1. A carrier that issues a health benefit plan shall offer and issue a health benefit plan to any small employer regardless of the health status of the employees of the small employer. Such health status includes, without limitation:
(a) Any preexisting medical condition of an insured, including, without limitation, any physical or mental illness;
(b) The claims history of the insured, including, without limitation, any prior health care services received by the insured;
(c) Genetic information relating to the insured; and
(d) Any increased risk for illness, injury or any other medical condition of the insured, including, without limitation, any medical condition caused by an act of domestic violence.
2. A carrier that offers or issues a health benefit plan shall not:
(a) Deny, limit or exclude a covered benefit based on the health status of an insured; or
(b) Require an insured, as a condition of enrollment or renewal, to pay a premium, deductible, copay or coinsurance based on his or her health status which is greater than the premium, deductible, copay or coinsurance charged to a similarly situated insured who does not have such a health status.
3. A carrier that offers or issues a health benefit plan shall not adjust a premium, deductible, copay or coinsurance for any insured on the basis of genetic information relating to the insured or the covered dependent of the insured.
4. A carrier that offers or issues a health benefit plan may include in the plan a wellness program that reduces a premium, deductible or copayment based on health status if:
(a) An insured who is eligible to participate in the wellness program is given the opportunity to qualify for the discount at least once each year;
(b) The amount of all discounts provided pursuant to such a wellness program does not exceed 30 percent, or if the program is designed to prevent or reduce tobacco use, 50 percent, of the cost of coverage for an insured or an insured and his or her dependents, as applicable, under the plan;
(c) The wellness program is reasonably designed to promote health or prevent disease;
(d) The carrier ensures that the full discount under the wellness program is available to all similarly situated insureds by providing a reasonable alternative standard by which an insured may qualify for the discount which, if based on health status, must accommodate the recommendations of the physician of the insured; and
(e) The plan discloses in all plan materials describing the terms of the wellness program, and in any disclosure that an insured did not satisfy the initial standard to be eligible for the discount, the availability of a reasonable alternative standard described in paragraph (d).
(Added to NRS by 1995, 981; A 1997, 2943; 2013, 3628; 2019, 302)
Structure Nevada Revised Statutes
Chapter 689C - Health Insurance for Small Employers
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.111 - Professional employer organization deemed large employer in certain circumstances.
NRS 689C.115 - Mandatory and optional coverage.
NRS 689C.125 - Rating factors for determining premiums; rating periods.
NRS 689C.160 - Carrier must uniformly apply requirements to determine whether to provide coverage.
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.169 - Coverage for severe mental illness required under group health insurance policy.
NRS 689C.200 - Circumstances in which carrier is not required to offer coverage.
NRS 689C.207 - Regulations concerning reissuance of health benefit plan.
NRS 689C.220 - Adjustment in rates required to be applied uniformly.
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.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.550 - Collection of premiums; trust account for deposit of premiums.
NRS 689C.580 - Prohibited acts.
NRS 689C.590 - Disciplinary or other action for violation of provisions.
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.