1. The Commissioner shall perform an actuarial review of and consider each rate filing of a health plan issued pursuant to the provisions of chapter 689A, 689B, 689C, 695B, 695C, 695D or 695F of NRS, including, without limitation, long-term care and Medicare supplement plans, filed with the Commissioner pursuant to subsection 1 of NRS 686B.070. If the Commissioner finds that a proposed rate which is contained in a rate filing will result in a rate which is not in compliance with NRS 686B.050 or subsection 3 of NRS 686B.070, the Commissioner shall disapprove the rate filing. The Commissioner shall approve or disapprove each rate filing not later than 60 days after the rate filing is determined by the Commissioner to be complete pursuant to subsection 4. If the Commissioner fails to approve or disapprove the rate filing within that period, the rate filing shall be deemed approved.
2. Whenever an insurer has no legally effective rates as a result of the Commissioner’s disapproval of rates or other act, the Commissioner shall on request specify interim rates for the insurer that are high enough to protect the interests of all parties and may order that a specified portion of the premiums be placed in an escrow account approved by the Commissioner. When new rates become legally effective, the Commissioner shall order the escrowed funds or any overcharge in the interim rates to be distributed appropriately, except that refunds to policyholders that are de minimis must not be required.
3. If the Commissioner disapproves a rate filing pursuant to subsection 1, and an insurer requests a hearing to determine the validity of the action of the Commissioner, the insurer has the burden of showing compliance with the applicable standards for rates established in NRS 686B.010 to 686B.1799, inclusive. Any such hearing must be held:
(a) Within 30 days after the request for a hearing has been submitted to the Commissioner; or
(b) Within a period agreed upon by the insurer and the Commissioner.
If the hearing is not held within the period specified in paragraph (a) or (b), or if the Commissioner fails to issue an order concerning the rate filing for which the hearing is held within 45 days after the hearing, the rate filing shall be deemed approved.
4. The Commissioner shall by regulation specify the documents or any other information which must be included in a rate filing submitted to the Commissioner pursuant to subsection 1. Each such rate filing shall be deemed complete upon its filing with the Commissioner, unless the Commissioner, within 15 business days after the rate filing is filed with the Commissioner, determines that the rate filing is incomplete because the rate filing does not comply with the regulations adopted by the Commissioner pursuant to this subsection.
5. The Commissioner may assess against an insurer the actual cost for the external actuarial review of a rate filing submitted pursuant to subsection 1.
(Added to NRS by 2017, 2343; A 2019, 1437, 1704)
Structure Nevada Revised Statutes
Chapter 686B - Rates and Essential Insurance
NRS 686B.010 - Construction and purposes.
NRS 686B.060 - Determination of whether rates comply with standards.
NRS 686B.080 - Filing and supporting information open to public inspection; copies; exceptions.
NRS 686B.100 - Filing of supporting data.
NRS 686B.115 - Hearing on rates open to public; cost for transcripts; public testimony.
NRS 686B.117 - Intervention in hearing on rates.
NRS 686B.125 - Limitation on rates for coverage for dental care; exception.
NRS 686B.150 - Binding agreements by insurers relating to rates and rules.
NRS 686B.170 - Examination of service organizations by Commissioner.
NRS 686B.1752 - "Advisory Organization" defined.
NRS 686B.1753 - "Basic premium rate" defined.
NRS 686B.1754 - "Classification of risks" defined.
NRS 686B.1755 - "Expenses" defined.
NRS 686B.1757 - "Industrial insurance" defined.
NRS 686B.1759 - "Insurer" defined.
NRS 686B.17595 - "Large-deductible agreement" defined.
NRS 686B.176 - "Plan for rating experience" defined.
NRS 686B.17605 - "Prospective loss cost" defined.
NRS 686B.1761 - "Rate" defined.
NRS 686B.1762 - "Willful" defined.
NRS 686B.1763 - Applicability of provisions; Commissioner required to administer provisions.
NRS 686B.1764 - Designation as statistical agent; duties.
NRS 686B.1767 - Prohibited acts by advisory organization.
NRS 686B.1769 - Uniform Plan for Rating Experience: Requirements; use.
NRS 686B.177 - Rating information to be filed with Commissioner; approval of rates.
NRS 686B.1779 - Disapproval of rates: Authority of Commissioner; required grounds.
NRS 686B.1785 - Request for reconsideration of rates by Advisory Organization or insurer; appeal.
NRS 686B.1786 - Large-deductible agreements: Applicability.
NRS 686B.1789 - Provisions governing hearing.
NRS 686B.179 - Revocation or suspension of license.
NRS 686B.180 - Unavailability of essential coverage; plans for providing coverage; regulations.
NRS 686B.185 - Immunity of Commissioner and association.
NRS 686B.200 - Voluntary plan for sharing risks: Submission to and approval by Commissioner.
NRS 686B.230 - Nevada Essential Insurance Association: General powers.
NRS 686B.240 - Nevada Essential Insurance Association: Powers of Commissioner and Association.
NRS 686B.250 - Nevada Essential Insurance Association: Immunity from liability.
NRS 686B.260 - Conversion into domestic stock insurer: "Insured" defined.
NRS 686B.290 - Conversion into domestic stock insurer: Notice to insurers and insureds; hearing.
NRS 686B.310 - Conversion into domestic stock insurer: Capitalization.
NRS 686B.320 - Conversion into domestic stock insurer: Issuance of certificate of authority.