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Nevada Chapter 695B — Nonprofit Corporations for Hospital, Medical and Dental Service

126 sections hosted, reproduced from the official public-domain source.

  • NRS 695B.010— Short title
  • NRS 695B.020— Scope
  • NRS 695B.030— Definitions
  • NRS 695B.035— Contract between corporation and provider of health care: Prohibiting corporation from charging provider of health care fee for inclusion on list of providers given to insureds; corporation required to use form to obtain information on provider of health care; modification; submission by corporation of schedule of payments to provider
  • NRS 695B.040— Corporations authorized to undertake and operate plans
  • NRS 695B.050— Manner of incorporation
  • NRS 695B.060— Directors: Qualifications
  • NRS 695B.070— Merger and consolidation: Procedure
  • NRS 695B.080— Merger and consolidation: Continuance of contracts and contribution certificates
  • NRS 695B.090— Merger and consolidation: Withdrawal of prior deposit of securities
  • NRS 695B.110— Certificate of authority: Required; fees
  • NRS 695B.120— Certificate of authority: Qualifications
  • NRS 695B.130— Certificate of authority: Application; issuance
  • NRS 695B.135— Certificate of authority: Expiration; renewal
  • NRS 695B.140— Reserve fund: Minimum amounts; computation; contracts with hospitals; participation of physicians or dentists
  • NRS 695B.150— Insolvency; determination of financial condition; actions by Commissioner; review; regulations
  • NRS 695B.160— Annual statement of condition and affairs; annual financial statement; quarterly statement; fees; examination by Commissioner
  • NRS 695B.165— Annual statement required to include report of net worth
  • NRS 695B.170— Acquisition costs and administrative expenses; effect of finding of excess costs
  • NRS 695B.176— Contract covering prescription drugs: Provision of notice and information regarding use of formulary
  • NRS 695B.180— Required provisions
  • NRS 695B.181— Provision in contract requiring binding arbitration authorized; procedures for arbitration; declaratory relief
  • NRS 695B.182— Required procedure for arbitration of disputes concerning independent medical, dental or chiropractic evaluations
  • NRS 695B.183— Insurer required to offer and issue plan regardless of health status of persons; prohibited acts; authority to include wellness program in plan that offers discounts based on health status under certain circumstances
  • NRS 695B.185— Group contract which offers difference of payment between preferred providers of health care and providers who are not preferred: Limitations on deductibles and copayments; circumstances in which service is deemed to be provided by preferred provider; processing of claims of providers who are not preferred
  • NRS 695B.187— Group contract issued to replace discontinued policy or coverage: Requirements; notice of reduction of benefits; statement of benefits; applicability to self-insured employer
  • NRS 695B.189— Group contract: Required provision permitting continuation of coverage
  • NRS 695B.190— Family contracts
  • NRS 695B.191— Required provision in policy covering mastectomies concerning coverage relating to mastectomy; prohibited acts
  • NRS 695B.192— Contract containing exclusion, reduction or limitation of coverage relating to complications of pregnancy prohibited; exception
  • NRS 695B.193— Contract covering family member of subscriber required to include certain coverage for subscriber’s newly born and adopted children and children placed with subscriber for adoption
  • NRS 695B.196— Reimbursement for acupuncture
  • NRS 695B.197— Reimbursement for treatment by licensed psychologist
  • NRS 695B.198— Reimbursement for treatment by chiropractic physician
  • NRS 695B.199— Reimbursement for services provided by certain nurses
  • NRS 695B.200— Group contracts written under master contract: Conditions required for issuance
  • NRS 695B.210— Group master service contract: Required provisions
  • NRS 695B.220— Blanket service contracts: Issuance to college, school or school personnel; pupils not to be compelled to accept service
  • NRS 695B.225— Policies of group insurance: Order of benefits
  • NRS 695B.230— Filing and approval of forms and schedules of premium rates
  • NRS 695B.240— Provision of group service coverage before approval of forms
  • NRS 695B.250— Extensions of time; automatic approval
  • NRS 695B.251— Group subscriber contracts required to contain provision for conversion to individual contracts; exceptions
  • NRS 695B.252— Conversion privilege available to spouse and children; conditions
  • NRS 695B.253— Denial of converted contract because of overinsurance; notice concerning cancellation of other coverage
  • NRS 695B.254— Choice of types of contracts required to be offered
  • NRS 695B.255— Benefits exceeding those provided under group contract not required; exclusions and limitations
  • NRS 695B.256— Issuance and effective date of converted contract; premiums; persons covered
  • NRS 695B.257— Notice of conversion privilege
  • NRS 695B.258— Extension of coverage under existing group contract
  • NRS 695B.259— Continuation of identical coverage in lieu of converted contract
  • NRS 695B.260— Suspension or revocation of permission to provide coverage before approval of forms
  • NRS 695B.270— Disapproval of forms; issuance unlawful
  • NRS 695B.280— Regulations; limitations
  • NRS 695B.285— Use of Uniform Billing and Claims Forms authorized
  • NRS 695B.290— Agent’s license required
  • NRS 695B.300— Contracts with agencies or political subdivisions of United States or State of Nevada; acceptance of money; subcontracts
  • NRS 695B.310— Corporation subject to same taxes, licenses, fees and supervision as domestic mutual insurer
  • NRS 695B.315— Provision of information regarding claims by policyholder for renewal of insurance policy required upon request; fee; regulations
  • NRS 695B.316— Corporation prohibited from denying coverage solely because claim involves act that constitutes domestic violence or applicant or insured was victim of domestic violence
  • NRS 695B.317— Corporation that provides health insurance prohibited from requiring or using information concerning genetic testing; exceptions
  • NRS 695B.318— Applicability of certain provisions concerning portability and availability of health insurance
  • NRS 695B.319— Offering policy of health insurance for purposes of establishing health savings account
  • NRS 695B.320— Applicability of other provisions
  • NRS 695B.330— Definitions
  • NRS 695B.340— Effect of eligibility for medical assistance under Medicaid; assignment of rights to state agency
  • NRS 695B.350— Corporation prohibited from asserting certain grounds to deny enrollment of child of insured pursuant to order
  • NRS 695B.360— Certain accommodations required to be made when child is covered under policy of noncustodial parent
  • NRS 695B.370— Corporation required to authorize enrollment of child of parent who is required by order to provide medical coverage under certain circumstances; termination of coverage of child
  • NRS 695B.380— Establishment; approval; requirements; examination
  • NRS 695B.390— Annual report; insurer required to maintain records of complaints concerning something other than health care services
  • NRS 695B.400— Written notice to insured required to be provided by insurer explaining right to file complaint; written notice to insured required when insurer denies coverage of health care service
  • NRS 695B.1901— Required provision in certain policies concerning coverage for continued medical treatment; exceptions; regulations
  • NRS 695B.1903— Required provision concerning coverage for certain treatment as part of clinical trial or study for treatment of cancer or chronic fatigue syndrome; authority of corporation to require certain information; immunity from liability
  • NRS 695B.1904— Required provision concerning coverage for services provided through telehealth to same extent as though provided in person or by other means; required provision concerning reimbursement for certain services provided through telehealth in same amount as though provided in person or by other means; prohibited acts
  • NRS 695B.1905— Contract covering prescription drugs prohibited from limiting or excluding coverage for certain prescription drugs previously approved for medical condition of insured; exceptions
  • NRS 695B.1906— Required provision in policy covering prescription drugs concerning coverage for prescription drugs irregularly dispensed for purpose of synchronization of chronic medications; prohibited acts; exception
  • NRS 695B.1907— Required provision in policy covering treatment of colorectal cancer concerning coverage for colorectal cancer screening
  • NRS 695B.1908— Required provision in certain contracts concerning coverage for certain drugs and related services for treatment of cancer
  • NRS 695B.1909— Contract covering treatment of cancer through use of chemotherapy: Prohibited acts related to orally administered chemotherapy
  • NRS 695B.1911— Required provision concerning coverage for screening, genetic counseling and testing related to BRCA gene in certain circumstances
  • NRS 695B.1912— Required provision concerning coverage for certain screenings and tests for breast cancer; prohibited acts
  • NRS 695B.1913— Required provision concerning coverage for examination of person who is pregnant for certain diseases
  • NRS 695B.1914— Required provision concerning coverage of certain gynecological and obstetrical services without authorization or referral from primary care physician; designation of obstetrician or gynecologist as primary care provider
  • NRS 695B.1915— Required provision concerning coverage for medically necessary treatment of conditions relating to gender dysphoria and gender incongruence; restriction on refusal to cover certain treatments; authority of corporation to prescribe requirements for covering surgical treatments for minors; determination of medical necessity
  • NRS 695B.1916— Required provision in contract covering prescription drugs or devices concerning coverage of hormone replacement therapy in certain circumstances; prohibited acts; exception
  • NRS 695B.1918— Required provision in contract covering outpatient care concerning coverage of health care services related to hormone replacement therapy; prohibited acts
  • NRS 695B.1919— Required provision concerning coverage for drug or device for contraception and related health services; prohibited acts; exceptions
  • NRS 695B.1923— Required provision concerning coverage for treatment of certain inherited metabolic diseases
  • NRS 695B.1924— Required provision concerning coverage for drugs, laboratory testing and certain services related to human immunodeficiency virus and hepatitis C; reimbursement of certain providers of health care for certain services; prohibited acts
  • NRS 695B.1925— Required provision concerning coverage for certain tests and vaccines relating to human papillomavirus; prohibited acts
  • NRS 695B.1926— Required provision concerning coverage for testing, treatment and prevention of sexually transmitted diseases; required provision concerning coverage for condoms for certain insureds
  • NRS 695B.1927— Required provision in contract covering hospital, medical or surgical expenses concerning coverage for management and treatment of diabetes
  • NRS 695B.1929— Required provision of coverage for management and treatment of sickle cell disease and its variants; policy covering prescription drugs required to provide coverage for medically necessary prescription drugs to treat sickle cell disease and its variants
  • NRS 695B.1931— Contract prohibited from excluding coverage relating to treatment of temporomandibular joint; exception
  • NRS 695B.1932— Policy covering prescription drugs: Denial of coverage prohibited for early refills of otherwise covered topical ophthalmic products
  • NRS 695B.1942— Required provision in contract covering treatment of prostate cancer concerning coverage for prostate cancer screening; prohibited act
  • NRS 695B.1944— Required provision in certain group contracts concerning continuing coverage for employee or member on leave without pay as result of total disability
  • NRS 695B.1948— Contract covering maternity care: Prohibited acts by insurer if insured is acting as gestational carrier; child deemed child of intended parent for purposes of contract
  • NRS 695B.1949— Contract covering anatomical gifts, organ transplants or treatments or services related to organ transplants: Prohibited acts by insurer if insured is person with disability
  • NRS 695B.1951— Reimbursement for treatment by podiatrist
  • NRS 695B.1955— Reimbursement for treatment by licensed clinical alcohol and drug counselor
  • NRS 695B.1973— Reimbursement for treatment by licensed marriage and family therapist or licensed clinical professional counselor
  • NRS 695B.1975— Reimbursement for treatment by licensed associate in social work, social worker, master social worker, independent social worker or clinical social worker
  • NRS 695B.1995— Reimbursement to provider of medical transportation
  • NRS 695B.1997— Assignment of benefits by insured to provider of health care
  • NRS 695B.2505— Approval or denial of claims; payment of claims and interest; requests for additional information; award of costs and attorney’s fees; compliance with requirements; imposition of administrative fine or suspension or revocation of certificate of authority for failure to comply; report of compliance by corporation
  • NRS 695B.2555— Benefits payable under converted contract authorized to be reduced by amount payable under group contract; limitation
  • NRS 695B.2565— Renewal of converted contract: Request for information on sources of other benefits; grounds for refusal to renew; notice concerning cancellation of other coverage
  • NRS 695B.2575— Converted contract delivered outside Nevada: Form
  • NRS 695B.2585— Provision of group coverage in lieu of converted individual contract
  • NRS 695B.3165— Corporation prohibited from denying coverage solely because applicant or insured was intoxicated or under the influence of controlled substance; exceptions
  • NRS 695B.3167— Corporation prohibited from discriminating against person with respect to participation or coverage on basis of gender identity or expression
  • NRS 695B.19045— Policy covering prescription drugs: Required actions by corporation related to acquisition of prescription drugs for certain insureds residing in area for which emergency or disaster has been declared
  • NRS 695B.19046— Policy covering prescription drugs: Submission to step therapy protocol for drug to treat psychiatric condition prohibited in certain circumstances
  • NRS 695B.19047— Policy covering prescription drug for medical condition that is part of step therapy protocol: Use of certain guidelines required; establishment of process to request exemption from step therapy protocol required; granting of request; applicability of provisions
  • NRS 695B.19055— Limitation on cost-sharing obligation for insulin covered under policy covering prescription insulin drugs prohibited from imposing certain cost-sharing obligations
  • NRS 695B.19065— Required provision concerning coverage for screening for lung cancer in policy that provides coverage for treatment of lung cancer
  • NRS 695B.19085— Policy covering prescription drug for treatment of cancer or cancer symptom that is part of step therapy protocol: Corporation required to allow insured or attending practitioner to apply exemption from step therapy protocol in certain circumstances; procedure for applying for and granting exemption
  • NRS 695B.19087— Required provision concerning coverage for biomarker testing for diagnosis, treatment, management and monitoring of cancer in certain circumstances; establishment of process to request exception or appeal denial of coverage; time for responding to request for prior authorization
  • NRS 695B.19155— Required provision concerning coverage for habilitative speech-language pathology and rehabilitative speech-language pathology as treatment for stuttering for certain persons; prohibited acts
  • NRS 695B.19192— Required provision concerning coverage for procedure or service for preservation of fertility in certain circumstances; exemption. [Effective January 1, 2027.]
  • NRS 695B.19195— Required provision concerning coverage for certain services, screenings and tests relating to wellness; prohibited acts
  • NRS 695B.19197— Required provision concerning coverage for certain drugs and services related to substance use disorder and opioid use disorder; reimbursement of pharmacists and pharmacies for certain services; prohibited acts
  • NRS 695B.19199— Required provision concerning coverage for noninvasive prenatal screening
  • NRS 695B.19305— Required provision concerning coverage for dental service provided by qualified dental hygienist in certain circumstances