1. Except as otherwise provided in this section, coverage under an individual health benefit plan must be renewed by the individual carrier that issued the plan, at the option of the individual, unless:
(a) The individual has failed to pay premiums or contributions in accordance with the terms of the health benefit plan or the individual carrier has not received timely premium payments.
(b) The individual has performed an act or a practice that constitutes fraud or has made an intentional misrepresentation of material fact under the terms of the coverage.
(c) The individual carrier decides to discontinue offering and renewing all health benefit plans delivered or issued for delivery in this state. If the individual carrier decides to discontinue offering and renewing such plans, the individual carrier shall:
(1) Provide notice of its intention to the Commissioner and the chief regulatory officer for insurance in each state in which the individual carrier is licensed to transact insurance at least 60 days before the date on which notice of cancellation or nonrenewal is delivered or mailed to the persons covered by the insurance to be discontinued pursuant to subparagraph (2).
(2) Provide notice of its intention to all persons covered by the discontinued insurance and to the Commissioner and the chief regulatory officer for insurance in each state in which such a person is known to reside. The notice must be made at least 180 days before the nonrenewal of any health benefit plan by the individual carrier.
(3) Discontinue all health insurance issued or delivered for issuance for individuals in this state and not renew coverage under any health benefit plan issued to such individuals.
(d) The Commissioner finds that the continuation of the coverage in this state by the individual carrier would not be in the best interests of the policyholders or certificate holders of the individual carrier or would impair the ability of the individual carrier to meet its contractual obligations. If the Commissioner makes such a finding, the Commissioner shall assist the persons covered by the discontinued insurance in this state in finding replacement coverage.
2. An individual carrier may discontinue a product pursuant to this subsection only if:
(a) The individual carrier notifies the Commissioner of its decision pursuant to this subsection to discontinue the product at least 60 days before the individual carrier notifies the persons covered by the discontinued product pursuant to paragraph (b).
(b) The individual carrier notifies each person covered by the discontinued product of the decision of the individual carrier to discontinue offering the product. The notice must be made to persons covered by the discontinued product at least 90 days before the date on which the individual carrier will discontinue offering the product.
(c) The individual carrier offers to each person covered by the discontinued product the option to purchase any other health benefit plan currently offered by the individual carrier to individuals in this state.
(d) In exercising the option to discontinue the product and in offering the option to purchase other coverage pursuant to paragraph (c), the individual carrier acts uniformly without regard to the claim experience of the persons covered by the discontinued product or any health status-related factor relating to those persons or beneficiaries covered by the discontinued product or any persons or beneficiaries who may become eligible for such coverage.
3. An individual carrier may discontinue the issuance and renewal of a health benefit plan that is made available to individuals pursuant to this chapter only through a bona fide association if:
(a) The membership of the individual in the association was the basis for the provision of coverage;
(b) The membership of the individual in the association ceases; and
(c) The coverage is terminated pursuant to this subsection uniformly without regard to any health status-related factor relating to the covered individual.
4. An individual carrier that elects not to renew a health benefit plan pursuant to paragraph (c) of subsection 1 shall not write new business for individuals pursuant to this chapter for 5 years after the date on which notice is provided to the Commissioner pursuant to subparagraph (2) of paragraph (c) of subsection 1.
5. If an individual carrier does business in only one geographic service area of this state, the provisions of this section apply only to the operations of the individual carrier in that service area.
(Added to NRS by 1997, 2890; A 2013, 3614; 2017, 2362)
Structure Nevada Revised Statutes
Chapter 689A - Individual Health Insurance
NRS 689A.030 - General requirements.
NRS 689A.0405 - Coverage for mammograms for certain women required; prohibited acts.
NRS 689A.0412 - Coverage for examination of person who is pregnant for certain diseases required.
NRS 689A.0423 - Coverage for treatment of certain inherited metabolic diseases required.
NRS 689A.0445 - Coverage for prostate cancer screening.
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.048 - Treatment by licensed psychologist.
NRS 689A.0487 - Treatment by licensed podiatrist.
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.075 - Cancellation and rescission of short-term limited duration medical plan.
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.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.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.380 - Definitions of terms used in policies.
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.700 - Regulations regarding rates.
NRS 689A.705 - Regulations concerning reissuance of health benefit plan.
NRS 689A.725 - Requirements for plan for coverage.
NRS 689A.745 - Establishment; approval; requirements; examination; exception.