Nevada Revised Statutes
Chapter 695F - Prepaid Limited Health Service Organizations
NRS 695F.350 - Suspension or revocation of certificate of authority: Grounds; notice; hearing; effect.


1. The Commissioner may suspend or revoke the certificate of authority of a prepaid limited health service organization issued pursuant to this chapter if the Commissioner determines that:
(a) The prepaid limited health service organization is operating substantially in violation of its basic organizational document or in a manner contrary to the manner described in and reasonably inferred from any other information submitted pursuant to NRS 695F.110 unless any amendment to its basic organization document or other information has been filed with and approved by the Commissioner;
(b) The prepaid limited health service organization issued an evidence of coverage or used rates or charges which do not comply with the requirements of NRS 695F.150 and 695F.160;
(c) The prepaid limited health service organization is not able to carry out its obligations to provide its limited health service;
(d) The prepaid limited health service organization is not financially responsible and may reasonably be expected to be unable to carry out its obligations to enrollees or prospective enrollees;
(e) The capital of the prepaid limited health service organization is less than the amount required by NRS 695F.200 or the organization has failed to correct any deficiency concerning its capital as required by the Commissioner;
(f) The prepaid limited health service organization has failed to establish and maintain in a reasonable manner the complaint system required by NRS 695F.230;
(g) The continued operation of the prepaid limited health service organization would be hazardous to its enrollees; or
(h) The prepaid limited health service organization has failed to comply with any other provision of this chapter.
2. If the Commissioner has cause to believe that grounds for the suspension or revocation of a certificate of authority of a prepaid limited health service organization exist, the Commissioner shall send written notice to the organization. The notice must include the reason for the suspension or revocation and a time not more than 30 days thereafter for a hearing on the matter. The hearing must be held in the manner set forth in NRS 695F.140.
3. If the certificate of authority of a prepaid limited health service organization is revoked, the organization shall proceed, immediately following the effective date of the order of revocation, to wind up its affairs. The organization shall not:
(a) Conduct any further business unless it is essential for the orderly conclusion of its affairs; and
(b) Engage in any further advertising or solicitation.
4. The Commissioner may, by written order, permit such further operation of the organization as the Commissioner considers necessary to enable the enrollees to obtain limited health services from another organization or provider.
(Added to NRS by 1991, 1119)

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.