Senate Bill No. 28–Senator Amodei

 

Prefiled January 19, 2001

 

____________

 

Referred to Committee on Commerce and Labor

 

SUMMARY—Authorizes formation of associations of self-insured private employers to provide health coverage. (BDR 57‑590)

 

FISCAL NOTE:            Effect on Local Government: No.

                                    Effect on the State: Yes.

 

~

 

EXPLANATION – Matter in bolded italics is new; matter between brackets [omitted material] is material to be omitted.

Green numbers along left margin indicate location on the printed bill (e.g., 5-15 indicates page 5, line 15).

 

AN ACT relating to health insurance; providing in skeleton form for the formation of associations of self-insured private employers to provide health coverage; imposing certain requirements upon such an association and its board of trustees; prohibiting certain acts without a solicitor’s permit issued by the commissioner of insurance; authorizing the commissioner of insurance to impose an administrative fine for certain violations; imposing certain requirements upon a third-party administrator for such an association; providing a penalty; and providing other matters properly relating thereto.

 

THE PEOPLE OF THE STATE OF NEVADA, REPRESENTED IN

SENATE AND ASSEMBLY, DO ENACT AS FOLLOWS:

 

1-1    Section 1.  Chapter 689C of NRS is hereby amended by adding thereto

1-2  the provisions set forth as sections 2 to 42, inclusive, of this act.

1-3    Sec. 2.  As used in sections 2 to 42, inclusive, of this act, unless the

1-4  context otherwise requires, the words and terms defined in sections 3 to

1-5  6, inclusive, of this act have the meanings ascribed to them in those

1-6  sections.

1-7    Sec. 3.  “Association of self-insured private employers” means a

1-8  nonprofit, unincorporated association composed of five or more private

1-9  employers that has been issued a certificate by the commissioner and is

1-10  subject to the provisions of sections 2 to 42, inclusive, of this act.

1-11    Sec. 4.  “Association’s administrator” means a person who is

1-12  employed by or has contracted with the board of trustees of an

1-13  association of self-insured private employers to carry out the policies of

1-14  the board of trustees and to be responsible for the daily operation of the

1-15  association.


2-1    Sec. 5.  “Tangible net worth” means all the assets of an association

2-2  of self-insured private employers or of a member of such an association

2-3  except:

2-4    1.  Accounts receivable, if they are factored or collateralized.

2-5    2.  An inventory, except one held for resale and not collateralized.

2-6    3.  A prepaid expense.

2-7    4.  An unqualified investment.

2-8    5.  An allocated bond fund.

2-9    6.  An investment in an affiliate.

2-10    7.  A restricted fund.

2-11    8.  A reserve.

2-12    9.  A security cost, such as a capitalized bond cost.

2-13    10.  A cash equivalent, unless it is described in the footnotes for the

2-14  balance sheet by item, and for investments, by duration and nature. A

2-15  cash flow statement is not a sufficient description.

2-16    11.  A contingency or commitment, including any estimated cost.

2-17    12.  Any book adjustment caused by a change in an accounting policy

2-18  or a restatement.

2-19    13.  Goodwill or excess cost over the fair market value of assets.

2-20    14.  Any other items listed in the assets that are deemed unacceptable

2-21  by the commissioner because they cannot be justified or because they do

2-22  not directly support the ability of the association or the member to pay a

2-23  claim.

2-24    Sec. 6.  “Third-party administrator” means a person who is hired by

2-25  an association of self-insured private employers to provide administrative

2-26  services for the association of self-insured private employers and to

2-27  manage claims. The term does not include an insurance company.

2-28    Sec. 7.  1.  An association of self-insured private employers may

2-29  provide health coverage through a trust fund and, where necessary,

2-30  deduct contributions to the maintenance of the fund from the

2-31  compensation of officers and employees and pay the deductions into the

2-32  fund.

2-33    2.  The money must be deposited in a state or national bank or credit

2-34  union authorized to transact business in this state.

2-35    3.  Any independent administrator of a fund created pursuant to this

2-36  section is subject to the licensing requirements of chapter 683A of NRS.

2-37    4.  Any contract with an independent administrator must be approved

2-38  by the commissioner as to the reasonableness of administrative charges

2-39  in relation to contributions collected and benefits provided.

2-40    5.  The provisions of NRS 689B.030 to 689B.050, inclusive, apply to

2-41  coverage provided pursuant to this section.

2-42    Sec. 8.  1.  A group of five or more employers may not act as an

2-43  association of self-insured private employers unless:

2-44    (a) Each member of the group is a member or associate member of a

2-45  bona fide trade association, as determined by the commissioner, which:

2-46      (1) Is incorporated in this state; and

2-47      (2) Has been in existence for at least 5 years; and

2-48    (b) The association of self-insured private employers has been issued

2-49  a certificate to act as such an association by the commissioner.


3-1    2.  An association of private employers that wishes to be issued a

3-2  certificate must file with the commissioner an application for

3-3  certification.

3-4    3.  The application must include:

3-5    (a) The name of the association.

3-6    (b) The address of:

3-7       (1) The principal office of the association; and

3-8       (2) The location where the books and records of the association will

3-9  be maintained.

3-10    (c) The date on which the association was organized.

3-11    (d) The name and address of each member of the association.

3-12    (e) The names of the initial members of the board of trustees and the

3-13  name of the initial association’s administrator.

3-14    (f) Such other information as the commissioner may require.

3-15    4.  The application must be accompanied by:

3-16    (a) A nonrefundable filing fee of $1,000.

3-17    (b) Proof of compliance with section 9 of this act.

3-18    (c) Proof that the association or its third-party administrator is

3-19  licensed or otherwise authorized to conduct business in this state

3-20  pursuant to Title 57 of NRS.

3-21    (d) A copy of the agreements entered into with the association’s

3-22  administrator and a third-party administrator.

3-23    (e) A copy of the bylaws of the association.

3-24    (f) A copy of an agreement jointly and severally binding the

3-25  association and each member of the association to secure the provision

3-26  of health coverage pursuant to the provisions of sections 2 to 42,

3-27  inclusive, of this act.

3-28    (g) A pro forma financial statement prepared by an independent

3-29  certified public accountant in accordance with generally accepted

3-30  accounting principles that shows the financial ability of the association

3-31  to provide health coverage pursuant to the provisions of sections 2 to 42,

3-32  inclusive, of this act.

3-33    (h) A financial statement reviewed and prepared by an independent

3-34  certified public accountant for each proposed member of the association

3-35  or evidence of the ability of the association or its proposed members to

3-36  provide a solvency bond pursuant to subsection 3 of section 9 of this act.

3-37    (i) Proof that each member of the association will make the initial

3-38  payment to the association required pursuant to section 29 of this act on

3-39  a date specified by the commissioner. The payment shall be deemed to be

3-40  a part of the assessment required to be paid by each member for the first

3-41  year of self-insurance if certification is issued to the association.

3-42    5.  Any financial information relating to a member of an association

3-43  received by the commissioner pursuant to the provisions of this section is

3-44  confidential and must not be disclosed.

3-45    6.  For the purposes of this section, “associate member of a bona fide

3-46  trade association” means a supplier whose business, as determined by the

3-47  commissioner:

3-48    (a) Is limited to a specific industry; and


4-1    (b) Primarily involves providing a product or service that is directly

4-2  used or consumed by substantially all the members of the trade

4-3  association or bears a direct relationship to the business of the members

4-4  of the trade association.

4-5    Sec. 9.  1.  An association of self-insured private employers shall:

4-6    (a) Execute an indemnity agreement jointly and severally binding the

4-7  association and each member of the association to secure the provision

4-8  of health coverage pursuant to sections 2 to 42, inclusive, of this act. The

4-9  indemnity agreement must be in a form prescribed by the commissioner.

4-10  An association may add provisions to the indemnity agreement if the

4-11  provisions are first approved by the commissioner.

4-12    (b) Except as otherwise provided in this subsection, maintain a policy

4-13  of specific and aggregate excess insurance in a form and amount

4-14  required by the commissioner. The excess insurance must be written by

4-15  an insurer approved by the commissioner. To determine the amount of

4-16  excess insurance required, the commissioner shall consider:

4-17      (1) The number of members in the association;

4-18      (2) The types of services provided by the members of the

4-19  association;

4-20      (3) The number of years the association has been in existence; and

4-21      (4) Such other information as the commissioner deems
necessary.

4-22  This paragraph does not prohibit an association from purchasing

4-23  secondary excess insurance in addition to the excess insurance required

4-24  by this paragraph.

4-25    (c) Collect an annual assessment from each member of the

4-26  association in an aggregate amount of at least $100,000 or in an

4-27  aggregate amount which the commissioner determines is satisfactory

4-28  based on an annual review conducted by the commissioner of the

4-29  actuarial solvency of the association.

4-30    (d) Except as otherwise provided in paragraph (e), deposit as security

4-31  with the commissioner a bond executed by the association as principal,

4-32  and by a licensed surety, payable to the State of Nevada, and conditioned

4-33  upon the provision of health coverage to their employees. The bond must

4-34  be in an amount determined by the commissioner to be reasonably

4-35  sufficient to ensure payment of obligations related to the provision of

4-36  health coverage, but in no event may it be less than $100,000.

4-37    (e) In lieu of a bond, deposit with the commissioner a like amount of

4-38  lawful money of the United States or any other form of security

4-39  authorized by NRS 100.065. If security is provided in the form of a

4-40  savings certificate, certificate of deposit or investment certificate, the

4-41  certificate must state that the amount is unavailable for withdrawal

4-42  except upon order of the commissioner.

4-43    2.  Except as otherwise provided in subsection 3, in addition to

4-44  complying with the requirements of subsection 1, an association of self-

4-45  insured private employers shall maintain a combined tangible net worth

4-46  of all members in the association of at least $1,000,000.

4-47    3.  In lieu of complying with the requirements of subsection 2, the

4-48  association’s administrator shall ensure that a solvency bond, in a form


5-1  prescribed by the commissioner and in an aggregate amount of at least

5-2  $1,000,000, is deposited with the commissioner by the association or

5-3  members of the association on behalf of the association.

5-4    4.  The association’s administrator shall deposit with the

5-5  commissioner a bond executed by the association’s administrator as

5-6  principal, and by a licensed surety, payable to the State of Nevada, and

5-7  conditioned upon the faithful performance of his duties. The bond must

5-8  be in an amount determined by the commissioner.

5-9    5.  Any third-party administrator providing claims services for the

5-10  association shall deposit with the commissioner a bond executed by the

5-11  third-party administrator as principal, and by a licensed surety, payable

5-12  to the State of Nevada, and conditioned upon the faithful performance of

5-13  its duties. The bond must be in an amount determined by the

5-14  commissioner.

5-15    6.  The commissioner may increase or decrease the amount of any

5-16  bond or money required to be deposited by this section in accordance

5-17  with chapter 681B of NRS and his regulations for loss reserves in health

5-18  insurance. If the commissioner requires an association, association’s

5-19  administrator or third-party administrator to increase its deposit, the

5-20  commissioner may specify the form of the additional security. The

5-21  association, association’s administrator or third-party administrator shall

5-22  comply with such a requirement within 60 days after receiving notice

5-23  from the commissioner.

5-24    7.  The account for health coverage for associations of self-insured

5-25  private employers is hereby created in the state agency fund for bonds.

5-26  All money received by the commissioner pursuant to this section must be

5-27  deposited with the state treasurer to the credit of the account. All claims

5-28  against this account must be paid as other claims against the state are

5-29  paid.

5-30    Sec. 10.  A surety or bonding company shall not furnish a bond or

5-31  any other form of security required by the provisions of sections 2 to 42,

5-32  inclusive, of this act for an association of self-insured private employers

5-33  or a member of such an association unless the surety or bonding

5-34  company holds a certificate of authority issued by the commissioner.

5-35    Sec. 11.  1.  The commissioner shall grant or deny an application

5-36  for certification as an association of self-insured private employers

5-37  within 60 days after receiving the application. If the application is

5-38  materially incomplete or does not comply with the applicable provisions

5-39  of the law, the commissioner shall notify the applicant of the additional

5-40  information or changes required. Under such circumstances, if the

5-41  commissioner is unable to act upon the application within this 60‑day

5-42  period, he may extend the period for granting or denying the application,

5-43  but for not longer than an additional 90 days.

5-44    2.  Upon determining that an association is qualified as an

5-45  association of self-insured private employers, the commissioner shall

5-46  issue a certificate to that effect to the association and the association’s

5-47  administrator. No certificate may be issued to an association that, within

5-48  the 2 years immediately preceding its application, has had its certification


6-1  as an association of self-insured private employers involuntarily

6-2  withdrawn by the commissioner.

6-3    3.  A certificate issued pursuant to this section must include, without

6-4  limitation:

6-5    (a) The name of the association;

6-6    (b) The name of each employer that the commissioner determines is a

6-7  member of the association at the time of the issuance of the certificate;

6-8    (c) An identification number assigned to the association by the

6-9  commissioner; and

6-10    (d) The date on which the certificate was issued.

6-11    4.  A certificate issued pursuant to this section remains in effect until

6-12  withdrawn by the commissioner or canceled at the request of the

6-13  association. Coverage for an association granted a certificate becomes

6-14  effective on the date of certification or the date specified in the

6-15  certificate, as appropriate.

6-16    5.  The commissioner shall not grant a request to cancel a certificate

6-17  unless the association has insured or reinsured all incurred obligations

6-18  with an insurer authorized to do business in this state pursuant to an

6-19  agreement filed with and approved by the commissioner. The agreement

6-20  must include coverage for actual claims and claims filed with the

6-21  association but not reported, and the expenses associated with those

6-22  claims.

6-23    Sec. 12.  1.  An association certified as an association of self-

6-24  insured private employers directly assumes the responsibility for

6-25  providing health coverage to the employees of the members of the

6-26  association and their beneficiaries pursuant to sections 2 to 42, inclusive,

6-27  of this act.

6-28    2.  The claims of employees and their beneficiaries while in the

6-29  employment of a member of an association must be handled in the

6-30  manner provided by sections 2 to 42, inclusive, of this act, and the

6-31  association is subject to the regulations of the commissioner with respect

6-32  to payment of those claims.

6-33    3.  The security deposited pursuant to section 9 of this act does not

6-34  relieve an association from responsibility for the administration of claims

6-35  and the provision of health coverage pursuant to sections 2 to 42,

6-36  inclusive, of this act.

6-37    Sec. 13.  1.  An association of self-insured private employers must

6-38  be operated by a board of trustees consisting of at least five members

6-39  whom the members of the association elect for terms set forth in the

6-40  bylaws of the association. At least two-thirds of the members of the board

6-41  of trustees must be employees, officers or directors of the members of the

6-42  association. No association’s administrator or third-party administrator

6-43  employed by the association, or any owner, officer, employee or other

6-44  person affiliated with the association’s administrator or third-party

6-45  administrator, may serve as a member of the board of trustees. Each

6-46  member of the board of trustees must be a resident of this state or an

6-47  officer of a corporation authorized to do business in this state.

6-48    2.  The board of trustees of an association shall:


7-1    (a) Ensure the prompt payment of claims relating to the health

7-2  coverage provided pursuant to sections 2 to 42, inclusive, of this act.

7-3    (b) Take such actions as are necessary to protect the assets of the

7-4  association.

7-5    (c) Employ full time an association’s administrator to carry out the

7-6  policies of the board of trustees and perform such duties as the board

7-7  delegates to him. An association’s administrator shall not perform any of

7-8  the duties assigned to a third-party administrator.

7-9    (d) Employ a third-party administrator to carry out the duties set forth

7-10  in section 41 of this act.

7-11    (e) Employ an independent certified public accountant to prepare the

7-12  statement of financial condition required by section 25 of this act.

7-13    (f) Maintain minutes of its meetings and make the minutes available

7-14  for inspection by the commissioner.

7-15    3.  The board of trustees of an association shall not:

7-16    (a) Extend credit to any member of the association for the payment of

7-17  the annual assessment for that member, except pursuant to a payment

7-18  plan approved by the commissioner; or

7-19    (b) Borrow any money from the association or in the name of the

7-20  association, except in the ordinary course of its business, without the

7-21  prior approval of the commissioner.

7-22    Sec. 14.  1.  The board of trustees of an association of self-insured

7-23  private employers is responsible for the money collected and disbursed by

7-24  the association.

7-25    2.  The board of trustees shall:

7-26    (a) Establish a claims account in a federally insured financial

7-27  institution in this state approved by the commissioner. Except as

7-28  otherwise provided in subsection 3, at least 75 percent of the annual

7-29  assessment collected by the association from its members must be

7-30  deposited in this account to pay:

7-31      (1) Claims;

7-32      (2) Expenses related to those claims; and

7-33      (3) The costs associated with the association’s policy of excess

7-34  insurance.

7-35    (b) Establish an administrative account in a federally insured

7-36  financial institution in this state approved by the commissioner. The

7-37  amount of the annual assessment collected by the association that is not

7-38  deposited in its claims account must be deposited in the administrative

7-39  account to pay the administrative expenses of the association.

7-40    3.  The commissioner may authorize an association to deposit less

7-41  than 75 percent of its annual assessment in its claims account if the

7-42  association presents evidence satisfactory to the commissioner that:

7-43    (a) More than 25 percent of the association’s annual assessment is

7-44  needed to maintain its program for loss control; and

7-45    (b) The association’s policy of excess insurance attaches at less than

7-46  75 percent.

7-47    4.  The board of trustees may invest the money of the association not

7-48  needed to pay the obligations of the association pursuant to chapter 682A

7-49  of NRS.


8-1    5.  The commissioner shall review the accounts of an association

8-2  established pursuant to this section at such times as he deems necessary

8-3  to ensure compliance with the provisions of this section.

8-4    Sec. 15.  1.  An association’s administrator employed by an

8-5  association of self-insured private employers, or an employee, officer or

8-6  director of an association’s administrator, may not be an employee,

8-7  officer or director of a third-party administrator employed by the

8-8  association or have a direct or indirect financial interest in the third-

8-9  party administrator of the association.

8-10    2.  The third-party administrator of an association of self-insured

8-11  private employers, or an employee, officer or director of the third-party

8-12  administrator, may not be an employee, officer or director of an

8-13  association’s administrator employed by the association or have a direct

8-14  or indirect financial interest in that association’s administrator.

8-15    3.  Any contract entered into by an association of self-insured private

8-16  employers and a third-party administrator must include a provision

8-17  which states that, unless the commissioner otherwise provides, the third-

8-18  party administrator shall administer any claim or other obligation of the

8-19  association to its conclusion during the period of the contract.

8-20    Sec. 16.  1.  Except as otherwise provided in this section, a person

8-21  shall not advertise or offer for sale in this state any policies or

8-22  memberships, or solicit or receive any money, subscriptions, applications,

8-23  premiums, assessments, memberships or any other fee or charge in

8-24  connection with a proposed association of self-insured private employers

8-25  unless he has obtained a solicitor’s permit from the commissioner.

8-26    2.  To obtain a solicitor’s permit, a person must file a written

8-27  application with the commissioner. The application must include:

8-28    (a) The name, type and purposes of the association formed or

8-29  proposed to be formed or financed;

8-30    (b) The name, residential address, business, professional or

8-31  employment experience for the preceding 10 years and qualifications of

8-32  each person associated or to be associated as director, promoter,

8-33  manager, member of the board or in any other similar capacity in the

8-34  association, or in the formation of the proposed association or in the

8-35  proposed financing, together with the fingerprints of each person so

8-36  associated or to be associated, on forms furnished by the commissioner;

8-37    (c) A full disclosure of the terms of all pertinent understandings and

8-38  agreements existing or proposed among any persons or entities so

8-39  associated or to be associated, and a copy of each such agreement;

8-40    (d) A copy of the articles of incorporation and bylaws of a solicitor, if

8-41  incorporated;

8-42    (e) The plan according to which solicitations are to be made and a

8-43  reasonably detailed estimate of all administrative and sales expenses to

8-44  be incurred;

8-45    (f) A copy of any certificate proposed to be offered, and a copy of any

8-46  proposed application of any certificate proposed to be offered;

8-47    (g) A copy of any prospectus, offering circular, advertising or sales

8-48  literature or materials proposed to be used;


9-1    (h) Proof of an escrow account and agreement for the deposit of all

9-2  money collected during the formation of the association; and

9-3    (i) Such additional pertinent information as the commissioner may

9-4  reasonably require.

9-5    3.  The application must be accompanied by a fee of $500 for the

9-6  filing of the application and for the issuance of the permit, if granted. A

9-7  solicitor must submit this fee each year thereafter if he continues to

9-8  recruit new members for an association.

9-9    4.  A person who violates subsection 1 is guilty of a category D felony

9-10  and shall be punished as provided in NRS 193.130.

9-11    5.  The provisions of this section do not apply to:

9-12    (a) A bona fide trade association that has been in existence for at least

9-13  5 years and solicits members of its trade association; or

9-14    (b) A person who is employed by:

9-15      (1) Current members of an association; or

9-16      (2) Employers that are considering membership in an
association,

9-17  whose primary duties do not include solicitation of potential members of

9-18  the association.

9-19    Sec. 17.  1.  After the filing of an application for a solicitor’s permit,

9-20  the commissioner shall promptly cause an investigation to be made of:

9-21    (a) The identity, character, reputation, experience, financial standing

9-22  and motives of the persons proposing to organize, promote or finance the

9-23  association of self-insured private employers;

9-24    (b) The character, financial responsibility, management experience

9-25  and business qualifications of the officers, directors and managers of the

9-26  existing or proposed association; and

9-27    (c) Any other aspects of the solicitor, association or proposed

9-28  financing as the commissioner deems advisable.

9-29    2.  The commissioner shall expeditiously examine an application for

9-30  a solicitor’s permit and complete the investigation required pursuant to

9-31  subsection 1. Except as otherwise provided in subsection 3, if the

9-32  commissioner finds, after performing an examination and investigation,

9-33  that:

9-34    (a) The application is complete and the applicable fee has been paid;

9-35    (b) The documents filed with the application are proper in form; and

9-36    (c) The proposed financing is reasonable and adequate in amount for

9-37  the purposes intended and the applicant is otherwise entitled to the

9-38  permit,

9-39  the commissioner shall issue a permit and assign a permit number to the

9-40  applicant.

9-41    3.  If the commissioner does not so find, or finds that:

9-42    (a) The applicant is not competent, trustworthy, financially

9-43  responsible or of good personal and business reputation;

9-44    (b) Any of the persons associated or to be associated with the

9-45  association are not of good reputation as to business affairs or financial

9-46  responsibility; or

9-47    (c) There is material variance, adverse to the applicant, as between
the information furnished by the applicant in connection with the


10-1  application and that determined by the commissioner on
investigation,

10-2  the commissioner shall give notice to the applicant that a permit will not

10-3  be granted, stating the particulars of the grounds for the denial. The

10-4  commissioner shall not refund the fee for the filing of the application.

10-5    Sec. 18.  1.  The commissioner may suspend or revoke a solicitor’s

10-6  permit if he reasonably believes that:

10-7    (a) A violation of Title 57 of NRS or the terms of the permit or any

10-8  proper order of the commissioner has occurred; or

10-9    (b) A material misrepresentation in the offering or sale of securities,

10-10  policies or memberships pursuant to the permit has occurred.

10-11  2.  If the commissioner suspends or revokes a permit pursuant to

10-12  subsection 1, he shall expeditiously conduct a hearing, giving the holder

10-13  of the permit a reasonable opportunity to appear and be heard.

10-14  Sec. 19.  1.  Any advertising or written material that solicits

10-15  employers to join an association of self-insured private employers must

10-16  contain the permit number of the solicitor.

10-17  2.  A solicitor shall provide to the commissioner upon request a copy

10-18  of any document relating to a solicitation which was prepared after the

10-19  solicitor filed his application for a permit.

10-20  Sec. 20.  1.  If an employer wishes to become a member of an

10-21  association of self-insured private employers, the employer must:

10-22  (a) Submit an application for membership to the board of trustees or

10-23  third-party administrator of the association; and

10-24  (b) Enter into an indemnity agreement as required by section 9 of this

10-25  act.

10-26  2.  The membership of the applicant becomes effective when all

10-27  members of the association have indicated their approval of the

10-28  application or on a later date specified by the association. The

10-29  application for membership and the action taken on the application must

10-30  be maintained as permanent records of the board of trustees.

10-31  3.  Each member who is a member of an association during the 12

10-32  months immediately following the formation of the association must have

10-33  a tangible net worth of at least $200,000. Any employer who seeks to

10-34  become a member of the association subsequently must meet the

10-35  requirement for tangible net worth of at least $200,000 unless the

10-36  commissioner adjusts the requirement for membership in the association

10-37  after conducting an annual review of the actuarial solvency of the

10-38  association in accordance with subsection 1 of section 9 of this act.

10-39  4.  A member of an association may terminate his membership at any

10-40  time. To terminate his membership, a member must submit to the

10-41  association’s administrator a notice of intent to withdraw from the

10-42  association at least 120 days before the effective date of withdrawal. The

10-43  association’s administrator shall, within 10 days after receipt of the

10-44  notice, notify the commissioner of the employer’s intent to withdraw from

10-45  the association.

10-46  5.  The members of an association may cancel the membership of any

10-47  member of the association in accordance with the bylaws of the

10-48  association.


11-1    6.  The association shall:

11-2    (a) Notify the commissioner of the termination or cancellation of the

11-3  membership of any member of the association within 10 days after the

11-4  termination or cancellation; and

11-5    (b) At the expense of the member whose membership is terminated or

11-6  canceled, maintain coverage for that member for 30 days after notice is

11-7  given pursuant to paragraph (a), unless the association first receives

11-8  notice from the commissioner that the member has:

11-9      (1) Become a member of another association of self-insured private

11-10  employers; or

11-11     (2) Become insured by an insurer.

11-12  7.  If a member of an association changes his name or form of

11-13  organization, the member remains liable for any obligations incurred or

11-14  any responsibilities imposed pursuant to sections 2 to 42, inclusive, of

11-15  this act under his former name or form of organization.

11-16  8.  An association is liable for the payment of any obligations

11-17  required to be paid by a member of the association pursuant to sections 2

11-18  to 42, inclusive, of this act during his period of membership. The

11-19  insolvency or bankruptcy of a member does not relieve the association of

11-20  liability for the provision of health coverage.

11-21  Sec. 21.  An association of self-insured private employers shall notify

11-22  the commissioner of any change in the information submitted in its

11-23  application for certification or in the manner of its compliance with

11-24  section 9 of this act not later than 30 days after the change.

11-25  Sec. 22.  1.  The commissioner may examine the books, records,

11-26  accounts and assets of an association of self-insured private employers as

11-27  he deems necessary to carry out the provisions of sections 2 to 42,

11-28  inclusive, of this act.

11-29  2.  The expense of any examination conducted pursuant to this

11-30  section must be paid by the association.

11-31  Sec. 23.  An association of self-insured private employers shall be

11-32  deemed to have appointed the commissioner as its resident agent to

11-33  receive any initial legal process authorized by law to be served upon the

11-34  association for as long as the association is obligated to provide health

11-35  coverage pursuant to sections 2 to 42, inclusive, of this act.

11-36  Sec. 24.  1.  An association of self-insured private employers may

11-37  merge with another association of self-insured private employers if:

11-38  (a) The members of the merging associations are engaged in the same

11-39  or similar trade;

11-40  (b) The resulting association assumes in full all obligations of the

11-41  merging associations; and

11-42  (c) The merger is approved by the commissioner.

11-43  2.  The commissioner shall conduct a hearing on the proposed

11-44  merger if any member of the merging associations so requests. The

11-45  commissioner may on his own motion conduct such a hearing.

11-46  Sec. 25.  1.  An association of self-insured private employers shall

11-47  file with the commissioner an audited statement of financial condition

11-48  prepared by an independent certified public accountant. The statement

11-49  must be filed on or before April 1 of each year or, if the fiscal year of the


12-1  association does not coincide with the calendar year, within 90 days after

12-2  the conclusion of the association’s fiscal year, and contain information

12-3  for the previous fiscal year.

12-4    2.  The statement required by subsection 1 must be in a form

12-5  prescribed by the commissioner and include, without limitation:

12-6    (a) A statement of the reserves for:

12-7      (1) Actual claims and expenses;

12-8      (2) Claims filed with the association but not reported, and the

12-9  expenses associated with those claims;

12-10     (3) Assessments that are due, but not paid; and

12-11     (4) Unpaid debts, which must be shown as liabilities.

12-12  (b) An actuarial opinion regarding reserves that is prepared by a

12-13  member of the American Academy of Actuaries or another specialist in

12-14  loss reserves identified in the annual statement adopted by the National

12-15  Association of Insurance Commissioners. The actuarial opinion must

12-16  include a statement of:

12-17     (1) Actual claims and the expenses associated with those claims;

12-18  and

12-19     (2) Claims filed with the association but not reported, and the

12-20  expenses associated with those claims.

12-21  3.  The commissioner may adopt a uniform financial reporting system

12-22  for associations of self-insured private employers to ensure the accurate

12-23  and complete reporting of financial information.

12-24  4.  The commissioner may require the filing of such other reports as

12-25  he deems necessary to carry out the provisions of this section.

12-26  Sec. 26.  The annual assessment required to be paid by each member

12-27  of an association of self-insured private employers must be calculated

12-28  pursuant to regulations adopted by the commissioner.

12-29  Sec. 27.  1.  The commissioner shall cause to be conducted at least

12-30  annually an audit of each association of self-insured private employers to

12-31  verify:

12-32  (a) The number of employees of each member of the association;

12-33  (b) The assessment required to be paid by each member of the

12-34  association; and

12-35  (c) Any other information the commissioner determines is necessary.

12-36  2.  The audit required by this section must be conducted by an auditor

12-37  approved by the commissioner.

12-38  3.  A report of the audit must be filed with the commissioner in a

12-39  form required by the commissioner.

12-40  4.  The expenses of any audit conducted pursuant to this section must

12-41  be paid by the association.

12-42  Sec. 28.  1.  If the assets of an association of self-insured private

12-43  employers exceed the amount necessary for the association to:

12-44  (a) Pay its obligations and administrative expenses;

12-45  (b) Carry reasonable reserves; and

12-46  (c) Provide for contingencies,

12-47  the board of trustees of the association may, after obtaining the approval

12-48  of the commissioner, declare and distribute dividends to the members of

12-49  the association.


13-1    2.  Any dividend declared pursuant to subsection 1 must be

13-2  distributed not less than 12 months after the end of the fiscal year.

13-3    3.  A dividend may be paid only to those members who are members

13-4  of the association for the entire fiscal year. The payment of a dividend

13-5  must not be conditioned upon the member continuing his membership in

13-6  the association after the fiscal year.

13-7    4.  An association shall give to each prospective member of the

13-8  association a written description of its plan for distributing dividends

13-9  when the prospective member applies for membership in the association.

13-10  Sec. 29.  1.  Each association of self-insured private employers shall

13-11  adopt a plan for the payment of annual assessments by the members of

13-12  the association which must be approved by the commissioner.

13-13  2.  The plan must include a requirement for:

13-14  (a) An initial payment, in advance, of a portion of the annual

13-15  assessment due from each member of the association. The initial

13-16  payment must be in an amount equal to at least 25 percent of the

13-17  member’s annual assessment.

13-18  (b) Payment of the balance of the annual assessment due in quarterly

13-19  or monthly installments.

13-20  Sec. 30.  Each association of self-insured private employers shall

13-21  maintain:

13-22  1.  Actuarially appropriate loss reserves. Such reserves must include

13-23  reserves for:

13-24  (a) Actual claims and the expenses associated with those claims; and

13-25  (b) Claims filed with the association but not reported, and the

13-26  expenses associated with those claims.

13-27  2.  Reserves for uncollected debts.

13-28  Sec. 31.  1.  If the assets of an association of self-insured private

13-29  employers are insufficient to make certain the prompt payment of claims

13-30  relating to the health coverage provided pursuant to sections 2 to 42,

13-31  inclusive, of this act and to maintain the reserves required by section 30

13-32  of this act, the association shall immediately notify the commissioner of

13-33  the deficiency and:

13-34  (a) Transfer any surplus acquired from a previous fiscal year to the

13-35  current fiscal year to make up the deficiency;

13-36  (b) Transfer money from its administrative account to its claims

13-37  account;

13-38  (c) Collect an additional assessment from its members in an amount

13-39  required to make up the deficiency; or

13-40  (d) Take any other action to make up the deficiency which is approved

13-41  by the commissioner.

13-42  2.  If the association wishes to transfer any surplus from one fiscal

13-43  year to another, the association must first notify the commissioner of the

13-44  transfer.

13-45  3.  The commissioner shall order the association to make up any

13-46  deficiency pursuant to subsection 1 if the association fails to do so within

13-47  30 days after notifying the commissioner of the deficiency. The

13-48  association shall be deemed insolvent if it fails to:


14-1    (a) Collect an additional assessment from its members within 30 days

14-2  after being ordered to do so by the commissioner; or

14-3    (b) Make up the deficiency in any other manner within 60 days after

14-4  being ordered to do so by the commissioner.

14-5    Sec. 32.  1.  The commissioner may issue an order requiring an

14-6  association of self-insured private employers or a member of the

14-7  association to cease and desist from engaging in any act or practice

14-8  found to be in violation of any provision of sections 2 to 42, inclusive, of

14-9  this act or any regulation adopted pursuant to those sections.

14-10  2.  If the commissioner determines that an association or a member

14-11  of the association has violated an order to cease and desist, the

14-12  commissioner may impose an administrative fine of not more than

14-13  $10,000 for each violation of the order, not to exceed an aggregate

14-14  amount of $100,000, or withdraw the certificate of the association, or

14-15  both.

14-16  Sec. 33.  1.  The commissioner may impose an administrative fine

14-17  for each violation of any provision of sections 2 to 42, inclusive, of this

14-18  act or any regulation adopted pursuant to those sections. Except as

14-19  otherwise provided in those sections, the amount of the fine may not

14-20  exceed $1,000 for each violation or an aggregate amount of $10,000.

14-21  2.  The commissioner may withdraw the certificate of an association

14-22  of self-insured private employers if:

14-23  (a) The certificate was obtained by fraud;

14-24  (b) The application for certification contained a material

14-25  misrepresentation;

14-26  (c) The association is found to be insolvent;

14-27  (d) The association fails to have five or more members;

14-28  (e) The association fails to pay the costs of any examination or any

14-29  penalty, fee or assessment required by the provisions of sections 2 to 42,

14-30  inclusive, of this act;

14-31  (f) The association fails to comply with any of the provisions of

14-32  sections 2 to 42, inclusive, of this act or any regulation adopted pursuant

14-33  to those sections;

14-34  (g) The association fails to comply with any order of the commissioner

14-35  within the time prescribed by the provisions of sections 2 to 42, inclusive,

14-36  of this act or in the order of the commissioner; or

14-37  (h) The association or its third-party administrator misappropriates,

14-38  converts, illegally withholds or refuses to pay any money to which a

14-39  person is entitled and that was entrusted to the association in its fiduciary

14-40  capacity.

14-41  3.  If the commissioner withdraws the certification of an association

14-42  of self-insured private employers, each employer who is a member of the

14-43  association remains liable for his obligations incurred before and after

14-44  the order of withdrawal.

14-45  Sec. 34.  1.  Before any action may be taken pursuant to subsection

14-46  2, the commissioner shall arrange an informal meeting with an

14-47  association of self-insured private employers to discuss and seek

14-48  correction of any conduct which would be grounds for withdrawal of the

14-49  certificate of the association.


15-1    2.  Except as otherwise provided in subsection 3, before the

15-2  commissioner may withdraw the certificate of any association of self-

15-3  insured private employers, the commissioner must give written notice to

15-4  the association by certified mail that its certificate will be withdrawn 10

15-5  days after receipt of the notice unless, within that time, the association

15-6  corrects the conduct set forth in the notice as the reason for the

15-7  withdrawal or submits a written request for a hearing to the

15-8  commissioner.

15-9    3.  The commissioner may grant additional time, not to exceed an

15-10  additional 120 days, before the withdrawal of the certificate of an

15-11  association if:

15-12  (a) The grounds for withdrawal of the certificate of the association

15-13  are based on paragraph (d) of subsection 2 of section 33 of this act; and

15-14  (b) The association is financially sound and capable of fulfilling its

15-15  commitments.

15-16  4.  If the association requests a hearing:

15-17  (a) The commissioner shall set a date for a hearing within 20 days

15-18  after receiving the request and give the association at least 10 business

15-19  days’ notice of the time and place of the hearing.

15-20  (b) A record of the hearing must be kept, but it need not be

15-21  transcribed unless requested by the association with the cost of

15-22  transcription to be charged to the association.

15-23  (c) Within 5 business days after the hearing, the commissioner shall

15-24  either affirm or disaffirm the withdrawal of the certificate of the

15-25  association and give the association written notice thereof by certified

15-26  mail. If withdrawal of certification is affirmed, the withdrawal becomes

15-27  effective 10 business days after the association receives notice of the

15-28  affirmance unless within that period the association corrects the conduct

15-29  which was grounds for the withdrawal or petitions for judicial review of

15-30  the affirmance.

15-31  5.  If the withdrawal of certification is affirmed following judicial

15-32  review, the withdrawal becomes effective 5 days after entry of the final

15-33  decree of affirmance.

15-34  Sec. 35.  1.  If for any reason the status of an association of self-

15-35  insured private employers as an association of self-insured employers is

15-36  terminated, the security deposited pursuant to section 9 of this act must

15-37  remain on deposit for at least 36 months in such an amount as is

15-38  necessary to secure the outstanding and contingent liability arising from

15-39  the provision of health coverage secured by the security.

15-40  2.  At the expiration of the 36-month period, or such other period as

15-41  the commissioner deems proper, the commissioner may accept in lieu of

15-42  any security so deposited a policy of paid-up insurance in a form

15-43  approved by the commissioner.

15-44  Sec. 36.  Any association of self-insured private employers that is

15-45  aggrieved by a decision of the commissioner may petition for judicial

15-46  review in the manner provided by chapter 233B of NRS.

15-47  Sec. 37.  1.  For the purposes of sections 2 to 42, inclusive, of this

15-48  act, an association of self-insured private employers is insolvent if it is


16-1  unable to pay its outstanding obligations as they mature in the regular

16-2  course of its business.

16-3    2.  If an association of self-insured private employers becomes

16-4  insolvent, institutes any voluntary proceeding pursuant to the Federal

16-5  Bankruptcy Act, 11 U.S.C. §§ 101 et seq., or is named in any voluntary

16-6  proceeding thereunder, makes a general or special assignment for the

16-7  benefit of creditors or fails to pay obligations pursuant to sections 2 to

16-8  42, inclusive, of this act after an order for the payment of any claim

16-9  becomes final, the commissioner may, after giving at least 10 days’ notice

16-10  to the association and any insurer or guarantor, use money or interest on

16-11  securities, sell securities or institute legal proceedings on surety bonds

16-12  deposited with the commissioner to the extent necessary to make those

16-13  payments.

16-14  3.  A licensed surety providing a surety bond pursuant to section 9 of

16-15  this act may terminate liability on its surety bond by giving the

16-16  commissioner and the association, association’s administrator or third-

16-17  party administrator 90 days’ written notice. The termination does not

16-18  limit liability that was incurred under the surety bond before the

16-19  termination. If the association fails to requalify as an association of self-

16-20  insured private employers on or before the termination date, the

16-21  association’s certificate is withdrawn when the termination becomes

16-22  effective.

16-23  Sec. 38.  1.  The commissioner may assess all associations of self-

16-24  insured private employers to provide for claims against any insolvent

16-25  association.

16-26  2.  All money received from such assessments must be deposited with

16-27  the state treasurer to the credit of the account for insolvent associations

16-28  of self-insured private employers, which is hereby created in the fund for

16-29  self-insured providers of health coverage, which is hereby created in the

16-30  state treasury as a special revenue fund. Money in the account must be

16-31  used solely to carry out the provisions of this section. All claims against

16-32  the account must be paid as other claims against the state are paid. The

16-33  state treasurer shall invest money in the account in the same manner and

16-34  in the same securities in which he may invest money in the state general

16-35  fund. Income realized from the investment of the money in the account

16-36  must be credited to the account.

16-37  Sec. 39.  The commissioner may adopt such regulations as are

16-38  necessary to carry out the provisions of sections 2 to 42, inclusive, of this

16-39  act.

16-40  Sec. 40.  1.  An association of self-insured private employers may

16-41  enter into a contract to have its plan of health coverage administered by a

16-42  third-party administrator.

16-43  2.  An association shall not enter into a contract with any person for

16-44  the administration of any part of the plan of health coverage unless that

16-45  person maintains an office in this state and has a valid certificate issued

16-46  by the commissioner pursuant to NRS 683A.085.

16-47  Sec. 41.  1.  A person shall not act as a third-party administrator for

16-48  an association of self-insured private employers pursuant to sections 2 to


17-1  42, inclusive, of this act without first obtaining a certificate issued by the

17-2  commissioner pursuant to NRS 683A.085.

17-3    2.  A person who acts as a third-party administrator pursuant to

17-4  sections 2 to 42, inclusive, of this act shall:

17-5    (a) Administer from one or more offices located in this state all the

17-6  claims arising under each plan of health coverage that he administers

17-7  and maintain in those offices all the records concerning those claims;

17-8    (b) Administer each plan of health coverage directly, without

17-9  subcontracting with another third-party administrator; and

17-10  (c) Upon the termination of his contract with an association, transfer

17-11  forthwith to a certified third-party administrator chosen by the

17-12  association all the records in his possession concerning claims arising

17-13  under the plan of health coverage.

17-14  3.  The commissioner may, under exceptional circumstances, waive

17-15  the requirements of subsection 2.

17-16  Sec. 42.  The commissioner shall impose an administrative fine of

17-17  not more than $1,000 against a third-party administrator for each

17-18  violation and may withdraw the certification of a third-party

17-19  administrator who:

17-20  1.  Fails to comply with any regulation adopted by the commissioner

17-21  regarding reports or other requirements necessary to carry out the

17-22  purposes of sections 2 to 42, inclusive, of this act; or

17-23  2.  Violates any provision of section 41 of this act or any regulation

17-24  adopted by the commissioner concerning the administration of the plan

17-25  of health coverage.

17-26  Sec. 43.  NRS 689C.015 is hereby amended to read as follows:

17-27  689C.015  Except as otherwise provided in [this chapter,] NRS

17-28  689C.015 to 689C.980, inclusive, as used in [this chapter,] NRS 689C.015

17-29  to 689C.980, inclusive, unless the context otherwise requires, the words

17-30  and terms defined in NRS 689C.017 to 689C.106, inclusive, have the

17-31  meanings ascribed to them in those sections.

17-32  Sec. 44.  The amendatory provisions of this act do not apply to

17-33  offenses committed before July 1, 2001.

17-34  Sec. 45.  This act becomes effective on July 1, 2001.

 

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