by more than 75 percent. 4. For the purposes of this section, rating characteristics must not include durational or tier rating, or adverse changes in health status or claim experience after the policy is issued. 5. As used in this section, “characteristics” means demographic or other information concerning individuals that is considered by a carrier in the determination of premium rates for individuals. (Added to NRS by 1997, 2894; A 1999, 2805) NRS 689A.685 Amount of change in rate of single block of business; plan with provision for restricted network; involuntary transfer of individual or dependent prohibited; premiums adjusted for block of business. 1. The amount of change in the rate of a single block of business of an individual carrier in any 12-month period because of claims experience or health status-related factors of that block of business, after adjustment for allowed rating characteristics and design of benefits, must not exceed the amount of any similar change in the rate of any other block of business of that individual carrier during the same period by more than 15 percent. 2. For the purposes of NRS 689A.470 to 689A.740, inclusive, a health benefit plan that contains a provision for a restricted network must not be considered to be a similar design of benefits when compared to a health benefit plan that does not contain such a provision if the restriction of benefits to the network providers results in substantial differences in the cost of claims. 3. An individual carrier shall not transfer an individual or his dependent covered by an individual health benefit plan issued by the individual carrier involuntarily into or out of a block of business. 4. If an individual carrier adjusts its premiums for a block of business to a level that is higher than permitted by requirements relating to the ratio of losses, as set forth in this Title and the regulations adopted pursuant thereto, to comply with this section and NRS 689A.680, the individual carrier shall make such adjustments on its entire individual health benefit plan business as needed to meet those requirements. (Added to NRS by 1997, 2895) NRS 689A.690 Information required to be disclosed as part of solicitation and sales materials; information required to be maintained at place of business; actuarial certification required to be filed with Commissioner. 1. As part of its solicitation and sales materials for an individual health benefit plan, an individual carrier shall disclose, to the extent reasonable: (a) The extent to which premium rates for an individual and his dependent are established or adjusted based upon rating characteristics; (b) The right of the individual carrier to change premium rates and the factors, other than claims experience, that may affect changes in premium rates; (c) Any provisions in the individual health benefit plan relating to the renewability of the plan; and (d) Any provisions in the individual health benefit plan relating to an exclusion for a preexisting condition. 2. For the purposes of this section, an individual carrier shall maintain at its principal place of business a complete and detailed description of its rating practices and underwriting practices, including information and documentation that demonstrate that its rating methods and practices are based upon commonly accepted actuarial assumptions and are in accordance with sound actuarial principles. 3. On or before March 1 of each year, an individual carrier shall file with the Commissioner an actuarial certification that the individual carrier is in compliance with NRS 689A.680 to 689A.700, inclusive, and that the rating methods of the individual carrier are actuarially sound. The certification must be in such a form and must contain such information as specified by the Commissioner. A copy of the certification must be retained by the individual carrier at its principal place of business. 4. As used in this section, “actuarial certification” means a written statement signed by a member of the American Academy of Actuaries or any other person acceptable to the Commissioner that an individual carrier is in compliance with the provisions of NRS 689A.680 to 689A.700, inclusive, based upon an examination conducted by the person which included a review of the appropriate records and the actuarial assumptions and methods used by the individual carrier in establishing premium rates for applicable health benefit plans. (Added to NRS by 1997, 2895) NRS 689A.695 Information and documents to be made available to Commissioner; proprietary information. An individual carrier shall make the information and documents described in NRS 689A.680 to 689A.700, inclusive, available to the Commissioner upon request. Except in cases of violations of the provisions of this chapter, the information, other than the premium rates charged by the individual carrier, is proprietary, constitutes a trade secret and is not subject to disclosure by the Commissioner to persons outside of the Division except as agreed to by the individual carrier or as ordered by a court of competent jurisdiction. (Added to NRS by 1997, 2896) NRS 689A.700 Regulations regarding rates. The Commissioner may adopt regulations to carry out the provisions of NRS 689A.680 to 689A.700, inclusive, and to ensure that the practices used by individual carriers relating to the establishment of rates are consistent with the purposes of NRS 689A.470 to 689A.740, inclusive, including, but not limited to, determining the manner in which geographic areas are designated by all individual carriers. (Added to NRS by 1997, 2895) NRS 689A.705 Regulations concerning reissuance of health benefit plan. The Commissioner may adopt regulations to require an individual carrier, as a condition of transacting business with individuals in this state after July 16, 1997, to reissue a health benefit plan to any individual whose health benefit plan has been terminated or not renewed by the individual carrier after July 1, 1997. The Commissioner may prescribe such terms for the reissue of coverage as he finds are reasonable and necessary to provide continuity of coverage to individuals. (Added to NRS by 1997, 2897) NRS 689A.710 Prohibited acts; denial of application for coverage; regulations; violation may constitute unfair trade practice; applicability of section. 1. Except as otherwise provided in this section, an individual carrier or a producer shall not, directly or indirectly: (a) Encourage or direct an eligible person to refrain from filing an application for coverage with an individual carrier because of the health status, claims experience, industry, occupation or geographic location of the eligible person. (b) Encourage or direct an eligible person to seek coverage from another carrier because of the health status, claims experience, industry, occupation or geographic location of the eligible person. 2. The provisions of subsection 1 do not apply to information provided to an eligible person by an individual carrier or a producer relating to the established geographic service area or a provision for a restricted network of the individual carrier. 3. Except as otherwise provided in this subsection, an individual carrier shall not, directly or indirectly, enter into any contract, agreement or arrangement with a producer if the contract, agreement or arrangement provides for or results in a variation to the compensation paid to a producer for the sale of a health benefit plan because of the health status, claims experience, industry, occupation or geographic location of the individual at the time that the health benefit plan is issued to or renewed by the individual. The provisions of this subsection do not apply to any arrangement for compensation that provides payment to a producer on the basis of a percentage of premiums, except that the percentage may no

Vegas Law