er that it has regained the capacity to deliver adequate service to additional eligible persons in that service area. (Added to NRS by 1997, 2893) NRS 689A.650 Coverage to eligible persons not required under certain circumstances; notice to Commissioner of and prohibition on writing new business after election not to offer new coverage required. 1. An individual carrier is not required to provide coverage to eligible persons pursuant to NRS 689A.640: (a) During any period in which the Commissioner determines that requiring the individual carrier to provide such coverage would place the individual carrier in a financially impaired condition. (b) If the individual carrier elects not to offer any new coverage to any persons in this State. An individual carrier that elects not to offer new coverage in accordance with this paragraph may maintain its existing policies issued to persons in this State, subject to the requirements of NRS 689A.630. 2. An individual carrier that elects not to offer new coverage pursuant to paragraph (b) of subsection 1 shall notify the Commissioner forthwith of that election and shall not thereafter write any new business to individuals in this State for 5 years after the date of the notification. (Added to NRS by 1997, 2893; A 1999, 2805) NRS 689A.655 Requirement to file basic and standard health benefit plans with Commissioner; disapproval of plan. 1. Each individual carrier shall file with the Commissioner within 90 days after the date on which a basic health benefit plan and a standard health benefit plan are approved pursuant to NRS 689C.770, or for a new individual carrier within 90 days after the date it enters the individual market in this State, in a format and manner prescribed by the Commissioner, the basic health benefit plans and the standard health benefit plans to be offered by the individual carrier. A health benefit plan filed pursuant to this section may not be offered by an individual carrier until the earlier of: (a) The date of approval by the Commissioner; or (b) Thirty days after the date on which the plans are filed, unless the Commissioner disapproves the use of the plans before the 30-day period expires. 2. The Commissioner may, at any time, after providing notice and an opportunity for a hearing, disapprove the continued use of a basic or standard health benefit plan by the individual carrier on the ground that the plan does not meet the requirements of NRS 689A.470 to 689A.740, inclusive, and 689C.610 to 689C.980, inclusive. (Added to NRS by 1997, 2892) NRS 689A.660 Prohibited acts concerning preexisting conditions and modification of health benefit plan. An individual carrier shall not: 1. Impose on an eligible person who is covered under a basic or standard health benefit plan any exclusion because of a preexisting condition. 2. Modify a health benefit plan, with respect to an eligible person, through riders, endorsements or otherwise, to restrict or exclude services otherwise covered by the plan. (Added to NRS by 1997, 2893; A 1999, 2805) NRS 689A.665 Certain health carriers not required to offer health benefit insurance coverage to individuals. Nothing in NRS 689A.640 to 689A.660, inclusive, requires a health carrier that offers a health benefit plan only in connection with a group health plan or through a bona fide association, or both, to offer such health benefit insurance coverage to individuals. (Added to NRS by 1997, 2893) NRS 689A.670 Election to operate as individual risk-assuming carrier or individual reinsuring carrier: Notice to Commissioner; effective date; change in status. 1. Within 30 days after the date on which a plan of operation is approved by the Commissioner pursuant to NRS 689C.770, or for a new carrier within 30 days after the date on which it enters the individual market in this state, an individual carrier shall elect to operate as either an individual risk-assuming carrier or an individual reinsuring carrier and shall notify the Commissioner of its election. 2. The initial election of an individual carrier to act as an individual risk-assuming or reinsuring carrier is effective on the individual carrier for 2 years after the date on which it notifies the Commissioner pursuant to subsection 1. After the initial 2-year period, such an election is effective for 5 years. The Commissioner may allow an individual carrier to modify its election at any time for good cause shown. The Commissioner may waive or modify the period during which the election of a carrier to operate as an individual risk-assuming or reinsuring carrier is effective. 3. An individual carrier may apply to the Commissioner, in a manner prescribed by the Commissioner by regulation, to change its status as an individual risk-assuming or reinsuring carrier. 4. An individual reinsuring carrier that elects or is subsequently authorized by the Commissioner to operate as a risk-assuming carrier: (a) Shall not continue to reinsure any individual health benefit plan with the Program of Reinsurance. (b) Shall pay a prorated assessment based upon business issued as an individual reinsuring carrier for any portion of the year that the business was reinsured. (Added to NRS by 1997, 2893) NRS 689A.675 Election to act as individual risk-assuming carrier: Suspension by Commissioner; applicable statutes. 1. The Commissioner may suspend the election of an individual carrier to act as an individual risk-assuming carrier, if the Commissioner finds that: (a) The financial condition of the individual carrier no longer supports the assumption of risk from issuing coverage to eligible persons in compliance with NRS 689A.640 to 689A.660, inclusive, without the protection afforded by the Program of Reinsurance; (b) The individual carrier has failed to market its health benefit plans fairly to all eligible persons in this state or in its established geographic service area, as applicable; or (c) The individual carrier has failed to provide coverage to eligible persons as required pursuant to NRS 689A.640 to 689A.660, inclusive. 2. An individual carrier that elects to become an individual risk-assuming carrier is subject to: (a) The provisions of NRS 689A.640 to 689A.660, inclusive, relating to the availability of coverage; and (b) The provisions of NRS 689A.680 to 689A.700, inclusive, relating to premium rates. (Added to NRS by 1997, 2894) NRS 689A.680 Rates for individual health benefit plans to be developed based on rating characteristics: Prohibited characteristics; health status as rating factor. 1. An individual carrier shall develop its rates for its individual health benefit plans pursuant to NRS 689A.470 to 689A.740, inclusive, based on rating characteristics. After any adjustments for rating characteristics and design of benefits, the rate for any block of business for an individual health benefit plan written on or after January 1, 2000, must not exceed the rate for any other block of business for an individual health benefit plan offered by the individual carrier by more than 50 percent. The rate for a block of business is equal to the average rate charged to all the insureds in the block of business. In determining whether the rate of a block of business complies with the provisions of this subsection, any differences in rating factors between blocks of business must be considered. 2. In determining the rating factors to establish premium rates for a health benefit plan, an individual carrier shall not use characteristics other than age, sex, occupation, geographic area, composition of the family of the individual and health status. 3. If an individual carrier uses health status as a rating factor in establishing premium rates, the highest factor associated with any classification for health status may not exceed the lowest factor

Vegas Law