CHAPTER........
AN ACT relating to industrial insurance; creating the appeals panel for industrial insurance to
hear grievances of certain employers concerning the establishment of experience
modification factors, the assignment of classifications of risk and the application of
certain information filed with the commissioner of insurance; and providing other
matters properly relating thereto.
THE PEOPLE OF THE STATE OF NEVADA, REPRESENTED IN
SENATE AND ASSEMBLY, DO ENACT AS FOLLOWS:
Section 1. Chapter 616A of NRS is hereby amended by adding thereto
a new section to read as follows:
"Appeals panel" means the appeals panel for industrial insurance that
hears grievances of employers, other than self-insured employers,
pursuant to the provisions of sections 5 to 17, inclusive, of this act.
Sec. 2.
NRS 616A.025 is hereby amended to read as follows:Sec. 3. (Deleted by amendment.)
Sec. 4. Chapter 616B of NRS is hereby amended by adding thereto the
provisions set forth as sections 5 to 17, inclusive, of this act.
Sec. 5. 1. The appeals panel for industrial insurance is hereby
created. The appeals panel consists of seven members who are appointed
by the governor, in consultation with the commissioner. From the
appropriate list of persons, if any, provided by the advisory organization
pursuant to subsection 2, the governor, in consultation with the
commissioner, shall appoint:
(a) An employee of the division of insurance of the department of
business and industry;
(b) An agent who is:
(1) Licensed pursuant to chapter 683A of NRS and qualified
pursuant to regulations adopted by the commissioner to take an
application for, procure or place on behalf of others, industrial
insurance; and
(2) A member of a nationally recognized association for the
profession of insurance agents;
(c) Two representatives of the general public:
(1) One of which must be employed by, or the proprietor of, a
business which is a member of:
(I) A local chamber of commerce; or
(II) Another organization representing the general business
interests of a group of businesses located in this state.
(2) Neither of which may be an independent contractor to, or an
employee or representative of, an insurance company, insurance broker,
insurance agent or insurance solicitor, a law firm, actuary or a
representative of a trade association that represents or supports the
interests specific to the trade of any such persons.
(3) Both of which must be knowledgeable in the field and business
of industrial insurance in this state;
(d) Two representatives of private carriers; and
(e) A representative of the advisory organization who administers
appeals panels for grievances of employers in other states.
2. On or before June 1 of a year in which the governor is to appoint
a member to the appeals panel, the advisory organization shall compile
lists of nominees for appointment pursuant to subsection 1 and provide
such lists to the governor and the commissioner. The advisory
organization shall compile three lists, each containing the names of at
least five persons who, in the opinion of the advisory organization, would
be appropriate members of the appeals panel as:
(a) The agent appointed pursuant to paragraph (b) of subsection 1;
(b) The two representatives of the general public appointed pursuant
to paragraph (c) of subsection 1; and
(c) The two representatives of private carriers appointed pursuant to
paragraph (d) of subsection 1.
3. Within 30 days after such appointments have been made, the
governor shall notify the advisory organization of the names of each new
member.
4. After the initial terms, members shall serve terms of 2 years,
except when appointed to fill unexpired terms.
5. A vacancy in the membership of the appeals panel must be filled
by the governor, in consultation with the commissioner, in accordance
with the provisions of subsections 1 and 2 for the remainder of the
unexpired term. The newly appointed member must have the same
qualifications as the vacating member, as specified in paragraph (a), (b),
(c), (d) or (e) of subsection 1, as appropriate.
Sec. 6.
1. At its first meeting of each year, the appeals panel shallelect a chairman from among its members.
2. The chairman shall hold office for 1 year.
3. If a vacancy occurs in the chairmanship, the members of the
panel shall elect a chairman from among its members for the remainder
of the unexpired term of the chairman.
4. Unless the members agree unanimously to a different date, the
first meeting of each year must be as soon as practicable after July 1.
Sec. 7.
1. The chairman of the appeals panel shall:(a) Schedule the time and place of the meetings and hearings of the
appeals panel;
(b) Establish the agenda for each meeting and hearing of the appeals
(c) Ensure that the meetings of the appeals panel are conducted in an
efficient manner.
2. The chairman of the appeals panel may appoint from the
membership of the appeals panel a secretary to whom he may delegate
his administrative functions.
Sec. 8.
1. The appeals panel shall meet at the times and placesspecified by a call of the chairman.
2. Four members of the appeals panel constitute a quorum to
transact all business, and a majority of those present must concur on any
decision.
Sec. 9.
1. Each member of the appeals panel is entitled to receive,for his attendance at the meetings of the appeals panel, the per diem
allowance and travel expenses provided for state officers and employees
generally.
2. Expenses of the members of the appeals panel must be paid from
assessments payable by each insurer pursuant to the formula filed with
and approved by the commissioner pursuant to section 20.2 of this act.
3. As used in this section, "insurer" has the meaning ascribed to it in
NRS 686B.1759.
Sec. 10.
1. An employer, other than a self-insured employer, whodetermines that circumstances specific to his case require a review of the:
(a) Establishment of the employer’s modification of premium based
on experience;
(b) Classification of risk assigned for the employer’s business; or
(c) Application of the supplementary rate information to the employer,
may file a written grievance with the appeals panel.
2. The insurer of that employer and the advisory organization may
participate in a hearing on the grievance by appearing and providing
testimony or other evidence. If an insurer or the advisory organization
participates in the hearing, the insurer or the advisory organization is a
party to the hearing and may appeal, pursuant to the provisions of
section 16 of this act, the decision made by the appeals panel.
3. As used in this section "supplementary rate information" has the
meaning ascribed to it in NRS 686B.020.
Sec. 11.
1. The appeals panel shall hear a grievance of anemployer filed pursuant to section 10 of this act.
2. The appeals panel shall not hear:
(a) Complaints concerning the effect of the classifications of risks or
rules that are applied by all insurers to all similarly classified businesses
within this state.
(b) Grievances concerning contested cases for compensation pursuant
to the provisions of chapters 616A to 616D, inclusive, or 617 of NRS.
Sec. 12.
1. Within 30 days after receipt of a written grievance froman employer pursuant to section 10 of this act and not less than 10 days
before the hearing on such grievance, the appeals panel shall provide
written notice to the employer, his insurer and the advisory organization
of the date and place of the hearing.
2. A decision on a grievance must be issued pursuant to section 15 of
this act within 30 days after the hearing.
Sec. 13.
A hearing held pursuant to section 11 of this act must beopen to the public, unless the appeals panel will be considering
proprietary information of the employer or the insurer. As used in this
section, the term "proprietary information" means any information
which, if disclosed to the general public, may result in a competitive
disadvantage to an insurer or employer, including, without limitation:
1. Rules, criteria and standards for underwriting policies that are
applied by an insurer.
2. Plans or other documents concerning the marketing or strategic
planning of an insurer or employer.
3. Data, studies and reports concerning the development of new
products or services.
4. Data that identify the share of the market of an insurer within
each class of risk.
Sec. 14.
1. If a member of the appeals panel determines that hehas a personal interest or a conflict of interest, directly or indirectly, with
a party to a hearing or the subject matter of the hearing, the chairman of
the appeals panel shall appoint a substitute member for that hearing who
has the same qualifications, as specified in paragraph (a), (b), (c), (d) or
(e) of subsection 1 of section 5 of this act as the member who has the
conflict of interest. If the chairman is the member with the conflict of
interest, another member of the appeals panel shall appoint the
substitute.
2. A conflict of interest may be waived if, after full written disclosure
of the facts raising such a conflict, all parties to the appeal agree in
writing to the hearing of the appeal by the member. Such waiver must be
filed with the chairman of the appeals panel before the hearing. If the
chairman is the member with the conflict of interest, the waiver must be
filed with the commissioner.
3. The member of the appeals panel who represents the advisory
organization shall be deemed not to have a conflict of interest with
respect to the advisory organization if it is a party to a hearing.
Sec. 15.
1. Within 30 days after each hearing, the chairman or amember of the appeals panel designated by the chairman shall prepare
and deliver personally or by mail to each party to the hearing and to the
commissioner a written memorandum stating:
(a) The reasons for the decision of the appeals panel concerning those
parties; and
(b) The rights of any party to the hearing to appeal pursuant to
section 16 of this act and a brief description of the procedure for making
such an appeal.
The votes of each member of the appeals panel must not be recorded on
this memorandum.
2. Each month, copies of all decisions made by the appeals panel
during the prior month must be delivered personally or by mail to the
advisory organization.
Sec. 16.
1. A party to the hearing who wishes to appeal a decisionof the appeals panel must do so pursuant to the provisions of NRS
679B.310. Such a hearing must be conducted by the commissioner
pursuant to the provisions of NRS 679B.310 to 679B.370, inclusive, and
the regulations adopted pursuant thereto.
2. The commissioner shall not hold a hearing on the request of an
employer concerning the establishment of the employer’s modification of
premium based on experience, the classification of risk assigned for the
employer’s business, or application of the insurer’s supplementary rate
information to the employer unless the employer has:
(a) Filed a written grievance with the appeals panel pursuant to
section 10 of this act; and
(b) Received a written decision from the appeals panel.
Sec. 17.
The commissioner may adopt regulations to carry out theprovisions of sections 5 to 17, inclusive, of this act.
Sec. 18.
NRS 616C.315 is hereby amended to read as follows:Sec. 20. NRS 679B.370 is hereby amended to read as follows:
Sec. 20.2. Chapter 686B of NRS is hereby amended by adding thereto
a new section to read as follows:
1. The advisory organization shall, at least 60 days before imposing
an assessment pursuant to this section, file with the commissioner a
formula for an assessment on all insurers, which results in an equitable
distribution among all insurers, of:
(a) The costs of paying the expenses of the members of the appeals
panel for industrial insurance pursuant to the provisions of section 9 of
this act; and
(b) Any costs incurred by the advisory organization to administer the
appeals panel for industrial insurance pursuant to the provisions of
sections 5 to 17, inclusive, of this act.
2. The formula for the assessment filed pursuant to subsection 1
shall be deemed approved unless it is disapproved by the commissioner
within 60 days after it is filed.
Sec. 20.4. NRS 686B.1751 is hereby amended to read as follows:
andSec. 21. NRS 686B.1785 is hereby amended to read as follows:
Sec. 22. As soon as practicable after the effective date of this act, the
governor, in consultation with the commissioner of insurance shall appoint:
1. One of the members described in paragraph (c) of subsection 1 of
section 5 of this act and one of the members described in paragraph (d) of
subsection 1 of section 5 of this act to terms that expire on June 30, 2000.
2. One of the members described in paragraph (c) of subsection 1 of
section 5 of this act and one of the members described in paragraph (d) of
subsection 1 of section 5 of this act and the members described in
paragraphs (a), (b) and (e) of subsection 1 of section 5 of this act to terms
that expire on June 30, 2001.
Sec. 23. 1. This section and sections 1 to 18, inclusive, 20 and 22 of
this act become effective upon passage and approval and expire by
limitation on July 1, 2001.
2. Sections 20.2, 20.4 and 21 of this act become effective at 12:01 a.m.
on July 1, 1999, and expire by limitation on July 1, 2001.
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