policy. A policy issued by a risk retention group must contain in 10-point type on the front page and the declaration page, the following notice: NOTICE This policy is issued by your risk retention group. Your risk retention group may not be subject to all of the insurance laws and regulations of your state. State insolvency guaranty funds are not available for your risk retention group. (Added to NRS by 1987, 1332) NRS 695E.190 Examination by Commissioner; compliance with order of Commissioner; enforcement of order issued by federal court. 1. A risk retention group shall submit to an examination by the Commissioner to determine its financial condition if the commissioner of insurance of the jurisdiction in which the group is chartered does not initiate such an examination within 60 days after a request by the Commissioner of Insurance of this state. The examination must be coordinated to avoid unjustified repetition and conducted in an expeditious manner. The Commissioner shall give due consideration to the procedure outlined in the handbook for examiners sponsored by the National Association of Insurance Commissioners. 2. A risk retention group not chartered in this state and doing business in this state shall comply with a lawful order issued in a proceeding for voluntary dissolution or in a delinquency proceeding commenced by a commissioner of insurance of any state if there has been a finding of financial impairment after an examination conducted pursuant to subsection 1. 3. An order issued by a District Court of the United States, entered upon a finding that a risk retention group is in a hazardous financial condition, that enjoins the group from conducting operations or transacting insurance in any state, must be enforced by the district courts of this state. (Added to NRS by 1987, 1332) NRS 695E.200 Prohibited acts. A risk retention group shall not: 1. Transact insurance with any person who is not eligible for membership in the risk retention group; 2. Conduct any business in this state if an insurer is directly or indirectly a member or owner of the group, unless all the members of the group are insurers; 3. Transact insurance or otherwise operate while financially impaired or in a hazardous financial condition; 4. Issue any insurance policy with terms providing, or which have been construed as providing, coverage prohibited by a specific statute of this state or declared unlawful by the highest court of this state which has rendered a judgment concerning the legality of that coverage; or 5. Join or contribute financially to the Nevada Insurance Guaranty Association, or to any similar organization or fund in this state, and the provisions of chapter 687A of NRS do not apply to a risk retention group. A risk retention group and its insureds shall not accept any benefit from such an organization or fund for claims arising out of the operation of the risk retention group. (Added to NRS by 1987, 1332; A 1995, 1783) MISCELLANEOUS PROVISIONS NRS 695E.210 Applicability of other provisions; fines and penalties for violation of chapter. 1. Any person acting, or offering to act, as an agent or broker for a purchasing group, a member of a purchasing group under the group policy, or a risk retention group transacting insurance in this state is subject to the provisions of chapters 683A and 685A of NRS. 2. Except as otherwise provided in this chapter, the provisions of chapter 679B of NRS apply to purchasing groups and risk retention groups, and to the provisions of this chapter, to the extent that the provisions of chapter 679B of NRS are not specifically preempted by the Product Liability Risk Retention Act of 1981, as amended by the Risk Retention Amendments of 1986. 3. A risk retention group that violates any provision of this chapter is subject to the fines and penalties, including revocation of its right to do business in this state, applicable to licensed insurers under this title. (Added to NRS by 1987, 1333; A 1995, 1784) NRS 695E.220 Annual notice of intent to continue doing business in Nevada. On or before March 1 of each year, a purchasing group and a risk retention group shall submit to the Commissioner a written notice of its intention to continue doing business in Nevada. (Added to NRS by 1991, 2037) CHAPTER 695G - MANAGED CARE GENERAL PROVISIONS NRS 695G.010 Definitions. NRS 695G.012 “Adverse determination” defined. NRS 695G.014 “Authorized representative” defined. NRS 695G.016 “Clinical peer” defined. NRS 695G.018 “External review organization” defined. NRS 695G.020 “Health care plan” defined. NRS 695G.030 “Insured” defined. NRS 695G.040 “Managed care” defined. NRS 695G.050 “Managed care organization” defined. NRS 695G.055 “Medically necessary” defined. NRS 695G.060 “Primary care physician” defined. NRS 695G.070 “Provider of health care” defined. NRS 695G.080 “Utilization review” defined. NRS 695G.090 Applicability. NRS 695G.095 Offering policy of health insurance for purposes of establishing health savings account. NRS 695G.100 Documents treated as public record. ADMINISTRATION OF MANAGED CARE ORGANIZATIONS NRS 695G.110 Medical director must be physician licensed in this State. NRS 695G.120 Utilization review: Written policies and procedures; subcontracting. NRS 695G.125 Contracts with certain federally qualified health centers. NRS 695G.130 Report regarding methods for reviewing quality of health care services: Requirements; availability for public inspection. NRS 695G.140 Responsibility for money in fiduciary relationship to insured. COVERAGE BY MANAGED CARE ORGANIZATIONS NRS 695G.150 Authorization of recommended and covered health care services required. NRS 695G.160 Written criteria concerning coverage of health care services and standards for quality of health care services. NRS 695G.163 Coverage for prescription drugs: Provision of notice and information regarding use of formulary. NRS 695G.164 Required provision concerning coverage for continued medical treatment. NRS 695G.166 Required provision concerning coverage for prescription drug previously approved for medical condition of insured. NRS 695G.168 Required provision concerning coverage for screening for colorectal cancer. NRS 695G.170 Required provision concerning coverage for medically necessary emergency services; prohibitions. NRS 695G.173 Required provision concerning coverage for treatment received as part of clinical trial or study. NRS 695G.175 Certain actions of managed care organization prohibited. QUALITY ASSURANCE PROGRAM NRS 695G.180 Quality assurance program: Requirements; written description; informing providers; necessary staff; review; responsibility for activities. NRS 695G.190 Quality improvement committee: Administration; duties. SYSTEM FOR RESOLVING COMPLAINTS OF INSUREDS NRS 695G.200 Approval; requirements; assistance for persons filing complaints; examination. NRS 695G.210 Review board; appeal; right to expedited review of complaint; notice to insured. NRS 695G.220 Annual report; managed care organization to maintain records of complaints concerning something other than health care services. NRS 695G.230 Written notice to insured explaining rights of insureds regarding decision to deny coverage; notice to insured when organization denies coverage of health care service. EXTERNAL REVIEW OF ADVERSE DETERMINATION NRS 695G.241 Adverse determination deemed final for purpose of submitting to external review organization. NRS 695G.251 Request for review; assignment of external review organ

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