b) If the individual carrier elects not to offer any new coverage to any28-33
28-34
new coverage in accordance with this paragraph may maintain its existing28-35
policies issued to28-36
of NRS 689A.630.28-37
2. An individual carrier that elects not to offer new coverage pursuant28-38
to paragraph (b) of subsection 1 shall notify the commissioner forthwith of28-39
that election and shall not thereafter write any new business to individuals28-40
in this state for 5 years after the date of the notification.29-1
Sec. 37. NRS 689A.660 is hereby amended to read as follows: 689A.660 An individual carrier shall not:29-3
1. Impose on an eligible person who is covered under a basic or29-4
standard health benefit plan any exclusion because of a preexisting29-5
condition.29-6
2. Modify a health benefit plan, with respect to an eligible person,29-7
through riders, endorsements or otherwise, to restrict or exclude services29-8
otherwise covered by the plan.29-9
Sec. 38. NRS 689A.680 is hereby amended to read as follows: 689A.680 1. An individual carrier shall develop its rates for its29-11
individual health benefit plans pursuant to NRS 689A.470 to 689A.740,29-12
inclusive, based on rating characteristics. After any adjustments for rating29-13
characteristics and design of benefits, the rate for any block of business for29-14
an individual health benefit plan written on or after29-15
January 1, 2000, must not exceed the rate for any other block of business29-16
for an individual health benefit plan offered by the individual carrier by29-17
more than29-18
average rate charged to all the insureds in the block of business. In29-19
determining whether the rate of a block of business complies with the29-20
provisions of this subsection, any differences in rating factors between29-21
blocks of business must be considered.29-22
2. In determining the rating factors to establish premium rates for a29-23
health benefit plan, an individual carrier shall not use characteristics other29-24
than age, sex, occupation, geographic area, composition of the family of the29-25
individual and health status.29-26
3. If an individual carrier uses health status as a rating factor in29-27
establishing premium rates, the highest factor associated with any29-28
classification for health status may not exceed the lowest factor by more29-29
than 75 percent.29-30
4. For the purposes of this section, rating characteristics must not29-31
include durational or tier rating, or adverse changes in health status or29-32
claim experience after the policy is issued.29-33
5. As used in this section, "characteristics" means demographic or29-34
other information concerning individuals that is considered by a carrier in29-35
the determination of premium rates for individuals.29-36
Sec. 39. NRS 689B.027 is hereby amended to read as follows: 689B.027 1. The commissioner shall adopt regulations which require29-38
an insurer to file with the commissioner, for his approval, a disclosure29-39
summarizing the coverage provided by each policy of group health29-40
insurance offered by the insurer. The disclosure must include:29-41
(a) Any significant exception, reduction or limitation that applies to the29-42
policy;30-1
(b) Any restrictions on payments for emergency care, including related30-2
definitions of an emergency and medical necessity;30-3
(c) Any provisions concerning the insurer’s right to change premium30-4
rates and the characteristics, other than claim experience, that affect30-5
changes in premium rates;30-6
(d) Any provisions relating to renewability;30-7
(e) Any provisions relating to preexisting conditions; and30-8
(f) Any other information,30-9
that the commissioner finds necessary to provide for full and fair disclosure30-10
of the provisions of the policy.30-11
2. The disclosure must be written in language which is easily30-12
understood and30-13
of the policy only, and that the policy30-14
the governing contractual provisions.30-15
3. The commissioner shall not approve any proposed disclosure30-16
submitted to him pursuant to this section which does not comply with the30-17
requirements of this section and the applicable regulations.30-18
4. The insurer shall make available to an employer or a producer30-19
acting on behalf of an employer upon request a copy of the disclosure30-20
approved by the commissioner pursuant to this section for each policy of30-21
health insurance coverage for which that employer may be eligible.30-22
Sec. 40. NRS 689B.380 is hereby amended to read as follows: 689B.380 "Creditable coverage" means health benefits or coverage30-24
provided to a person pursuant to:30-25
1. A group health plan;30-26
2. A health benefit plan;30-27
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;30-28
4. Title XIX of the Social Security Act, 42 U.S.C. §§ 1396 et seq., also30-29
known as Medicaid, other than coverage consisting solely of benefits under30-30
section 1928 of that Title30-31
30-32
5. The Civilian Health and Medical Program of Uniformed Services30-33
30-34
6. A medical care program of the Indian Health Service or of a tribal30-35
organization;30-36
7. A state health benefit risk pool;30-37
8. A health plan offered pursuant to30-38
30-39
30-40
9. A public health plan as defined in federal regulations authorized by30-41
the Public Health Service Act,30-42
31-1
10. A health benefit plan under section 5(e) of the Peace Corps Act ,31-2
31-3
11. A short-term health insurance policy; or31-4
12. A blanket student accident and health insurance policy.31-5
Sec. 41. NRS 689B.410 is hereby amended to read as follows: 689B.410 1. "Health benefit plan" means a policy, contract,31-7
certificate or agreement offered by a carrier to provide for, arrange for31-8
payment of, pay for or reimburse any of the costs of health care services.31-9
Except as otherwise provided in this section, the term includes31-10
31-11
incurred basis.31-12
2. The term does not include:31-13
(a) Coverage that is only for accident or disability income insurance, or31-14
any combination thereof;31-15
(b) Coverage issued as a supplement to liability insurance;31-16
(c) Liability insurance, including general liability insurance and31-17
automobile liability insurance;31-18
(d) Workers’ compensation or similar insurance;31-19
(e) Coverage for medical payments under a policy of automobile31-20
insurance;31-21
(f) Credit insurance;31-22
(g) Coverage for on-site medical clinics;31-23
(h) Other similar insurance coverage specified in federal regulations31-24
issued pursuant to the Health Insurance Portability and Accountability31-25
Act of 1996, Public Law 104-191 , under which benefits for medical care31-26
are secondary or incidental to other insurance benefits31-27
(i) Coverage under a short-term health insurance policy; and31-28
(j) Coverage under a blanket student accident and health insurance31-29
policy.31-30
3. If the benefits are provided under a separate policy, certificate or31-31
contract of insurance or are otherwise not an integral part of a health31-32
benefit plan, the term does not include the following benefits:31-33
(a) Limited-scope dental or vision benefits;31-34
(b) Benefits for long-term care, nursing home care, home health care or31-35
community-based care, or any combination thereof; and31-36
(c) Such other similar benefits as are specified in any federal regulations31-37
adopted pursuant to the Health Insurance Portability and Accountability31-38
Act of 1996, Public Law 104-191.31-39
4. For the purposes of NRS 689B.340 to 689B.600, inclusive, if the31-40
benefits are provided under a separate policy, certificate or contract of31-41
insurance, there is no coordination between the provision of the benefits31-42
and any exclusion of benefits under any group health plan maintained by31-43
the same plan sponsor, and32-1
regard to whether benefits are provided for such a claim under any group32-2
health plan maintained by the same plan sponsor, the term does not include:32-3
(a) Coverage that is only for a specified disease or illness; and32-4
(b) Hospital indemnity or other fixed indemnity insurance.32-5
5. For the purposes of NRS 689B.340 to 689B.600, inclusive, if32-6
offered as a separate policy, certificate or contract of insurance, the term32-7
does not include:32-8
(a) Medicare supplemental health insurance as defined in section32-9
1882(g)(1) of the Social Security Act, 42 U.S.C. § 1395ss, as that section32-10
existed on July 16, 1997;32-11
(b) Coverage supplemental to the coverage provided pursuant to32-12
32-13
Medical Program of Uniformed Services32-14
10 U.S.C. §§ 1071 et seq.; and32-15
(c) Similar supplemental coverage provided under a group health plan.32-16
Sec. 42. NRS 689B.460 is hereby amended to read as follows: 689B.460 "Waiting period" means the period established by a plan of32-18
health insurance that must pass before a person who is an eligible32-19
participant or beneficiary in a plan is covered for benefits under the terms32-20
of the plan. The term includes the period from the date a person submits32-21
an application to an individual carrier for coverage under a health32-22
benefit plan until the first day of coverage under that health benefit plan.32-23
Sec. 43. NRS 689B.500 is hereby amended to read as follows: 689B.500 1. Except as otherwise provided in this section, a carrier32-25
that issues a group health plan or coverage under group health insurance32-26
shall not deny, exclude or limit a benefit for a preexisting condition for:32-27
(a) More than 12 months after the effective date of coverage if the32-28
employee enrolls through open enrollment or after the first day of the32-29
waiting period for32-30
(b) More than 18 months after the effective date of coverage for a late32-31
enrollee.32-32
A carrier may not define a preexisting condition more restrictively than that32-33
term is defined in NRS 689B.450.32-34
2. The period of any exclusion for a preexisting condition imposed by32-35
a group health plan or coverage under group health insurance on a person32-36
to be insured in accordance with the provisions of this chapter must be32-37
reduced by the aggregate period of creditable coverage of that person, if the32-38
creditable coverage was continuous to a date not more than 63 days before32-39
the effective date of the coverage. The period of continuous coverage must32-40
not include:32-41
(a) Any waiting period for the effective date of the new coverage32-42
applied by the employer or the carrier; or33-1
(b) Any affiliation period not to exceed 60 days for a new enrollee and33-2
33-3
in the group health plan.33-4
3. A health maintenance organization authorized to transact insurance33-5
pursuant to chapter 695C of NRS that does not restrict coverage for a33-6
preexisting condition may require an affiliation period before coverage33-7
becomes effective under a plan of insurance if the affiliation period applies33-8
uniformly to all employees and without regard to any health status-related33-9
factors. During the affiliation period, the carrier shall not collect any33-10
premiums for coverage of the employee.33-11
4. An insurer that restricts coverage for preexisting conditions shall not33-12
impose an affiliation period.33-13
5. A carrier shall not impose any exclusion for a preexisting condition:33-14
(a) Relating to pregnancy.33-15
(b) In the case of a person who, as of the last day of the 30-day period33-16
beginning on the date of his birth, is covered under creditable coverage.33-17
(c) In the case of a child who is adopted or placed for adoption before33-18
attaining the age of 18 years and who, as of the last day of the 30-day33-19
period beginning on the date of adoption or placement for adoption,33-20
whichever is earlier, is covered under creditable coverage. The provisions33-21
of this paragraph do not apply to coverage before the date of adoption or33-22
placement for adoption.33-23
(d) In the case of a condition for which medical advice, diagnosis, care33-24
or treatment was recommended or received for the first time while the33-25
covered person held creditable coverage, and the medical advice, diagnosis,33-26
care or treatment was a benefit under the plan, if the creditable coverage33-27
was continuous to a date not more than 63 days before the effective date of33-28
the new coverage.33-29
The provisions of paragraphs (b) and (c) do not apply to a person after the33-30
end of the first 63-day period during all of which the person was not33-31
covered under any creditable coverage.33-32
6. As used in this section, "late enrollee" means an eligible employee,33-33
or his dependent, who requests enrollment in a group health plan following33-34
the initial period of enrollment, if that initial period of enrollment is at least33-35
30 days, during which the person is entitled to enroll under the terms of the33-36
health benefit plan. The term does not include an eligible employee or his33-37
dependent if:33-38
(a) The employee or dependent:33-39
(1) Was covered under creditable coverage at the time of the initial33-40
enrollment;33-41
(2) Lost coverage under creditable coverage as a result of cessation of33-42
contributions by his employer, termination of employment or eligibility,33-43
reduction in the number of hours of employment, involuntary termination34-1
of creditable coverage, or death of, or divorce or legal separation from, a34-2
covered spouse; and34-3
(3) Requests enrollment not later than 30 days after the date on which34-4
his creditable coverage was terminated or on which the change in34-5
conditions that gave rise to the termination of the coverage occurred.34-6
(b) The employee enrolls during the open enrollment period, as34-7
provided in the contract or as otherwise specifically provided by specific34-8
statute.34-9
(c) The employer of the employee offers multiple health benefit plans34-10
and the employee elected a different plan during an open enrollment period.34-11
(d) A court has ordered coverage to be provided to the spouse or a34-12
minor or dependent child of an employee under a health benefit plan of the34-13
employee and a request for enrollment is made within 30 days after the34-14
issuance of the court order.34-15
(e) The employee changes status from not being an eligible employee to34-16
being an eligible employee and requests enrollment, subject to any waiting34-17
period, within 30 days after the change in status.34-18
(f) The person has continued coverage in accordance with the34-19
Consolidated Omnibus Budget Reconciliation Act of 1985 , Public Law34-20
99-272, and34-21
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 basic34-23
and standard health benefit plans are approved pursuant to NRS 689C.77034-24
as part of the plan of operation of the program of reinsurance, each carrier34-25
required to offer to a person a converted policy pursuant to NRS 689B.12034-26
shall only offer as a converted policy a choice of the basic and standard34-27
health benefit plans.34-28
2. A person with a converted policy issued before the effective date of34-29
the requirement set forth in subsection 1 may, at each annual renewal of the34-30
converted policy elect a basic or standard health benefit plan as a substitute34-31
converted policy, except that the carrier may, if the person has not made an34-32
election within 3 years after first becoming eligible to do so, require the34-33
person to make such an election. Once a person has elected34-34
basic or standard health benefit plan as a substitute converted policy, he34-35
may not elect another converted policy.34-36
3. The premium for a converted policy may not exceed the small group34-37
index rate, as defined in paragraph (b) of subsection 3 of NRS 689C.230,34-38
applicable to the carrier by more than34-39
index rate used by a carrier that does not write insurance to small34-40
employers in this state must be the average small group index rate, as34-41
determined by the commissioner, of the five largest carriers that provide34-42
coverage to small employers pursuant to this chapter for their basic and34-43
standard health benefit plans. The commissioner shall annually determine35-1
the average small group index rate, as measured by the premium volume of35-2
the plans, of those five largest carriers.35-3
4. The rates for new and renewal converted policies for persons with35-4
the same converted policies whose case characteristics are similar must be35-5
the same.35-6
5. Any losses suffered by a carrier on its converted policies issued35-7
pursuant to this section must be spread across the entire book of the health35-8
benefit coverage of the carrier issued or delivered for issuance to small35-9
employers and large group employers in this state.35-10
6. The commissioner shall adopt such regulations as are necessary to35-11
carry out the provisions of this section.35-12
Sec. 45. Chapter 689C of NRS is hereby amended by adding thereto35-13
the provisions set forth as sections 46 and 47 of this act.35-14
Sec. 46. No member, agent or employee of the board may be held35-15
liable in a civil action for any act that he performs in good faith in the35-16
execution of his duties pursuant to the provisions of this chapter.35-17
Sec. 47. The provisions of this chapter apply to health benefit plans35-18
that provide coverage to the employees of small employers in this state35-19
and to carriers that offer those health benefit plans if:35-20
1. A portion of the premium or benefits are paid by or on behalf of35-21
the small employer;35-22
2. An eligible employee or his dependent is reimbursed for a portion35-23
of the premium, whether by wage adjustments or otherwise, by or on35-24
behalf of the small employer; or35-25
3. The health benefit plan is considered by the small employer or any35-26
of his eligible employees or dependents as part of a plan or program for35-27
the purposes of sections 106, 125 or 162 of the Internal Revenue Code,35-28
26 U.S.C. § 106, 125 or 162.35-29
Sec. 48. NRS 689C.053 is hereby amended to read as follows: 689C.053 "Creditable coverage" means health benefits or coverage35-31
provided to a person pursuant to:35-32
1. A group health plan;35-33
2. A health benefit plan;35-34
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;35-35
4. Title XIX of the Social Security Act, 42 U.S.C. §§ 1396 et seq., also35-36
known as Medicaid, other than coverage consisting solely of benefits under35-37
section 1928 of that Title35-38
35-39
5. The Civilian Health and Medical Program of Uniformed Services35-40
35-41
6. A medical care program of the Indian Health Service or of a tribal35-42
organization;36-1
7. A state health benefit risk pool;36-2
8. A health plan offered pursuant to36-3
36-4
36-5
9. A public health plan as defined in federal regulations authorized by36-6
the Public Health Service Act,36-7
36-8
10. A health benefit plan under section 5(e) of the Peace Corps Act ,36-9
36-10
11. A short-term health insurance policy; or36-11
12. A blanket student accident and health insurance policy.36-12
Sec. 49. NRS 689C.075 is hereby amended to read as follows: 689C.075 1. "Health benefit plan" means a policy or certificate for36-14
hospital or medical expenses, a contract for dental, hospital or medical36-15
services, or a health care plan of a health maintenance organization36-16
available for use, offered or sold to a small employer. Except as otherwise36-17
provided in this section, the term includes short-term and catastrophic36-18
health insurance policies, and a policy that pays on a cost-incurred basis.36-19
2. The term does not include:36-20
(a) Coverage that is only for accident or disability income insurance, or36-21
any combination thereof;36-22
(b) Coverage issued as a supplement to liability insurance;36-23
(c) Liability insurance, including general liability insurance and36-24
automobile liability insurance;36-25
(d) Workers’ compensation or similar insurance;36-26
(e) Coverage for medical payments under a policy of automobile36-27
insurance;36-28
(f) Credit insurance;36-29
(g) Coverage for on-site medical clinics;36-30
(h) Coverage under a short-term health insurance policy;36-31
(i) Coverage under a blanket student accident and health insurance36-32
policy; and36-33
(j) Other similar insurance coverage specified in federal regulations36-34
issued pursuant to the Health Insurance Portability and Accountability36-35
Act of 1996, Public Law 104-191 , under which benefits for medical care36-36
are secondary or incidental to other insurance benefits.36-37
3. If the benefits are provided under a separate policy, certificate or36-38
contract of insurance or are otherwise not an integral part of a health36-39
benefit plan, the term does not include the following benefits:36-40
(a) Limited-scope dental or vision benefits;36-41
(b) Benefits for long-term care, nursing home care, home health care or36-42
community-based care, or any combination thereof; and37-1
(c) Such other similar benefits as are specified in any federal regulations37-2
adopted pursuant to the Health Insurance Portability and Accountability37-3
Act of 1996, Public Law 104-191.37-4
4. If the benefits are provided under a separate policy, certificate or37-5
contract of insurance, there is no coordination between the provision of the37-6
benefits and any exclusion of benefits under any group health plan37-7
maintained by the same plan sponsor, and37-8
claim without regard to whether benefits are provided for such a claim37-9
under any group health plan maintained by the same plan sponsor, the term37-10
does not include:37-11
(a) Coverage that is only for a specified disease or illness; and37-12
(b) Hospital indemnity or other fixed indemnity insurance.37-13
5. If offered as a separate policy, certificate or contract of insurance,37-14
the term does not include:37-15
(a) Medicare supplemental health insurance as defined in section37-16
1882(g)(1) of the Social Security Act, 42 U.S.C. § 1395ss, as that section37-17
existed on July 16, 1997;37-18
(b) Coverage supplemental to the coverage provided pursuant to37-19
37-20
Medical Program of Uniformed Services37-21
10 U.S.C. §§ 1071 et seq.; and37-22
(c) Similar supplemental coverage provided under a group health plan.37-23
Sec. 50. NRS 689C.095 is hereby amended to read as follows: 689C.095 1. "Small employer" means ,37-25
37-26
37-27
who employed on business days during the preceding calendar year an37-28
average of at least 237-29
37-30
of 30 hours or more, and37-31
first day of the plan year .37-32
37-33
37-34
37-35
37-36
employees, organizations which are affiliated or which are eligible to file a37-37
combined tax return for the purposes of taxation constitute one employer.37-38
2. For the purposes of this section, organizations are "affiliated" if one37-39
directly, or indirectly, through one or more intermediaries, controls or is37-40
controlled by, or is under common control with, the other, as determined37-41
pursuant to the provisions of NRS 692C.050.38-1
Sec. 51. NRS 689C.106 is hereby amended to read as follows: 689C.106 "Waiting period" means the period established by a plan of38-3
health insurance that must pass before a person who is an eligible38-4
participant or beneficiary in a plan is covered for benefits under the terms38-5
of the plan. The term includes the period from the date a person submits38-6
an application to an individual carrier for coverage under a health38-7
benefit plan until the first day of coverage under that health benefit plan.38-8
Sec. 52. NRS 689C.210 is hereby amended to read as follows: 689C.210 1. Except as otherwise provided in subsection 3, a carrier38-10
shall not increase the premium rate charged to a small employer for a new38-11
rating period by a percentage greater than the sum of:38-12
(a) The percentage of change in the premium rate for new business for38-13
the policy under which the small employer is covered, measured from the38-14
first day of the previous rating period to the first day of the new rating38-15
period;38-16
(b) An adjustment, not to exceed 15 percent annually, adjusted pro rata38-17
for rating periods of less than 1 year, on account of the claim experience,38-18
health status, or duration of coverage of the employees or dependents of the38-19
small employer as determined from the carrier’s rate manual for the class of38-20
business; and38-21
(c) Any adjustment on account of change in coverage or change in the38-22
characteristics of the small employer as determined from the carrier’s rate38-23
manual for the class of business.38-24
2. If the carrier no longer issues new policies for that class of business,38-25
the carrier shall use the percentage of change in the premium rate for new38-26
business for the class of business which is most similar to the closed class38-27
of business and for which the carrier is issuing new policies.38-28
3. In the case of health benefit plans delivered or issued for delivery38-29
before January 1, 1996, for groups with38-30
and38-31
with38-32
employees, a premium rate for a rating period may exceed the ranges set38-33
forth in38-34
period of 3 years following that date. In that case, the percentage of38-35
increase in the premium rate charged to a small employer for a new rating38-36
period may not exceed the sum of:38-37
(a) The percentage of change in the premium rate for new business38-38
measured from the first day of the previous rating period to the first day of38-39
the new rating period. In the case of a health benefit plan into which the38-40
carrier is no longer enrolling new small employers, the carrier shall use the38-41
percentage of change in the base premium rate if that change does not39-1
exceed, on a percentage basis, the change in the premium rate for new39-2
business for the most similar health benefit plan into which the carrier is39-3
actively enrolling new small employers.39-4
(b) Any adjustment on account of change in coverage or change in the39-5
characteristics of the small employer as determined from the carrier’s rate39-6
manual for the class of business.39-7
Sec. 53. NRS 689C.270 is hereby amended to read as follows: 689C.270 1. The commissioner shall adopt regulations which require39-9
a carrier to file with the commissioner, for his approval, a disclosure39-10
offered by the carrier to a small employer. The disclosure must include:39-11
(a) Any significant exception, reduction or limitation that applies to the39-12
policy;39-13
(b) Any restrictions on payments for emergency care, including, without39-14
limitation, related definitions of an emergency and medical necessity;39-15
(c) The provision of the health benefit plan concerning the carrier’s right39-16
to change premium rates and the characteristics, other than claim39-17
experience, that affect changes in premium rates;39-18
(d) The provisions relating to renewability of policies and contracts;39-19
(e) The provisions relating to any preexisting condition; and39-20
(f) Any other information that the commissioner finds necessary to39-21
provide for full and fair disclosure of the provisions of a policy or contract39-22
of insurance issued pursuant to this chapter.39-23
2. The disclosure must be written in language which is easily39-24
understood and must include a statement that the disclosure is a summary39-25
of the policy only, and that the policy itself should be read to determine the39-26
governing contractual provisions.39-27
3. The commissioner shall not approve any proposed disclosure39-28
submitted to him pursuant to this section which does not comply with the39-29
requirements of this section and the applicable regulations.39-30
4. The carrier shall make available to a small employer or a producer39-31
acting on behalf of a small employer, upon request a copy of the39-32
disclosure approved by the commissioner pursuant to this section for39-33
policies of health insurance for which that employer may be eligible.39-34
Sec. 54. (Deleted by amendment.)39-35
Sec. 55. NRS 689C.610 is hereby amended to read as follows: 689C.610 As used in NRS 689C.610 to 689C.980, inclusive, and39-37
section 46 of this act, unless the context otherwise requires, the words and39-38
terms defined in NRS 689C.620 to 689C.730, inclusive, have the meanings39-39
ascribed to them in those sections.39-40
Sec. 56. NRS 689C.870 is hereby amended to read as follows: 689C.870 1. If, in each of 2 consecutive years, the board determines39-42
that the amount of the assessment needed exceeds 5 percent of the total39-43
premiums earned in the previous calendar year from health benefit plans40-1
delivered or issued for delivery to small employers by reinsuring carriers,40-2
the program of reinsurance is eligible for additional funding pursuant to this40-3
section.40-4
2. If, in each of 2 consecutive years, the board determines that the40-5
amount of the assessment needed exceeds 5 percent of the total premiums40-6
earned in the previous calendar year from health benefit plans delivered or40-7
issued for delivery to individuals by individual reinsuring carriers, the40-8
program of reinsurance is eligible for additional funding pursuant to this40-9
section.40-10
3. To raise40-11
formula pursuant to which additional assessments may be made on all40-12
carriers that offer a health benefit plan or provide stop-loss coverage for a40-13
health benefit plan which is an40-14
plan or a plan established pursuant to the Labor-Management Relations40-15
Act, 1947, as amended. The total additional assessments on all such40-16
carriers combined may not exceed one-half of 1 percent of the total40-17
premiums earned from all health benefit plans and stop-loss coverage40-18
issued in this state in the previous calendar year.40-19
Sec. 57. NRS 690B.042 is hereby amended to read as follows: 690B.042 1. Except as otherwise provided in subsection 2, any party40-21
against whom a claim is asserted for compensation or damages for personal40-22
injury under a policy of motor vehicle insurance covering a private40-23
passenger car may require any attorney representing the claimant to provide40-24
to the party and his insurer or attorney, not more than once every 90 days,40-25
all medical reports40-26
2. In lieu of providing medical reports40-27
to subsection 1, the claimant or any attorney representing the claimant may40-28
40-29
40-30
party, his insurer or his attorney a written authorization to receive the40-31
reports, records and bills from the provider of health care. At the written40-32
request of the claimant or his attorney, copies of all reports, records and40-33
bills obtained pursuant to the authorization must be provided to the40-34
claimant or his attorney within 30 days after the date they are received. If40-35
the claimant or his attorney makes a written request for the reports,40-36
records and bills, the claimant or his attorney shall pay for the40-37
reasonable costs of copying the reports, records and bills.40-38
3. Upon receipt of any photocopies of medical reports40-39
and bills , or a written authorization pursuant to subsection 2, the insurer40-40
who issued the policy specified in subsection 1 shall, upon request,40-41
immediately disclose to the insured or the claimant all pertinent facts or40-42
provisions of the policy relating to any coverage at issue.41-1
Sec. 58. NRS 692A.105 is hereby amended to read as follows: 692A.105 1. The commissioner may refuse to license any title agent41-3
or escrow officer or may suspend or revoke any license or impose a fine of41-4
not more than $500 for each violation by entering an order to that effect,41-5
with his findings in respect thereto, if upon a hearing, it is determined that41-6
the applicant or licensee:41-7
(a) In the case of a title agent, is insolvent or in such a financial41-8
condition that he cannot continue in business with safety to his customers;41-9
(b) Has violated any provision of this chapter or any regulation adopted41-10
pursuant thereto or has aided and abetted another to do so;41-11
(c) Has committed fraud in connection with any transaction governed by41-12
this chapter;41-13
(d) Has intentionally or knowingly made any misrepresentation or false41-14
statement to, or concealed any essential or material fact known to him from,41-15
any principal or designated agent of the principal in the course of the41-16
escrow business;41-17
(e) Has intentionally or knowingly made or caused to be made to the41-18
commissioner any false representation of a material fact or has suppressed41-19
or withheld from him any information which the applicant or licensee41-20
possesses;41-21
(f) Has failed without reasonable cause to furnish to the parties of an41-22
escrow their respective statements of the settlement within a reasonable41-23
time after the close of escrow;41-24
(g) Has failed without reasonable cause to deliver, within a reasonable41-25
time after the close of escrow, to the respective parties of an escrow41-26
transaction any money, documents or other properties held in escrow in41-27
violation of the provisions of the escrow instructions;41-28
(h) Has refused to permit an examination by the commissioner of his41-29
books and affairs or has refused or failed, within a reasonable time, to41-30
furnish any information or make any report that may be required by the41-31
commissioner pursuant to the provisions of this chapter;41-32
(i) Has been convicted of a felony or any misdemeanor of which an41-33
essential element is fraud;41-34
(j) In the case of a title agent, has failed to maintain complete and41-35
accurate records of all transactions within the last 7 years;41-36
(k) Has commingled the money of41-37
or converted the money of41-38
(l) Has failed, before the close of escrow, to obtain written instructions41-39
concerning any essential or material fact or intentionally failed to follow41-40
the written instructions which have been agreed upon by the parties and41-41
accepted by the holder of the escrow;41-42
(m) Has failed to disclose in writing that he is acting in the dual capacity41-43
of escrow agent or agency and undisclosed principal in any transaction;42-1
(n) In the case of an escrow officer, has been convicted of, or entered a42-2
plea of guilty or nolo contendere to, any crime involving moral turpitude42-3
; or42-4
(o) Has failed to obtain and maintain a copy of the executed42-5
agreement or contract that establishes the conditions for the sale of real42-6
property.42-7
2. It is sufficient cause for the imposition of a fine or the refusal,42-8
suspension or revocation of the license of a partnership, corporation or any42-9
other association if any member of the partnership or any officer or director42-10
of the corporation or association has been guilty of any act or omission42-11
directly arising from the business activities of a title agent which would be42-12
cause for such action had the applicant or licensee been a natural person.42-13
3. The commissioner may suspend or revoke the license of a title agent,42-14
or impose a fine, if the commissioner finds that the title agent:42-15
(a) Failed to maintain adequate supervision of an escrow officer title42-16
agent he has appointed or employed.42-17
(b) Instructed an escrow officer to commit an act which would be cause42-18
for the revocation of the escrow officer’s license and the escrow officer42-19
committed the act. An escrow officer is not subject to disciplinary action42-20
for committing such an act under instruction by the title agent.42-21
4. The commissioner may refuse to issue a license to any person who,42-22
within 10 years before the date of applying for a current license, has had42-23
suspended or revoked a license issued pursuant to this chapter or a42-24
comparable license issued by any other state, district or territory of the42-25
United States or any foreign country.42-26
Sec. 59. Chapter 695C of NRS is hereby amended by adding thereto a42-27
new section to read as follows:42-28
1. To the extent authorized by federal law, the commissioner shall42-29
adopt regulations for the licensing of provider-sponsored organizations42-30
in this state.42-31
2. As used in this section, "provider-sponsored organization" has the42-32
meaning ascribed to it in 42 U.S.C. § 1395w-25(d).42-33
Sec. 60. NRS 695C.350 is hereby amended to read as follows: 695C.350 1. The commissioner may, in lieu of suspension or42-35
revocation of a certificate of authority under NRS 695C.330, levy an42-36
administrative penalty in an amount not42-37
$2,50042-38
of the intent to levy the penalty .42-39
42-40
42-41
2. Any person who violates the provisions of this chapter is guilty of a42-42
misdemeanor.43-1
3. If the commissioner or the state board of health for any reason have43-2
cause to believe that any violation of this chapter has occurred or is43-3
threatened, the commissioner or the state board of health may give notice to43-4
the health maintenance organization and to the representatives, or other43-5
persons who appear to be involved in43-6
arrange a conference with the alleged violators or their authorized43-7
representatives43-8
determine the facts relating to43-9
43-10
at an adequate and effective means of correcting or preventing43-11
violation.43-12
4.43-13
pursuant to the provisions of subsection 3 must not be governed by any43-14
formal procedural requirements, and may be conducted in such manner as43-15
the commissioner or the state board of health may deem appropriate under43-16
the circumstances.43-17
5. The commissioner may issue an order directing a health maintenance43-18
organization or a representative of a health maintenance organization to43-19
cease and desist from engaging in any act or practice in violation of the43-20
provisions of this chapter.43-21
6. Within 30 days after service of the order43-22
respondent may request a hearing on the question of whether acts or43-23
practices in violation of this chapter have occurred.43-24
43-25
43-26
provisions of chapter 233B of NRS and judicial review must be available43-27
as provided therein.43-28
7. In the case of any violation of the provisions of this chapter, if the43-29
commissioner elects not to issue a cease and desist order, or in the event of43-30
noncompliance with a cease and desist order issued pursuant to subsection43-31
5, the commissioner may institute a proceeding to obtain injunctive relief,43-32
or seek other appropriate relief in the district court of the judicial district of43-33
the county in which the violator resides.43-34
Sec. 61. NRS 696B.415 is hereby amended to read as follows: 696B.415 1. Upon the issuance of an order of liquidation with a43-36
finding of insolvency against a domestic insurer, the commissioner shall43-37
apply to the district court for authority to disburse money to the Nevada43-38
insurance guaranty association or the Nevada life and health insurance43-39
guaranty association out of the43-40
insurer, as money becomes available, in amounts equal to disbursements43-41
made or to be made by the association for claims-handling expense and43-42
covered-claims obligations upon the presentation of evidence that43-43
disbursements have been made by the association. The commissioner shall44-1
apply to the district court for authority to make similar disbursements to44-2
insurance guaranty associations in other jurisdictions if one of the Nevada44-3
associations is entitled to like payment44-4
relating to insolvent insurers in the jurisdiction in which the organization is44-5
domiciled.44-6
2. The commissioner, in determining the amounts available for44-7
disbursement to the Nevada insurance guaranty association, the Nevada life44-8
and health insurance guaranty association, and similar organizations in44-9
other jurisdictions, shall reserve sufficient assets for the payment of the44-10
expenses of administration.44-11
3. The commissioner shall establish procedures for the ratable44-12
allocation of disbursements to the Nevada insurance guaranty association,44-13
the Nevada life and health insurance guaranty association, and similar44-14
organizations in other jurisdictions, and shall secure from each organization44-15
to which money is paid as a condition to advances in reimbursement of44-16
covered-claims obligations an agreement to return to the commissioner, on44-17
demand, amounts previously advanced which are required to pay claims of44-18
secured creditors and claims falling within the priorities established in44-19
paragraph (a) or (b) of subsection 1 of NRS 696B.420 .44-20
44-21
44-22
Sec. 62. NRS 696B.420 is hereby amended to read as follows: 696B.420 1. The order of distribution of claims from the44-24
estate of the insurer on liquidation of the insurer must be as44-25
forth in this section.44-26
44-27
44-28
44-29
44-30
each class must be paid in full or adequate money retained for the payment44-31
before the members of the next class receive any payment. No subclasses44-32
may be established within any class. Except as otherwise provided in44-33
subsection 2, the order of distribution and of priority must be as follows:44-34
(a) Administration costs and expenses, including, but not limited to, the44-35
following:44-36
(1) The actual and necessary costs of preserving or recovering the44-37
assets of the insurer;44-38
(2) Compensation for44-39
(3) Any necessary filing fees;44-40
(4) The fees and mileage payable to witnesses; and44-41
(5) Reasonable attorney’s fees.44-42
(b) Loss claims, including44-43
incurred, including third party claims,45-1
for liability for bodily injury or for injury to or destruction of tangible45-2
property which are not under policies, and45-3
insurance guaranty association, the Nevada life and health insurance45-4
guaranty association, and other similar statutory organizations in other45-5
jurisdictions .45-6
45-7
annuity policies, whether for death proceeds, annuity proceeds or45-8
investment values, must be treated as loss claims.45-9
45-10
45-11
by other benefits or advantages recovered or recoverable by the claimant45-12
may not be included in this class, other than benefits or advantages45-13
recovered or recoverable in discharge of familial obligations of support or45-14
45-15
as gratuities. No payment made by an employer to his employee may be45-16
treated as a gratuity.45-17
(c) Unearned premiums and small loss claims, including claims under45-18
nonassessable policies for unearned premiums or other premium refunds .45-19
45-20
45-21
(d) Claims of the Federal Government .45-22
(e) Claims of any state or local government, including, but not limited45-23
to, a claim of45-24
penalty or forfeiture.45-25
45-26
exceed $1,000 to each employee, that have been earned within 1 year45-27
before the filing of the petition for liquidation. Officers of the insurer are45-28
not entitled to the benefit of this priority. The priority set forth in this45-29
paragraph must be in lieu of any other similar priority authorized by law as45-30
to wages or compensation of employees.45-31
45-32
within other classes45-33
Claims for a penalty or forfeiture must be allowed in this class only to the45-34
extent of the pecuniary loss sustained from the act, transaction or45-35
proceeding out of which the penalty or forfeiture arose, with reasonable and45-36
actual costs occasioned thereby. The remainder of45-37
be postponed to the class of claims45-38
45-39
(h) Judgment claims based solely on judgments. If a claimant files a45-40
claim and bases45-41
facts, the claim must be considered by the liquidator, who shall give the45-42
judgment such weight as he deems appropriate. The claim as allowed must45-43
receive the priority it would receive in the absence of the judgment. If the46-1
judgment is larger than the allowance on the underlying claim, the46-2
remaining portion of the judgment must be treated as if it were a claim46-3
based solely on a judgment.46-4
46-5
legal rate compounded annually on46-6
specified in paragraphs (a) to46-7
petition for liquidation or the date on which the claim becomes due,46-8
whichever is later, until the date on which the dividend is declared. The46-9
liquidator, with the approval of the court, may46-10
(1) Make reasonable classifications of claims for purposes of46-11
computing interest46-12
(2) Make approximate computations ; and46-13
(3) Ignore certain classifications and periods as de minimis.46-14
46-15
46-16
paragraph46-17
46-18
46-19
46-20
(1) Claims subordinated by NRS 696B.430;46-21
46-22
46-23
46-24
(4) Claims or portions of claims the payment of which is provided by46-25
other benefits or advantages recovered or recoverable by the claimant; and46-26
46-27
46-28
notes, or similar obligations, and premium refunds on assessable policies.46-29
Interest at the legal rate must be added to each claim, as provided in46-30
paragraphs46-31
46-32
(l) Proprietary claims of shareholders or other owners.46-33
2. If there are no existing or potential claims of the government against46-34
the estate, claims for wages have priority over46-35
paragraphs (c) to46-36
subsection must not be construed to require the46-37
accumulation of interest for claims as described in paragraph46-38
subsection 1.46-39
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 bail46-41
agent, bail enforcement agent or bail solicitor, or perform any of the46-42
functions, duties or powers prescribed for a bail agent, bail enforcement46-43
agent or bail solicitor under the provisions of this chapter, unless that47-1
person is qualified and licensed as provided in this chapter. The47-2
commissioner may, after notice and a hearing, impose a fine of not more47-3
than $1,000 for each act or violation of the provisions of this subsection.47-4
2. A person, whether or not located in this state, shall not act as or hold47-5
himself out to be a general agent unless qualified and licensed as such47-6
under the provisions of this chapter.47-7
3. For the protection of the people of this state, the commissioner shall47-8
not issue or renew, or permit to exist, any license except in compliance with47-9
this chapter. The commissioner shall not issue or renew, or permit to exist,47-10
a license for any person found to be untrustworthy or incompetent, or who47-11
has not established to the satisfaction of the commissioner that he is47-12
qualified therefor in accordance with this chapter.47-13
Sec. 63.5. NRS 697.100 is hereby amended to read as follows: 697.100 1. Except as otherwise provided in this section, no license47-15
may be issued:47-16
(a) Except in compliance with this chapter.47-17
(b) To a bail agent, bail enforcement agent or bail solicitor, unless he is47-18
a natural person.47-19
2. A corporation may be licensed as a bail agent or bail enforcement47-20
agent if47-21
(a) The corporation is owned and controlled by an insurer authorized47-22
to write surety in this state or a subsidiary corporation of such an47-23
insurer; or47-24
(b) Ownership and control of the corporation is retained by one or more47-25
licensed agents.47-26
3. This section does not prohibit two or more licensed bail agents from47-27
entering into a partnership for the conduct of their bail business. No person47-28
may be a member of such a partnership unless he is licensed pursuant to47-29
this chapter in the same capacity as all other members of the partnership. A47-30
limited partnership or a natural person may not have any proprietary47-31
interest, directly or indirectly, in a partnership or the conduct of business47-32
thereunder except licensed bail agents as provided in this chapter.47-33
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 be47-35
accompanied by:47-36
(a) Proof of the completion of a 6-hour course of instruction in bail47-37
bonds that is:47-38
(1) Offered by a state or national organization of bail agents or47-39
another organization that administers training programs for general agents;47-40
and47-41
(2) Approved by the commissioner.47-42
(b) A written appointment by an authorized insurer as general agent,47-43
subject to the issuance of the license.48-1
(c) A letter from a local law enforcement agency in the applicant’s48-2
county of residence which indicates that the applicant:48-3
(1) Has not been convicted of a felony in this state or of any offense48-4
committed in another state which would be a felony if committed in this48-5
state; and48-6
(2) Has not been convicted of an offense involving moral turpitude or48-7
the unlawful use, sale or possession of a controlled substance.48-8
(d) A copy of the contract or agreement that authorizes the general48-9
agent to act as general agent for the insurer.48-10
(e) Any other information the commissioner may require.48-11
2. If the applicant for a license as a general agent is a firm or48-12
corporation, the application must include the names of the members,48-13
officers and directors and designate each natural person who is to exercise48-14
the authority granted by the license. Each person so designated must furnish48-15
information about himself as though the application were for an individual48-16
license.48-17
Sec. 65. NRS 697.190 is hereby amended to read as follows: 697.190 1.48-19
48-20
with the application, and thereafter maintain in force while so licensed, a48-21
bond in favor of the people of the State of Nevada executed by an48-22
authorized surety insurer. The bond may be continuous in form with total48-23
aggregate liability limited to payment as follows:48-24
(a) Bail agent $25,00048-25
(b) Bail solicitor 10,00048-26
(c) General agent 50,00048-27
2. The bond must be conditioned upon full accounting and payment to48-28
the person entitled thereto of money, property or other matters coming into48-29
the licensee’s possession through bail bond transactions under the license.48-30
3. The bond must remain in force until released by the commissioner,48-31
or canceled by the surety. Without prejudice to any liability previously48-32
incurred under the bond, the surety may cancel the bond upon 30 days’48-33
advance written notice to the licensee and the commissioner.48-34
Sec. 65.3. NRS 277.055 is hereby amended to read as follows: 277.055 1. As used in this section:48-36
(a) "Medical facility" has the meaning ascribed to it in NRS 449.0151.48-37
(b) "Nonprofit medical facility" means a nonprofit medical facility in48-38
this or another state.48-39
(c) "Public agency" has the meaning ascribed to it in NRS 277.100, and48-40
includes any municipal corporation.49-1
2. Any two or more public agencies or nonprofit medical facilities may49-2
enter into a cooperative agreement for the purchase of insurance or the49-3
establishment of a self-insurance reserve or fund for coverage under a plan49-4
of:49-5
(a) Casualty insurance, as that term is defined in NRS 681A.020;49-6
(b) Marine and transportation insurance, as that term is defined in NRS49-7
681A.050;49-8
(c) Property insurance, as that term is defined in NRS 681A.060;49-9
(d) Surety insurance, as that term is defined in NRS 681A.070;49-10
(e) Health insurance, as that term is defined in NRS 681A.030; or49-11
(f) Insurance for any combination of these kinds.49-12
3. Every such agreement must:49-13
(a) Be ratified by formal resolution or ordinance of the governing body49-14
or board of trustees of each agency or nonprofit medical facility included;49-15
(b) Be included in the minutes of each governing body or board of49-16
trustees, or attached in full to the minutes as an exhibit;49-17
(c) Be submitted to the commissioner of insurance not less than 30 days49-18
before the date on which the agreement is to become effective for49-19
approval in the manner provided by NRS 277.150; and49-20
(d) If a public agency is a party to the agreement, comply with the49-21
provisions of NRS 277.080 to 277.180, inclusive.49-22
4. Each participating agency or nonprofit medical facility shall provide49-23
for any expense to be incurred under any such agreement.49-24
Sec. 65.5. NRS 287.025 is hereby amended to read as follows: 287.025 The governing body of any county, school district, municipal49-26
corporation, political subdivision, public corporation or other public49-27
agency of the State of Nevada may, in addition to the other powers granted49-28
in NRS 287.010 and 287.020:49-29
1. Negotiate and contract with any other such agency or with the49-30
committee on benefits for the state’s group insurance plan to secure group49-31
insurance for its officers and employees and their dependents by49-32
participation in any group insurance plan established or to be established or49-33
in the state’s group insurance plan .49-34
(a) Must be submitted to the commissioner of insurance not less than49-35
30 days before the date on which the contract is to become effective for49-36
approval.49-37
(b) Does not become effective unless approved by the commissioner.49-38
(c) Shall be deemed to be approved if not disapproved by the49-39
commissioner of insurance within 30 days after its submission.49-40
2. To secure group health or life insurance for its officers and49-41
employees and their dependents, participate as a member of a nonprofit49-42
cooperative association or nonprofit corporation that has been established50-1
in this state to secure such insurance for its members from an insurer50-2
licensed pursuant to the provisions of Title 57 of NRS.50-3
3. In addition to the provisions of subsection 2, participate as a50-4
member of a nonprofit cooperative association or nonprofit corporation that50-5
has been established in this state to:50-6
(a) Facilitate contractual arrangements for the provision of medical50-7
services to its members’ officers and employees and their dependents and50-8
for related administrative services.50-9
(b) Procure health-related information and disseminate that information50-10
to its members’ officers and employees and their dependents.50-11
Sec. 65.7. NRS 287.0434 is hereby amended to read as follows: 287.0434 The committee on benefits may:50-13
1. Use its assets to pay the expenses of health care for its members and50-14
covered dependents, to pay its employees’ salaries and to pay50-15
administrative and other expenses.50-16
2. Enter into contracts relating to the administration of a plan of50-17
insurance, including contracts with licensed administrators and qualified50-18
actuaries. Each such contract with a licensed administrator:50-19
(a) Must be submitted to the commissioner of insurance not less than50-20
30 days before the date on which the contract is to become effective for50-21
approval as to the reasonableness of administrative charges in relation to50-22
contributions collected and benefits provided.50-23
(b) Does not become effective unless approved by the commissioner.50-24
(c) Shall be deemed to be approved if not disapproved by the50-25
commissioner of insurance within 30 days after its submission.50-26
3. Enter into contracts with physicians, surgeons, hospitals, health50-27
maintenance organizations and rehabilitative facilities for medical, surgical50-28
and rehabilitative care and the evaluation, treatment and nursing care of50-29
members and covered dependents.50-30
4. Enter into contracts for the services of other experts and specialists50-31
as required by a plan of insurance.50-32
5. Charge and collect from an insurer, health maintenance50-33
organization, organization for dental care or nonprofit medical service50-34
corporation, a fee for the actual expenses incurred by the committee, the50-35
state or a participating public employer in administering a plan of insurance50-36
offered by that insurer, organization or corporation.50-37
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 of50-39
insurance administered by a third-party administrator.50-40
2. An insurer shall not enter into a contract with any person for the50-41
administration of any part of the plan of insurance unless that person50-42
maintains an office in this state and has a50-43
commissioner pursuant to51-1
system may, as a part of a contract entered into with an organization for51-2
managed care pursuant to NRS 616B.515, require the organization to act as51-3
its third-party administrator.51-4
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 for51-6
an insurer without a certificate issued by the commissioner pursuant to51-7
51-8
2. A person who acts as a third-party administrator pursuant to chapters51-9
616A to 616D, inclusive, or chapter 617 of NRS shall:51-10
(a) Administer from one or more offices located in this state all of the51-11
claims arising under each plan of insurance that he administers and51-12
maintain in those offices all of the records concerning those claims;51-13
(b) Administer each plan of insurance directly, without subcontracting51-14
with another third-party administrator; and51-15
(c) Upon the termination of his contract with an insurer, transfer51-16
forthwith to a certified third-party administrator chosen by the insurer all of51-17
the records in his possession concerning claims arising under the plan of51-18
insurance.51-19
3. The commissioner may, under exceptional circumstances, waive the51-20
requirements of subsection 2.51-21
Sec. 68. NRS 683A.0867, 686C.060 and 686C.085 are hereby51-22
repealed.51-23
Sec. 69. Sections 20 and 67 of this act become effective at 12:01 a.m.51-24
on October 1, 1999.
51-25
TEXT OF REPEALED SECTIONS683A.0867 Standards to be provided in agreement. The
51-27
agreement between the administrator and the insurer shall provide for51-28
underwriting and other standards pertaining to the business underwritten by51-29
the insurer.51-30
686C.060 "Board" defined. "Board" means the board of directors51-31
of the Nevada Life and Health Insurance Guaranty Association. 686C.085 "Domiciliary state" defined. "Domiciliary state" has the51-33
meaning ascribed to it in NRS 696B.070.~