1. An insurer shall provide to each policyholder, or producer of insurance acting on behalf of a policyholder, on a form approved by the Commissioner, a summary of the coverage provided by each policy of group or blanket health insurance offered by the insurer. The summary must disclose any:
(a) Significant exception, reduction or limitation that applies to the policy;
(b) Restriction on payment for care in an emergency, including related definitions of emergency and medical necessity;
(c) Right of the insurer to change the rate of premium and the factors, other than claims experienced, which affect changes in rate;
(d) Provisions relating to renewability; and
(e) Other information that the Commissioner finds necessary for full and fair disclosure of the provisions of the policy.
2. The language of the disclosure must be easily understood. The disclosure must state that it is only a summary of the policy and that the policy should be read to ascertain the governing contractual provisions.
3. The Commissioner shall not approve a proposed disclosure that does not satisfy the requirements of this section and of applicable regulations.
4. In addition to the disclosure, the insurer shall provide information about guaranteed availability of basic and standard plans for benefits to an eligible person.
5. The insurer shall provide the summary before the policy is issued.
(Added to NRS by 2001, 2219; A 2019, 300)
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.