2735; 2003, 3333, 3367) NRS 695C.057 Applicability of certain provisions concerning portability and availability of health insurance. 1. A health maintenance organization is subject to the provisions of NRS 689B.340 to 689B.590, inclusive, and chapter 689C of NRS relating to the portability and availability of health insurance offered by such organizations. If there is a conflict between the provisions of this chapter and the provisions of NRS 689B.340 to 689B.590, inclusive, and chapter 689C of NRS, the provisions of NRS 689B.340 to 689B.590, inclusive, and chapter 689C of NRS control. 2. For the purposes of subsection 1, unless the context requires that a provision apply only to a group health plan or a carrier that provides coverage under a group health plan, any reference in those sections to “group health plan” or “carrier” must be replaced by “health maintenance organization.” (Added to NRS by 1997, 2957) NRS 695C.060 Establishment of organization. 1. Any person may apply to the Commissioner for and obtain a certificate of authority to establish and operate a health maintenance organization in compliance with this chapter. No person shall operate a health maintenance organization without obtaining a certificate of authority under this chapter. A foreign corporation may qualify under this chapter, subject to its qualification to do business in this state as a foreign corporation. 2. No person shall be certified to establish or operate a health maintenance organization in this state, nor sell or offer to sell, or solicit offers to purchase or receive advance or periodic consideration in conjunction with health care plans unless such health maintenance organization provides or arranges for the provision of comprehensive health care services. 3. Every health maintenance organization or person operating a health maintenance organization shall submit an application for a certificate of authority under NRS 695C.070 within 30 days after July 1, 1973. Each such applicant may continue to operate until the Commissioner acts upon the application. In the event that an application is denied under NRS 695C.090 and 695C.100, the applicant shall thereafter be treated as a health maintenance organization whose certificate of authority has been revoked. For purposes of this subsection, a health maintenance organization shall be deemed to be in operation only if health care services are being provided to the public generally or to some group or groups thereof. (Added to NRS by 1973, 1247) NRS 695C.070 Certificate of authority: Application. Each application for a certificate of authority must be verified by an officer or authorized representative of the applicant, must be in a form prescribed by the Commissioner, and must set forth or be accompanied by the following: 1. A copy of the basic organizational document, if any, of the applicant, and all amendments thereto; 2. A copy of the bylaws, rules or regulations, or a similar document, if any, regulating the conduct of the internal affairs of the applicant; 3. A list of the names, addresses and official positions of the persons who will be responsible for the conduct of the affairs of the applicant, including all members of the board of directors, board of trustees, executive committee, or other governing board or committee, the officers in the case of a corporation, and the partners or members in the case of a partnership or association; 4. A copy of any contract made or to be made between any providers or persons listed in subsection 3 and the applicant; 5. A statement generally describing the health maintenance organization, its health care plan or plans, the location of facilities at which health care services will be regularly available to enrollees and the type of health care personnel who will provide the health care services; 6. A copy of the form of evidence of coverage to be issued to the enrollees; 7. A copy of the form of the group contract, if any, which is to be issued to employers, unions, trustees or other organizations; 8. Certified financial statements showing the applicant’s assets, liabilities and sources of financial support; 9. The proposed method of marketing the plan, a financial plan which includes a 3-year projection of the initial operating results anticipated and the sources of working capital and any other sources of funding; 10. A power of attorney, executed by the applicant, appointing the Commissioner and his authorized deputies as the true and lawful attorney of such applicant in and for this State upon whom all lawful process in any legal action or proceeding against the health maintenance organization on a cause of action arising in this State may be served; 11. A statement reasonably describing the geographic area to be served; 12. A description of the procedures for resolving complaints and procedures for external reviews to be used as required under NRS 695C.260; 13. A description of the procedures and programs to be implemented to meet the quality of health care requirements in NRS 695C.080; 14. A description of the mechanism by which enrollees will be afforded an opportunity to participate in matters of program content under subsection 2 of NRS 695C.110; and 15. Such other information as the Commissioner may require to make the determinations required in NRS 695C.080. (Added to NRS by 1973, 1247, A 2003, 777) NRS 695C.080 Certificate of authority: Evaluation of application. 1. Upon receipt of an application for issuance of a certificate of authority, the Commissioner shall forthwith transmit copies of such application and accompanying documents to the State Board of Health. 2. The State Board of Health shall determine whether the applicant for a certificate of authority, with respect to health care services to be furnished: (a) Has demonstrated the willingness and ability to assure that such health care services will be provided in a manner to assure both availability and accessibility of adequate personnel and facilities and in a manner enhancing availability, accessibility and continuity of service; (b) Has organizational arrangements, established in accordance with regulations promulgated by the State Board of Health; and (c) Has a procedure established in accordance with regulations of the State Board of Health to develop, compile, evaluate and report statistics relating to the cost of its operations, the pattern of utilization of its services, the availability and accessibility of its services and such other matters as may be reasonably required by the State Board of Health. 3. Within 90 days of receipt of the application for issuance of a certificate of authority, the State Board of Health shall certify to the Commissioner whether the proposed health maintenance organization meets the requirements of subsection 2. If the State Board of Health certifies that the health maintenance organization does not meet such requirements, it shall specify in what respects it is deficient. (Added to NRS by 1973, 1249) NRS 695C.090 Certificate of authority: Issuance. The Commissioner shall issue or deny a certificate of authority to any person filing an application pursuant to NRS 695C.060 within 90 days of receipt of the certification from the State Board of Health. Issuance of a certificate of authority must be granted upon payment of the fees prescribed in NRS 695C.230 if the Commissioner is satisfied that the following conditions are met: 1. The persons responsible for the conduct of the affairs of the applicant are competent, trustworthy and possess good reputations. 2. The State Board of Health certifies, in accordance with NRS 695C.080, that the health maintenance organization’s proposed plan of operation meets the requirements of subsection 2 of NRS 695C.080. 3. The health care plan furnishes co

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