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s, benefits and rights provided therein.
(Added to NRS by 1971, 1764)
NRS 689A.320 Requirements of other jurisdictions.
1. Any policy of a foreign or alien insurer, when delivered or issued for delivery to any person in this state, may contain any provision which is not less favorable to the insured or the beneficiary than the provisions of this chapter and which is prescribed or required by the law of the state or country under which the insurer is organized.
2. Any policy of a domestic insurer may, when issued for delivery in any other state or country, contain any provision permitted or required by the laws of such other state or country.
(Added to NRS by 1971, 1764)
NRS 689A.330 Policies issued for delivery in another state. If any policy is issued by a domestic insurer for delivery to a person residing in another state, and if the insurance commissioner or corresponding public officer of that other state has informed the Commissioner that the policy is not subject to approval or disapproval by that officer, the Commissioner may by ruling require that the policy meet the standards set forth in NRS 689A.030 to 689A.320, inclusive.
(Added to NRS by 1971, 1765; A 1985, 1447; 1989, 1273; 1997, 743; 1999, 760, 1997; 2003, 1334, 3355, 3522)
NRS 689A.340 Limitation on provisions not subject to chapter; effect of violation.
1. No policy provision which is not subject to this chapter shall make a policy, or any portion thereof, less favorable in any respect to the insured or the beneficiary than the provisions thereof which are subject to this chapter.
2. A policy delivered or issued for delivery to any person in this state in violation of this chapter shall be held valid but shall be construed as provided in this chapter. When any provision in a policy subject to this chapter is in conflict with any provision of this chapter, the rights, duties and obligations of the insurer, the insured and the beneficiary shall be governed by the provisions of this chapter.
(Added to NRS by 1971, 1765)
NRS 689A.350 Age limit. If any such policy contains a provision establishing, as an age limit or otherwise, a date after which the coverage provided by the policy will not be effective, and if such date falls within a period for which a premium is accepted by the insurer or if the insurer accepts a premium after such date, the coverage provided by the policy will continue in force subject to any right of termination until the end of the period for which the premium has been accepted. If the age of the insured has been misstated and if, according to the correct age of the insured, the coverage provided by the policy would not have become effective, or would have ceased prior to the acceptance of such premium or premiums, then the liability of the insurer shall be limited to the refund of all premiums paid for the period not covered by the policy.
(Added to NRS by 1971, 1765)
NRS 689A.360 Filing of rates. Each insurer issuing individual health insurance policies for delivery in this state shall, before use thereof, file with the Commissioner its premium rates and classification of risks pertaining to such policies. The insurer shall adhere to its rates and classifications as filed with the Commissioner. The insurer may change such filings from time to time as it deems proper.
(Added to NRS by 1971, 1765)
NRS 689A.370 Health insurance on franchise plan.
1. Health insurance on a franchise plan is hereby declared to be that form of health insurance issued to:
(a) Three or more employees of any corporation, copartnership or individual employer or any governmental corporation, agency or department thereof; or
(b) Ten or more members, employees or employees of members of any trade or professional association or of a labor union or of any other association having had an active existence for at least 2 years where such association or union has a constitution or bylaws and is formed in good faith for purposes other than that of obtaining insurance,
where such persons with or without their dependents, are issued the same form of an individual policy varying only as to amounts and kinds of coverage applied for by such persons under an arrangement whereby the premiums on such policies may be paid to the insurer periodically by the employer, with or without payroll deductions, or by the insured, or the association or union for its members, or by some designated person acting on behalf of such employer or association or union. The term “employees” as used in this section shall be deemed to include the officers, managers and employees and retired employees of the employer and the individual proprietor or partners if the employer is an individual proprietor or partnership.
2. Each policy issued under this section shall provide that the coverage shall terminate when the insured individual no longer qualifies for such policy under this section; but the policy may provide that it may be continued in force or be replaced with another policy if the premium, benefits and other relevant factors of the continued or replacement policy are the same as those of a similar individual policy not issued under or pursuant to this section.
(Added to NRS by 1971, 1765)
NRS 689A.380 Definitions of terms used in policies. As used in any policy of health insurance delivered, issued for delivery or used in this state, unless otherwise provided in the policy or in an endorsement thereon or in a rider attached thereto:
1. “Accidental death” means death by accident exclusively and independently of all other causes.
2. “Confinement to house” or “house confinement” includes the activities of a convalescent not able to be gainfully employed.
3. “Medical or surgical services” includes also services within the scope of his license rendered by any person while duly licensed by the State of Nevada under any of the following chapters of NRS: 631 (dentistry); 633 (osteopathic medicine); 634 (chiropractic); 634A (Oriental medicine); 635 (podiatry); or 636 (optometry). No policy of health insurance may provide that the insured does not have the option of selecting any licensee provided for in this subsection to perform any medical or surgical services covered by a policy of insurance if the service is within the scope of his license.
4. “Total disability” means inability to perform the duties of any gainful occupation for which the insured is reasonably fitted by training, experience and accomplishment.
(Added to NRS by 1971, 1766; A 1971, 1953; 1975, 240; 1977, 966)
NRS 689A.390 Summary of coverage: Contents of disclosure; approval by Commissioner.
1. The Commissioner shall adopt regulations which require an insurer to file with the Commissioner, for his approval, a disclosure summarizing the coverage provided by each policy of health insurance offered by the insurer. The disclosure must include:
(a) Any significant exception, reduction or limitation that applies to the policy; and
(b) Any other information,
that the Commissioner finds necessary to provide for full and fair disclosure of the provisions of the policy.
2. The disclosure must be written in language which is easily understood and must include a statement that the disclosure is a summary of the policy only, and that the policy itself should be read to determine the governing contractual provisions.
3. The Commissioner shall not approve any proposed disclosure submitted to him pursuant to this section which does not comply with the requirements of this section and the applicable regulations.
(Added to NRS by 1989, 1248)
NRS 689A.400 Summary of coverage: Copy to be provided before policy issued; policy may not be offered unless summary approved by Commissioner. An insurer shall provide each person to whom it offers a policy of health insurance with a copy of the disclosure approved for that policy pursuant
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