1. As used in NRS 687B.470 to 687B.500, inclusive, "health benefit plan" means a policy, contract, certificate or agreement offered by a carrier to provide for, deliver payment for, arrange for the payment of, pay for or reimburse any of the costs of health care services. Except as otherwise provided in this section, the term includes catastrophic health insurance policies and a policy that pays on a cost-incurred basis.
2. The term does not include:
(a) Coverage that is only for accident or disability income insurance, or any combination thereof;
(b) Coverage issued as a supplement to liability insurance;
(c) Liability insurance, including general liability insurance and automobile liability insurance;
(d) Workers’ compensation or similar insurance;
(e) Coverage for medical payments under a policy of automobile insurance;
(f) Credit insurance;
(g) Coverage for on-site medical clinics;
(h) Other similar insurance coverage specified pursuant to the Health Insurance Portability and Accountability Act of 1996, Public Law 104-191, under which benefits for medical care are secondary or incidental to other insurance benefits;
(i) Coverage under a short-term health insurance policy which is:
(1) Issued to provide coverage that does not result in an individual being covered by one or more short-term health insurance policies for more than 185 days in a 365-day period, but such coverage may be extended to provide coverage until the end of a period of hospitalization for a condition which the person covered by the policy is hospitalized on the day coverage would have otherwise ended; and
(2) Nonrenewable or is extended to provide coverage for the period of hospitalization; and
(j) Coverage under a blanket student accident and health insurance policy.
3. The term does not include the following benefits if the benefits are provided under a separate policy, certificate or contract of insurance or are otherwise not an integral part of a health benefit plan:
(a) Limited-scope dental or vision benefits;
(b) Benefits for long-term care, nursing home care, home health care or community-based care, or any combination thereof; and
(c) Such other similar benefits as are specified in any federal regulations adopted pursuant to the Health Insurance Portability and Accountability Act of 1996, Public Law 104-191.
4. The term does not include the following benefits if the benefits are provided under a separate policy, certificate or contract, there is no coordination between the provisions of the benefits and any exclusion of benefits under any group health plan maintained by the same plan sponsor, and the benefits are paid for a claim without regard to whether benefits are provided for such a claim under any group health plan maintained by the same plan sponsor:
(a) Coverage that is only for a specified disease or illness; and
(b) Hospital indemnity or other fixed indemnity insurance.
5. The term does not include any of the following, if offered as a separate policy, certificate or contract of insurance:
(a) Medicare supplemental health insurance as defined in section 1882(g)(1) of the Social Security Act, 42 U.S.C. § 1395ss, as that section existed on July 16, 1997;
(b) Coverage supplemental to the coverage provided pursuant to the Civilian Health and Medical Program of Uniformed Services, TRICARE, 10 U.S.C. §§ 1071 et seq.; and
(c) Similar supplemental coverage provided under a group health plan.
(Added to NRS by 2013, 3606; A 2017, 2354; 2019, 1427)
Structure Nevada Revised Statutes
Chapter 687B - Contracts of Insurance
NRS 687B.015 - "Binder" defined.
NRS 687B.030 - Waiver of payment of premium.
NRS 687B.040 - Insurable interest: Personal insurance.
NRS 687B.050 - Insurable interest: Exception when certain institutions designated beneficiary.
NRS 687B.060 - Insurable interest: Property.
NRS 687B.070 - Power to contract; purchase of insurance and annuities by minors.
NRS 687B.090 - Alteration of application: Life and health insurance.
NRS 687B.100 - Application as evidence.
NRS 687B.110 - Representations in applications.
NRS 687B.122 - Readability of policies: Applicability of requirements.
NRS 687B.128 - Readability of policies: Required approval by Commissioner in certain circumstances.
NRS 687B.130 - Grounds for disapproval or withdrawal of previous approval.
NRS 687B.140 - Standard provisions.
NRS 687B.160 - Execution of policies.
NRS 687B.170 - Underwriters’ and combination policies.
NRS 687B.180 - Validity and construction of noncomplying forms.
NRS 687B.182 - Binders: Issuance; period of effectiveness.
NRS 687B.183 - Binders: Forms; required statement related to certain policies; delivery of copies.
NRS 687B.185 - Binders: Prohibition of use to lower premiums.
NRS 687B.186 - Binders: Proof of insurance coverage; penalties for refusal to accept; exception.
NRS 687B.187 - Binders: Disapproval of insurer.
NRS 687B.200 - Assignability: Life or health insurance policy.
NRS 687B.220 - Forms for proof of loss required to be furnished by insurer to insured claimant.
NRS 687B.240 - Administration of claims not waiver.
NRS 687B.250 - Payment not to constitute admission of liability or waiver of defenses.
NRS 687B.255 - Insurer required to pay claim with negotiable instrument.
NRS 687B.260 - Exemption of proceeds of certain policies.
NRS 687B.270 - Exemption of proceeds: Health insurance.
NRS 687B.280 - Exemption of proceeds: Group insurance.
NRS 687B.290 - Exemption of proceeds: Annuities; assignability of rights.
NRS 687B.300 - Retention of proceeds of policy by insurer.
NRS 687B.310 - Cancellations and nonrenewals; scope of application.
NRS 687B.330 - Anniversary cancellation.
NRS 687B.345 - Annual review of coverage and benefits provided in policy.
NRS 687B.470 - "Health benefit plan" defined.
NRS 687B.500 - Basis for premium rate; exceptions.
NRS 687B.602 - "Administrator" defined.
NRS 687B.605 - "Covered person" defined.
NRS 687B.606 - "Dental care" defined.
NRS 687B.607 - "Direct notification" defined.
NRS 687B.610 - "Evidence of coverage" defined.
NRS 687B.615 - "Health benefit plan" defined.
NRS 687B.620 - "Health care services" defined.
NRS 687B.625 - "Health carrier" defined.
NRS 687B.630 - "Intermediary" defined.
NRS 687B.635 - "Medically necessary" defined.
NRS 687B.640 - "Network" defined.
NRS 687B.645 - "Network plan" defined.
NRS 687B.650 - "Participating provider of health care" defined.
NRS 687B.655 - "Primary care physician" defined.
NRS 687B.658 - "Provider network contract" defined.
NRS 687B.660 - "Provider of health care" defined.
NRS 687B.664 - "Third party" defined.
NRS 687B.665 - "Utilization review" defined.
NRS 687B.670 - Requirements to offer or issue network plan.
NRS 687B.675 - Provision of information to Office for Consumer Health Assistance.
NRS 687B.740 - Inducement to provide less than medically necessary health care services prohibited.
NRS 687B.760 - Health records; confidentiality.
NRS 687B.800 - Retaliation for good faith reporting to state or federal authority prohibited.
NRS 687B.820 - Procedures for resolution of disputes.
NRS 687B.862 - "Attachment point" defined.
NRS 687B.864 - "Group health plan" defined.
NRS 687B.866 - "Health care services" defined.
NRS 687B.868 - "Multiple employer welfare arrangement" defined.
NRS 687B.870 - "Network" defined.
NRS 687B.872 - "Policy of provider stop-loss insurance" defined.
NRS 687B.874 - "Policy of stop-loss insurance" defined.
NRS 687B.876 - "Provider of health care" defined.
NRS 687B.878 - Reporting of premiums written in this State for policies of stop-loss insurance.