Nevada Revised Statutes
Chapter 689C - Health Insurance for Small Employers
NRS 689C.155 - Regulations.

The Commissioner may adopt regulations to carry out the provisions of NRS 689C.109 to 689C.143, inclusive, 689C.156 to 689C.159, inclusive, 689C.165, 689C.183, 689C.187, 689C.191 to 689C.198, inclusive, 689C.203, 689C.207, 689C.265, 689C.325, 689C.355 and 689C.610 to 689C.940, inclusive, and to ensure that rating practices used by carriers serving small employers are consistent with those sections, including regulations that:
1. Ensure that differences in rates charged for health benefit plans by such carriers are reasonable and reflect only differences in the designs of the plans, the terms of the coverage, the amount contributed by the employers to the cost of coverage and differences based on the rating factors established by the carrier.
2. Prescribe the manner in which rating factors may be used by such carriers.
(Added to NRS by 1995, 980; A 1997, 2942; 2013, 3626; 2015, 640)

Structure Nevada Revised Statutes

Nevada Revised Statutes

Chapter 689C - Health Insurance for Small Employers

NRS 689C.015 - Definitions.

NRS 689C.017 - "Affiliated" defined.

NRS 689C.019 - "Affiliation period" defined.

NRS 689C.023 - "Bona fide association" defined.

NRS 689C.025 - "Carrier" defined.

NRS 689C.045 - "Class of business" defined.

NRS 689C.047 - "Control" defined.

NRS 689C.053 - "Creditable coverage" defined.

NRS 689C.055 - "Dependent" defined.

NRS 689C.065 - "Eligible employee" defined.

NRS 689C.066 - "Employee leasing company" defined.

NRS 689C.071 - "Geographic rating area" defined.

NRS 689C.072 - "Geographic service area" defined.

NRS 689C.073 - "Group health plan" defined.

NRS 689C.075 - "Health benefit plan" defined.

NRS 689C.077 - "Network plan" defined.

NRS 689C.078 - "Open enrollment" defined.

NRS 689C.079 - "Plan for coverage of a bona fide association" defined.

NRS 689C.081 - "Plan sponsor" defined.

NRS 689C.082 - "Preexisting condition" defined.

NRS 689C.083 - "Producer" defined.

NRS 689C.0835 - "Professional employer organization" defined.

NRS 689C.085 - "Rating period" defined.

NRS 689C.095 - "Small employer" defined.

NRS 689C.104 - "Voluntary purchasing group" defined.

NRS 689C.106 - "Waiting period" defined.

NRS 689C.1065 - Applicability.

NRS 689C.109 - Certain plan, fund or program established or maintained by partnership required to be treated as employee welfare benefit plan which is group health plan; partnership deemed employer of each partner.

NRS 689C.111 - Professional employer organization deemed large employer in certain circumstances.

NRS 689C.113 - Requirements for employee welfare benefit plan for providing benefits for employees of more than one employer.

NRS 689C.115 - Mandatory and optional coverage.

NRS 689C.125 - Rating factors for determining premiums; rating periods.

NRS 689C.131 - Contracts between carrier and providers of health care: Prohibiting carrier from charging provider of health care fee for inclusion on list of providers given to insureds; carrier required to use form to obtain information on provider...

NRS 689C.135 - Effect of provision in health benefit plan for restricted network on determination of rates.

NRS 689C.143 - Offering of policy of health insurance for purposes of establishing health savings account.

NRS 689C.155 - Regulations.

NRS 689C.156 - Each health benefit plan marketed in this State required to be offered to small employers; issuance; carrier required to provide system for resolving complaints of employees if services provided or paid for through managed care.

NRS 689C.1565 - Coverage to small employers not required under certain circumstances; notice required to Commissioner of and prohibition on writing new business after election not to offer new coverage required.

NRS 689C.158 - Producer authorized only to market to or sign up small employers and eligible employees in bona fide associations if employers and employees are actively engaged in or directly related to bona fide association.

NRS 689C.159 - Certain provisions inapplicable to plan that carrier makes available only through bona fide association.

NRS 689C.160 - Carrier must uniformly apply requirements to determine whether to provide coverage.

NRS 689C.165 - Carrier prohibited from modifying plan to restrict or exclude coverage or benefits for specific diseases, medical conditions or services otherwise covered by plan; exceptions.

NRS 689C.1655 - Coverage for autism spectrum disorders for certain persons required; prohibited acts.

NRS 689C.166 - Coverage for alcohol or substance use disorder: Required in group health insurance policy.

NRS 689C.167 - Coverage for alcohol or substance use disorders: Benefits provided by group health insurance policy.

NRS 689C.1671 - Coverage for drugs, laboratory testing and certain services related to human immunodeficiency virus required; reimbursement of pharmacist for certain services.

NRS 689C.1672 - Coverage for certain tests and vaccines relating to human papillomavirus required; prohibited acts.

NRS 689C.1673 - Coverage for screening, genetic counseling and testing related to BRCA gene required in certain circumstances. [Effective January 1, 2022.]

NRS 689C.1674 - Coverage for mammograms for certain women required; prohibited acts.

NRS 689C.1675 - Coverage for examination of person who is pregnant for certain diseases required.

NRS 689C.1676 - 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 689C.1678 - Coverage for certain services, screenings and tests relating to wellness required; prohibited acts.

NRS 689C.1679 - Plan covering prescription drugs: Required actions by carrier related to acquisition of prescription drugs for certain insureds residing in area for which emergency or disaster has been declared.

NRS 689C.168 - Plan covering prescription drugs prohibited from limiting or excluding coverage for prescription drug previously approved for medical condition of insured; exception.

NRS 689C.1683 - Coverage for prescription drugs irregularly dispensed for purpose of synchronization of chronic medications required in plan covering prescription drugs; prohibited acts; exception.

NRS 689C.1684 - Plan covering prescription drug for treatment of cancer or cancer symptom that is part of step therapy protocol: Carrier required to allow insured or attending practitioner to apply for exemption from step therapy protocol in certain...

NRS 689C.1685 - Plan covering prescription drugs: Denial of coverage prohibited for early refills of otherwise covered topical ophthalmic products.

NRS 689C.1687 - 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 in plan covering prescription drugs.

NRS 689C.169 - Coverage for severe mental illness required under group health insurance policy.

NRS 689C.170 - Authorized variation of minimum participation and contributions; denial of coverage based on industry prohibited.

NRS 689C.180 - Carrier to offer same coverage to all eligible employees; denial of coverage to otherwise eligible employee.

NRS 689C.183 - Plan and carrier required to permit employee or dependent of employee to enroll for coverage under certain circumstances.

NRS 689C.187 - Manner and period for enrolling dependent of covered employee; period of special enrollment.

NRS 689C.190 - Carrier required to offer and issue plan regardless of health status of employees; prohibited acts; authority to include wellness program in plan that offers discounts based on health status under certain circumstances.

NRS 689C.191 - Determination of applicable creditable coverage of person; determining period of creditable coverage of person; required statement for certain election by carrier; applicability.

NRS 689C.192 - Written certification of coverage required for purpose of determining period of creditable coverage accumulated by person.

NRS 689C.193 - Carrier prohibited from imposing restriction on being participant of or beneficiary of plan inconsistent with certain provisions; restrictions on rules of eligibility that may be established.

NRS 689C.194 - Plan covering maternity and pediatric care: Required to allow minimum stay in hospital in connection with childbirth; exceptions; prohibited acts.

NRS 689C.1945 - Plan covering maternity care: Prohibited acts by carrier if insured is acting as gestational carrier; child deemed child of intended parent for purposes of plan.

NRS 689C.1947 - Plan covering anatomical gifts, organ transplants or treatments or services related to organ transplants: Prohibited acts by carrier if insured is person with disability.

NRS 689C.195 - 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 ter...

NRS 689C.196 - Insurer prohibited from denying coverage solely because claim involves act that constitutes domestic violence or applicant or insured was victim of domestic violence.

NRS 689C.197 - Carrier prohibited from denying coverage because applicant or insured was intoxicated or under influence of controlled substance; exceptions.

NRS 689C.198 - Insurer prohibited from requiring or using information concerning genetic testing; exceptions.

NRS 689C.200 - Circumstances in which carrier is not required to offer coverage.

NRS 689C.203 - Requirement for denial of application for coverage from small employer; regulations setting standards for fair marketing and broad availability of plans.

NRS 689C.207 - Regulations concerning reissuance of health benefit plan.

NRS 689C.220 - Adjustment in rates required to be applied uniformly.

NRS 689C.265 - Carrier authorized to modify coverage for insurance product under certain circumstances.

NRS 689C.281 - Plan covering prescription drugs: Provision of notice and information regarding use of formulary.

NRS 689C.310 - Renewal of plan; discontinuance of issuance or renewal of coverage or of plan offered only through bona fide association; discontinuance of product; applicability.

NRS 689C.320 - Required notification when carrier discontinues transacting insurance in this State or particular geographic service area of state; restrictions on carrier that discontinues transacting insurance.

NRS 689C.325 - Coverage offered through network plan not required to be offered to eligible employee who does not reside or work in geographic service area or if carrier lacks capacity to deliver adequate service to additional employers and employees...

NRS 689C.335 - 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 689C.350 - Health benefit plan which offers difference of payment between preferred providers of health care and providers who are not preferred: Limitations on deductibles and copayments; circumstances in which service is deemed to be provided b...

NRS 689C.355 - Prohibited acts of carrier or producer related to encouraging or directing small employer to take certain actions; exceptions; prohibited acts by carrier related to contract or agreement with producer; violation may constitute unfair t...

NRS 689C.360 - Definitions.

NRS 689C.380 - "Contract" defined.

NRS 689C.390 - "Dependent" defined.

NRS 689C.420 - "Voluntary purchasing group" defined.

NRS 689C.425 - Applicability of other provisions.

NRS 689C.430 - Entities which are authorized to offer contracts to voluntary purchasing groups; compliance with provisions required.

NRS 689C.435 - Contracts between carrier and providers of health care: Prohibiting carrier from charging provider of health care fee for inclusion on list of providers given to insureds; form to obtain information on provider of health care; modifica...

NRS 689C.455 - Coverage for prescription drugs: Provision of notice and information regarding use of formulary.

NRS 689C.460 - Carrier to offer same coverage to all eligible employees; denial of coverage to otherwise eligible employee.

NRS 689C.470 - Renewal of contract; discontinuance of product or issuance or renewal of plan offered only through bona fide association.

NRS 689C.480 - Required notification when carrier ceases to renew all contracts; restrictions on carrier that ceases to renew all contracts.

NRS 689C.485 - 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 689C.490 - Formation of voluntary purchasing group by small employers; requirements when affiliate of group ceases to qualify as small employer.

NRS 689C.500 - Registration: Requirements; application.

NRS 689C.510 - Registration: Fee for application; response to application; regulations.

NRS 689C.520 - Registration: Additional requirements.

NRS 689C.530 - Filing reports; annual renewal fee; regulations.

NRS 689C.540 - Duties.

NRS 689C.550 - Collection of premiums; trust account for deposit of premiums.

NRS 689C.560 - Regulations governing bond or other security to be maintained by voluntary purchasing group.

NRS 689C.570 - Organizer prohibited from acquiring financial interest in group’s business for specified period.

NRS 689C.580 - Prohibited acts.

NRS 689C.590 - Disciplinary or other action for violation of provisions.

NRS 689C.600 - Regulations.

NRS 689C.610 - Definitions.

NRS 689C.630 - "Church plan" defined.

NRS 689C.660 - "Individual carrier" defined.

NRS 689C.670 - "Individual health benefit plan" defined.

NRS 689C.940 - Regulations concerning determination of status of stop-loss policy.