Nevada Revised Statutes
Chapter 695F - Prepaid Limited Health Service Organizations
NRS 695F.151 - Organization required to offer and issue plan regardless of health status of persons; prohibited acts; authority to include wellness program in plan that offers discounts based on health status under certain circumstances.


1. A prepaid limited health service organization shall offer and issue a health benefit plan to any person regardless of the health status of the person or any dependent of the person. Such health status includes, without limitation:
(a) Any preexisting medical condition of the person, including, without limitation, any physical or mental illness;
(b) The claims history of the person, including, without limitation, any prior health care services received by the person;
(c) Genetic information relating to the person; and
(d) Any increased risk for illness, injury or any other medical condition of the person, including, without limitation, any medical condition caused by an act of domestic violence.
2. A prepaid limited health service organization 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 enrollee; or
(b) Require an enrollee, 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 enrollee who does not have such a health status.
3. A prepaid limited health service organization that offers or issues a health benefit plan shall not adjust a premium, deductible, copay or coinsurance for any enrollee on the basis of genetic information relating to the enrollee or the covered dependent of the enrollee.
4. A prepaid limited health service organization 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 enrollee 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 enrollee or an enrollee 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 prepaid limited health service organization ensures that the full discount under the wellness program is available to all similarly situated enrollees by providing a reasonable alternative standard by which an enrollee may qualify for the discount which, if based on health status, must accommodate the recommendations of the physician of the enrollee; and
(e) The plan discloses in all plan materials describing the terms of the wellness program, and in any disclosure that an enrollee did not satisfy the initial standard to be eligible for the discount, the availability of a reasonable alternative standard described in paragraph (d).
5. As used in this section, "health benefit plan" has the meaning ascribed to it in NRS 687B.470.
(Added to NRS by 2019, 312)

Structure Nevada Revised Statutes

Nevada Revised Statutes

Chapter 695F - Prepaid Limited Health Service Organizations

NRS 695F.010 - Definitions.

NRS 695F.020 - "Enrollee" defined.

NRS 695F.030 - "Evidence of coverage" defined.

NRS 695F.040 - "Limited health service" defined.

NRS 695F.043 - "Medicaid" defined.

NRS 695F.047 - "Order for medical coverage" defined.

NRS 695F.050 - "Prepaid limited health service organization" defined.

NRS 695F.060 - "Provider" defined.

NRS 695F.070 - "Subscriber" defined.

NRS 695F.080 - General applicability of title 57 of NRS.

NRS 695F.090 - Applicability of chapter and other provisions.

NRS 695F.100 - Certificate required.

NRS 695F.110 - Application; fee.

NRS 695F.120 - Review of application; issuance of certificate.

NRS 695F.130 - Application of person who is licensed as insurer or holds another certificate of authority.

NRS 695F.140 - Denial of application; hearing.

NRS 695F.150 - Evidence of coverage: Issuance; contents; amendment.

NRS 695F.151 - Organization required to offer and issue plan regardless of health status of persons; prohibited acts; authority to include wellness program in plan that offers discounts based on health status under certain circumstances.

NRS 695F.153 - Evidence of coverage covering prescription drugs: Provision of notice and information regarding use of formulary.

NRS 695F.156 - Evidence of coverage covering prescription drugs prohibited from limiting or excluding coverage for certain prescription drugs previously approved for medical condition of enrollee; exceptions.

NRS 695F.158 - Evidence of coverage covering prescription drugs: Required actions by organization related to acquisition of prescription drugs for certain insureds residing in area for which emergency or disaster has been declared.

NRS 695F.160 - Rates and charges: Reasonableness.

NRS 695F.170 - Procedure for modification of rates, charges, benefits, organization, operations, documents or services.

NRS 695F.180 - Investments.

NRS 695F.190 - Requirements for reserve.

NRS 695F.200 - Maintenance of capital account, surety bond or deposit and risk-based capital; determination of amount of increase by Commissioner.

NRS 695F.210 - Maintenance of fidelity bond or deposit in lieu of bond.

NRS 695F.212 - Hazardous financial condition: Regulations; determination; powers of Commissioner.

NRS 695F.220 - Contract between organization and provider or subcontractor for provision of services to enrollees: Required terms and conditions.

NRS 695F.230 - Establishment of system for resolution of complaints.

NRS 695F.300 - Regulations.

NRS 695F.310 - Examinations and investigations.

NRS 695F.320 - Annual report and financial statement; quarterly statement; additional reports; penalties for failure to file report or statement.

NRS 695F.330 - Payment of premium tax.

NRS 695F.340 - Fees.

NRS 695F.350 - Suspension or revocation of certificate of authority: Grounds; notice; hearing; effect.

NRS 695F.360 - Violations of chapter: Order to cease and desist; fine.

NRS 695F.400 - License required to apply, procure, negotiate or place for another any policy or contract of organization.

NRS 695F.410 - Confidentiality and disclosure of information.

NRS 695F.420 - Certain insurers and organizations authorized to exclude coverage duplicated pursuant to this chapter.

NRS 695F.430 - Provision of services excluded from practice of any healing arts; solicitation excluded from provisions regarding solicitation or advertising by practitioner of healing art.

NRS 695F.440 - Effect of eligibility for medical assistance under Medicaid; assignment of rights to state agency.

NRS 695F.450 - Organization prohibited from asserting certain grounds to deny enrollment of child pursuant to order if parent is insured.

NRS 695F.460 - Certain accommodations required to be made when child is covered under evidence of coverage of noncustodial parent.

NRS 695F.470 - Organization required to authorize enrollment of child of parent who is required by order to provide medical coverage under certain circumstances; termination of coverage of child.

NRS 695F.480 - Organization prohibited from restricting coverage of child based on preexisting condition if person who is eligible for group coverage adopts or assumes legal obligation for child.