Nevada Revised Statutes
Chapter 689A - Individual Health Insurance
NRS 689A.040 - Contents of policy; substitution of provisions; captions; omission or modification of provisions.

1. Except as otherwise provided in subsection 2, each such policy delivered or issued for delivery to any person in this State must contain the provisions specified in NRS 689A.050 to 689A.170, inclusive, in the words in which the provisions appear, except that the insurer may, at its option, substitute for one or more of the provisions corresponding provisions of different wording approved by the Commissioner which are in each instance not less favorable in any respect to the insured or the beneficiary. Each such provision must be preceded individually by the applicable caption shown or, at the option of the insurer, by such appropriate individual or group captions or subcaptions as the Commissioner may approve.
2. If any such provision is in whole or in part inapplicable to or inconsistent with the coverage provided by a particular form of policy, the insurer, with the approval of the Commissioner, may omit from the policy any inapplicable provision or part of a provision, and shall modify any inconsistent provision or part of a provision in such a manner as to make the provision as contained in the policy consistent with the coverage provided by the policy.
(Added to NRS by 1971, 1753; A 1973, 547; 1985, 1059; 2007, 3237; 2013, 3610; 2019, 1429)

Structure Nevada Revised Statutes

Nevada Revised Statutes

Chapter 689A - Individual Health Insurance

NRS 689A.010 - Short title.

NRS 689A.020 - Scope.

NRS 689A.030 - General requirements.

NRS 689A.032 - Insurer required to offer and issue plan regardless of health status of persons; prohibited acts.

NRS 689A.035 - Contracts between insurer and provider of health care: Prohibiting insurer from charging provider of health care fee for inclusion on list of providers given to insureds; insurer required to use form to obtain information on provider o...

NRS 689A.040 - Contents of policy; substitution of provisions; captions; omission or modification of provisions.

NRS 689A.0403 - Procedure for arbitration of disputes concerning independent medical, dental or chiropractic evaluations. [Effective through December 31, 2021.] Procedure for arbitration of disputes concerning independent medical, dental or chiroprac...

NRS 689A.04033 - Coverage for certain treatment received as part of clinical trial or study for treatment of cancer or chronic fatigue syndrome required; authority of insurer to require certain information; immunity from liability.

NRS 689A.04036 - Coverage for continued medical treatment required in certain policies; exceptions; regulations.

NRS 689A.0404 - Coverage for use of certain drugs and related services for treatment of cancer required in certain policies.

NRS 689A.04041 - Policy covering prescription drug for treatment of cancer or cancer symptom that is part of step therapy protocol: Insurer required to allow insured or attending practitioner to apply for exemption from step therapy protocol in certa...

NRS 689A.04042 - Coverage for colorectal cancer screening required in policy covering treatment of colorectal cancer.

NRS 689A.04044 - Policy covering prescription drugs: Required actions by insurer related to acquisition of prescription drugs for certain insureds residing in area for which emergency or disaster has been declared.

NRS 689A.04045 - Policy covering prescription drugs prohibited from limiting or excluding coverage for prescription drug previously approved for medical condition of insured; exception.

NRS 689A.04046 - Coverage for prescription drugs irregularly dispensed for purpose of synchronization of chronic medications required in policy covering prescription drugs; prohibited acts; exception.

NRS 689A.04047 - Policy covering prescription drugs: Denial of coverage prohibited for early refills of otherwise covered topical ophthalmic products.

NRS 689A.04049 - Coverage for screening, genetic counseling and testing related to BRCA gene required in certain circumstances. [Effective January 1, 2022.]

NRS 689A.0405 - Coverage for mammograms for certain women required; prohibited acts.

NRS 689A.041 - Coverage relating to mastectomy required in policy covering mastectomies; prohibited acts.

NRS 689A.0412 - Coverage for examination of person who is pregnant for certain diseases required.

NRS 689A.0413 - Coverage for certain gynecological or obstetrical services without authorization or referral from primary care physician required.

NRS 689A.0415 - Coverage for hormone replacement therapy in certain circumstances required in policy covering prescription drugs or devices; prohibited acts; exception.

NRS 689A.0417 - Coverage for health care services related to hormone replacement therapy required in policy covering outpatient care; prohibited acts.

NRS 689A.0418 - Coverage for drug or device for contraception and related health services required; prohibited acts; exceptions. [Effective through December 31, 2021.] Coverage for drug or device for contraception and related health services required...

NRS 689A.0419 - Coverage for certain services, screenings and tests relating to wellness required; prohibited acts.

NRS 689A.042 - Policy containing exclusion, reduction or limitation of coverage relating to complications of pregnancy prohibited; exception.

NRS 689A.0423 - Coverage for treatment of certain inherited metabolic diseases required.

NRS 689A.0424 - Policy covering maternity care: Prohibited acts by insurer if insured is acting as gestational carrier; child deemed child of intended parent for purposes of policy.

NRS 689A.0425 - Individual health benefit plan that includes coverage for maternity care and pediatric care: Requirement to allow minimum stay in hospital in connection with childbirth; prohibited acts.

NRS 689A.0427 - Coverage for management and treatment of diabetes required in policy covering hospital, medical or surgical expenses.

NRS 689A.0428 - Coverage for management and treatment of sickle cell disease and its variants required; coverage for medically necessary prescription drugs to treat sickle cell disease and its variants required by plan covering prescription drugs.

NRS 689A.043 - Policy covering family on expense-incurred basis required to include certain coverage for insured’s newly born and adopted children and children placed with insured for adoption.

NRS 689A.0435 - Option of coverage for autism spectrum disorders for certain persons required; prohibited acts.

NRS 689A.0437 - Coverage for drugs, laboratory testing and certain services related to human immunodeficiency virus required; reimbursement of pharmacist for certain services.

NRS 689A.044 - Coverage for certain tests and vaccines relating to human papillomavirus required; prohibited acts.

NRS 689A.0445 - Coverage for prostate cancer screening.

NRS 689A.0447 - Policy covering treatment of cancer through use of chemotherapy: Prohibited acts related to orally administered chemotherapy.

NRS 689A.0455 - Coverage for treatment of conditions relating to severe mental illness required.

NRS 689A.046 - Benefits for treatment of alcohol or substance use disorder required.

NRS 689A.0463 - Coverage for services provided through telehealth required to same extent and in same amount as though provided in person or by other means; exception; prohibited acts. [Effective through 1 year after the date on which the Governor te...

NRS 689A.0464 - Policy covering anatomical gifts, organ transplants or treatments or services related to organ transplants: Prohibited acts by insurer if insured is person with disability.

NRS 689A.0465 - Policy prohibited from excluding coverage of treatment of temporomandibular joint; exception.

NRS 689A.0475 - Acupuncture.

NRS 689A.048 - Treatment by licensed psychologist.

NRS 689A.0483 - Treatment by licensed marriage and family therapist or licensed clinical professional counselor.

NRS 689A.0485 - Treatment by licensed associate in social work, social worker, master social worker, independent social worker or clinical social worker.

NRS 689A.0487 - Treatment by licensed podiatrist.

NRS 689A.049 - Treatment by licensed chiropractor; restriction on policy limitations. [Effective through December 31, 2021.] Treatment by licensed chiropractic physician; restriction on policy limitations. [Effective January 1, 2022.]

NRS 689A.0493 - Treatment by licensed clinical alcohol and drug counselor.

NRS 689A.0495 - Services provided by certain registered nurses.

NRS 689A.0497 - Provider of medical transportation.

NRS 689A.050 - Entire contract; changes.

NRS 689A.060 - Time limit on certain defenses.

NRS 689A.070 - Grace period.

NRS 689A.075 - Cancellation and rescission of short-term limited duration medical plan.

NRS 689A.080 - Reinstatement.

NRS 689A.090 - Notice of claim.

NRS 689A.100 - Claim forms: Required provision.

NRS 689A.105 - Claim forms: Uniform billing and claims forms.

NRS 689A.110 - Claim forms: Proofs of loss.

NRS 689A.120 - Time of payment of claims.

NRS 689A.130 - Payment of claims.

NRS 689A.135 - Assignment of benefits by insured to provider of health care.

NRS 689A.140 - Physical examination and autopsy.

NRS 689A.150 - Legal actions.

NRS 689A.160 - Change of beneficiary.

NRS 689A.170 - Right to examine and return policy.

NRS 689A.180 - Optional provisions: Requirements; substitution of provisions; captions.

NRS 689A.190 - Extended disability benefit.

NRS 689A.200 - Change of occupation.

NRS 689A.210 - Misstatement of age.

NRS 689A.220 - Coordination of benefits: Same insurer.

NRS 689A.230 - Coordination of benefits: All coverages.

NRS 689A.240 - Relation of earnings to insurance.

NRS 689A.250 - Unpaid premiums.

NRS 689A.260 - Conformity with state statutes.

NRS 689A.270 - Illegal occupation.

NRS 689A.290 - Renewability.

NRS 689A.300 - Order of certain provisions.

NRS 689A.310 - Ownership of policy by person other than insured.

NRS 689A.320 - Requirements of other jurisdictions.

NRS 689A.330 - Policies issued for delivery in another state.

NRS 689A.340 - Limitation on provisions not subject to chapter; effect of violation of chapter; conflict among provisions.

NRS 689A.350 - Age limit.

NRS 689A.380 - Definitions of terms used in policies.

NRS 689A.405 - Policy covering prescription drugs: Provision of notice and information regarding use of formulary.

NRS 689A.410 - 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 certi...

NRS 689A.413 - Insurer prohibited from denying coverage solely because claim involves act that constitutes domestic violence or applicant or insured was victim of domestic violence.

NRS 689A.415 - Insurer prohibited from denying coverage solely because applicant or insured was intoxicated or under influence of controlled substance; exceptions.

NRS 689A.417 - Insurer prohibited from requiring or using information concerning genetic testing; exceptions.

NRS 689A.419 - Offering policy of health insurance for purposes of establishing health savings account.

NRS 689A.420 - Definitions.

NRS 689A.430 - Effect of eligibility for medical assistance under Medicaid; assignment of rights to state agency.

NRS 689A.440 - Insurer prohibited from asserting certain grounds to deny enrollment of child of insured pursuant to order.

NRS 689A.450 - Certain accommodations required to be made when child is covered under policy of noncustodial parent.

NRS 689A.460 - Insurer 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 689A.470 - Definitions.

NRS 689A.475 - "Affiliated" defined.

NRS 689A.485 - "Bona fide association" defined.

NRS 689A.490 - "Church plan" defined.

NRS 689A.495 - "Control" defined.

NRS 689A.505 - "Creditable coverage" defined.

NRS 689A.510 - "Dependent" defined.

NRS 689A.523 - "Exclusion for a preexisting condition" defined.

NRS 689A.525 - "Geographic rating area" defined.

NRS 689A.527 - "Geographic service area" defined.

NRS 689A.530 - "Governmental plan" defined.

NRS 689A.535 - "Group health plan" defined.

NRS 689A.540 - "Health benefit plan" defined.

NRS 689A.550 - "Individual carrier" defined.

NRS 689A.555 - "Individual health benefit plan" defined.

NRS 689A.570 - "Plan for coverage of a bona fide association" defined.

NRS 689A.580 - "Plan sponsor" defined.

NRS 689A.585 - "Preexisting condition" defined.

NRS 689A.590 - "Producer" defined.

NRS 689A.600 - "Provision for a restricted network" defined.

NRS 689A.615 - Certain plan, fund or program to be treated as employee welfare benefit plan which is group health plan; partnership deemed employer of each partner.

NRS 689A.630 - Requirement to renew coverage at option of individual; exceptions; discontinuation of product; discontinuation of health benefit plan available through bona fide association.

NRS 689A.635 - Coverage offered through network plan not required to be offered to person who does not reside or work in geographic service area or geographic rating area.

NRS 689A.637 - Coverage offered through plan that provides for restricted network: Contracts with certain federally qualified health centers.

NRS 689A.696 - Information and documents required to be made available to Commissioner; proprietary information.

NRS 689A.700 - Regulations regarding rates.

NRS 689A.705 - Regulations concerning reissuance of health benefit plan.

NRS 689A.710 - Prohibited acts; denial of application for coverage; regulations; violation may constitute unfair trade practice; applicability of section.

NRS 689A.715 - Requirements for employee welfare benefit plan for providing benefits for employees of more than one employer.

NRS 689A.717 - Individual health benefit plan covering maternity care and pediatric care: Requirement to allow minimum stay in hospital in connection with childbirth; prohibited acts.

NRS 689A.720 - Written certification of coverage required for determining period of creditable coverage accumulated by person; provision of certificate to insured.

NRS 689A.725 - Requirements for plan for coverage.

NRS 689A.740 - Regulations.

NRS 689A.745 - Establishment; approval; requirements; examination; exception.

NRS 689A.750 - Annual report; insurer required to maintain records of and report complaints concerning something other than health care services.

NRS 689A.755 - Written notice required to be provided by insurer to insured explaining right to file complaint; written notice to insured required when insurer denies coverage of health care service.