e Retirement Security Act of 1974, as that section existed on July 16, 1997. (Added to NRS by 1997, 2888) NRS 689A.585 “Preexisting condition” defined. “Preexisting condition” means a condition, regardless of the cause of the condition, for which medical advice, diagnosis, care or treatment was recommended or received during the 6 months preceding the effective date of the new coverage. The term does not include genetic information in the absence of a diagnosis of the condition related to such information. (Added to NRS by 1997, 2888) NRS 689A.590 “Producer” defined. “Producer” means an agent or broker licensed pursuant to this Title. (Added to NRS by 1997, 2888) NRS 689A.595 “Program of Reinsurance” defined. “Program of Reinsurance” means the Program of Reinsurance for Small Employers and Eligible Persons established pursuant to NRS 689C.740. (Added to NRS by 1997, 2888) NRS 689A.600 “Provision for a restricted network” defined. “Provision for a restricted network” means any provision of a health benefit plan that conditions the payment of benefits, in whole or in part, on the use of a provider of health care that has entered into a contractual arrangement with an individual carrier to provide health care services to individuals covered by the plan. (Added to NRS by 1997, 2888) NRS 689A.605 “Standard health benefit plan” defined. “Standard health benefit plan” means a standard health benefit plan developed pursuant to NRS 689C.610 to 689C.980, inclusive. (Added to NRS by 1997, 2888) NRS 689A.610 Applicability; ceding arrangement prohibited in certain circumstances. 1. NRS 689A.470 to 689A.740, inclusive, apply to: (a) Any health benefit plan that must be made available to eligible persons; and (b) Any certificate issued to a trust or an association or other similar groupings of persons for coverage of eligible persons, regardless of the location of delivery of the policy or certificate, if the eligible person pays the premium and is not otherwise covered under the policy or contract pursuant to any federal or state law relating to the continuation of benefits. 2. For the purposes of NRS 689A.470 to 689A.740, inclusive, and except as otherwise provided in subsection 3, two or more individual carriers which are affiliated companies or which are eligible to file a consolidated tax return shall be deemed to be one individual carrier, and any restriction or limitation imposed by NRS 689A.470 to 689A.740, inclusive, applies as if all health benefit plans delivered or issued for delivery to eligible persons in this State by the affiliated individual carriers were issued by one individual carrier. 3. An affiliated individual carrier that is a health maintenance organization having a certificate of authority issued pursuant to the provisions of chapter 695C of NRS may be considered a separate individual carrier for the purposes of NRS 689A.470 to 689A.740, inclusive. 4. Unless otherwise authorized by the Commissioner, an individual carrier shall not enter into any ceding arrangement with respect to a health benefit plan delivered or issued for delivery to any eligible person in this State if the ceding arrangement would result in the ceding individual carrier retaining less than 30 percent of the insurance obligations or risks for that health benefit plan. (Added to NRS by 1997, 2888) NRS 689A.615 Certain plan, fund or program to be treated as employee welfare benefit plan which is group health plan; partnership deemed employer of each partner. For the purposes of NRS 689A.470 to 689A.740, inclusive: 1. Any plan, fund or program which would not be, but for section 2721(e) of the Public Health Service Act, as amended by Public Law 104-191, as that section existed on July 16, 1997, an employee welfare benefit plan and which is established or maintained by a partnership to the extent that the plan, fund or program provides medical care to current or former partners in the partnership or to their dependents, as defined under the terms of the plan, fund or program, directly or through insurance, reimbursement or otherwise, must be treated, subject to subsection 2, as an employee welfare benefit plan which is a group health plan. 2. In the case of a group health plan, a partnership shall be deemed to be the employer of each partner. (Added to NRS by 1997, 2889) NRS 689A.620 Certain person with break in coverage deemed eligible person. A person who meets the requirements to be an eligible person as set forth in NRS 689A.515, except that the person had a break in creditable coverage of more than 63 days, shall be deemed to be an eligible person and is eligible to obtain health insurance coverage pursuant to this chapter as an eligible person if the person seeks that coverage between January 1, 1998, and January 31, 1998, inclusive. (Added to NRS by 1997, 2889) NRS 689A.625 Supplemental coverage not health benefit plan if individual carrier files annual certification with Commissioner. Supplemental coverage is not a health benefit plan if: 1. On or before March 1 of each year, the individual carrier files a certification with the Commissioner which contains: (a) A statement from the individual carrier certifying that the policies or certificates described are being offered and marketed as supplemental health insurance and not as a substitute for hospital or medical expense insurance or major medical expense insurance; and (b) A summary description of each policy or certificate described, including the average annual premium rates, or range of premium rates for cases in which premiums vary by age, sex or other factors, charged for the policies and certificates in this state. 2. In the case of a policy or certificate that is offered for the first time in this state on or after January 1, 1998, the individual carrier files with the Commissioner the statement and summary description required by subsection 1 at least 30 days before the date on which the policy or certificate is issued or delivered in this state. (Added to NRS by 1997, 2890) Individual Carriers NRS 689A.630 Requirement to renew coverage at option of individual; exceptions; discontinuation of form of product of health benefit plan; discontinuation of health benefit plan available through bona fide association. 1. Except as otherwise provided in this section, coverage under an individual health benefit plan must be renewed by the individual carrier that issued the plan, at the option of the individual, unless: (a) The individual has failed to pay premiums or contributions in accordance with the terms of the health benefit plan or the individual carrier has not received timely premium payments. (b) The individual has performed an act or a practice that constitutes fraud or has made an intentional misrepresentation of material fact under the terms of the coverage. (c) The individual carrier decides to discontinue offering and renewing all health benefit plans delivered or issued for delivery in this state. If the individual carrier decides to discontinue offering and renewing such plans, the individual carrier shall: (1) Provide notice of its intention to the Commissioner and the chief regulatory officer for insurance in each state in which the individual carrier is licensed to transact insurance at least 60 days before the date on which notice of cancellation or nonrenewal is delivered or mailed to the persons covered by the insurance to be discontinued pursuant to subparagraph (2). (2) Provide notice of its intention to all persons covered by the discontinued insurance and to the Commissioner and the chief regulatory officer for insurance in each state in which such a person is known to reside. The notice must be made at least 180 days before the nonrenewal of any health benefit plan by the individual carrier.

Vegas Law