1. Except as otherwise provided in this section, no policy of group health insurance may be delivered or issued for delivery in this state if it contains an exclusion of coverage of the treatment of the temporomandibular joint whether by specific language in the policy or by a claims settlement practice. A policy may exclude coverage of those methods of treatment which are recognized as dental procedures, including, but not limited to, the extraction of teeth and the application of orthodontic devices and splints.
2. The insurer may limit its liability on the treatment of the temporomandibular joint to:
(a) No more than 50 percent of the usual and customary charges for such treatment actually received by an insured, but in no case more than 50 percent of the maximum benefits provided by the policy for such treatment; and
(b) Treatment which is medically necessary.
3. Any provision of a policy subject to the provisions of this chapter and issued or delivered on or after January 1, 1990, which is in conflict with this section is void.
(Added to NRS by 1989, 2138)
Structure Nevada Revised Statutes
Chapter 689B - Group and Blanket Health Insurance
NRS 689B.010 - Short title; scope.
NRS 689B.0265 - Policy to guaranteed association.
NRS 689B.030 - Required provisions.
NRS 689B.038 - Reimbursement for treatments by licensed psychologist.
NRS 689B.0393 - Reimbursement for treatments by podiatrist.
NRS 689B.0397 - Reimbursement for treatment by licensed clinical alcohol and drug counselor.
NRS 689B.045 - Reimbursement for services provided by certain nurses.
NRS 689B.047 - Reimbursement to provider of medical transportation.
NRS 689B.049 - Reimbursement for acupuncture.
NRS 689B.050 - Extended disability benefit.
NRS 689B.060 - Readjustment of premiums; dividends.
NRS 689B.063 - Primary and secondary policies: Determination of benefits.
NRS 689B.064 - Primary and secondary policies: Order of benefits.
NRS 689B.070 - "Blanket accident and health insurance" defined.
NRS 689B.080 - Authority to issue; required provisions.
NRS 689B.090 - Application and certificates.
NRS 689B.100 - Payment of benefits.
NRS 689B.110 - Legal liability of policyholders for death of or injury to insured member unaffected.
NRS 689B.250 - Acceptance of uniform forms for billing and claims.
NRS 689B.280 - Disclosure of information concerning medication of insured prohibited.
NRS 689B.350 - "Affiliation period" defined.
NRS 689B.355 - "Blanket accident and health insurance" defined.
NRS 689B.360 - "Carrier" defined.
NRS 689B.370 - "Contribution" defined.
NRS 689B.380 - "Creditable coverage" defined.
NRS 689B.390 - "Group health plan" defined.
NRS 689B.400 - "Group participation" defined.
NRS 689B.430 - "Open enrollment" defined.
NRS 689B.440 - "Plan sponsor" defined.
NRS 689B.450 - "Preexisting condition" defined.