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 787-1
23. Licenses and renewals for bail enforcement agents:7-2
(a) Application and license $787-3
(b) Triennial renewal of each license 787-4
24. Licenses, appointments and renewals for general bail7-5
agents:7-6
(a) Application and license $787-7
(b) Initial appointment by each insurer 57-8
(c) Triennial renewal of each license 787-9
25. Licenses and renewals for bail solicitors:7-10
(a) Application and license $787-11
(b) Triennial renewal of each license 787-12
26. Licenses and renewals for title agents and escrow7-13
officers:7-14
(a) Resident title agents and escrow officers:7-15
(1) Application and license $787-16
(2) Triennial renewal of each license 787-17
(b) Nonresident title agents and escrow officers:7-18
(1) Application and license 1387-19
(2) Triennial renewal of each license 1387-20
(c) Change in name or location of business or in association 107-21
27. Certificate of authority and renewal for a seller of7-22
prepaid funeral contracts $787-23
28. Licenses and renewals for agents for prepaid funeral7-24
contracts:7-25
(a) Resident agents:7-26
(1) Application and license $787-27
(2) Triennial renewal of each license 787-28
(b) Nonresident agents:7-29
(1) Application and license 1387-30
(2) Triennial renewal of each license 1387-31
29. Licenses, appointments and renewals for agents for7-32
fraternal benefit societies:7-33
(a) Resident agents:7-34
(1) Application and license $787-35
(2) Appointment 57-36
(3) Triennial renewal of each license 787-37
(b) Nonresident agents:7-38
(1) Application and license 1387-39
(2) Triennial renewal of each license 1387-40
30. Reinsurance intermediary broker or manager:7-41
(a) Resident agents:7-42
(1) Application and license $787-43
(2) Triennial renewal of each license 788-1
(b) Nonresident agents:8-2
(1) Application and license $1388-3
(2) Triennial renewal of each license 1388-4
31. Agents for and sellers of prepaid burial contracts:8-5
(a) Resident agents and sellers:8-6
(1) Application and certificate or license $788-7
(2) Triennial renewal 788-8
(b) Nonresident agents and sellers:8-9
(1) Application and certificate or license 1388-10
(2) Triennial renewal 1388-11
32. Risk retention groups:8-12
(a) Initial registration and review of an application $2,4508-13
(b) Each annual continuation of a certificate of registration 2,4508-14
33. Required filing of forms:8-15
(a) For rates and policies $258-16
(b) For riders and endorsements 108-17
Sec. 5. NRS 681B.290 is hereby amended to read as follows: 681B.290 1.8-19
or before March 1 of each year, each domestic insurer, and each foreign8-20
insurer domiciled in a state which does not have requirements for reporting8-21
risk-based capital, that transacts property, casualty, life or health insurance8-22
in this state shall prepare and submit to the commissioner, and to each8-23
person designated by the commissioner, a report of the level of the risk-8-24
based capital of the insurer as of the end of the immediately preceding8-25
calendar year. The report must be in such form and contain such8-26
information as required by the regulations adopted by the commissioner8-27
pursuant to this section.8-28
2. The commissioner shall adopt regulations concerning the amount of8-29
risk-based capital required to be maintained by each insurer licensed to do8-30
business in this state that is transacting property, casualty, life or health8-31
insurance in this state. The regulations must be consistent with the8-32
instructions for reporting risk-based capital adopted by the National8-33
Association of Insurance Commissioners, as those instructions existed on8-34
January 1, 1997. If the instructions are amended, the commissioner may8-35
amend the regulations to maintain consistency with the instructions if he8-36
determines that the amended instructions are appropriate for use in this8-37
state.8-38
3. The commissioner may exempt from the provisions of this section8-39
a domestic insurer who:8-40
(a) Does not transact insurance in any other state; and8-41
(b) Does not assume reinsurance that is more than 5 percent of the8-42
direct premiums written by the insurer.8-43
Secs. 5.2-5.8. (Deleted by amendment.)9-1
Sec. 6. Chapter 683A of NRS is hereby amended by adding thereto the9-2
provisions set forth as sections 7 to 16, inclusive, of this act.9-3
Sec. 7. As used in NRS 683A.085 to 683A.0893, inclusive, and9-4
sections 7 to 16, inclusive, of this act, unless the context otherwise9-5
requires, the words and terms defined in sections 8 to 11, inclusive, of9-6
this act have the meanings ascribed to them in those sections.9-7
Sec. 8. "Affiliate" has the meaning ascribed to it in NRS 692C.030.9-8
Sec. 9. "Control" has the meaning ascribed to it in NRS 692C.050.9-9
Sec. 10. "Insurer" includes, without limitation:9-10
1. An insurance company licensed pursuant to the provisions of this9-11
code;9-12
2. A prepaid limited health service organization that has been issued9-13
a certificate of authority pursuant to chapter 695F of NRS;9-14
3. A health maintenance organization that has been issued a9-15
certificate of authority pursuant to chapter 695C of NRS;9-16
4. A multiple employer welfare arrangement as defined in 29 U.S.C.§ 1002;
9-17
5. An employer for whom a program of self-insurance is9-18
administered by an administrator; and9-19
6. An organization for dental care that has been issued a certificate9-20
of authority pursuant to chapter 695D of NRS.9-21
Sec. 11. "Underwrite" includes, without limitation:9-22
1. Accepting applications for insurance coverage in accordance with9-23
the written rules of an insurer;9-24
2. Planning and coordinating a program of insurance; and9-25
3. Procuring bonds and excess insurance.9-26
Sec. 12. The commissioner:9-27
1. Shall suspend or revoke the certificate of registration of an9-28
administrator if the commissioner has determined, after notice and a9-29
hearing, that the administrator:9-30
(a) Is in an unsound financial condition;9-31
(b) Uses methods or practices in the conduct of his business that are9-32
hazardous or injurious to insured persons or members of the general9-33
public; or9-34
(c) Has failed to pay any judgment against him in this state within 609-35
days after the judgment became final.9-36
2. May suspend or revoke the certificate of registration of an9-37
administrator if the commissioner determines, after notice and a hearing,9-38
that the administrator:9-39
(a) Has willfully violated or failed to comply with any provision of this9-40
code, any regulation adopted pursuant to this code or any order of the9-41
commissioner;10-1
(b) Has refused to be examined by the commissioner or has refused to10-2
produce accounts, records or files for examination upon the request of10-3
the commissioner;10-4
(c) Has, without just cause, refused to pay claims or perform services10-5
pursuant to his contracts or has, without just cause, caused persons to10-6
accept less than the amount of money owed to them pursuant to the10-7
contracts, or has caused persons to employ an attorney or bring a civil10-8
action against him to receive full payment or settlement of claims;10-9
(d) Is affiliated with, managed by or owned by another administrator10-10
or an insurer who transacts insurance in this state without a certificate of10-11
authority or a certificate of registration;10-12
(e) Fails to comply with any of the requirements for a certificate of10-13
registration;10-14
(f) Has been convicted of, or has entered a plea of guilty or nolo10-15
contendere to a felony, whether or not adjudication was withheld; or10-16
(g) Has had his authority to act as an administrator in another state10-17
limited, suspended or revoked.10-18
3. May, upon notice to the administrator, suspend the certificate of10-19
registration of the administrator pending a hearing if:10-20
(a) The administrator is impaired or insolvent;10-21
(b) A proceeding for receivership, conservatorship or rehabilitation10-22
has been commenced against the administrator in any state; or10-23
(c) The financial condition or the business practices of the10-24
administrator represent an imminent threat to the public health, safety or10-25
welfare of the residents of this state.10-26
4. May, in addition to or in lieu of the suspension or revocation of10-27
the certificate of registration of the administrator, impose a fine of10-28
$2,000 for each act or violation.10-29
Sec. 13. Each application for a certificate of registration as an10-30
administrator must include or be accompanied by:10-31
1. A financial statement that is certified by an officer of the applicant10-32
and must include:10-33
(a) The amount of money that the applicant expects to collect from or10-34
disburse to residents of this state during the next calendar year;10-35
(b) Financial information for the 90 days immediately preceding the10-36
date the application was filed with the commissioner; and10-37
(c) An income statement and balance sheet for the 2 years10-38
immediately preceding the application that are prepared in accordance10-39
with generally accepted accounting principles. The submission by the10-40
applicant of his consolidated income statement and balance sheet does10-41
not constitute compliance with the provisions of this paragraph.10-42
2. The documents used to create the business association of the10-43
administrator, including, without limitation, articles of incorporation,11-1
articles of association, a partnership agreement, a trust agreement and a11-2
shareholder agreement.11-3
3. The documents used to regulate the internal affairs of the11-4
administrator, including, without limitation, the bylaws, rules or11-5
regulations of the administrator.11-6
4. A certificate of registration issued pursuant to NRS 600.350 for a11-7
trade name or trade-mark used by the administrator.11-8
5. An organizational chart that identifies each person who directly or11-9
indirectly controls the administrator and each affiliate of the11-10
administrator.11-11
6. A notarized affidavit from each person who manages or controls11-12
the administrator, including, without limitation, each member of the11-13
board of directors or board of trustees, each officer, partner, and member11-14
of the business association of the administrator, and each shareholder of11-15
the administrator who holds not less than 10 percent of the voting stock11-16
of the administrator. The affidavit must include, without limitation:11-17
(a) The personal history, business record and insurance experience of11-18
the affiant;11-19
(b) Whether the affiant has been investigated by any regulatory11-20
authority or has had any license or certificate denied, suspended or11-21
revoked in any state; and11-22
(c) Any other information that the commissioner may require.11-23
7. The complete name and address of each office of the11-24
administrator, including, offices located outside this state.11-25
8. A statement that sets forth whether the administrator has:11-26
(a) Held a license or certificate to transact any kind of insurance in11-27
this state or any other state and whether that license or certificate has11-28
been refused, suspended or revoked;11-29
(b) Been indebted to any person and, if so, the circumstances of that11-30
debt; and11-31
(c) Had an administrative agreement canceled and, if so, the11-32
circumstances of that cancellation.11-33
9. A statement that describes the business plan of the administrator.11-34
The statement must include information:11-35
(a) Concerning the number of persons on the staff of the11-36
administrator and the activities proposed in this state or in any other11-37
state.11-38
(b) That demonstrates the capability of the administrator to provide a11-39
sufficient number of experienced and qualified persons for the11-40
processing of claims, the keeping of records and, if applicable,11-41
underwriting.11-42
10. If the applicant intends to solicit new or renewal business, proof11-43
that the applicant employs or has contracted with an agent licensed in12-1
this state to solicit and take applications. An applicant who intends to12-2
solicit insurance contracts directly or to act as an insurance agent must12-3
provide proof that he is licensed as an insurance agent in this state.12-4
Sec. 14. 1. Except as otherwise provided by subsection 2, the12-5
commissioner shall issue a certificate of registration as an administrator12-6
to an applicant who:12-7
(a) Submits an application on a form prescribed by the commissioner;12-8
(b) Has complied with the provisions of section 13 of this act; and12-9
(c) Pays the fee for the issuance of a certificate of registration12-10
prescribed in NRS 680B.010.12-11
2. The commissioner may refuse to issue a certificate of registration12-12
as an administrator to an applicant if the commissioner determines that12-13
the applicant or any person who has completed an affidavit pursuant to12-14
subsection 6 of section 13 of this act:12-15
(a) Is not competent to act as an administrator;12-16
(b) Is not trustworthy or financially responsible;12-17
(c) Does not have a good personal or business reputation;12-18
(d) Has had a license or certificate to transact insurance denied for12-19
cause, suspended or revoked in this state or any other state; or12-20
(e) Has failed to comply with any provision of this chapter.12-21
Sec. 15. 1. A certificate of registration as an administrator is valid12-22
for 3 years after the date the commissioner issues the certificate to the12-23
administrator.12-24
2. An administrator may renew a certificate of registration if he12-25
submits to the commissioner:12-26
(a) An application on a form prescribed by the commissioner; and12-27
(b) The fee for the renewal of the certificate of registration prescribed12-28
in NRS 680B.010.12-29
3. A certificate of registration that is suspended or revoked must be12-30
surrendered immediately to the commissioner.12-31
Sec. 16. Not later than March 1 of each year, each holder of a12-32
certificate of registration as an administrator shall file a financial12-33
statement with the commissioner on a form approved by the12-34
commissioner.12-35
Sec. 17. NRS 683A.025 is hereby amended to read as follows: 683A.025 1. Except as limited by this section, "administrator" means12-37
a person who:12-38
(a)12-39
premiums from or adjusts or settles claims of residents of this state or any12-40
other state from within this state in connection with workers’12-41
compensation insurance, life or health insurance coverage or annuities,12-42
including coverage or annuities provided by an employer for his12-43
employees;13-1
(b) Administers13-2
NRS 287.010;13-3
(c) Administers a program of self-insurance for an employer;13-4
(d) Administers a program which is funded by an employer and which13-5
provides pensions, annuities, health benefits, death benefits or other similar13-6
benefits for his employees13-7
(e) Is an insurance company that is licensed to do business in this13-8
state or is acting as an insurer with respect to a policy lawfully issued and13-9
delivered in a state where the insurer is authorized to do business, if the13-10
insurance company performs any act described in paragraphs (a) to (d),13-11
inclusive, for or on behalf of another insurer.13-12
2. "Administrator" does not include:13-13
(a) An employee authorized to act on behalf of an administrator who13-14
holds a certificate of registration from the commissioner.13-15
(b) An employer acting on behalf of his employees or the employees of13-16
a subsidiary or affiliated concern.13-17
(c) A labor union acting on behalf of its members.13-18
(d)13-19
1, an insurance company licensed to do business in this state or acting as an13-20
insurer with respect to a policy lawfully issued and delivered in a state in13-21
which the insurer was authorized to do business.13-22
(e) A life or health insurance agent or broker licensed in this state, when13-23
his activities are limited to the sale of insurance.13-24
(f) A creditor acting on behalf of his debtors with respect to insurance13-25
covering a debt between the creditor and debtor.13-26
(g) A trust and its trustees, agents and employees acting for it, if the trust13-27
was established under the provisions of 29 U.S.C. § 186.13-28
(h) A trust which is exempt from taxation under section 501(a) of the13-29
Internal Revenue Code, 26 U.S.C. § 501(2), its trustees and employees, and13-30
a custodian, his agents and employees acting under a custodial account13-31
which meets the requirements of section 401(f) of the Internal Revenue13-32
Code13-33
(i) A bank, credit union or other financial institution which is subject to13-34
supervision by federal or state banking authorities.13-35
(j) A company which issues credit cards, and which advances for and13-36
collects premiums or charges from credit card holders who have authorized13-37
it to do so, if the company does not adjust or settle claims.13-38
(k) An attorney at law who adjusts or settles claims in the normal course13-39
of his practice or employment, but who does not collect charges or13-40
premiums in connection with life or health insurance coverage or with13-41
annuities.14-1
Sec. 18. NRS 683A.085 is hereby amended to read as follows: 683A.08514-3
as or hold himself out to the public as an administrator, unless he has14-4
obtained a certificate of registration as an administrator from the14-5
commissioner14-6
14-7
14-8
14-9
14-10
14-11
14-12
14-13
14-14
14-15
14-16
14-17
14-18
pursuant to section 14 of this act.14-19
Sec. 19. NRS 683A.0857 is hereby amended to read as follows: 683A.0857 1.14-21
commissioner a bond with an authorized surety in favor of the State of14-22
Nevada, continuous in form and in an amount determined by the14-23
commissioner of not less than14-24
2. The commissioner shall establish schedules for the amount of the14-25
bond required, based on the amount of money received and distributed by14-26
an administrator.14-27
3. The bond must inure to the benefit of any person damaged by any14-28
fraudulent act or conduct of the administrator and must be conditioned14-29
upon faithful accounting and application of all money coming into the14-30
administrator’s possession in connection with his activities as an14-31
administrator.14-32
4. The bond remains in force until released by the commissioner or14-33
canceled by the surety. Without prejudice to any liability previously14-34
incurred, the surety may cancel the bond upon 90 days’ advance notice to14-35
the administrator and the commissioner. An administrator’s certificate is14-36
automatically suspended if he does not file with the commissioner a14-37
replacement bond before the date of cancellation of the previous bond. A14-38
replacement bond must meet all requirements of this section for the initial14-39
bond.14-40
Sec. 20. NRS 683A.086 is hereby amended to read as follows: 683A.086 1. No person may act as an administrator unless he has14-42
entered into a written agreement with an insurer, and the written agreement14-43
contains provisions to effectuate the requirements contained in NRS15-1
15-2
Bill No. 145 of this15-3
act which apply to the duties of the administrator.15-4
2. The written agreement must set forth:15-5
(a) The duties the administrator will be required to perform on behalf15-6
of the insurer; and15-7
(b) The lines, classes or types of insurance that the administrator is15-8
authorized to administer on behalf of the insurer.15-9
3. A copy of an agreement entered into under the provisions of this15-10
section must be retained in the records of the administrator and of the15-11
insurer for a period of 5 years after the termination of the agreement.15-12
15-13
trust agreement and amendments must be obtained by the administrator and15-14
a copy forwarded to the insurer. Each agreement must be retained by the15-15
administrator and15-16
termination of the policy.15-17
15-18
functions an administrator may perform on behalf of an insurer.15-19
6. The insurer or administrator may, upon written notice to the other15-20
party to the agreement and to the commissioner, terminate the written15-21
agreement for any cause specified in the agreement. The insurer may15-22
suspend the authority of the administrator while any dispute regarding15-23
the cause for termination is pending. The insurer shall perform any15-24
obligations with respect to the policies affected by the agreement15-25
regardless of any dispute with the administrator.15-26
Sec. 21. NRS 683A.087 is hereby amended to read as follows: 683A.087 An administrator may advertise the insurance which he15-28
administers only15-29
underwrites the business involved.15-30
Sec. 22. NRS 683A.0873 is hereby amended to read as follows: 683A.0873 1. Each administrator shall maintain at his principal15-32
office adequate books and records of all transactions between himself, the15-33
insurer and the insured. The books and records must be maintained in15-34
accordance with prudent standards of recordkeeping for insurance and with15-35
regulations of the commissioner for a period of 5 years after the transaction15-36
to which they respectively relate. After the 5-year period the administrator15-37
may remove the books and records from the state, store their contents on15-38
microfilm or return them to the appropriate insurer.15-39
2. The commissioner may examine, audit and inspect books and15-40
records15-41
provisions of this section15-42
to 679B.300, inclusive.16-1
3. The names and addresses of insured persons and any other material16-2
which is in the books and records of an administrator are confidential16-3
except when used in proceedings against the administrator.16-4
4. The insurer may inspect and examine all books and records to the16-5
extent necessary to fulfill all contractual obligations to insured persons,16-6
subject to restrictions in the written agreement between the insurer and16-7
administrator.16-8
Sec. 23. NRS 683A.0877 is hereby amended to read as follows: 683A.0877 1. All insurance charges and premiums collected by an16-10
administrator on behalf of an insurer and return premiums received from an16-11
insurer are held by the administrator in a fiduciary capacity.16-12
2. Money16-13
persons entitled to it, or16-14
16-15
the administrator16-16
financial institution in this state. The fiduciary accounts must be separate16-17
from the personal or business accounts of the administrator.16-18
3. If charges or premiums deposited in an account have been collected16-19
for or on behalf of more than one insurer, the administrator shall cause the16-20
bank ,16-21
fiduciary account is maintained to record clearly the deposits and16-22
withdrawals from the account on behalf of each insurer.16-23
4. The administrator shall promptly obtain and keep copies of16-24
16-25
insurer with copies of the records which pertain to him upon demand of the16-26
insurer.16-27
5. The administrator16-28
money from his fiduciary account16-29
deposited.16-30
6. Withdrawals16-31
between the insurer and the administrator for:16-32
(a) Remittance to the insurer.16-33
(b) Deposit in an account maintained in the name of the insurer.16-34
(c) Transfer to and deposit in an account for the payment of claims.16-35
(d) Payment to a group policyholder for remittance to the insurer16-36
entitled to the money.16-37
(e) Payment to the administrator of his commission, fees or charges.16-38
(f) Remittance of return premiums to persons entitled to them.16-39
7. The administrator shall maintain copies of all records relating to16-40
deposits or withdrawals and, upon the request of an insurer, provide the16-41
insurer with copies of those records.17-1
Sec. 24. NRS 683A.088 is hereby amended to read as follows: 683A.088 Each claim paid by the administrator from17-3
collected for or on behalf of an insurer17-4
draft upon and as authorized by the insurer.17-5
Sec. 25. NRS 683A.0883 is hereby amended to read as follows: 683A.0883 1. The compensation paid to an administrator for his17-7
services may be based upon premiums or charges collected, on number of17-8
claims paid or processed or on17-9
the administrator and the insurer, except as provided in subsection 2.17-10
2. Compensation paid to an administrator may not be based upon or17-11
contingent upon :17-12
(a) The claim experience of the policies17-13
handles; or17-14
(b) The savings realized by the administrator by adjusting, settling or17-15
paying the losses covered by an insurer.17-16
Sec. 26. NRS 683A.0887 is hereby amended to read as follows: 683A.0887 1. Each administrator shall advise each insured, by means17-18
of a written notice approved by the insurer, of the identity of and17-19
relationship among the insurer, administrator and insured.17-20
2. An administrator who seeks to collect premiums or charges shall17-21
clearly17-22
charge set by the insurer for the insurance coverage17-23
the collection of the premium or charge. Each charge must be set forth17-24
separately from the premium.17-25
3. The administrator shall disclose to an insurer, in writing, all17-26
charges, fees and commissions the administrator receives in connection17-27
with the provision of administrative services for the insurer, including,17-28
without limitation, the fees and commissions paid by insurers providing17-29
reinsurance or excess of loss insurance.17-30
Sec. 26.5. NRS 685A.070 is hereby amended to read as follows: 685A.070 1. A broker shall not knowingly place surplus lines17-32
insurance with an insurer which is unsound financially or ineligible17-33
pursuant to this section.17-34
2.17-35
eligible for the acceptance of surplus lines risks pursuant to this chapter17-36
unless it has surplus as to policyholders in an amount of not less than17-37
$5,000,000 and, if an alien insurer, unless it has and maintains in a bank or17-38
trust company which is a member of the United States Federal Reserve17-39
System a trust fund established pursuant to terms reasonably adequate for17-40
the protection of all of its policyholders in the United States in an amount17-41
of not less than $1,500,000. Such a trust fund must not have an expiration17-42
date which is at any time less than 5 years in the future, on a continuing17-43
basis. In the case of:18-1
(a) A group of insurers which includes individual unincorporated18-2
insurers, such a trust fund must not be less than $100,000,000.18-3
(b) A group of incorporated insurers under common administration,18-4
such a trust fund must not be less than $100,000,000. The group of18-5
incorporated insurers must:18-6
(1) Operate under the supervision of the Department of Trade and18-7
Industry of the United Kingdom;18-8
(2) Possess aggregate policyholders surplus of $10,000,000,000,18-9
which must consist of money in trust in an amount not less than the18-10
assuming insurers’ liabilities attributable to insurance written in the United18-11
States; and18-12
(3) Maintain a joint trusteed surplus of which $100,000,000 must be18-13
held jointly for the benefit of United States ceding insurers of any member18-14
of the group.18-15
(c) An insurance exchange created by the laws of a state,18-16
insurance exchange shall have and maintain a trust fund18-17
an amount of not less than $50,000,00018-18
policyholders in an amount of not less than $50,000,000. If an insurance18-19
exchange maintains money for the protection of all policyholders, each18-20
syndicate shall maintain minimum capital and surplus of not less than18-21
$5,000,000 and must qualify separately to be eligible for the acceptance of18-22
surplus lines risks pursuant to this chapter.18-23
The commissioner may require larger trust funds or surplus as to18-24
policyholders than those set forth in this section if, in his judgment, the18-25
volume of business being transacted or proposed to be transacted warrants18-26
larger amounts.18-27
3. No insurer is eligible to write surplus lines of insurance unless it has18-28
established a reputation for financial integrity and satisfactory practices in18-29
underwriting and handling claims. In addition, a foreign insurer must be18-30
authorized in the state of its domicile to write the kinds of insurance which18-31
it intends to write in Nevada.18-32
4. The commissioner may from time to time compile or approve a list18-33
of all surplus lines insurers deemed by him to be eligible currently, and may18-34
mail a copy of the list to each broker at his office last of record with the18-35
commissioner. To be placed on the list, a surplus lines insurer must file an18-36
application with the commissioner. The application must be accompanied18-37
by a nonrefundable fee of $2,450. This subsection does not require the18-38
commissioner to determine the actual financial condition or claims18-39
practices of any unauthorized insurer. The status of eligibility, if granted by18-40
the commissioner, indicates only that the insurer appears to be sound18-41
financially and to have satisfactory claims practices, and that the18-42
commissioner has no credible evidence to the contrary. While any such list19-1
is in effect, the broker shall restrict to the insurers so listed all surplus lines19-2
business placed by him.19-3
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,19-5
or be a surplus lines broker with respect to subjects of insurance resident,19-6
located or to be performed in this state or elsewhere unless he is licensed as19-7
such by the commissioner pursuant to this chapter.19-8
2. Any person who has been licensed by this state as a19-9
for general lines for at least 6 months , or has been licensed in another state19-10
as a surplus lines broker for at least 1 year and continues to be licensed in19-11
that state, and who is deemed by the commissioner to be competent and19-12
trustworthy with respect to the handling of surplus lines may be licensed as19-13
a surplus lines broker upon:19-14
(a) Application for a license and payment of the applicable fee for a19-15
license and a fee of $15 for deposit in the insurance recovery account19-16
created by NRS 679B.305;19-17
(b) Submitting the statement required pursuant to NRS 685A.127; and19-18
(c) Passing any examination prescribed by the commissioner on the19-19
subject of surplus lines.19-20
3. An application for a license must be submitted to the commissioner19-21
on a form designated and furnished by him. The application must include19-22
the social security number of the applicant.19-23
4. A license issued pursuant to this chapter continues in force for 319-24
years unless it is suspended, revoked or otherwise terminated. The license19-25
may be renewed upon submission of the statement required pursuant to19-26
NRS 685A.127 and payment of the applicable fee for renewal and a fee of19-27
$15 for deposit in the insurance recovery account created by NRS19-28
679B.305 to the commissioner on or before the last day of the month in19-29
which the license is renewable.19-30
5. A license which is not renewed expires at midnight on the last day19-31
specified for its renewal. The commissioner may accept a request for19-32
renewal received by him within 30 days after the expiration of the license if19-33
the request is accompanied by the statement required pursuant to NRS19-34
685A.127, a fee for renewal of 150 percent of the fee otherwise required19-35
and a fee of $15 for deposit in the insurance recovery account created by19-36
NRS 679B.305.19-37
Sec. 28. NRS 685A.140 is hereby amended to read as follows: 685A.140 1. In addition to other grounds therefor, the commissioner19-39
may suspend or revoke any surplus lines broker’s license:19-40
(a) If the broker fails to file the annual statement or to remit the tax as19-41
required by NRS 685A.170 and 685A.180;19-42
(b) If the broker fails to maintain an office in this state19-43
where he was issued a license as a resident broker, or to keep the records,20-1
or to allow the commissioner to examine his records as required by this20-2
chapter, or if he removes his records from the state; or20-3
(c) If the broker places a surplus lines coverage in an insurer other than20-4
as authorized under this chapter.20-5
2. Upon suspending or revoking the broker’s surplus lines license the20-6
commissioner may also suspend or revoke all other licenses of or as to the20-7
same individual under this code.20-8
Sec. 29. NRS 685A.160 is hereby amended to read as follows: 685A.160 1. Each broker shall keep in his office20-10
and true record of each surplus lines coverage procured by him, including a20-11
copy of each daily report, if any, a copy of each certificate of insurance20-12
issued by him, and such of the following items as may be applicable:20-13
(a)20-14
(b)20-15
(c)20-16
(d)20-17
property;20-18
(e)20-19
(f)20-20
the proportion of the entire risk assumed by20-21
the entire risk;20-22
(g)20-23
(h)20-24
where located or to be performed; and20-25
(i)20-26
commissioner.20-27
2. The record20-28
the office of the broker and must be open to examination by the20-29
commissioner or his representative at all times within 5 years after issuance20-30
of the coverage to which it relates.20-31
Sec. 30. NRS 686A.130 is hereby amended to read as follows: 686A.130 1. No property, casualty, surety or title insurer or20-33
underwritten title company or any employee or representative thereof, and20-34
no broker, agent or solicitor may pay, allow or give, or offer to pay, allow20-35
or give, directly or indirectly, as an inducement to insurance, or after20-36
insurance has been effected, any rebate, discount, abatement, credit or20-37
reduction of the premium named in a policy of insurance, or any special20-38
favor or advantage in the dividends or other benefits to accrue thereon, or20-39
any valuable consideration or inducement whatever, not specified or20-40
provided for in the policy, except to the extent provided for in an20-41
applicable filing with the commissioner.21-1
2. No title insurer or underwritten title company may:21-2
(a) Pay, directly or indirectly, to the insured or any person acting as21-3
agent, representative, attorney or employee of the owner, lessee,21-4
mortgagee, existing or prospective, of the real property or interest therein21-5
which is the subject matter of title insurance or as to which a service is to21-6
be performed, any commission , rebate or part of its fee or charges or other21-7
consideration as inducement or compensation for the placing of any order21-8
for a title insurance policy or for performance of any escrow or other21-9
service by the insurer or underwritten title company with respect thereto; or21-10
(b) Issue any policy or perform any service in connection with which it21-11
or any agent or other person has paid or contemplates paying any21-12
commission, rebate or inducement in violation of this section.21-13
3. No insured named in a policy or any employee of21-14
may knowingly receive or accept, directly or indirectly, any such rebate,21-15
discount, abatement, credit or reduction of premium, or any such special21-16
favor or advantage or valuable consideration or inducement.21-17
4. No such insurer may make or permit any unfair discrimination21-18
between insured or property having like insuring or risk characteristics, in21-19
the premium or rates charged for insurance, or in the dividends or other21-20
benefits payable thereon, or in any other of the terms and conditions of21-21
insurance.21-22
5. No casualty insurer may make or permit any unfair discrimination21-23
between persons legally qualified to provide a particular service, in the21-24
amount of the fee or charge for that service payable as a benefit under any21-25
policy or contract of casualty insurance.21-26
6.21-27
not prohibit:21-28
(a) The payment of commissions or other compensation to licensed21-29
agents, brokers or solicitors.21-30
(b) The extension of credit to an insured for the payment of any21-31
premium and for which credit a reasonable rate of interest is charged and21-32
collected.21-33
(c) Any insurer from allowing or returning to its participating21-34
policyholders, members or subscribers, dividends, savings or unabsorbed21-35
premium deposits.21-36
21-37
(d) With respect to title insurance, bulk rates or special rates for21-38
customers of prescribed classes if21-39
provided for in the21-40
title insurer or underwritten title company.21-41
7.21-42
wet marine and transportation insurance.22-1
Sec. 31. NRS 686C.035 is hereby amended to read as follows: 686C.035 1. This chapter does not provide coverage for:22-3
(a) Any portion of a policy or contract not guaranteed by the insurer, or22-4
under which the risk is borne by the22-5
contract.22-6
(b) Any policy or contract of reinsurance unless assumption certificates22-7
have been issued22-8
(c) Any portion of a policy or contract to the extent that the rate of22-9
interest on which it is based:22-10
(1) When averaged over the period of 4 years before the date22-11
on which the association becomes obligated with respect to the policy or22-12
contract, or averaged for the period since the policy or contract was issued22-13
if it was issued less than 4 years before the association became obligated,22-14
exceeds the rate of interest determined by subtracting 2 percentage points22-15
from Moody’s Corporate Bond Yield Average averaged for the same22-16
period; and22-17
(2) On or after the date on which the association becomes obligated22-18
with respect to the policy or contract, exceeds the rate of interest22-19
determined by subtracting 3 percentage points from the most recent22-20
Moody’s Corporate Bond Yield Average.22-21
(d) Any portion of a policy or contract issued to a plan or program of22-22
an employer, association or22-23
22-24
members or other persons to the extent that the plan or program is self-22-25
funded or uninsured, including, but not limited to, benefits payable by an22-26
employer, association or22-27
(1) A22-28
welfare arrangement as defined in 29 U.S.C. § 1002;22-29
(2) A minimum-premium group insurance plan;22-30
(3) A stop-loss group insurance plan; or22-31
(4) A contract for administrative services only.22-32
(e) Any portion of a policy or contract to the extent that it provides for22-33
dividends, credits for experience, voting rights or the payment of any fee22-34
or allowance to any person, including the22-35
policy or contract, for services or administration connected with the policy22-36
or contract.22-37
(f) Any policy or contract issued in this state by a member insurer at a22-38
time when the member insurer was not authorized to issue the policy or22-39
contract22-40
(g)22-41
22-42
23-1
23-2
23-3
23-4
23-5
23-6
portion of a policy or contract to the extent that the assessments required23-7
by NRS 686C.230 for the policy or contract are preempted by federal law.23-8
(h) An obligation that does not arise under the written terms of a23-9
policy or contract issued by the insurer.23-10
(i) An unallocated annuity contract.23-11
2. As used in this section, "Moody’s Corporate Bond Yield Average"23-12
means the monthly average for corporate bonds published by Moody’s23-13
Investors Service, Inc., or any successor average.23-14
Sec. 32. NRS 687B.440 is hereby amended to read as follows: 687B.440 1. An insurer offering an umbrella policy to an individual23-16
shall obtain a signed disclosure statement from the individual indicating23-17
whether the umbrella policy includes uninsured or underinsured vehicle23-18
coverage.23-19
2. The disclosure statement for an umbrella policy that includes23-20
uninsured or underinsured vehicle coverage must be on a form provided23-21
by the commissioner or in substantially the following form:23-22
UMBRELLA POLICY DISCLOSURE STATEMENT23-23
UNINSURED/UNDERINSURED VEHICLE COVERAGE23-24 ¨
Your Umbrella Policy does provide coverage in excess of the23-25
limits of the uninsured/underinsured vehicle coverage in your primary23-26
auto insurance only if the requirements for the uninsured/underinsured23-27
vehicle coverage in your underlying auto insurance are maintained.23-28
23-29
23-30
23-31
23-32
vehicle coverage provided by this umbrella policy is limited to23-33
$……… .23-34
I understand and acknowledge the above disclosure.23-35
23-36
Insured Date24-1
3. The disclosure statement for an umbrella policy that does not24-2
include uninsured or underinsured vehicle coverage must be on a form24-3
provided by the commissioner or in substantially the following form:24-4 ¨
Your Umbrella Liability Policy does not provide any24-5
uninsured/underinsured vehicle coverage.24-6
I understand and acknowledge the above disclosure.24-7
24-8
Insured Date24-9
24-10
protects a person against losses in excess of the underlying amount required24-11
to be covered by other policies.24-12
Sec. 33. NRS 689A.505 is hereby amended to read as follows: 689A.505 "Creditable coverage" means, with respect to a person,24-14
health benefits or coverage provided pursuant to:24-15
1. A group health plan;24-16
2. A health benefit plan;24-17
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;24-18
4. Title XIX of the Social Security Act, 42 U.S.C. §§ 1396 et seq., also24-19
known as Medicaid, other than coverage consisting solely of benefits under24-20
section 1928 of that Title24-21
24-22
5. The Civilian Health and Medical Program of Uniformed Services24-23
24-24
6. A medical care program of the Indian Health Service or of a tribal24-25
organization;24-26
7. A state health benefit risk pool;24-27
8. A health plan offered pursuant to24-28
24-29
24-30
9. A public health plan as defined in 45 C.F.R. § 146.113, authorized24-31
by the Public Health Service Act,24-32
24-33
10. A health benefit plan under section 5(e) of the Peace Corps Act, 2224-34
U.S.C. § 2504(e);24-35
11. The children’s health insurance program established pursuant to 4224-36
U.S.C. §§ 1397aa to 1397jj, inclusive24-37
12. A short-term health insurance policy; or24-38
13. A blanket student accident and health insurance policy.25-1
Sec. 34. NRS 689A.515 is hereby amended to read as follows: 689A.515 "Eligible person" means:25-3
1. A person:25-4
(a) Who, as of the date on which he seeks coverage pursuant to this25-5
chapter, has an aggregate period of creditable coverage that is 18 months or25-6
more;25-7
(b) Whose most recent prior creditable coverage , other than coverage25-8
under a short-term health insurance policy, was under a group health25-9
plan, governmental plan, church plan or health insurance coverage offered25-10
in connection with any such plan;25-11
(c) Who is not eligible for coverage under a group health plan, Part A or25-12
Part B of Title XVIII of the Social Security Act, 42 U.S.C. §§ 1395c et25-13
seq., also known as Medicare, a state plan pursuant to Title XIX of the25-14
Social Security Act, 42 U.S.C. §§ 1396 et seq., also known as Medicaid, or25-15
any successor program, and who does not have any other health insurance25-16
coverage;25-17
(d) Whose most recent health insurance coverage within the period of25-18
aggregate creditable coverage was not terminated because of a failure to25-19
pay premiums or fraud;25-20
(e) Who has exhausted his continuation of coverage under the25-21
Consolidation Omnibus Budget Reconciliation Act of 198525-22
99-272, or under a similar state program, if any; and25-23
(f) Who has not had a break of more than 63 consecutive days in his25-24
creditable coverage.25-25
2. A person whose most recent prior creditable coverage was under a25-26
basic or standard health benefit plan and was not renewed by a carrier25-27
who discontinued offering and renewing individual health benefit plans25-28
in this state pursuant to NRS 689A.630.25-29
3. Notwithstanding the provisions of paragraph (a) of subsection 1, a25-30
newborn child or a child placed for adoption, if the child was enrolled25-31
timely and would have otherwise met the requirements of an eligible person25-32
as set forth in subsection 1.25-33
Sec. 35. NRS 689A.540 is hereby amended to read as follows: 689A.540 1. "Health benefit plan" means a policy, contract,25-35
certificate or agreement offered by a carrier to provide for, deliver payment25-36
for, arrange for the payment of, pay for or reimburse any of the costs of25-37
health care services. Except as otherwise provided in this section, the term25-38
includes25-39
policy that pays on a cost-incurred basis.25-40
2. The term does not include:25-41
(a) Coverage that is only for accident or disability income insurance, or25-42
any combination thereof;25-43
(b) Coverage issued as a supplement to liability insurance;26-1
(c) Liability insurance, including general liability insurance and26-2
automobile liability insurance;26-3
(d) Workers’ compensation or similar insurance;26-4
(e) Coverage for medical payments under a policy of automobile26-5
insurance;26-6
(f) Credit insurance;26-7
(g) Coverage for on-site medical clinics;26-8
(h) Other similar insurance coverage specified in federal regulations26-9
issued pursuant to Public Law 104-191 under which benefits for medical26-10
care are secondary or incidental to other insurance benefits26-11
(i) Coverage under a short-term health insurance policy; and26-12
(j) Coverage under a blanket student accident and health insurance26-13
policy.26-14
3. The term does not include the following benefits if the benefits are26-15
provided under a separate policy, certificate or contract of insurance or are26-16
otherwise not an integral part of a health benefit plan:26-17
(a) Limited-scope dental or vision benefits;26-18
(b) Benefits for long-term care, nursing home care, home health care or26-19
community-based care, or any combination thereof; and26-20
(c) Such other similar benefits as are specified in any federal regulations26-21
adopted pursuant to the Health Insurance Portability and Accountability26-22
Act of 1996, Public Law 104-191.26-23
4. The term does not include the following benefits if the benefits are26-24
provided under a separate policy, certificate or contract of insurance, there26-25
is no coordination between the provision of the benefits and any exclusion26-26
of benefits under any group health plan maintained by the same plan26-27
sponsor, and26-28
whether benefits are provided for such a claim under any group health plan26-29
maintained by the same plan sponsor:26-30
(a) Coverage that is only for a specified disease or illness; and26-31
(b) Hospital indemnity or other fixed indemnity insurance.26-32
5. The term does not include any of the following, if offered as a26-33
separate policy, certificate or contract of insurance:26-34
(a) Medicare supplemental health insurance as defined in section26-35
1882(g)(1) of the Social Security Act, 42 U.S.C. § 1395ss, as that section26-36
existed on July 16, 1997;26-37
(b) Coverage supplemental to the coverage provided pursuant to26-38
26-39
Medical Program of Uniformed Services26-40
10 U.S.C. §§ 1071 et seq.; and26-41
(c) Similar supplemental coverage provided under a group health plan.27-1
Sec. 36. NRS 689A.650 is hereby amended to read as follows: 689A.650 1. An individual carrier is not required to provide27-3
coverage to eligible persons pursuant to NRS 689A.640:27-4
(a) During any period in which the commissioner determines that27-5
requiring the individual carrier to provide such coverage would place the27-6
individual carrier in a financially impaired condition.27-7
(b) If the individual carrier elects not to offer any new coverage to any27-8
27-9
new coverage in accordance with this paragraph may maintain its existing27-10
policies issued to27-11
of NRS 689A.630.27-12
2. An individual carrier that elects not to offer new coverage pursuant27-13
to paragraph (b) of subsection 1 shall notify the commissioner forthwith of27-14
that election and shall not thereafter write any new business to individuals27-15
in this state for 5 years after the date of the notification.27-16
Sec. 37. NRS 689A.660 is hereby amended to read as follows: 689A.660 An individual carrier shall not:27-18
1. Impose on an eligible person who is covered under a basic or27-19
standard health benefit plan any exclusion because of a preexisting27-20
condition.27-21
2. Modify a health benefit plan, with respect to an eligible person,27-22
through riders, endorsements or otherwise, to restrict or exclude services27-23
otherwise covered by the plan.27-24
Sec. 38. NRS 689A.680 is hereby amended to read as follows: 689A.680 1. An individual carrier shall develop its rates for its27-26
individual health benefit plans pursuant to NRS 689A.470 to 689A.740,27-27
inclusive, based on rating characteristics. After any adjustments for rating27-28
characteristics and design of benefits, the rate for any block of business for27-29
an individual health benefit plan written on or after27-30
January 1, 2000, must not exceed the rate for any other block of business27-31
for an individual health benefit plan offered by the individual carrier by27-32
more than27-33
average rate charged to all the insureds in the block of business. In27-34
determining whether the rate of a block of business complies with the27-35
provisions of this subsection, any differences in rating factors between27-36
blocks of business must be considered.27-37
2. In determining the rating factors to establish premium rates for a27-38
health benefit plan, an individual carrier shall not use characteristics other27-39
than age, sex, occupation, geographic area, composition of the family of the27-40
individual and health status.27-41
3. If an individual carrier uses health status as a rating factor in27-42
establishing premium rates, the highest factor associated with any28-1
classification for health status may not exceed the lowest factor by more28-2
than 75 percent.28-3
4. For the purposes of this section, rating characteristics must not28-4
include durational or tier rating, or adverse changes in health status or28-5
claim experience after the policy is issued.28-6
5. As used in this section, "characteristics" means demographic or28-7
other information concerning individuals that is considered by a carrier in28-8
the determination of premium rates for individuals.28-9
Sec. 39. NRS 689B.027 is hereby amended to read as follows: 689B.027 1. The commissioner shall adopt regulations which require28-11
an insurer to file with the commissioner, for his approval, a disclosure28-12
summarizing the coverage provided by each policy of group health28-13
insurance offered by the insurer. The disclosure must include:28-14
(a) Any significant exception, reduction or limitation that applies to the28-15
policy;28-16
(b) Any restrictions on payments for emergency care, including related28-17
definitions of an emergency and medical necessity;28-18
(c) Any provisions concerning the insurer’s right to change premium28-19
rates and the characteristics, other than claim experience, that affect28-20
changes in premium rates;28-21
(d) Any provisions relating to renewability;28-22
(e) Any provisions relating to preexisting conditions; and28-23
(f) Any other information,28-24
that the commissioner finds necessary to provide for full and fair disclosure28-25
of the provisions of the policy.28-26
2. The disclosure must be written in language which is easily28-27
understood and28-28
of the policy only, and that the policy28-29
the governing contractual provisions.28-30
3. The commissioner shall not approve any proposed disclosure28-31
submitted to him pursuant to this section which does not comply with the28-32
requirements of this section and the applicable regulations.28-33
4. The insurer shall make available to an employer or a producer28-34
acting on behalf of an employer upon request a copy of the disclosure28-35
approved by the commissioner pursuant to this section for each policy of28-36
health insurance coverage for which that employer may be eligible.28-37
Sec. 40. NRS 689B.380 is hereby amended to read as follows: 689B.380 "Creditable coverage" means health benefits or coverage28-39
provided to a person pursuant to:28-40
1. A group health plan;28-41
2. A health benefit plan;28-42
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;29-1
4. Title XIX of the Social Security Act, 42 U.S.C. §§ 1396 et seq., also29-2
known as Medicaid, other than coverage consisting solely of benefits under29-3
section 1928 of that Title29-4
29-5
5. The Civilian Health and Medical Program of Uniformed Services29-6
29-7
6. A medical care program of the Indian Health Service or of a tribal29-8
organization;29-9
7. A state health benefit risk pool;29-10
8. A health plan offered pursuant to29-11
29-12
29-13
9. A public health plan as defined in 45 C.F.R. § 146.113, authorized29-14
by the Public Health Service Act,29-15
29-16
10. A health benefit plan under section 5(e) of the Peace Corps Act, 2229-17
U.S.C. § 2504(e);29-18
11. The children’s health insurance program established pursuant to 4229-19
U.S.C. §§ 1397aa to 1397jj, inclusive29-20
12. A short-term health insurance policy; or29-21
13. A blanket student accident and health insurance policy.29-22
Sec. 41. NRS 689B.410 is hereby amended to read as follows: 689B.410 1. "Health benefit plan" means a policy, contract,29-24
certificate or agreement offered by a carrier to provide for, arrange for the29-25
payment of, pay for or reimburse any of the costs of health care services.29-26
Except as otherwise provided in this section, the term includes29-27
29-28
incurred basis.29-29
2. The term does not include:29-30
(a) Coverage that is only for accident or disability income insurance, or29-31
any combination thereof;29-32
(b) Coverage issued as a supplement to liability insurance;29-33
(c) Liability insurance, including general liability insurance and29-34
automobile liability insurance;29-35
(d) Workers’ compensation or similar insurance;29-36
(e) Coverage for medical payments under a policy of automobile29-37
insurance;29-38
(f) Credit insurance;29-39
(g) Coverage for on-site medical clinics;29-40
(h) Other similar insurance coverage specified in federal regulations29-41
issued pursuant to the Health Insurance Portability and Accountability Act29-42
of 1996, Public Law 104-191, under which benefits for medical care are29-43
secondary or incidental to other insurance benefits30-1
(i) Coverage under a short-term health insurance policy; and30-2
(j) Coverage under a blanket student accident and health insurance30-3
policy.30-4
3. If the benefits are provided under a separate policy, certificate or30-5
contract of insurance or are otherwise not an integral part of a health30-6
benefit plan, the term does not include the following benefits:30-7
(a) Limited-scope dental or vision benefits;30-8
(b) Benefits for long-term care, nursing home care, home health care or30-9
community-based care, or any combination thereof; and30-10
(c) Such other similar benefits as are specified in any federal regulations30-11
adopted pursuant to the Health Insurance Portability and Accountability30-12
Act of 1996, Public Law 104-191.30-13
4. For the purposes of NRS 689B.340 to 689B.590, inclusive, if the30-14
benefits are provided under a separate policy, certificate or contract of30-15
insurance, there is no coordination between the provision of the benefits30-16
and any exclusion of benefits under any group health plan maintained by30-17
the same plan sponsor, and30-18
regard to whether benefits are provided for such a claim under any group30-19
health plan maintained by the same plan sponsor, the term does not include:30-20
(a) Coverage that is only for a specified disease or illness; and30-21
(b) Hospital indemnity or other fixed indemnity insurance.30-22
5. For the purposes of NRS 689B.340 to 689B.590, inclusive, if30-23
offered as a separate policy, certificate or contract of insurance, the term30-24
does not include:30-25
(a) Medicare supplemental health insurance as defined in section30-26
1882(g)(1) of the Social Security Act, 42 U.S.C. § 1395ss, as that section30-27
existed on July 16, 1997;30-28
(b) Coverage supplemental to the coverage provided pursuant to the30-29
Civilian Health and Medical Program of Uniformed Services, CHAMPUS,30-30
10 U.S.C. §§ 1071 et seq.; and30-31
(c) Similar supplemental coverage provided under a group health plan.30-32
Sec. 42. NRS 689B.460 is hereby amended to read as follows: 689B.460 "Waiting period" means the period established by a plan of30-34
health insurance that must pass before a person who is an eligible30-35
participant or beneficiary in a plan is covered for benefits under the terms30-36
of the plan. The term includes the period from the date a person submits30-37
an application to an individual carrier for coverage under a health30-38
benefit plan until the first day of coverage under that health benefit plan.30-39
Sec. 43. NRS 689B.500 is hereby amended to read as follows: 689B.500 1. Except as otherwise provided in this section, a carrier30-41
that issues a group health plan or coverage under group health insurance30-42
shall not deny, exclude or limit a benefit for a preexisting condition for:31-1
(a) More than 12 months after the effective date of coverage if the31-2
employee enrolls through open enrollment or after the first day of the31-3
waiting period for31-4
(b) More than 18 months after the effective date of coverage for a late31-5
enrollee.31-6
A carrier may not define a preexisting condition more restrictively than that31-7
term is defined in NRS 689B.450.31-8
2. The period of any exclusion for a preexisting condition imposed by31-9
a group health plan or coverage under group health insurance on a person31-10
to be insured in accordance with the provisions of this chapter must be31-11
reduced by the aggregate period of creditable coverage of that person, if the31-12
creditable coverage was continuous to a date not more than 63 days before31-13
the effective date of the coverage. The period of continuous coverage must31-14
not include:31-15
(a) Any waiting period for the effective date of the new coverage31-16
applied by the employer or the carrier; or31-17
(b) Any affiliation period not to exceed 60 days for a new enrollee and31-18
31-19
in the group health plan.31-20
3. A health maintenance organization authorized to transact insurance31-21
pursuant to chapter 695C of NRS that does not restrict coverage for a31-22
preexisting condition may require an affiliation period before coverage31-23
becomes effective under a plan of insurance if the affiliation period applies31-24
uniformly to all employees and without regard to any health status-related31-25
factors. During the affiliation period, the carrier shall not collect any31-26
premiums for coverage of the employee.31-27
4. An insurer that restricts coverage for preexisting conditions shall not31-28
impose an affiliation period.31-29
5. A carrier shall not impose any exclusion for a preexisting condition:31-30
(a) Relating to pregnancy.31-31
(b) In the case of a person who, as of the last day of the 30-day period31-32
beginning on the date of his birth, is covered under creditable coverage.31-33
(c) In the case of a child who is adopted or placed for adoption before31-34
attaining the age of 18 years and who, as of the last day of the 30-day31-35
period beginning on the date of adoption or placement for adoption,31-36
whichever is earlier, is covered under creditable coverage. The provisions31-37
of this paragraph do not apply to coverage before the date of adoption or31-38
placement for adoption.31-39
(d) In the case of a condition for which medical advice, diagnosis, care31-40
or treatment was recommended or received for the first time while the31-41
covered person held creditable coverage, and the medical advice, diagnosis,31-42
care or treatment was a benefit under the plan, if the creditable coverage32-1
was continuous to a date not more than 63 days before the effective date of32-2
the new coverage.32-3
The provisions of paragraphs (b) and (c) do not apply to a person after the32-4
end of the first 63-day period during all of which the person was not32-5
covered under any creditable coverage.32-6
6. As used in this section, "late enrollee" means an eligible employee,32-7
or his dependent, who requests enrollment in a group health plan following32-8
the initial period of enrollment, if that initial period of enrollment is at least32-9
30 days, during which the person is entitled to enroll under the terms of the32-10
health benefit plan. The term does not include an eligible employee or his32-11
dependent if:32-12
(a) The employee or dependent:32-13
(1) Was covered under creditable coverage at the time of the initial32-14
enrollment;32-15
(2) Lost coverage under creditable coverage as a result of cessation of32-16
contributions by his employer, termination of employment or eligibility,32-17
reduction in the number of hours of employment, involuntary termination32-18
of creditable coverage, or death of, or divorce or legal separation from, a32-19
covered spouse; and32-20
(3) Requests enrollment not later than 30 days after the date on which32-21
his creditable coverage was terminated or on which the change in32-22
conditions that gave rise to the termination of the coverage occurred.32-23
(b) The employee enrolls during the open enrollment period, as32-24
provided in the contract or as otherwise specifically provided by specific32-25
statute.32-26
(c) The employer of the employee offers multiple health benefit plans32-27
and the employee elected a different plan during an open enrollment period.32-28
(d) A court has ordered coverage to be provided to the spouse or a32-29
minor or dependent child of an employee under a health benefit plan of the32-30
employee and a request for enrollment is made within 30 days after the32-31
issuance of the court order.32-32
(e) The employee changes status from not being an eligible employee to32-33
being an eligible employee and requests enrollment, subject to any waiting32-34
period, within 30 days after the change in status.32-35
(f) The person has continued coverage in accordance with the32-36
Consolidated Omnibus Budget Reconciliation Act of 1985 , Public Law32-37
99-272, and32-38
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 basic32-40
and standard health benefit plans are approved pursuant to NRS 689C.77032-41
as part of the plan of operation of the program of reinsurance, each carrier32-42
required to offer to a person a converted policy pursuant to NRS 689B.12033-1
shall only offer as a converted policy a choice of the basic and standard33-2
health benefit plans.33-3
2. A person with a converted policy issued before the effective date of33-4
the requirement set forth in subsection 1 may, at each annual renewal of the33-5
converted policy elect a basic or standard health benefit plan as a substitute33-6
converted policy, except that the carrier may, if the person has not made an33-7
election within 3 years after first becoming eligible to do so, require the33-8
person to make such an election. Once a person has elected33-9
basic or standard health benefit plan as a substitute converted policy, he33-10
may not elect another converted policy.33-11
3. The premium for a converted policy may not exceed the small group33-12
index rate, as defined in paragraph (b) of subsection 3 of NRS 689C.230,33-13
applicable to the carrier by more than33-14
index rate used by a carrier that does not write insurance to small33-15
employers in this state must be the average small group index rate, as33-16
determined by the commissioner, of the five largest carriers that provide33-17
coverage to small employers pursuant to this chapter for their basic and33-18
standard health benefit plans. The commissioner shall annually determine33-19
the average small group index rate, as measured by the premium volume of33-20
the plans, of those five largest carriers.33-21
4. The rates for new and renewal converted policies for persons with33-22
the same converted policies whose case characteristics are similar must be33-23
the same.33-24
5. Any losses suffered by a carrier on its converted policies issued33-25
pursuant to this section must be spread across the entire book of the health33-26
benefit coverage of the carrier issued or delivered for issuance to small33-27
employers and large group employers in this state.33-28
6. The commissioner shall adopt such regulations as are necessary to33-29
carry out the provisions of this section.33-30
Sec. 45. Chapter 689C of NRS is hereby amended by adding thereto33-31
the provisions set forth as sections 46 and 47 of this act.33-32
Sec. 46. No member, agent or employee of the board may be held33-33
liable in a civil action for any act that he performs in good faith in the33-34
execution of his duties pursuant to the provisions of this chapter.33-35
Sec. 47. The provisions of this chapter apply to health benefit plans33-36
that provide coverage to the employees of small employers in this state33-37
and to carriers that offer those health benefit plans if:33-38
1. A portion of the premium or benefits are paid by or on behalf of33-39
the small employer;33-40
2. An eligible employee or his dependent is reimbursed for a portion33-41
of the premium, whether by wage adjustments or otherwise, by or on33-42
behalf of the small employer; or34-1
3. The health benefit plan is considered by the small employer or any34-2
of his eligible employees or dependents as part of a plan or program for34-3
the purposes of sections 106, 125 or 162 of the Internal Revenue Code,34-4
26 U.S.C. § 106, 125 or 162.34-5
Sec. 48. NRS 689C.053 is hereby amended to read as follows: 689C.053 "Creditable coverage" means health benefits or coverage34-7
provided to a person pursuant to:34-8
1. A group health plan;34-9
2. A health benefit plan;34-10
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;34-11
4. Title XIX of the Social Security Act, 42 U.S.C. §§ 1396 et seq., also34-12
known as Medicaid, other than coverage consisting solely of benefits under34-13
section 1928 of that Title34-14
34-15
5. The Civilian Health and Medical Program of Uniformed Services34-16
34-17
6. A medical care program of the Indian Health Service or of a tribal34-18
organization;34-19
7. A state health benefit risk pool;34-20
8. A health plan offered pursuant to34-21
34-22
34-23
9. A public health plan as defined in federal regulations authorized by34-24
the Public Health Service Act,34-25
34-26
10. A health benefit plan under section 5(e) of the Peace Corps Act, 2234-27
U.S.C. § 2504(e);34-28
11. The children’s health insurance program established pursuant to 4234-29
U.S.C. §§ 1397aa to 1397jj, inclusive34-30
12. A short-term health insurance policy; or34-31
13. A blanket student accident and health insurance policy.34-32
Sec. 49. NRS 689C.075 is hereby amended to read as follows: 689C.075 1. "Health benefit plan" means a policy or certificate for34-34
hospital or medical expenses, a contract for dental, hospital or medical34-35
services, or a health care plan of a health maintenance organization34-36
available for use, offered or sold to a small employer. Except as otherwise34-37
provided in this section, the term includes short-term and catastrophic34-38
health insurance policies, and a policy that pays on a cost-incurred basis.34-39
2. The term does not include:34-40
(a) Coverage that is only for accident or disability income insurance, or34-41
any combination thereof;34-42
(b) Coverage issued as a supplement to liability insurance;35-1
(c) Liability insurance, including general liability insurance and35-2
automobile liability insurance;35-3
(d) Workers’ compensation or similar insurance;35-4
(e) Coverage for medical payments under a policy of automobile35-5
insurance;35-6
(f) Credit insurance;35-7
(g) Coverage for on-site medical clinics;35-8
(h) Coverage under a short-term health insurance policy;35-9
(i) Coverage under a blanket student accident and health insurance35-10
policy; and35-11
(j) Other similar insurance coverage specified in federal regulations35-12
issued pursuant to the Health Insurance Portability and Accountability35-13
Act of 1996, Public Law 104-191 , under which benefits for medical care35-14
are secondary or incidental to other insurance benefits.35-15
3. If the benefits are provided under a separate policy, certificate or35-16
contract of insurance or are otherwise not an integral part of a health35-17
benefit plan, the term does not include the following benefits:35-18
(a) Limited-scope dental or vision benefits;35-19
(b) Benefits for long-term care, nursing home care, home health care or35-20
community-based care, or any combination thereof; and35-21
(c) Such other similar benefits as are specified in any federal regulations35-22
adopted pursuant to the Health Insurance Portability and Accountability35-23
Act of 1996, Public Law 104-191.35-24
4. If the benefits are provided under a separate policy, certificate or35-25
contract of insurance, there is no coordination between the provision of the35-26
benefits and any exclusion of benefits under any group health plan35-27
maintained by the same plan sponsor, and35-28
claim without regard to whether benefits are provided for such a claim35-29
under any group health plan maintained by the same plan sponsor, the term35-30
does not include:35-31
(a) Coverage that is only for a specified disease or illness; and35-32
(b) Hospital indemnity or other fixed indemnity insurance.35-33
5. If offered as a separate policy, certificate or contract of insurance,35-34
the term does not include:35-35
(a) Medicare supplemental health insurance as defined in section35-36
1882(g)(1) of the Social Security Act, 42 U.S.C. § 1395ss, as that section35-37
existed on July 16, 1997;35-38
(b) Coverage supplemental to the coverage provided pursuant to35-39
35-40
Medical Program of Uniformed Services35-41
10 U.S.C. §§ 1071 et seq.; and35-42
(c) Similar supplemental coverage provided under a group health plan.36-1
Sec. 50. NRS 689C.095 is hereby amended to read as follows: 689C.095 1. "Small employer" means ,36-3
36-4
36-5
who employed on business days during the preceding calendar year an36-6
average of at least 236-7
36-8
of 30 hours or more, and36-9
first day of the plan year .36-10
36-11
36-12
36-13
36-14
employees, organizations which are affiliated or which are eligible to file a36-15
combined tax return for the purposes of taxation constitute one employer.36-16
2. For the purposes of this section, organizations are "affiliated" if one36-17
directly, or indirectly, through one or more intermediaries, controls or is36-18
controlled by, or is under common control with, the other, as determined36-19
pursuant to the provisions of NRS 692C.050.36-20
Sec. 51. NRS 689C.106 is hereby amended to read as follows: 689C.106 "Waiting period" means the period established by a plan of36-22
health insurance that must pass before a person who is an eligible36-23
participant or beneficiary in a plan is covered for benefits under the terms36-24
of the plan. The term includes the period from the date a person submits36-25
an application to an individual carrier for coverage under a health36-26
benefit plan until the first day of coverage under that health benefit plan.36-27
Sec. 52. NRS 689C.210 is hereby amended to read as follows: 689C.210 1. Except as otherwise provided in subsection 3, a carrier36-29
shall not increase the premium rate charged to a small employer for a new36-30
rating period by a percentage greater than the sum of:36-31
(a) The percentage of change in the premium rate for new business for36-32
the policy under which the small employer is covered, measured from the36-33
first day of the previous rating period to the first day of the new rating36-34
period;36-35
(b) An adjustment, not to exceed 15 percent annually, adjusted pro rata36-36
for rating periods of less than 1 year, on account of the claim experience,36-37
health status, or duration of coverage of the employees or dependents of the36-38
small employer as determined from the carrier’s rate manual for the class of36-39
business; and36-40
(c) Any adjustment on account of change in coverage or change in the36-41
characteristics of the small employer as determined from the carrier’s rate36-42
manual for the class of business.37-1
2. If the carrier no longer issues new policies for that class of business,37-2
the carrier shall use the percentage of change in the premium rate for new37-3
business for the class of business which is most similar to the closed class37-4
of business and for which the carrier is issuing new policies.37-5
3. In the case of health benefit plans delivered or issued for delivery37-6
before January 1, 1996, for groups with37-7
and37-8
with37-9
employees, a premium rate for a rating period may exceed the ranges set37-10
forth in37-11
period of 3 years following that date. In that case, the percentage of37-12
increase in the premium rate charged to a small employer for a new rating37-13
period may not exceed the sum of:37-14
(a) The percentage of change in the premium rate for new business37-15
measured from the first day of the previous rating period to the first day of37-16
the new rating period. In the case of a health benefit plan into which the37-17
carrier is no longer enrolling new small employers, the carrier shall use the37-18
percentage of change in the base premium rate if that change does not37-19
exceed, on a percentage basis, the change in the premium rate for new37-20
business for the most similar health benefit plan into which the carrier is37-21
actively enrolling new small employers.37-22
(b) Any adjustment on account of change in coverage or change in the37-23
characteristics of the small employer as determined from the carrier’s rate37-24
manual for the class of business.37-25
Sec. 53. NRS 689C.270 is hereby amended to read as follows: 689C.270 1. The commissioner shall adopt regulations which require37-27
a carrier to file with the commissioner, for his approval, a disclosure37-28
offered by the carrier to a small employer. The disclosure must include:37-29
(a) Any significant exception, reduction or limitation that applies to the37-30
policy;37-31
(b) Any restrictions on payments for emergency care, including, without37-32
limitation, related definitions of an emergency and medical necessity;37-33
(c) The provision of the health benefit plan concerning the carrier’s right37-34
to change premium rates and the characteristics, other than claim37-35
experience, that affect changes in premium rates;37-36
(d) The provisions relating to renewability of policies and contracts;37-37
(e) The provisions relating to any preexisting condition; and37-38
(f) Any other information that the commissioner finds necessary to37-39
provide for full and fair disclosure of the provisions of a policy or contract37-40
of insurance issued pursuant to this chapter.37-41
2. The disclosure must be written in language which is easily37-42
understood and must include a statement that the disclosure is a summary38-1
of the policy only, and that the policy itself should be read to determine the38-2
governing contractual provisions.38-3
3. The commissioner shall not approve any proposed disclosure38-4
submitted to him pursuant to this section which does not comply with the38-5
requirements of this section and the applicable regulations.38-6
4. The carrier shall make available to a small employer or a producer38-7
acting on behalf of a small employer, upon request a copy of the38-8
disclosure approved by the commissioner pursuant to this section for38-9
policies of health insurance for which that employer may be eligible.38-10
Sec. 54. (Deleted by amendment.)38-11
Sec. 55. NRS 689C.610 is hereby amended to read as follows: 689C.610 As used in NRS 689C.610 to 689C.980, inclusive, and38-13
section 46 of this act, unless the context otherwise requires, the words and38-14
terms defined in NRS 689C.620 to 689C.730, inclusive, have the meanings38-15
ascribed to them in those sections.38-16
Sec. 56. NRS 689C.870 is hereby amended to read as follows: 689C.870 1. If, in each of 2 consecutive years, the board determines38-18
that the amount of the assessment needed exceeds 5 percent of the total38-19
premiums earned in the previous calendar year from health benefit plans38-20
delivered or issued for delivery to small employers by reinsuring carriers,38-21
the program of reinsurance is eligible for additional funding pursuant to this38-22
section.38-23
2. If, in each of 2 consecutive years, the board determines that the38-24
amount of the assessment needed exceeds 5 percent of the total premiums38-25
earned in the previous calendar year from health benefit plans delivered or38-26
issued for delivery to individuals by individual reinsuring carriers, the38-27
program of reinsurance is eligible for additional funding pursuant to this38-28
section.38-29
3. To raise38-30
formula pursuant to which additional assessments may be made on all38-31
carriers that offer a health benefit plan or provide stop-loss coverage for a38-32
health benefit plan which is an38-33
plan or a plan established pursuant to the Labor-Management Relations38-34
Act, 1947, as amended. The total additional assessments on all such38-35
carriers combined may not exceed one-half of 1 percent of the total38-36
premiums earned from all health benefit plans and stop-loss coverage38-37
issued in this state in the previous calendar year.38-38
Sec. 57. NRS 690B.042 is hereby amended to read as follows: 690B.042 1. Except as otherwise provided in subsection 2, any party38-40
against whom a claim is asserted for compensation or damages for personal38-41
injury under a policy of motor vehicle insurance covering a private38-42
passenger car may require any attorney representing the claimant to provide39-1
to the party and his insurer or attorney, not more than once every 90 days,39-2
all medical reports39-3
2. In lieu of providing medical reports39-4
to subsection 1, the claimant or any attorney representing the claimant may39-5
39-6
39-7
party, his insurer or his attorney a written authorization to receive the39-8
reports, records and bills from the provider of health care. At the written39-9
request of the claimant or his attorney, copies of all reports, records and39-10
bills obtained pursuant to the authorization must be provided to the39-11
claimant or his attorney within 30 days after the date they are received. If39-12
the claimant or his attorney makes a written request for the reports,39-13
records and bills, the claimant or his attorney shall pay for the39-14
reasonable costs of copying the reports, records and bills.39-15
3. Upon receipt of any photocopies of medical reports39-16
and bills , or a written authorization pursuant to subsection 2, the insurer39-17
who issued the policy specified in subsection 1 shall, upon request,39-18
immediately disclose to the insured or the claimant all pertinent facts or39-19
provisions of the policy relating to any coverage at issue.39-20
Sec. 58. NRS 692A.105 is hereby amended to read as follows: 692A.105 1. The commissioner may refuse to license any title agent39-22
or escrow officer or may suspend or revoke any license or impose a fine of39-23
not more than $500 for each violation by entering an order to that effect,39-24
with his findings in respect thereto, if upon a hearing, it is determined that39-25
the applicant or licensee:39-26
(a) In the case of a title agent, is insolvent or in such a financial39-27
condition that he cannot continue in business with safety to his customers;39-28
(b) Has violated any provision of this chapter or any regulation adopted39-29
pursuant thereto or has aided and abetted another to do so;39-30
(c) Has committed fraud in connection with any transaction governed by39-31
this chapter;39-32
(d) Has intentionally or knowingly made any misrepresentation or false39-33
statement to, or concealed any essential or material fact known to him from,39-34
any principal or designated agent of the principal in the course of the39-35
escrow business;39-36
(e) Has intentionally or knowingly made or caused to be made to the39-37
commissioner any false representation of a material fact or has suppressed39-38
or withheld from him any information which the applicant or licensee39-39
possesses;39-40
(f) Has failed without reasonable cause to furnish to the parties of an39-41
escrow their respective statements of the settlement within a reasonable39-42
time after the close of escrow;40-1
(g) Has failed without reasonable cause to deliver, within a reasonable40-2
time after the close of escrow, to the respective parties of an escrow40-3
transaction any money, documents or other properties held in escrow in40-4
violation of the provisions of the escrow instructions;40-5
(h) Has refused to permit an examination by the commissioner of his40-6
books and affairs or has refused or failed, within a reasonable time, to40-7
furnish any information or make any report that may be required by the40-8
commissioner pursuant to the provisions of this chapter;40-9
(i) Has been convicted of a felony or any misdemeanor of which an40-10
essential element is fraud;40-11
(j) In the case of a title agent, has failed to maintain complete and40-12
accurate records of all transactions within the last 7 years;40-13
(k) Has commingled the money of40-14
or converted the money of40-15
(l) Has failed, before the close of escrow, to obtain written instructions40-16
concerning any essential or material fact or intentionally failed to follow40-17
the written instructions which have been agreed upon by the parties and40-18
accepted by the holder of the escrow;40-19
(m) Has failed to disclose in writing that he is acting in the dual capacity40-20
of escrow agent or agency and undisclosed principal in any transaction;40-21
(n) In the case of an escrow officer, has been convicted of, or entered a40-22
plea of guilty or nolo contendere to, any crime involving moral turpitude40-23
; or40-24
(o) Has failed to obtain and maintain a copy of the executed40-25
agreement or contract that establishes the conditions for the sale of real40-26
property.40-27
2. It is sufficient cause for the imposition of a fine or the refusal,40-28
suspension or revocation of the license of a partnership, corporation or any40-29
other association if any member of the partnership or any officer or director40-30
of the corporation or association has been guilty of any act or omission40-31
directly arising from the business activities of a title agent which would be40-32
cause for such action had the applicant or licensee been a natural person.40-33
3. The commissioner may suspend or revoke the license of a title agent,40-34
or impose a fine, if the commissioner finds that the title agent:40-35
(a) Failed to maintain adequate supervision of an escrow officer title40-36
agent he has appointed or employed.40-37
(b) Instructed an escrow officer to commit an act which would be cause40-38
for the revocation of the escrow officer’s license and the escrow officer40-39
committed the act. An escrow officer is not subject to disciplinary action40-40
for committing such an act under instruction by the title agent.40-41
4. The commissioner may refuse to issue a license to any person who,40-42
within 10 years before the date of applying for a current license, has had40-43
suspended or revoked a license issued pursuant to this chapter or a41-1
comparable license issued by any other state, district or territory of the41-2
United States or any foreign country.41-3
Sec. 59. Chapter 695C of NRS is hereby amended by adding thereto a41-4
new section to read as follows:41-5
1. To the extent authorized by federal law, the commissioner shall41-6
adopt regulations for the licensing of provider-sponsored organizations41-7
in this state.41-8
2. As used in this section, "provider-sponsored organization" has the41-9
meaning ascribed to it in 42 U.S.C. § 1395w-25(d).41-10
Sec. 60. NRS 695C.350 is hereby amended to read as follows: 695C.350 1. The commissioner may, in lieu of suspension or41-12
revocation of a certificate of authority under NRS 695C.330, levy an41-13
administrative penalty in an amount not41-14
$2,50041-15
of the intent to levy the penalty .41-16
41-17
41-18
2. Any person who violates the provisions of this chapter is guilty of a41-19
misdemeanor.41-20
3. If the commissioner or the state board of health for any reason have41-21
cause to believe that any violation of this chapter has occurred or is41-22
threatened, the commissioner or the state board of health may give notice to41-23
the health maintenance organization and to the representatives, or other41-24
persons who appear to be involved in41-25
arrange a conference with the alleged violators or their authorized41-26
representatives41-27
determine the facts relating to41-28
41-29
at an adequate and effective means of correcting or preventing41-30
violation.41-31
4.41-32
pursuant to the provisions of subsection 3 must not be governed by any41-33
formal procedural requirements, and may be conducted in such manner as41-34
the commissioner or the state board of health may deem appropriate under41-35
the circumstances.41-36
5. The commissioner may issue an order directing a health maintenance41-37
organization or a representative of a health maintenance organization to41-38
cease and desist from engaging in any act or practice in violation of the41-39
provisions of this chapter.41-40
6. Within 30 days after service of the order41-41
respondent may request a hearing on the question of whether acts or41-42
practices in violation of this chapter have occurred.41-43
42-1
42-2
provisions of chapter 233B of NRS and judicial review must be available42-3
as provided therein.42-4
7. In the case of any violation of the provisions of this chapter, if the42-5
commissioner elects not to issue a cease and desist order, or in the event of42-6
noncompliance with a cease and desist order issued pursuant to subsection42-7
5, the commissioner may institute a proceeding to obtain injunctive relief,42-8
or seek other appropriate relief in the district court of the judicial district of42-9
the county in which the violator resides.42-10
Secs. 61 and 62. (Deleted by amendment.)42-11
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 bail42-13
agent, bail enforcement agent or bail solicitor, or perform any of the42-14
functions, duties or powers prescribed for a bail agent, bail enforcement42-15
agent or bail solicitor under the provisions of this chapter, unless that42-16
person is qualified and licensed as provided in this chapter. The42-17
commissioner may, after notice and a hearing, impose a fine of not more42-18
than $1,000 for each act or violation of the provisions of this subsection.42-19
2. A person, whether or not located in this state, shall not act as or hold42-20
himself out to be a general agent unless qualified and licensed as such42-21
under the provisions of this chapter.42-22
3. For the protection of the people of this state, the commissioner shall42-23
not issue or renew, or permit to exist, any license except in compliance with42-24
this chapter. The commissioner shall not issue or renew, or permit to exist,42-25
a license for any person found to be untrustworthy or incompetent, or who42-26
has not established to the satisfaction of the commissioner that he is42-27
qualified therefor in accordance with this chapter.42-28
Sec. 63.5. NRS 697.100 is hereby amended to read as follows: 697.100 1. Except as otherwise provided in this section, no license42-30
may be issued:42-31
(a) Except in compliance with this chapter.42-32
(b) To a bail agent, bail enforcement agent or bail solicitor, unless he is42-33
a natural person.42-34
2. A corporation may be licensed as a bail agent or bail enforcement42-35
agent if42-36
(a) The corporation is owned and controlled by an insurer authorized42-37
to write surety in this state or a subsidiary corporation of such an42-38
insurer; or42-39
(b) Ownership and control of the corporation is retained by one or more42-40
licensed agents.42-41
3. This section does not prohibit two or more licensed bail agents from42-42
entering into a partnership for the conduct of their bail business. No person42-43
may be a member of such a partnership unless he is licensed pursuant to43-1
this chapter in the same capacity as all other members of the partnership. A43-2
limited partnership or a natural person may not have any proprietary43-3
interest, directly or indirectly, in a partnership or the conduct of business43-4
thereunder except licensed bail agents as provided in this chapter.43-5
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 be43-7
accompanied by:43-8
(a) Proof of the completion of a 6-hour course of instruction in bail43-9
bonds that is:43-10
(1) Offered by a state or national organization of bail agents or43-11
another organization that administers training programs for general agents;43-12
and43-13
(2) Approved by the commissioner.43-14
(b) A written appointment by an authorized insurer as general agent,43-15
subject to the issuance of the license.43-16
(c) A letter from a local law enforcement agency in the applicant’s43-17
county of residence which indicates that the applicant:43-18
(1) Has not been convicted of a felony in this state or of any offense43-19
committed in another state which would be a felony if committed in this43-20
state; and43-21
(2) Has not been convicted of an offense involving moral turpitude or43-22
the unlawful use, sale or possession of a controlled substance.43-23
(d) A copy of the contract or agreement that authorizes the general43-24
agent to act as general agent for the insurer.43-25
(e) Any other information the commissioner may require.43-26
2. If the applicant for a license as a general agent is a firm or43-27
corporation, the application must include the names of the members,43-28
officers and directors and designate each natural person who is to exercise43-29
the authority granted by the license. Each person so designated must furnish43-30
information about himself as though the application were for an individual43-31
license.43-32
Sec. 65. NRS 697.190 is hereby amended to read as follows: 697.190 1.43-34
43-35
with the application, and thereafter maintain in force while so licensed, a43-36
bond in favor of the people of the State of Nevada executed by an43-37
authorized surety insurer. The bond may be continuous in form with total43-38
aggregate liability limited to payment as follows:43-39
(a) Bail agent $25,00043-40
(b) Bail solicitor 10,00043-41
(c) General agent 50,00044-1
2. The bond must be conditioned upon full accounting and payment to44-2
the person entitled thereto of money, property or other matters coming into44-3
the licensee’s possession through bail bond transactions under the license.44-4
3. The bond must remain in force until released by the commissioner,44-5
or canceled by the surety. Without prejudice to any liability previously44-6
incurred under the bond, the surety may cancel the bond upon 30 days’44-7
advance written notice to the licensee and the commissioner.44-8
Sec. 65.3. NRS 277.055 is hereby amended to read as follows: 277.055 1. As used in this section:44-10
(a) "Medical facility" has the meaning ascribed to it in NRS 449.0151.44-11
(b) "Nonprofit medical facility" means a nonprofit medical facility in44-12
this or another state.44-13
(c) "Public agency" has the meaning ascribed to it in NRS 277.100, and44-14
includes any municipal corporation.44-15
2. Any two or more public agencies or nonprofit medical facilities may44-16
enter into a cooperative agreement for the purchase of insurance or the44-17
establishment of a self-insurance reserve or fund for coverage under a plan44-18
of:44-19
(a) Casualty insurance, as that term is defined in NRS 681A.020;44-20
(b) Marine and transportation insurance, as that term is defined in NRS44-21
681A.050;44-22
(c) Property insurance, as that term is defined in NRS 681A.060;44-23
(d) Surety insurance, as that term is defined in NRS 681A.070;44-24
(e) Health insurance, as that term is defined in NRS 681A.030; or44-25
(f) Insurance for any combination of these kinds.44-26
3. Every such agreement must:44-27
(a) Be ratified by formal resolution or ordinance of the governing body44-28
or board of trustees of each agency or nonprofit medical facility included;44-29
(b) Be included in the minutes of each governing body or board of44-30
trustees, or attached in full to the minutes as an exhibit;44-31
(c) Be submitted to the commissioner of insurance not less than 30 days44-32
before the date on which the agreement is to become effective for44-33
approval in the manner provided by NRS 277.150; and44-34
(d) If a public agency is a party to the agreement, comply with the44-35
provisions of NRS 277.080 to 277.180, inclusive.44-36
4. Each participating agency or nonprofit medical facility shall provide44-37
for any expense to be incurred under any such agreement.44-38
Sec. 65.5. NRS 287.025 is hereby amended to read as follows: 287.025 The governing body of any county, school district, municipal44-40
corporation, political subdivision, public corporation or other public44-41
agency of the State of Nevada may, in addition to the other powers granted44-42
in NRS 287.010 and 287.020:45-1
1. Negotiate and contract with any other such agency or with the45-2
committee on benefits for the state’s group insurance plan to secure group45-3
insurance for its officers and employees and their dependents by45-4
participation in any group insurance plan established or to be established or45-5
in the state’s group insurance plan .45-6
(a) Must be submitted to the commissioner of insurance not less than45-7
30 days before the date on which the contract is to become effective for45-8
approval.45-9
(b) Does not become effective unless approved by the commissioner.45-10
(c) Shall be deemed to be approved if not disapproved by the45-11
commissioner of insurance within 30 days after its submission.45-12
2. To secure group health or life insurance for its officers and45-13
employees and their dependents, participate as a member of a nonprofit45-14
cooperative association or nonprofit corporation that has been established45-15
in this state to secure such insurance for its members from an insurer45-16
licensed pursuant to the provisions of Title 57 of NRS.45-17
3. In addition to the provisions of subsection 2, participate as a45-18
member of a nonprofit cooperative association or nonprofit corporation that45-19
has been established in this state to:45-20
(a) Facilitate contractual arrangements for the provision of medical45-21
services to its members’ officers and employees and their dependents and45-22
for related administrative services.45-23
(b) Procure health-related information and disseminate that information45-24
to its members’ officers and employees and their dependents.45-25
Sec. 65.7. NRS 287.0434 is hereby amended to read as follows: 287.0434 The committee on benefits may:45-27
1. Use its assets to pay the expenses of health care for its members and45-28
covered dependents, to pay its employees’ salaries and to pay45-29
administrative and other expenses.45-30
2. Enter into contracts relating to the administration of a plan of45-31
insurance, including contracts with licensed administrators and qualified45-32
actuaries. Each such contract with a licensed administrator:45-33
(a) Must be submitted to the commissioner of insurance not less than45-34
30 days before the date on which the contract is to become effective for45-35
approval as to the reasonableness of administrative charges in relation to45-36
contributions collected and benefits provided.45-37
(b) Does not become effective unless approved by the commissioner.45-38
(c) Shall be deemed to be approved if not disapproved by the45-39
commissioner of insurance within 30 days after its submission.45-40
3. Enter into contracts with physicians, surgeons, hospitals, health45-41
maintenance organizations and rehabilitative facilities for medical, surgical45-42
and rehabilitative care and the evaluation, treatment and nursing care of45-43
members and covered dependents.46-1
4. Enter into contracts for the services of other experts and specialists46-2
as required by a plan of insurance.46-3
5. Charge and collect from an insurer, health maintenance46-4
organization, organization for dental care or nonprofit medical service46-5
corporation, a fee for the actual expenses incurred by the committee, the46-6
state or a participating public employer in administering a plan of insurance46-7
offered by that insurer, organization or corporation.46-8
Sec. 66. NRS 616B.500 is hereby amended to read as follows: 616B.500 1. An insurer may enter into a contract to have his plan of46-10
insurance administered by a third-party administrator.46-11
2. An insurer shall not enter into a contract with any person for the46-12
administration of any part of the plan of insurance unless that person46-13
maintains an office in this state and has a46-14
commissioner pursuant to46-15
system may, as a part of a contract entered into with an organization for46-16
managed care pursuant to NRS 616B.515, require the organization to act as46-17
its third-party administrator.46-18
Sec. 67. NRS 616B.503 is hereby amended to read as follows: 616B.503 1. A person shall not act as a third-party administrator for46-20
an insurer without a certificate issued by the commissioner pursuant to46-21
46-22
2. A person who acts as a third-party administrator pursuant to chapters46-23
616A to 616D, inclusive, or chapter 617 of NRS shall:46-24
(a) Administer from one or more offices located in this state all of the46-25
claims arising under each plan of insurance that he administers and46-26
maintain in those offices all of the records concerning those claims;46-27
(b) Administer each plan of insurance directly, without subcontracting46-28
with another third-party administrator; and46-29
(c) Upon the termination of his contract with an insurer, transfer46-30
forthwith to a certified third-party administrator chosen by the insurer all of46-31
the records in his possession concerning claims arising under the plan of46-32
insurance.46-33
3. The commissioner may, under exceptional circumstances, waive the46-34
requirements of subsection 2.46-35
Sec. 68. Section 38 of Senate Bill No. 37 of this session is hereby46-36
amended to read as follows:46-37
Sec. 38. NRS 616B.500 is hereby amended to read as follows:46-38
616B.500 1. An insurer may enter into a contract to have his46-39
plan of insurance administered by a third-party administrator.46-40
2. An insurer shall not enter into a contract with any person for46-41
the administration of any part of the plan of insurance unless that46-42
person maintains an office in this state and has a certificate issued46-43
by the commissioner pursuant to section 14 of47-1
47-2
47-3
47-4
this session.47-5
Sec. 69. NRS 683A.0867, 686C.060 and 686C.085 are hereby47-6
repealed.47-7
Sec. 70. Sections 20, 23 and 67 of this act become effective at 12:0147-8
a.m. on October 1, 1999.
47-9
TEXT OF REPEALED SECTIONS683A.0867 Standards to be provided in agreement. The
47-11
agreement between the administrator and the insurer shall provide for47-12
underwriting and other standards pertaining to the business underwritten by47-13
the insurer.47-14
686C.060 "Board" defined. "Board" means the board of directors47-15
of the Nevada Life and Health Insurance Guaranty Association. 686C.085 "Domiciliary state" defined. "Domiciliary state" has the47-17
meaning ascribed to it in NRS 696B.070.~