1. All individual and group service or indemnity-type contracts issued by a nonprofit corporation which provide coverage for a family member of the subscriber must as to such coverage provide that the health benefits applicable for children are payable with respect to:
(a) A newly born child of the subscriber from the moment of birth;
(b) An adopted child from the date the adoption becomes effective, if the child was not placed in the home before adoption; and
(c) A child placed with the subscriber for the purpose of adoption from the moment of placement as certified by the public or private agency making the placement. The coverage of such a child ceases if the adoption proceedings are terminated as certified by the public or private agency making the placement.
The contracts must provide the coverage specified in subsection 3, and must not exclude premature births.
2. The contract may require that notification of:
(a) The birth of a newly born child;
(b) The effective date of adoption of a child; or
(c) The date of placement of a child for adoption,
and payments of the required fees, if any, must be furnished to the nonprofit service corporation within 31 days after the date of birth, adoption or placement for adoption in order to have the coverage continue beyond the 31-day period.
3. The coverage for newly born and adopted children and children placed for adoption consists of coverage of injury or sickness, including the necessary care and treatment of medically diagnosed congenital defects and birth abnormalities and, within the limits of the policy, necessary transportation costs from place of birth to the nearest specialized treatment center under major medical policies, and with respect to basic policies to the extent such costs are charged by the treatment center.
4. For covered services provided to the child, the corporation shall reimburse noncontracted providers of health care to an amount equal to the average amount of payment for which the organization has agreements, contracts or arrangements for those covered services.
(Added to NRS by 1975, 1110; A 1989, 741; 1995, 2434; 1997, 2956; 2019, 306)
Structure Nevada Revised Statutes
Chapter 695B - Nonprofit Corporations for Hospital, Medical and Dental Service
NRS 695B.040 - Corporations authorized to undertake and operate plans.
NRS 695B.050 - Manner of incorporation.
NRS 695B.060 - Directors: Qualifications.
NRS 695B.070 - Merger and consolidation: Procedure.
NRS 695B.080 - Merger and consolidation: Continuance of contracts and contribution certificates.
NRS 695B.090 - Merger and consolidation: Withdrawal of prior deposit of securities.
NRS 695B.110 - Certificate of authority: Required; fees.
NRS 695B.120 - Certificate of authority: Qualifications.
NRS 695B.130 - Certificate of authority: Application; issuance.
NRS 695B.135 - Certificate of authority: Expiration; renewal.
NRS 695B.165 - Annual statement required to include report of net worth.
NRS 695B.170 - Acquisition costs and administrative expenses; effect of finding of excess costs.
NRS 695B.180 - Required provisions.
NRS 695B.189 - Group contract: Required provision permitting continuation of coverage.
NRS 695B.190 - Family contracts.
NRS 695B.1951 - Reimbursement for treatment by podiatrist.
NRS 695B.1955 - Reimbursement for treatment by licensed clinical alcohol and drug counselor.
NRS 695B.196 - Reimbursement for acupuncture.
NRS 695B.197 - Reimbursement for treatment by licensed psychologist.
NRS 695B.199 - Reimbursement for services provided by certain nurses.
NRS 695B.1995 - Reimbursement to provider of medical transportation.
NRS 695B.200 - Group contracts written under master contract: Conditions required for issuance.
NRS 695B.210 - Group master service contract: Required provisions.
NRS 695B.225 - Policies of group insurance: Order of benefits.
NRS 695B.230 - Filing and approval of forms and schedules of premium rates.
NRS 695B.240 - Provision of group service coverage before approval of forms.
NRS 695B.250 - Extensions of time; automatic approval.
NRS 695B.252 - Conversion privilege available to spouse and children; conditions.
NRS 695B.254 - Choice of types of contracts required to be offered.
NRS 695B.256 - Issuance and effective date of converted contract; premiums; persons covered.
NRS 695B.257 - Notice of conversion privilege.
NRS 695B.2575 - Converted contract delivered outside Nevada: Form.
NRS 695B.258 - Extension of coverage under existing group contract.
NRS 695B.2585 - Provision of group coverage in lieu of converted individual contract.
NRS 695B.259 - Continuation of identical coverage in lieu of converted contract.
NRS 695B.260 - Suspension or revocation of permission to provide coverage before approval of forms.
NRS 695B.270 - Disapproval of forms; issuance unlawful.
NRS 695B.280 - Regulations; limitations.
NRS 695B.285 - Use of Uniform Billing and Claims Forms authorized.
NRS 695B.290 - Agent’s license required.
NRS 695B.320 - Applicability of other provisions.
NRS 695B.380 - Establishment; approval; requirements; examination.