1. Except as otherwise provided in NRS 689B.270 and subject to the approval of the Commissioner, a policy of group health insurance may include a provision which requires a member or a dependent of a member of the insured group and the insurer to submit for binding arbitration any dispute between the member or dependent and the insurer concerning any matter directly or indirectly related to, or associated with, the policy. If such a provision is included in the policy:
(a) A member and any dependent of the member must be given the opportunity to decline to participate in binding arbitration at the time they elect to be covered by the policy.
(b) It must clearly state that the insurer and a member or dependent of a member of the insured group who has not declined to participate in binding arbitration agree to forego their right to resolve any such dispute in a court of law or equity.
2. Except as otherwise provided in subsection 3, the arbitration must be conducted pursuant to the rules for commercial arbitration established by the American Arbitration Association. The insurer is responsible for any administrative fees and expenses relating to the arbitration, except that the insurer is not responsible for attorney’s fees and fees for expert witnesses unless those fees are awarded by the arbitrator.
3. If a dispute required to be submitted to binding arbitration requires an immediate resolution to protect the physical health of a member or a dependent of a member, any party to the dispute may waive arbitration and seek declaratory relief in a court of competent jurisdiction.
4. If a provision described in subsection 1 is included in a policy of group health insurance, the provision shall not be deemed unenforceable as an unreasonable contract of adhesion if the provision is included in compliance with the provisions of subsection 1.
(Added to NRS by 1995, 2557)
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.