1. Each copayment and deductible required to be paid by a member must be reasonable and reasonably related to the cost of the particular service.
2. Every organization for dental care shall submit to the Commissioner for approval any proposal for copayment or deductible before it is imposed on the members. The Commissioner shall approve or disapprove the proposal within 30 days after it is submitted to the Commissioner. If the Commissioner disapproves a copayment or deductible, the Commissioner shall notify the organization of the reasons for disapproval. The Commissioner shall grant a hearing on any such disapproval within 15 days after the organization requests, in writing, a hearing on the matter.
3. The Commissioner may adopt regulations to define:
(a) "Reasonable" as it relates to copayments and deductibles; and
(b) A "reasonable relationship" between the cost of particular services and the amount of related copayments and deductibles.
(Added to NRS by 1987, 1783)
Structure Nevada Revised Statutes
Chapter 695D - Plans for Dental Care
NRS 695D.012 - "Administrator" defined.
NRS 695D.020 - "Commissioner" defined.
NRS 695D.030 - "Dental care" defined.
NRS 695D.040 - "Dentist" defined.
NRS 695D.050 - "Member" defined.
NRS 695D.060 - "Organization for dental care" defined.
NRS 695D.070 - "Plan for dental care" defined.
NRS 695D.080 - "Policy" defined.
NRS 695D.090 - Applicability of title to organizations for dental care; applicability of chapter.
NRS 695D.102 - Summary of coverage: Contents of disclosure; approval by Commissioner; regulations.
NRS 695D.120 - Certificate of authority: Application.
NRS 695D.130 - Certificate of authority: Issuance; fees.
NRS 695D.150 - Certificate of authority: Expiration; renewal; fees.
NRS 695D.153 - Capital account: Minimum amount; requirements.
NRS 695D.157 - Hazardous financial condition: Regulations; determination; powers of Commissioner.
NRS 695D.180 - Requirements concerning bond.
NRS 695D.205 - Copayments and deductibles: Reasonableness; approval of Commissioner; regulations.
NRS 695D.220 - Licensing of agents.
NRS 695D.270 - Examination by Commissioner.
NRS 695D.280 - Rehabilitation, liquidation or conservation: Conduct.
NRS 695D.300 - Disciplinary action: Grounds; penalties.
NRS 695D.310 - Disciplinary or other action: Notice; hearing; order.