Nac: Chapter 683A - Persons Involved In Sale Or Administration Of Insurance

Link to law: http://www.leg.state.nv.us/nac/NAC-683A.html
Published: 2015

[Rev. 11/22/2013 10:24:34

AM--2013]



[NAC-683A Revised Date: 11-13]

CHAPTER 683A - PERSONS INVOLVED IN SALE OR

ADMINISTRATION OF INSURANCE

GENERAL PROVISIONS

683A.005         Definitions.

LICENSING OF BANKS

683A.080         Adoption of definitions pertaining

to certain restrictions on licensing.

683A.082         “Affiliate” defined.

683A.086         “Company” defined.

683A.088         “Control” defined.

683A.089         “Credit property insurance” defined.

683A.090         “Demand deposit” defined.

683A.092         “Parent” defined.

683A.094         “Subsidiary” defined.

ADMINISTRATORS

683A.100         “Insurer” defined.

683A.103         Interpretation of terms used in

definition of “administrator.”

683A.105         Application for certificate of

registration.

683A.115         Evaluation of applicant.

683A.119         Determination of whether

administrator or applicant is financially unsound.

683A.125         Duty to notify Commissioner of

certain changes and provide copies of certain agreements.

683A.131         Annual report: Contents of financial

statement.

683A.133         Annual report: Filing fee.

683A.155         Bond or certificate of deposit.

683A.165         Administrator of self-insurance

reserve fund.

PRELICENSING EDUCATION

683A.170         Exemptions.

683A.180         Course of instruction required;

passing grade.

683A.190         Approval of course of instruction

and instructor.

683A.201         Qualifications of instructor;

limitation on instruction by unqualified instructor or mechanical aid.

683A.211         Correspondence, extension or

self-study course.

683A.221         Subject matter of courses; hours of

instruction.

683A.225         Course of instruction for bail

bonds.

683A.231         Records; submission of certain

information quarterly; certificate of completion for student.

683A.241         Changes in sponsor, instructor or

outline of course; suspension and revocation of approval of course.

683A.251         Submission or issuance of false or

fraudulent documents; determination of sponsor or instructor as unsuitable

person.

683A.261         Forms.

LICENSING OF PRODUCERS OF INSURANCE AND INSURANCE CONSULTANTS

683A.270         Required score on examination.

683A.272         Search of records of criminal

history.

683A.275         Short-term lessor of passenger

vehicles: Licensure requirement; provision for training and supervision of

employees; maintenance and availability of records.

REGISTRATION OF AGENTS WHO PERFORM UTILIZATION REVIEW

683A.280         Definitions.

683A.285         Registration of insurer; plan for

utilization review; insurer to report changes; renewal of registration.

683A.290         Employee of registered agent not

required to pay certain fees for registration or renewal.

683A.295         Fees for photocopies of plan for

utilization review; written request for photocopies required.

MISCELLANEOUS PROVISIONS

683A.310         Payments of premium made after

termination of producer’s agreement.

683A.315         Sale of annuities by banks: Required

disclosures.

683A.317         Renewal of appointment of producer

of insurance: Verification of records; fee.

CONTINUING EDUCATION

683A.318         Definitions.

683A.320         “Course” defined.

683A.322         “Designated representative” defined.

683A.325         Applicability of provisions.

683A.327         Designated representative: Authority

of Commissioner.

683A.330         Requirements for renewal of license.

683A.335         Requirements for approval of

courses.

683A.337         Requirements for advertisement of

courses.

683A.340         Duties of providers of approved

courses.

683A.345         Credit for completion of certain

unapproved courses.

683A.350         Number of hours approved for certain

courses; credit for licensee who attends or teaches course.

683A.355         Limitations on receipt and use of

credit.

683A.360         Verification of continuing

education.

683A.365         Suspension or revocation of approval

of course; auditing of course; reinstatement of approval.

683A.370         Compliance with requirements;

submission of false or fraudulent affidavit.

FIDUCIARY ACCOUNTS

683A.390         “Licensee” defined.

683A.400         Authorized types of accounts.

683A.410         Licensee to be named as trustee;

signature cards.

683A.420         Formula for determining status of

fiduciary account.

683A.430         Curing of deficiency.

683A.440         Failure to remit return premium.

MANAGING GENERAL AGENTS

683A.450         Definitions.

683A.460         Licensing and bonding; maintenance

of policy for errors and omissions.

683A.470         Written contract with insurer.

683A.480         Accounts, books and records.

683A.490         Retention of reserve; assignment of

contract with insurer.

683A.500         Authority of insurer to terminate

contract with agent, suspend agent’s authority, and cancel or refuse to renew

policy.

683A.510         Handling of claims which agent has

authority to settle; suspension and termination of authority to settle claims.

683A.520         Sharing of profits between agent and

insurer.

683A.530         Prohibited acts of agent.

683A.540         Duties of insurers.

683A.550         Acts of agent deemed to be acts of

insurer; examination of agent.

683A.560         Disciplinary action; rights of

policyholders, claimants and auditors not restricted.

EXTERNAL REVIEW ORGANIZATIONS

Certification

683A.600         Application for initial issuance of

certificate: Generally.

683A.610         Application for initial issuance of

certificate: Organization certified or accredited by accrediting body that is

nationally recognized.

683A.620         Issuance of certificate by

Commissioner.

683A.630         Expiration and renewal of

certificate.

683A.640         Fees of Commissioner.

683A.650         Refusal, suspension or revocation of

certification: Grounds; surrender of certificate.

683A.660         Duties of organization upon

termination of certification or accreditation by accrediting body that is

nationally recognized.

Conduct of Business

683A.670         Fees to conduct external reviews.

DUTIES OF BROKERS TO CLIENTS

683A.700         Definitions.

683A.702         “Affiliate” defined.

683A.704         “Broker” defined.

683A.706         “Client” defined.

683A.708         “Compensation” defined.

683A.710         “Represents” defined.

683A.712         “Transaction” defined.

683A.714         Applicability of duties.

683A.716         Self-dealing; disclosures concerning

compensation and certain quotes.

683A.718         Effect of violation.

CONTINUOUS CARE COVERAGE

683A.750         “Continuous care coverage” defined.

683A.760         Licensing required to sell, solicit

or negotiate continuous care coverage.

683A.770         Instruction required for approval of

request to sell, solicit and negotiate continuous care coverage.

683A.780         Instruction counts toward continuing

education hours.

 

GENERAL PROVISIONS

      NAC 683A.005  Definitions. (NRS 679B.130)  As used

in this chapter, unless the context otherwise requires:

     1.  “Commissioner” means the Commissioner of

Insurance of the Division.

     2.  “Division” means the Division of

Insurance of the Department of Business and Industry.

     3.  “Unsuitable person” has the meaning

ascribed to it in NAC 679B.039.

     (Supplied in codification; A by Comm’r of Insurance by

R152-99, 1-28-2000)

LICENSING OF BANKS

      NAC 683A.080  Adoption of definitions pertaining to certain restrictions on

licensing. (NRS 679B.130, 683A.231)

     1.  To carry out the purposes of NRS 683A.231, the Commissioner

adopts the definitions set forth in NAC 683A.082

to 683A.094, inclusive.

     2.  As used in NAC

683A.082 to 683A.094, inclusive, “person”

means a natural person, corporation, association, partnership or other legal

entity.

     (Added to NAC by Comm’r of Insurance, eff. 8-2-82; A 1-19-84;

5-27-92; 5-23-96)

      NAC 683A.082  “Affiliate” defined. (NRS 679B.130, 683A.231)  “Affiliate”

means any person who, directly or indirectly, controls, is controlled by or is

under common control with a bank located in this State that accepts deposits

that the depositor has a legal right to withdraw on demand.

     (Added to NAC by Comm’r of Insurance, eff. 8-2-82; A 5-23-96)

      NAC 683A.086  “Company” defined. (NRS 679B.130, 683A.231)  “Company”

means persons interested in some commercial or industrial undertaking, or other

legitimate business, but does not include a corporation in which the United

States or any state owns a majority of the shares.

     (Added to NAC by Comm’r of Insurance, eff. 8-2-82)

      NAC 683A.088  “Control” defined. (NRS 679B.130, 683A.231)

     1.  “Control” means the possession, by any

means, direct or indirect, of the power to direct or cause the direction of the

management and policies of a person, including a bank.

     2.  Control will be presumed to exist if any

person, directly or indirectly, owns, controls, holds with the power to vote or

holds proxies representing 25 percent or more of the voting securities of any

other person, including a bank.

     (Added to NAC by Comm’r of Insurance, eff. 8-2-82)

      NAC 683A.089  “Credit property insurance” defined. (NRS 679B.130,

683A.231)  “Credit

property insurance” means insurance which provides for payment of:

     1.  The outstanding balance of a loan if the

property given as security for the loan is destroyed; or

     2.  The cost of repairing the property given

as security for the loan up to the amount of the outstanding balance of the

loan.

     (Added to NAC by Comm’r of Insurance, eff. 1-19-84)

      NAC 683A.090  “Demand deposit” defined. (NRS 679B.130, 683A.231)  “Demand

deposit” means a deposit that the depositor has a legal right to withdraw upon

a proper written request.

     (Added to NAC by Comm’r of Insurance, eff. 8-2-82)

      NAC 683A.092  “Parent” defined. (NRS 679B.130, 683A.231)  “Parent”

means a person who owns or controls, directly or indirectly, in whole or in

part, a bank located in this State that accepts deposits that the depositor has

a legal right to withdraw on demand, or a bank holding company.

     (Added to NAC by Comm’r of Insurance, eff. 8-2-82; A 5-23-96)

      NAC 683A.094  “Subsidiary” defined. (NRS 679B.130, 683A.231)  “Subsidiary”

means any person owned or controlled, directly or indirectly, in whole or in

part, by a bank located in this State that accepts deposits that the depositor

has a legal right to withdraw on demand, or a bank holding company.

     (Added to NAC by Comm’r of Insurance, eff. 8-2-82; A 5-23-96)

ADMINISTRATORS

      NAC 683A.100  “Insurer” defined. (NRS 679B.130)  Unless

the context otherwise requires, any reference to “insurer” contained in NRS 683A.025, 683A.085 to 683A.0893, inclusive, and NAC 683A.105 to 683A.165,

inclusive, shall be deemed to include any employer for whom a program of

self-insurance is administered by an administrator.

     (Added to NAC by Comm’r of Insurance, eff. 11-21-88)

      NAC 683A.103  Interpretation of terms used in definition of “administrator.” (NRS 679B.130,

683A.025)

     1.  For the purposes of subsection 1 of NRS 683A.025, the “adjustment or

settlement of claims” includes, but is not limited to:

     (a) Investigating or examining claims; or

     (b) Receiving, disbursing, handling or otherwise

being responsible for the claim funds,

Ê of an

insurance company, internal service fund, program of self-insurance, or other

entity which is an administrator pursuant to NRS 683A.025.

     2.  The exemption from the definition of

“administrator” provided by paragraph (d) of subsection 2 of NRS 683A.025 does not apply to

any separate subsidiary or affiliated corporation of an insurance company.

     (Added to NAC by Comm’r of Insurance, eff. 11-21-88; A

12-15-94; R152-99, 1-28-2000)

      NAC 683A.105  Application for certificate of registration. (NRS 679B.130,

683A.08522)  Each

applicant for a certificate of registration as an administrator shall submit:

     1.  If the applicant is a newly formed

business, a pro forma balance sheet and a statement listing estimated income

and expenses for the first year, compiled in a form which complies with

generally accepted accounting principles.

     2.  Evidence of the ability of the applicant

to pay its obligations when they are due. The Division, in determining an applicant’s

ability to pay its obligations when due, will consider the capitalization and

current financial condition of the applicant and may request credit reports of

the applicant and the owners.

     (Added to NAC by Comm’r of Insurance, eff. 1-22-86; A 5-27-92;

12-15-94; R152-99, 1-28-2000)

      NAC 683A.115  Evaluation of applicant. (NRS 679B.130, 683A.08524)

     1.  The Division will, to evaluate the

competency and personal and business reputations of an applicant, review the

applicant’s past performance in handling, settling and adjudicating claims. The

applicant must include with his or her application information in his or her

business plan concerning:

     (a) The names, experience and qualifications of the

members of his or her staff;

     (b) A description of the facilities for handling

claims, including a description of any computer software used in the process;

and

     (c) The method used for handling inquiries from

claimants.

     2.  To determine:

     (a) An applicant’s or licensee’s ability to

administer; and

     (b) Whether an applicant is administering claims

properly,

Ê the Division

will review reports from clients, other agencies of this State and any agency

of another state.

     3.  An applicant who is licensed, certified

or otherwise authorized by another state to act as an administrator shall

submit to the Division a letter or certificate of good standing from the

appropriate agency of that state.

     (Added to NAC by Comm’r of Insurance, eff. 1-22-86; A 5-27-92;

12-15-94; R152-99, 1-28-2000)

      NAC 683A.119  Determination of whether administrator or applicant is

financially unsound. (NRS 679B.130, 683A.08524, 683A.0892)  The

Commissioner will consider the following to determine whether an administrator

or an applicant for a certificate of registration as an administrator is

financially unsound pursuant to NRS

683A.08524 or 683A.0892:

     1.  The administrator or applicant:

     (a) Submits a financial statement to the

Commissioner, pursuant to NRS

683A.08522 or 683A.08528,

reporting:

          (1) The sum of its assets is less than the sum

of its liabilities;

          (2) A recurring operating loss;

          (3) Negative cash flow from operations; or

          (4) A significant decrease in assets within a

fiscal year or over a period of years;

     (b) Has defaulted on a loan or restructuring of

debt;

     (c) Has lost key personnel; or

     (d) Has experienced an uninsured or underinsured

catastrophe.

     2.  The administrator loses more than 50

percent of its contracts to act as an administrator within a fiscal year.

     3.  Adverse findings reported in examinations

concerning the financial condition of the administrator or applicant that the

Commissioner determines to be material.

     4.  Information and reports concerning the

administrator or applicant from the Insurance Regulatory Information System of

the National Association of Insurance Commissioners.

     5.  Whether the portfolio of assets of the

administrator or applicant, when considered in light of the current economic

conditions, is of sufficient value, liquidity or diversity to ensure the

ability of the administrator or applicant to meet its outstanding obligations

as those obligations mature.

     6.  An opinion issued by an independent

certified public accountant that the administrator or applicant is unable to

operate as a going concern.

     (Added to NAC by Comm’r of Insurance by R171-03, eff.

12-16-2003)

      NAC 683A.125  Duty to notify Commissioner of certain changes and provide copies

of certain agreements. (NRS 679B.130)  An

administrator shall:

     1.  Notify the Commissioner of any change in

its members, owners, directors or officers within 90 days after the change.

     2.  Provide to the Commissioner a copy of

each written agreement that the administrator enters into with an insurer or

other entity within 90 days after he or she enters into the agreement.

     (Added to NAC by Comm’r of Insurance, eff. 1-22-86; A

11-21-88; 12-15-94; R152-99, 1-28-2000)

      NAC 683A.131  Annual report: Contents of financial statement. (NRS 679B.130,

683A.08528)  The

financial statement of an administrator submitted pursuant to NRS 683A.08528 must include:

     1.  A balance sheet that reports the assets,

liabilities and net worth of the administrator;

     2.  An income statement that reports the

revenue and expenses of the administrator;

     3.  A statement of cash flow; and

     4.  Notes to the financial statement.

     (Added to NAC by Comm’r of Insurance by R171-03, eff.

12-16-2003)

      NAC 683A.133  Annual report: Filing fee. (NRS 679B.130, 680B.010, 683A.08528)  An

administrator who files an annual report with the Commissioner pursuant to NRS 683A.08528 must pay the

filing fee required pursuant to subsection 3 of NRS 680B.010.

     (Added to NAC by Comm’r of Insurance by R171-03, eff.

12-16-2003)

      NAC 683A.155  Bond or certificate of deposit. (NRS 679B.130, 683A.0857)

     1.  Except as otherwise provided in

subsection 3, and in addition to the amount prescribed by statute, the amount

of the bond for each administrator must be increased as follows for each

$1,000,000 received and distributed by the administrator within this State

during an average month:

 



 





         Total

Amount







          Amount

Received and Distributed





             of

Bond







 





 







          $1,000,000

or less .......................................................................





                               $100,000







          More

than $1,000,000, but less than $2,000,000........................





                                 200,000







          $2,000,000

or more, but less than $3,000,000............................





                                 300,000







          $3,000,000

or more, but less than $4,000,000............................





                                 400,000







          $4,000,000

or more, but less than $5,000,000............................





                                 500,000







          $5,000,000

or more.....................................................................





      10 percent of the amount







 





      received and distributed,







 





  but

not more than







 





  $1,000,000





 

     2.  If the Commissioner finds that the

increased bonds are unavailable, the Division will accept proof of coverage

over $100,000 in the additional amounts specified in subsection 1 under a

fidelity policy and a policy which covers the errors and omissions of the

administrator or his or her employees. The policies must be reviewed and approved

by the Division and provide for notice to the Division 90 days before their

cancellation or nonrenewal. Proof of the increases in the bond or the policies

of insurance must be furnished to the Division within 30 days after the

increase.

     3.  If an administrator is not authorized to

issue a check or draft and only handles claims for the person employing him or

her, the administrator is only required to maintain the bond for $100,000.

     4.  For the purposes of this section, the

amount of money received and distributed by the administrator during an average

month is the total amount of money received and distributed by him or her in

this State during a fiscal year, divided by 12. Within 90 days after the end of

his or her fiscal year, each administrator shall file with the Commissioner a

report stating the total amount of money so received and distributed during the

preceding fiscal year. The report:

     (a) Must be certified by an officer or partner of

the administrator, if it is a corporation or partnership; and

     (b) If there is any change in the required amount

of the bond because of an increase or decrease in the amount of money received

and distributed by the administrator, must be accompanied by a replacement bond

in the appropriate amount.

     5.  An administrator may submit a certificate

of deposit from a financial institution in this State that is insured

federally, made payable to the Commissioner of Insurance and the administrator,

in lieu of the bond required by NRS

683A.0857. The certificate of deposit must:

     (a) State that the amount of the deposit is

unavailable for withdrawal except upon the signed authorization of the

Division; and

     (b) Be accompanied by a statement or letter from

the issuing financial institution which verifies that:

          (1) The requisite amount of money is being

held to satisfy the requirement for a deposit; and

          (2) The amount of the deposit is unavailable

for withdrawal except upon the signed authorization of the Division.

     (Added to NAC by Comm’r of Insurance, eff. 1-22-86; A

11-21-88; 5-27-92; 12-15-94; R152-99, 1-28-2000)

      NAC 683A.165  Administrator of self-insurance reserve fund. (NRS 679B.130)  An

administrator of a self-insurance reserve fund pursuant to paragraph (c) of

subsection 1 of NRS 287.010:

     1.  If it is a corporation, shall submit to

the Division to establish that it is a resident of Nevada, evidence that it

has:

     (a) Its principal place of business in Nevada;

     (b) Been qualified to do business in Nevada by the

Secretary of State; or

     (c) Articles of incorporation which authorize it to

transact business in Nevada.

     2.  Shall keep all books and records relating

to the plan in Nevada.

     (Added to NAC by Comm’r of Insurance, eff. 1-22-86; A 5-27-92)

PRELICENSING EDUCATION

      NAC 683A.170  Exemptions. (NRS 679B.130)

     1.  NAC 683A.170

to 683A.261, inclusive, do not apply to:

     (a) A person applying for a nonresident license.

     (b) A person exempted from the requirement of

taking the licensing examination by NRS

683A.291.

     (c) A person who has been employed by an insurer

for at least 10 years and has been actively involved in the underwriting of

insurance or settling claims.

     (d) A person with at least 10 years’ current

experience as a licensed insurance producer. For the purposes of this

paragraph, “current” means active employment as a producer of insurance within

the last 15 years.

     (e) A person who:

          (1) Pursuant to NAC

683A.325, is subject to the provisions of NAC

683A.318 to 683A.370, inclusive; and

          (2) Successfully completes, within the 12

months immediately preceding his or her application for a license, 30 hours of

continuing education in courses approved by the Division pursuant to NAC 683A.318 to 683A.370,

inclusive.

     (f) A person who has earned and continues to

maintain a designation, for the line of authority of:

          (1) Life insurance, as a:

               (I) Certified employee benefit specialist

(CEBS);

               (II) Certified financial planner (CFP);

               (III) Certified insurance counselor

(CIC);

               (IV) Chartered financial consultant

(ChFC);

               (V) Chartered life underwriter (CLU);

               (VI) Fellow, life management institute

(FLMI); and

               (VII) Life underwriter training council

fellow (LUTCF);

          (2) Accident and health insurance, as a:

               (I) Certified employee benefit specialist

(CEBS);

               (II) Health insurance associate (HIA);

               (III) Registered employee benefits

consultant (REBC); and

               (IV) Registered health underwriter (RHU);

and

          (3) Casualty insurance, personal lines of

insurance or property insurance, as:

               (I) An accredited adviser in insurance

(AAI);

               (II) An associate in risk management

(ARM);

               (III) A certified insurance counselor

(CIC); and

               (IV) A chartered property casualty

underwriter (CPCU).

     2.  A person claiming exemption from the

requirements of NAC 683A.170 to 683A.261, inclusive, pursuant to:

     (a) Paragraph (c) of subsection 1 must submit to

the Division:

          (1) A written claim of exemption; and

          (2) Documentation from the insurer by which

the person has been employed indicating that he or she has met the requirements

of that paragraph.

     (b) Paragraph (d) of subsection 1 must submit to

the Division:

          (1) A written claim of exemption; and

          (2) Documentation from the entity by which the

person has been licensed indicating that he or she has met the requirements of

that paragraph.

     (c) Paragraph (f) of subsection 1 must submit to

the Division:

          (1) A written claim of exemption; and

          (2) Documentation from the entity by which the

person has been designated indicating that the person has met the requirements

of that paragraph.

     (Added to NAC by Comm’r of Insurance, eff. 6-4-86; A 7-22-88,

eff. 10-1-88; 2-15-95; R172-01, 7-5-2002; R108-10, 9-14-2012)

      NAC 683A.180  Course of instruction required; passing grade. (NRS 679B.130)  In

addition to the requirements of chapter

683A of NRS, an applicant for a license to act as a producer of insurance

or an insurance consultant for:

     1.  Life insurance, including annuities;

     2.  Accident and health insurance;

     3.  Property insurance;

     4.  Casualty insurance;

     5.  Personal lines; or

     6.  Any combination of those types of

insurance,

Ê must

complete, with a final grade of at least 70 percent, a course of instruction

approved by the Commissioner for the line of insurance for which he or she is

applying for a license. The course must have been completed within the 2 years

immediately preceding the date of the application for the license.

     (Added to NAC by Comm’r of Insurance, eff. 6-4-86; A by

R152-99, 1-28-2000; R172-01, 7-5-2002)

      NAC 683A.190  Approval of course of instruction and instructor. (NRS 679B.130)

     1.  A course of instruction and the

instructor for the course must be approved by the Division before the course is

offered to a prospective applicant for a license. The sponsor of the course

shall submit to the Division:

     (a) An application for approval of the instructor,

specifying his or her experience and qualifications;

     (b) An application for approval of the course,

including a detailed outline of the course and a description of the scale to be

used in grading the persons taking the course;

     (c) A schedule of the times the course is to be

taught; and

     (d) A certification that the content of the course

complies with NAC 683A.170 to 683A.261, inclusive.

     2.  The Division shall not approve a course

which:

     (a) Substantially involves techniques for taking

the licensing examination;

     (b) Is directed towards teaching techniques of

selling, motivation or finding customers;

     (c) Is substantially a course to teach clerical

skills; or

     (d) Does not meet the requirements of NAC 683A.170 to 683A.261,

inclusive.

     3.  No approved course may have more than 8

hours of instruction in the classroom each day.

     (Added to NAC by Comm’r of Insurance, eff. 6-4-86; A 5-27-92)

      NAC 683A.201  Qualifications of instructor; limitation on instruction by

unqualified instructor or mechanical aid. (NRS 679B.130)

     1.  An instructor must:

     (a) Have at least 5 years of relevant experience in

the line or lines of insurance which he or she plans to teach; or

     (b) Be approved by the Nevada System of Higher

Education to teach insurance within that System.

     2.  No more than one-third of any course

approved by the Division may be taught by:

     (a) An instructor who does not satisfy the

requirements of subsection 1;

     (b) Videotapes or audiotapes; or

     (c) Any other mechanical teaching aids.

     (Added to NAC by Comm’r of Insurance, eff. 6-4-86; A 5-27-92;

2-15-95)

      NAC 683A.211  Correspondence, extension or self-study course. (NRS 679B.130)

     1.  A correspondence, extension or self-study

course may be approved by the Division if:

     (a) The course satisfies all of the requirements of

NAC 683A.170 to 683A.261,

inclusive;

     (b) The student has quick and easy access to the

sponsor or instructor of the course; and

     (c) The student must pass a final examination at

the end of the course to receive credit and the examination is directly

supervised by the sponsor, instructor or his or her representative.

     2.  The Division shall determine the

equivalent number of hours of instruction in the classroom allowed for each

approved correspondence, extension or self-study course.

     (Added to NAC by Comm’r of Insurance, eff. 6-4-86; A 7-22-88,

eff. 10-1-88; 5-27-92; 2-15-95)

      NAC 683A.221  Subject matter of courses; hours of instruction. (NRS 679B.130)  A course

must consist of at least 5 hours of instruction in the classroom, or the equivalent

in a self-study course approved by the Division pursuant to NAC 683A.211, in the provisions of title 57 of NRS

and the regulations adopted pursuant to those provisions, at least one-half of

which must cover the laws and regulations common to all lines of insurance,

and:

     1.  For a course in life insurance, at least

15 hours of instruction in the classroom or the equivalent in a self-study

course approved pursuant to NAC 683A.211,

covering:

     (a) Principles and concepts of insurance in

general;

     (b) Basic principles and concepts of life

insurance;

     (c) The contract for life insurance and provisions

of the policy;

     (d) Classifications and types of life insurance;

     (e) Annuities;

     (f) The ethical responsibilities of the producer;

     (g) The organization of the business of life

insurance; and

     (h) Regulation by the government.

     2.  For a course in accident and health

insurance, at least 15 hours of instruction in the classroom or the equivalent

in a self-study course approved pursuant to NAC

683A.211, covering:

     (a) Principles and concepts of insurance in

general;

     (b) Basic principles and concepts of accident and

health insurance;

     (c) The contract for accident and health insurance

and provisions of the policy;

     (d) Accident and health insurance offered by

private companies;

     (e) Accident and health insurance offered by a

governmental entity;

     (f) Types of policies and coverage for accident and

health insurance;

     (g) Group insurance and plans of special insurance;

     (h) The ethical responsibilities of the producer;

and

     (i) Regulation by the government.

     3.  For a course in property insurance, at

least 15 hours of instruction in the classroom or the equivalent in a

self-study course approved pursuant to NAC 683A.211,

covering:

     (a) Principles and concepts of insurance in

general;

     (b) Basic principles and concepts of property and

casualty insurance;

     (c) The contract for property insurance and

provisions of the policy;

     (d) Types of policies and coverage for property

insurance;

     (e) The ethical responsibilities of the producer;

     (f) The organization of the business of property

insurance; and

     (g) Regulation by the government.

     4.  For a course in casualty insurance, at

least 15 hours of instruction in the classroom or the equivalent in a

self-study course approved pursuant to NAC 683A.211,

covering:

     (a) Principles and concepts of insurance in

general;

     (b) Basic principles and concepts of property and

casualty insurance;

     (c) The contract for casualty insurance and

provisions of the policy;

     (d) Insurance to protect against liability;

     (e) Automobile insurance;

     (f) Workers’ compensation and employers’ liability

insurance;

     (g) Fidelity insurance, surety bonds and other

types of casualty insurance;

     (h) The ethical responsibilities of the producer;

     (i) The organization of the business of casualty

insurance; and

     (j) Regulation by the government.

     5.  For a course in a combination of life and

health insurance or property and casualty insurance, at least 35 hours of

instruction in the classroom or the equivalent in a self-study course approved

pursuant to NAC 683A.211, covering all the

subjects required for each of those separate lines of insurance.

     6.  For a course in a combination of life and

health insurance and property and casualty insurance, at least 75 hours of

instruction in the classroom or the equivalent in a self-study course approved

pursuant to NAC 683A.211, covering the subjects required

for each of those separate lines of insurance.

     7.  For a course in personal lines insurance,

at least 15 hours of instruction in the classroom or the equivalent in a

self-study course approved pursuant to NAC 683A.211,

covering the subjects of property and casualty dealing with personal lines

insurance.

     8.  For a course in a combination of life and

health insurance, property and casualty insurance and personal lines insurance,

at least 95 hours of instruction in the classroom or the equivalent in a

self-study course approved pursuant to NAC 683A.211,

covering the subjects required for each of those separate lines of insurance.

     (Added to NAC by Comm’r of Insurance, eff. 6-4-86; A by

R172-01, 7-5-2002; R161-08, 9-18-2008)

      NAC 683A.225  Course of instruction for bail bonds. (NRS 679B.130)  A person

who requests approval of the course of instruction for bail bonds required by NRS 697.150, 697.170 or 697.184 must comply with the

provisions of NAC 683A.190, 683A.201, 683A.211 and 683A.231 to 683A.261,

inclusive.

     (Added to NAC by Comm’r of Insurance by R152-99, eff. 1-28-2000)

      NAC 683A.231  Records; submission of certain information quarterly; certificate

of completion for student. (NRS 679B.130)

     1.  Each sponsor of a course shall maintain a

complete record of each person attending the course. The record must:

     (a) Indicate each person’s attendance;

     (b) Indicate his or her final grade in the course;

and

     (c) Be available for review by the Division upon

request during normal business hours.

     2.  Each sponsor shall submit quarterly to

the Division for each course offered, the sponsor of the course, the date the

course was completed, and the name and grade of each person attending the

course. If the course is a self-study course, the sponsor shall also submit the

name and description of the course.

     3.  Each sponsor of a course must give to

each person who successfully completes the course an original certificate of

completion. The certificate must list the sponsor and instructor of the course,

the line of insurance included in the course, the grade obtained by the student

in the course, and the location and times the course was offered. An applicant

for a license must submit the certificate with his or her application for a

license.

     (Added to NAC by Comm’r of Insurance, eff. 6-4-86; A 5-27-92;

R152-99, 1-28-2000)

      NAC 683A.241  Changes in sponsor, instructor or outline of course; suspension

and revocation of approval of course. (NRS 679B.130)

     1.  If the sponsor, instructor or outline of

a course changes after approval has been granted, the new sponsor, instructor

or outline of the course must be approved by the Division.

     2.  A person designated by the Division may

audit any approved course to ensure that the course, instructor or sponsor

continues to meet the requirements of this regulation.

     3.  If the sponsor, instructor or outline of

the course has changed and has not been reapproved, or if the sponsor or

instructor is not following the approved outline of the course, the Division

may suspend its approval of that course.

     4.  If the sponsor or instructor has not

taken appropriate action to correct the conditions that were the basis of the

suspension within 30 days, the Division may revoke its approval of the course.

     5.  If the sponsor or instructor of an

approved course solicits from any person information on the content of the

questions on the Division’s licensing examination, the Division may revoke its

approval of that instructor or sponsor for at least 1 year.

     (Added to NAC by Comm’r of Insurance, eff. 6-4-86; A 5-27-92;

R152-99, 1-28-2000)

      NAC 683A.251  Submission or issuance of false or fraudulent documents;

determination of sponsor or instructor as unsuitable person. (NRS 679B.130)

     1.  The Commissioner will refuse to license,

or will suspend or revoke the license of any person who knowingly submits to

the Division a false or fraudulent certificate of completion of education.

     2.  The Division shall revoke its approval of

any sponsor or instructor who knowingly submits or issues a false or

fraudulent:

     (a) Certificate of completion;

     (b) Outline or schedule for a course; or

     (c) Application for approval as an instructor or

sponsor.

     3.  The Division shall not reapprove any

sponsor or instructor who has had his or her approval revoked pursuant to this

section for at least 1 year after the approval of the sponsor or instructor was

revoked.

     4.  The Commissioner may suspend or revoke

the approval of any sponsor or instructor who the Commissioner has determined

is an unsuitable person.

     (Added to NAC by Comm’r of Insurance, eff. 6-4-86; A 5-27-92;

R152-99, 1-28-2000)

      NAC 683A.261  Forms. (NRS 679B.130)  Every

application, certificate or other form required to be filed with the Division

pursuant to NAC 683A.170 to 683A.261, inclusive, must be on a form furnished by

the Division.

     (Added to NAC by Comm’r of Insurance, eff. 6-4-86; A 5-27-92)

LICENSING OF PRODUCERS OF INSURANCE AND INSURANCE

CONSULTANTS

      NAC 683A.270  Required score on examination. (NRS 679B.130, 683A.241, 683C.030)  An

applicant for a license as a producer of insurance or an insurance consultant

who is required to complete an examination for licensure must attain an

adjusted score of 80 or more points on the appropriate licensing examination to

pass the examination. The examination must have been successfully completed

within the 2 years immediately preceding the date of application for the

license.

     (Added to NAC by Comm’r of Insurance, eff. 3-15-84; A

by R172-01, 7-5-2002; R162-08, 9-18-2008)

      NAC 683A.272  Search of records of criminal history. (NRS 679B.130,

683A.251)

     1.  An applicant for a license as a resident

producer of insurance must:

     (a) Submit with his or her application:

          (1) Two complete sets of fingerprints which

the Commissioner may forward to the Central Repository for Nevada Records of

Criminal History for a search concerning him or her:

               (I) Conducted by the Federal Bureau of

Investigation in its national criminal records; and

               (II) Of the Central Repository for Nevada

Records of Criminal History; and

          (2) A cashier’s check or money order made

payable to the Central Repository for Nevada Records of Criminal History for

the applicable fees established by the General Services Division of the

Department of Public Safety.

     (b) Comply with the procedures for obtaining the

information required in this subsection that are established by the General

Services Division of the Department of Public Safety and the Central Repository

for Nevada Records of Criminal History in NRS 179A.075 to 179A.160, inclusive.

     2.  The Commissioner may issue a license as a

resident producer of insurance before the criminal background search of the

applicant conducted pursuant to subsection 1 is completed if the applicant:

     (a) Indicates and certifies on his or her

application for a license that he or she has no criminal history; and

     (b) Has complied with the procedures required

pursuant to subsection 1.

     3.  The Commissioner may contract with a

person outside the Division to process the fingerprints submitted pursuant to

subsection 1 so that the fingerprints may be electronically transmitted to the

Central Repository for Nevada Records of Criminal History or another law

enforcement agency.

     (Added to NAC by Comm’r of Insurance by R172-01, eff. 7-5-2002;

A by R170-03, 2-12-2004; R163-08, 9-18-2008)

      NAC 683A.275  Short-term lessor of passenger vehicles: Licensure requirement;

provision for training and supervision of employees; maintenance and

availability of records. (NRS 679B.130)

     1.  A person licensed as a short-term lessor

of passenger vehicles pursuant to NRS

482.363 must be licensed as a limited producer pursuant to paragraph (k) of

subsection 1 of NRS 683A.261

before engaging in the sale or solicitation of policies of insurance requested

by short-term lessees of passenger vehicles.

     2.  Each short-term lessor of passenger

vehicles shall provide training for each employee who will solicit or sell

policies of insurance to short-term lessees. The training must include

instruction relating to:

     (a) The policies of insurance that will be offered

for sale to short-term lessees;

     (b) Ethical practices concerning the sale of

policies of insurance; and

     (c) The sales materials and disclosures provided to

short-term lessees.

     3.  The manager of each location of a

short-term lessor of passenger vehicles is responsible for the supervision of

each employee who solicits or sells policies of insurance at that location.

     4.  A short-term lessor of passenger vehicles

shall maintain the following records for at least 5 years:

     (a) A copy of the instructional materials used to

train employees pursuant to subsection 2;

     (b) A list that includes the name of each manager

who is responsible for the supervision of employees pursuant to subsection 3;

     (c) A list that includes the name of each employee

who is authorized by the short-term lessor to solicit or sell policies of insurance

to short-term lessees; and

     (d) Proof that each such employee has completed the

training required by subsection 2.

     5.  A short-term lessor of passenger vehicles

shall make the records required by subsection 4 available for examination by

the Commissioner or a designee thereof upon request.

     (Added to NAC by Comm’r of Insurance by R152-99, eff. 1-28-2000;

A by R172-01, 7-5-2002)

REGISTRATION OF AGENTS WHO PERFORM UTILIZATION REVIEW

      NAC 683A.280  Definitions. (NRS 679B.130)  As used

in NAC 683A.280 to 683A.295,

inclusive:

     1.  “Agent who performs utilization review”

has the meaning ascribed to it in NRS

683A.376.

     2.  “Insured” has the meaning ascribed to it

in NRS 683A.376.

     3.  “Insurer” includes:

     (a) An authorized insurer;

     (b) A fraternal benefit society that is certified

pursuant to chapter 695A of NRS;

     (c) A nonprofit corporation for hospital, medical

or dental services that is certified pursuant to chapter 695B of NRS;

     (d) A health maintenance organization that is

certified pursuant to chapter 695C

of NRS; and

     (e) An organization for dental care that is

certified pursuant to chapter 695D

of NRS.

     4.  “Utilization review” has the meaning

ascribed to it in NRS 683A.376.

     (Added to NAC by Comm’r of Insurance, eff. 1-24-92)

      NAC 683A.285  Registration of insurer; plan for utilization review; insurer to

report changes; renewal of registration. (NRS 679B.130, 683A.378)

     1.  An insurer shall not perform utilization

review for another person unless it registers with the Commissioner as an agent

who performs utilization review and has a medical director who is a physician

or, in the case of an agent who reviews dental services, a dentist, licensed in

any state.

     2.  An insurer may apply for registration by

filing with the Commissioner the following information on a form provided by

the Commissioner:

     (a) The insurer’s name, address, telephone number

and normal business hours;

     (b) The name and telephone number of a person the

Commissioner may contact for information concerning the insurer;

     (c) The name of the medical director of the insurer

and the state in which he or she is licensed to practice medicine or dentistry;

and

     (d) A summary of the insurer’s plan for utilization

review, including procedures for appealing determinations made through

utilization review.

     3.  An insurer that registers as an agent who

performs utilization review shall file with the Commissioner any material

changes in the information provided pursuant to subsection 2 within 30 days

after the change occurs.

     4.  The Commissioner will not evaluate the

plan submitted pursuant to paragraph (d) of subsection 2. The Commissioner will

make the plan available upon request and charge the fee set forth in NAC 683A.295 for providing a copy of the plan.

     5.  Registration pursuant to this section

must be renewed on or before March 1 of each year by providing the information

specified in subsection 2.

     (Added to NAC by Comm’r of Insurance, eff. 1-24-92; A

by R152-99, 1-28-2000)

      NAC 683A.290  Employee of registered agent not required to pay certain fees for

registration or renewal. (NRS 679B.130, 683A.378)  A person

employed by a registered agent who performs utilization review is not required

to pay the fees for registration or renewal set forth in NRS 683A.378.

     (Added to NAC by Comm’r of Insurance, eff. 1-24-92; A

by R103-09, 1-28-2010)

      NAC 683A.295  Fees for photocopies of plan for utilization review; written

request for photocopies required. (NRS 679B.130)

     1.  The Commissioner will charge the

following fees for photocopies of a plan for utilization review filed pursuant

to NRS 683A.378 or NAC 683A.285:

     (a) If the photocopies are made by the Division, a

fee of 50 cents per page, plus postage.

     (b) If the photocopies are made at the Division’s

offices by the person requesting the copies, a fee of 7 cents per page.

     2.  A request to make or have made by the

Division photocopies of a plan for utilization review must be made in writing

to the Division at least 5 days, excluding Saturdays, Sundays and legal

holidays, before the photocopies are made.

     (Added to NAC by Comm’r of Insurance, eff. 1-24-92)

MISCELLANEOUS PROVISIONS

      NAC 683A.310  Payments of premium made after termination of producer’s

agreement. (NRS 679B.130)  Where

the license and agency contract of the original writing producer are

terminated, and a mutual agreement between the company and producer is made,

the producer may collect and forward future installment premium payments to the

company on a net basis.

     [Comm’r of Insurance, PC-13, eff. 9-23-72]—(NAC A by

R172-01, 7-5-2002)

      NAC 683A.315  Sale of annuities by banks: Required disclosures. (NRS 679B.130)

     1.  A bank licensed by the Commissioner to

sell annuities shall disclose to its customers that the annuities sold by the

bank:

     (a) Are not insured by the Federal Deposit

Insurance Corporation;

     (b) Are not obligations of the bank;

     (c) Are not guaranteed by the bank; and

     (d) Involve investment risks, including the

possible loss of principal.

     2.  The disclosure must be:

     (a) Printed on or attached to each policy or

advertisement for the sale of an annuity which is provided by the bank to its

customers; and

     (b) Printed in at least 10-point type.

     3.  A bank which fails to comply with the

provisions of this section is subject to disciplinary action by the

Commissioner pursuant to NRS

683A.451 to 683A.490,

inclusive.

     (Added to NAC by Comm’r of Insurance, eff. 12-15-94; A

by R172-01, 7-5-2002)

      NAC 683A.317  Renewal of appointment of producer of insurance: Verification of

records; fee. (NRS 679B.130)

     1.  Pursuant to subsection 4 of NRS 683A.321, an insurer shall

annually renew each appointment of a producer of insurance who acts as his or

her agent. An appointment as a producer expires on June 30 of each year

beginning June 30, 2002.

     2.  Before June 30, 2002, each insurer shall

verify that the records of the insurer and those of the Division are the same.

Verification can be made:

     (a) Electronically through a vendor that provides

information concerning appointments of producers of insurance; or

     (b) By written request to the Division and payment

of the appropriate fee.

     3.  The Division shall send an invoice to

each insurer before July 1 of each year for all appointments that are active on

the database of the Division as of June 30. The insurer shall return the invoice

to the Division with full payment of the requested amount to renew the

appointments. Any insurer who disputes the amount of the invoice must file a

written complaint with the Division that explains the reason why the insurer

disagrees with the fee. The Division will not issue a refund, but the Division

may issue a credit, if a discrepancy is the result of an error made by the

Division.

     (Added to NAC by Comm’r of Insurance, eff. 1-18-96; A

by R172-01, 7-5-2002)

CONTINUING EDUCATION

      NAC 683A.318  Definitions. (NRS 679B.130)  As used

in NAC 683A.318 to 683A.370,

inclusive, unless the context otherwise requires, the words and terms defined

in NAC 683A.320 and 683A.322

have the meanings ascribed to them in those sections.

     (Supplied in codification)

      NAC 683A.320  “Course” defined. (NRS 679B.130)  “Course”

includes, but is not limited to, a program of instruction, correspondence

course, course of independent study, self-study course or seminar.

     (Added to NAC by Comm’r of Insurance, eff. 3-7-90; A 2-15-95;

R152-99, 1-28-2000)

      NAC 683A.322  “Designated representative” defined. (NRS 679B.130)  “Designated

representative” means a person with whom the Commissioner contracts pursuant to

NAC 683A.327.

     (Added to NAC by Comm’r of Insurance by R170-03, eff. 2-12-2004)

      NAC 683A.325  Applicability of provisions. (NRS 679B.130)

     1.  Except as otherwise provided in

subsection 2, the provisions of NAC 683A.318 to 683A.370, inclusive, apply to a person who:

     (a) Holds a license as a producer of insurance

issued pursuant to chapter 683A of

NRS or an insurance consultant issued pursuant to chapter 683C of NRS; and

     (b) Engages in the business of insurance.

     2.  The provisions of NAC

683A.318 to 683A.370, inclusive, do not apply

to a person who holds:

     (a) A limited license issued pursuant to NRS 683A.261; or

     (b) A license as a nonresident producer of

insurance or a nonresident insurance consultant.

     (Added to NAC by Comm’r of Insurance, eff. 3-7-90; A by

R172-01, 7-5-2002; R170-3, 2-12-2004)

      NAC 683A.327  Designated representative: Authority of Commissioner. (NRS 679B.130)  The

Commissioner may contract with a person outside the Division to perform all or

part of the administrative duties of the continuing education program, subject

to the direction and approval of the Commissioner.

     (Added to NAC by Comm’r of Insurance by R170-03, eff. 2-12-2004)

      NAC 683A.330  Requirements for renewal of license. (NRS 679B.130)

     1.  Except as otherwise provided in this

section, to renew a license as a producer of insurance or an insurance

consultant, each licensee must certify that he or she has successfully

completed 30 hours of approved continuing education within the 3-year period before

the date of renewal. Three of the 30 hours of continuing education must be in

the subject of ethics. The hours of continuing education must be related to the

line or lines of insurance for which the licensee holds such a license.

     2.  The Commissioner will exempt a licensee

from the requirements for continuing education if the licensee certifies that

he or she:

     (a) Has earned and continues to maintain his or her

designation as a chartered property casualty underwriter (CPCU), chartered life

underwriter (CLU), certified insurance counselor (CIC), certified financial

planner (CFP) or chartered financial consultant (ChFC); or

     (b) Has 20 years of continuous experience and has

earned his or her primary source of income in the business of insurance by

selling, marketing, underwriting, adjusting, practicing law, managing or

regulating, or engaging in any combination of these fields of insurance.

     3.  The certification required by subsection

1 or 2 must be submitted to the Commissioner in an affidavit approved by the

Commissioner.

     (Added to NAC by Comm’r of Insurance, 3-7-90, eff. 7-1-90;

A 2-15-95; R172-01, 7-5-2002; R164-08, 9-18-2008)

      NAC 683A.335  Requirements for approval of courses. (NRS 679B.130)

     1.  Any person who requests approval for a

course for continuing education shall furnish to the Commissioner or to a

designated representative thereof at least 60 days before the beginning of the

course:

     (a) An outline of the subject matter;

     (b) The method of presentation;

     (c) The qualifications of the instructor;

     (d) The number of classroom hours or, if for a

correspondence course, a self-study course or an on-line computer course, the

equivalent of classroom hours, and a written procedure for conducting a

supervised final examination;

     (e) Any applicable fees established and required by

the Commissioner; and

     (f) Any other information required by the

Commissioner or a designated representative.

     2.  Submission of the information required by

subsection 1 must be on an application approved by the Commissioner.

     3.  The course must be designed to increase

the knowledge and understanding of the licensee of:

     (a) Principles and coverage of insurance;

     (b) Applicable laws, rules and regulations

concerning insurance;

     (c) Recent changes in coverages; and

     (d) The duties, ethics and responsibilities of the

licensee.

     4.  The Commissioner or a designated

representative will not approve a course that:

     (a) Is provided by a producer of insurance or an

agency licensed to sell insurance in this State unless the producer of

insurance or agency is a trade association of the insurance industry; or

     (b) Teaches:

          (1) Prelicensing training;

          (2) Motivation or psychology;

          (3) Marketing;

          (4) Prospecting;

          (5) Recruiting;

          (6) Sales;

          (7) Computer applications that are unrelated

to insurance;

          (8) Skills for communication; or

          (9) The management of personnel or of an

office.

Ê The

provisions of this subsection do not limit the authority of the Commissioner or

a designated representative to refuse to approve a course for noncompliance

with any other provision of NAC 683A.318 to 683A.370, inclusive.

     5.  The Commissioner or a designated

representative will not approve a course if the total number of classroom hours

is less than 1 hour. One hour of credit will be awarded for each 50 minutes of

instruction, or the equivalent in self-study approved pursuant to NAC 683A.211.

     6.  The Commissioner or a designated

representative will grant or deny approval of each course in writing within 60

days after receiving the information required pursuant to subsection 1.

     7.  Any material change in the content of a

course approved by the Commissioner or a designated representative must be

submitted for approval before presentation of the course.

     8.  A course that has been approved by the

Commissioner or a designated representative is not required to be approved for

any subsequent presentation of the course, except that the provider of the

course shall submit a notice to the Commissioner or a designated

representative, not later than 30 days before the course is offered, that

includes the following information:

     (a) The name and number of the course;

     (b) The name of the instructor of the course;

     (c) The place where the course will be offered; and

     (d) The date and time when the course will be

offered.

     (Added to NAC by Comm’r of Insurance, eff. 3-7-90; A 2-15-95;

R152-99, 1-28-2000; R172-01, 7-5-2002; R170-03, 2-12-2004)

      NAC 683A.337  Requirements for advertisement of courses. (NRS 679B.130)

     1.  A course of continuing education must not

be advertised unless the Commissioner or his or her designated representative

has approved the course in writing.

     2.  Any advertisement of an approved course

of continuing education must contain:

     (a) The title of the course;

     (b) The name and address of the person approved to

provide the course;

     (c) The lines of insurance for which the course has

been approved;

     (d) The number of hours of credit for continuing

education for which the course has been approved; and

     (e) A brief summary or outline of the contents of the

course.

     (Added to NAC by Comm’r of Insurance, eff. 2-15-95; A

by R170-03, 2-12-2004; R165-08, 9-18-2008)

      NAC 683A.340  Duties of providers of approved courses. (NRS 679B.130)  The provider

of a course approved by the Commissioner or a designated representative thereof

shall:

     1.  Give a certificate of completion to each

person who successfully completes the course. The certificate must be on a form

approved by the Commissioner.

     2.  Maintain records of attendance and

examination scores for 4 years.

     3.  Make these records and scores available

to the Division upon request.

     4.  Not employ an unsuitable person as an

instructor for the course.

     (Added to NAC by Comm’r of Insurance, eff. 3-7-90; A by

R152-99, 1-28-2000; R170-03, 2-12-2004)

      NAC 683A.345  Credit for completion of certain unapproved courses. (NRS 679B.130)  A

licensee who is seeking approval for hours of continuing education after

completing a course organized by and conducted with the supervision of a trade

association of the insurance industry or a national association of agents and

brokers that was not approved by the Commissioner or a designated representative

thereof must:

     1.  Request approval of the hours from the

Commissioner or a designated representative;

     2.  Submit the information required in

subsection 1 of NAC 683A.335; and

     3.  Submit a document signed by the

instructor or provider of the course which verifies the attendance of the

licensee and his or her successful completion of each portion of the course for

which credit is sought.

     (Added to NAC by Comm’r of Insurance, 3-7-90, eff. 7-1-90;

A by R170-03, 2-12-2004)

      NAC 683A.350  Number of hours approved for certain courses; credit for licensee

who attends or teaches course. (NRS 679B.130)

     1.  The following courses are approved for

continuing education for the hours set forth below:

     (a) Any of the parts of the life insurance

curriculum of the Life Underwriter Training Council, 30 hours for each part.

     (b) The health insurance curriculum of the Life

Underwriter Training Council, 25 hours.

     (c) Any part of the curriculum of the American

College, Bryn Mawr, Pennsylvania, leading to the professional designation of

Chartered Life Underwriter (CLU), 30 hours for each part.

     (d) Any part of the curriculum of the American

Institute for Property and Liability Underwriters leading to the professional

designation of Chartered Property Casualty Underwriter (CPCU), 30 hours for

each part.

     (e) Any part of the curriculum of the Life Office

Management Association, Atlanta, Georgia, leading to the professional

designation of Fellow, Life Management Institute, 30 hours for each part.

     (f) Any part of the curriculum of the Insurance

Institute of America leading to the designation as an associate in a specialty

such as underwriting, management, claims, loss control or auditing, 25 hours

for each part.

     (g) Any of the parts of the general insurance

curriculum of the Insurance Institute of America, 25 hours for each part.

     (h) Any part of the curriculum of the College for

Financial Planning, Denver, Colorado, leading to the professional designation

of Certified Financial Planner, 25 hours for each part.

     (i) Any part of the educational program of the

Health Insurance Association of America, 15 hours for each part.

     (j) Any part of the educational program of the

Society of Certified Insurance Counselors, 25 hours for each part.

     (k) Any part of the curriculum of the National

Association of Health Underwriters, 25 hours for each part.

     (l) Any course relating to insurance taught by an

accredited college or university, 10 hours for each unit of credit awarded by

the college or university.

     2.  To receive the credit set forth in

subsection 1, a licensee must:

     (a) Receive a passing grade on the final

examination if the course is a self-study course; or

     (b) Attend all classes of the course if attendance

is required for the course.

     3.  A licensee who teaches an approved course

may receive credit for continuing education for the number of hours that would

be granted to a licensee taking and successfully completing the course. A

licensee will receive credit in this manner only once during a renewal period

for each course taught.

     (Added to NAC by Comm’r of Insurance, eff. 3-7-90; A by

R152-99, 1-28-2000)

      NAC 683A.355  Limitations on receipt and use of credit. (NRS 679B.130)  A

licensee:

     1.  May receive credit for continuing

education only once during a renewal period for each course taken.

     2.  May not carry forward to the next renewal

period any hours of continuing education that are accumulated during a renewal

period in excess of the hours required pursuant to NAC

683A.330.

     (Added to NAC by Comm’r of Insurance, eff. 3-7-90)

      NAC 683A.360  Verification of continuing education. (NRS 679B.130)

     1.  Each licensee shall furnish to the

Division upon the renewal of his or her license or upon the request of the

Division, the original certificate of completion issued by the provider for

each course.

     2.  The licensee shall keep a copy of each

certificate of completion for 4 years after the completion of the course.

     3.  Failure to provide verification of

continuing education credits upon request by the Division is evidence that the

licensee did not complete the required continuing education.

     (Added to NAC by Comm’r of Insurance, 3-7-90, eff. 7-1-90;

A 5-27-92; R152-99, 1-28-2000)

      NAC 683A.365  Suspension or revocation of approval of course; auditing of

course; reinstatement of approval. (NRS 679B.130)

     1.  The Commissioner or a designated

representative thereof may suspend or revoke the approval of a course if he or

she determines that:

     (a) The content of the course has been changed

without notice to the Commissioner or a designated representative and the

change affects the number of hours of credit assigned to the course;

     (b) A certificate of completion has been issued and

hours credited to a person who has not completed the course;

     (c) A certificate of completion has not been issued

and hours have not been credited when requested to a person who has

successfully completed the course;

     (d) The quality of instruction is inadequate;

     (e) The content of the course does not meet the

objectives of subsection 3 of NAC 683A.335;

     (f) The provider has not maintained the records

required by subsection 2 of NAC 683A.340; or

     (g) The provider has employed an unsuitable person

as an instructor for the course.

     2.  The Commissioner or a designated

representative may audit a course to ensure that the content or instructor

meets the requirements of NAC 683A.335.

     3.  If approval of a course is suspended or

revoked by the Commissioner or a designated representative, approval may be

reinstated at the discretion of the Commissioner or a designated representative

and after the Commissioner or a designated representative receives proof that

the conditions giving rise to the suspension or revocation have been corrected.

     (Added to NAC by Comm’r of Insurance, eff. 3-7-90; A 5-27-92;

R152-99, 1-28-2000; R170-03, 2-12-2004)

      NAC 683A.370  Compliance with requirements; submission of false or fraudulent

affidavit. (NRS 679B.130)

     1.  The Division will not:

     (a) Renew the license of a licensee who fails to

comply with the requirements of NAC 683A.318 to 683A.370, inclusive; or

     (b) Issue any license to a licensee until he or she

complies with the requirements of NAC 683A.318 to 683A.370, inclusive.

     2.  Any person who submits a false or

fraudulent affidavit that certifies his or her compliance with the requirements

of NAC 683A.318 to 683A.370,

inclusive, shall be deemed to have:

     (a) Violated a regulation for the purposes of

subsection 1 of NRS 683A.451;

     (b) Made a material misrepresentation in

application for a license for the purposes of subsection 1 or 3 of NRS 683A.451; and

     (c) Proven himself or herself untrustworthy for the

purposes of subsection 8 of NRS

683A.451.

     (Added to NAC by Comm’r of Insurance, 3-7-90, eff. 7-1-90;

A 5-27-92; R172-01, 7-5-2002)

FIDUCIARY ACCOUNTS

      NAC 683A.390  “Licensee” defined. (NRS 679B.130)  As used

in NAC 683A.390 to 683A.440,

inclusive, “licensee” includes any person licensed by the Commissioner,

including producers of insurance, surplus lines brokers, motor club agents,

bail bondsmen and administrators.

     (Added to NAC by Comm’r of Insurance, eff. 12-3-84; A

by R172-01, 7-5-2002)

      NAC 683A.400  Authorized types of accounts. (NRS 679B.130, 683A.400)  The

types of accounts which may be maintained by a person for the deposit of money

received pursuant to NRS 683A.400

are:

     1.  Checking accounts, whether or not they

bear interest;

     2.  Time deposits; and

     3.  Savings accounts.

     (Added to NAC by Comm’r of Insurance, eff. 12-3-84)

      NAC 683A.410  Licensee to be named as trustee; signature cards. (NRS 679B.130,

683A.400)  The

licensee must be named as trustee on accounts maintained pursuant to NRS 683A.400. The signature card

for the account must include language which has substantially the same effect

as the following:

 

To: (Name of Bank)

The account referred to on this card

and carried by the undersigned with you in the name of John Doe, Trustee, is an

account maintained under the provisions of NRS 683A.400. In the event of

death of the undersigned, the executor or administrator of his or her estate

will be the successor trustee.

 

                                                                                                (John

Doe)

 

     [Comm’r of Insurance, M-2, eff. 5-13-72]—(NAC A 12-3-84)

      NAC 683A.420  Formula for determining status of fiduciary account. (NRS 679B.130,

683A.400)  The

Commissioner will use the following formula to determine the status of a

fiduciary account:

     1.  From the total of the gross accounts

receivable from insureds the Commissioner will deduct any uncollected

commissions remaining in the accounts receivable then add the total of the

deposits in all accounts identified as trust accounts. The Commissioner will

use the average rate for commissions to determine the uncollected commissions.

     2.  The Commissioner will add the net

accounts payable to producers of insurance to the sum of all accounts receivable

which are more than 90 days old.

     3.  If the total in subsection 2 is greater

than the total in subsection 1, the account has a deficit.

     (Added to NAC by Comm’r of Insurance, eff. 12-3-84; A

by R172-01, 7-5-2002)

      NAC 683A.430  Curing of deficiency. (NRS 679B.130, 683A.400)

     1.  Any person having a deficit in his or her

fiduciary account, as measured pursuant to NAC

683A.420, must cure the deficiency within 5 days after receiving notice of

the deficiency from the Commissioner by:

     (a) Depositing an amount equal to the deficiency in

the trust account; and

     (b) Sending a written explanation for the

deficiency to the Commissioner.

     2.  The Commissioner will consider any person

who fails to cure a deficiency in the fiduciary account pursuant to subsection

1, to be financially irresponsible pursuant to subsection 8 of NRS 683A.451.

     (Added to NAC by Comm’r of Insurance, eff. 12-3-84; A

by R172-01, 7-5-2002)

      NAC 683A.440  Failure to remit return premium. (NRS 679B.130, 683A.400, 683A.451)  The

Commissioner will consider any person who fails to remit a return premium to

the person to whom it is owed within 30 days after receiving the return

premium:

     1.  To have violated the provisions of NRS 683A.400; and

     2.  To be financially irresponsible pursuant

to subsection 4 of NRS 683A.451.

     (Added to NAC by Comm’r of Insurance, eff. 12-3-84; A

by R172-01, 7-5-2002)

MANAGING GENERAL AGENTS

      NAC 683A.450  Definitions. (NRS 679B.130)  As used

in NAC 683A.450 to 683A.560,

inclusive, unless the context otherwise requires:

     1.  “Actuary” means a person who is a member

in good standing of the American Academy of Actuaries.

     2.  “Insurer” means a person who holds a

certificate of authority in this State pursuant to NRS 680A.060.

     3.  “Managing general agent”:

     (a) Means a person who adjusts or pays claims in

excess of an amount prescribed by the Commissioner or negotiates the sale of

reinsurance on behalf of the insurer or:

          (1) Manages all or part of the business of an

insurer, including a division, department or underwriting office;

          (2) Acts as an agent for the insurer

regardless of his or her title; and

          (3) Produces and underwrites direct written

premiums equal to 5 percent or more of the surplus of the insurer for any 1

year or quarter reported in the last annual statement filed by the insurer

pursuant to the provisions of NRS

680A.270.

     (b) Does not include a person:

          (1) Who is an employee of the insurer;

          (2) Who is a manager located in the United

States of a branch located in the United States of an alien insurer; or

          (3) Whose compensation is based on a criteria

other than the volume of premiums written and who has underwriting authority,

manages all of the insurance and is an affiliate of the insurer. As used in

this subparagraph, “affiliate” has the meaning ascribed to it in NRS 692C.030.

     4.  “Underwrite” means the authority to

assume or reject risks on behalf of the insurer.

     (Added to NAC by Comm’r of Insurance, eff. 9-19-90; A

by R172-01, 7-5-2002)

      NAC 683A.460  Licensing and bonding; maintenance of policy for errors and

omissions. (NRS 679B.130)  A

managing general agent:

     1.  Shall not represent an insurer in this

State unless he or she holds a license issued by this State as a producer of insurance.

     2.  Shall maintain a bond for $50,000 and may

maintain a policy that covers any errors and omissions of the managing general

agent.

     (Added to NAC by Comm’r of Insurance, eff. 9-19-90; A

by R172-01, 7-5-2002)

      NAC 683A.470  Written contract with insurer. (NRS 679B.130)

     1.  A managing general agent shall not bind

an insurer to a contract of insurance with a third person unless the managing

general agent enters into a written contract with the insurer.

     2.  Such a contract must set forth:

     (a) The rights and duties of the insurer and

managing general agent and, if a duty is shared by them, the contract must

specify the duty each party performs.

     (b) The rights and duties set forth in NAC 683A.470 to 683A.530,

inclusive.

     (c) Guidelines which the managing general agent

agrees to follow when underwriting insurance, including:

          (1) The maximum annual premium volume of

insurance he or she may write;

          (2) The rules he or she must follow to

establish the rates for the insurance he or she may write;

          (3) The types of insurance he or she may

write;

          (4) The maximum amount of liability per policy

which he or she may commit the insurer to assume;

          (5) The exclusions from coverage, including

any special limits on the coverage he or she writes for the insurer;

          (6) The territory in which he or she may write;

          (7) The provisions for the cancellation of the

insurance; and

          (8) The maximum period for which each policy

may be written.

     (Added to NAC by Comm’r of Insurance, eff. 9-19-90)

      NAC 683A.480  Accounts, books and records. (NRS 679B.130)  Each

managing general agent shall:

     1.  Submit to the insurer an accounting of

each transaction that the managing general agent enters into on behalf of the

insurer. The records of each insurer of the managing general agent must be kept

separate.

     2.  Hold in a fiduciary capacity and

immediately deposit, in an account set up for the insurer in a bank which is a

member of the Federal Reserve System, all money collected on behalf of each

insurer.

     3.  Submit to the insurer all money due to

the insurer not less than once each month.

     4.  Allow the insurer to examine and copy all

books, records and accounts pertaining to the insurer in the control of the

managing general agent.

     5.  Allow the Commissioner to examine and

copy all books, records and bank accounts of the managing general agent.

     6.  Keep at his or her principal place of

business in this State his or her books, records, documents, accounts and

vouchers as required by the provisions of NRS 693A.050 for domestic

insurers.

     (Added to NAC by Comm’r of Insurance, eff. 9-19-90)

      NAC 683A.490  Retention of reserve; assignment of contract with insurer. (NRS 679B.130)  A

managing general agent shall not:

     1.  Retain more than 3 months’ reserve for:

     (a) An amount estimated to be necessary to pay all

of the unpaid claims of the insurer; and

     (b) The allocated loss adjustment expenses, in the

account set up for the insurer pursuant to the requirements of NAC 683A.480.

     2.  Assign any part of his or her contract

with the insurer required pursuant to NAC 683A.470.

     (Added to NAC by Comm’r of Insurance, eff. 9-19-90)

      NAC 683A.500  Authority of insurer to terminate contract with agent, suspend

agent’s authority, and cancel or refuse to renew policy. (NRS 679B.130)  An

insurer may:

     1.  Terminate his or her contract with a

managing general agent for cause by written notice to the agent.

     2.  If the insurer and the managing general agent

enter into a dispute regarding the cause for the termination of the agent,

suspend the authority of the agent to underwrite insurance for the insurer

during the dispute.

     3.  Cancel or refuse to renew any policy of

insurance subject to the provisions of NRS 687B.310 to 687B.410, inclusive.

     (Added to NAC by Comm’r of Insurance, eff. 9-19-90)

      NAC 683A.510  Handling of claims which agent has authority to settle;

suspension and termination of authority to settle claims. (NRS 679B.130)  If the

contract required pursuant to NAC 683A.470 allows

the managing general agent to settle claims on behalf of the insurer:

     1.  The managing general agent shall:

     (a) Report all claims to the insurer in a timely

manner; and

     (b) Send the insurer a copy of the claim file if

the insurer so requests or as soon as the managing general agent knows that the

claim:

          (1) Has the potential to exceed an amount

determined by the Commissioner or exceeds the limit set by the insurer,

whichever is less;

          (2) Involves a coverage dispute;

          (3) May exceed the agent’s authority to settle

a claim;

          (4) Is open for more than 6 months; or

          (5) Is closed by payment of an amount set by

the Commissioner or an amount set by the insurer, whichever is less.

     2.  Except as otherwise provided, all claims

files are the joint property of the insurer and managing general agent. Upon an

order of liquidation of the insurer, the files become the sole property of the

insurer or its estate. The agent may have reasonable access to, and the right

to copy the files on a timely basis.

     3.  The insurer may terminate any settlement

authority granted to the agent:

     (a) For cause upon the insurer’s written notice to

the agent; or

     (b) Upon the termination of the contract.

Ê The insurer

may suspend the settlement authority during the pendency of any dispute

regarding the cause for termination.

     4.  The contract must address the timely

transmission of information if claims are handled electronically.

     (Added to NAC by Comm’r of Insurance, eff. 9-19-90)

      NAC 683A.520  Sharing of profits between agent and insurer. (NRS 679B.130)

     1.  If the contract required pursuant to NAC 683A.470, provides for the managing general agent

and insurer to share profits and the agent has the authority to determine the

amount of the interim profits by establishing loss reserves or controlling

claim payments, or in any other manner, the profits must not be paid to the

managing general agent until:

     (a) One year after they are earned for property

insurance business; and

     (b) Five years after they are earned on casualty

business.

     2.  The profits must be verified pursuant to NAC 683A.540.

     (Added to NAC by Comm’r of Insurance, eff. 9-19-90)

      NAC 683A.530  Prohibited acts of agent. (NRS 679B.130)  A

managing general agent shall not:

     1.  Commit the insurer to participate in an

insurance or reinsurance syndicate.

     2.  Appoint a producer of insurance who is

not licensed by this State as a producer for the type of insurance for which he

or she is appointed.

     3.  Without the prior approval of the

insurer:

     (a) Pay or commit the insurer to pay a claim over

an amount specified by the insurer, net of reinsurance, which exceeds 1 percent

of the policyholder’s surplus of the insurer on December 31 of the prior

calendar year.

     (b) Collect a payment from a reinsurer or commit

the insurer to a claim settlement with a reinsurer without the prior approval

of the insurer. If the approval is given by the insurer, the managing general

agent shall promptly submit a report of the transaction to the insurer.

     4.  Allow a person who is an agent of the

managing general agent to serve on the board of directors of the managing

general agent.

     5.  Employ a person who is an employee of the

insurer.

     6.  Delegate any duty imposed on him or her

by the provisions of NAC 683A.470 to 683A.530, inclusive.

     7.  Bind reinsurance or retrocessions on

behalf of the insurer. The managing general agent may bind facultative

reinsurance contracts under obligatory facultative agreements if his or her

contract with the insurer contains reinsurance underwriting guidelines

including, for both reinsurance assumed and ceded:

     (a) A list of reinsurers with which such automatic

agreements are in effect;

     (b) The coverages and amounts or percentages that

may be reinsured; and

     (c) Schedules for commissions.

     (Added to NAC by Comm’r of Insurance, eff. 9-19-90; A

by R172-01, 7-5-2002)

      NAC 683A.540  Duties of insurers. (NRS 679B.130)

     1.  The insurer shall file with the Division,

in a form approved by the Commissioner, an independent financial examination of

each managing general agent with which it has done business.

     2.  If a managing general agent establishes

loss reserves, the insurer shall obtain annually the opinion of an actuary

attesting to the adequacy of the loss reserves established for losses incurred

and on the outstanding business produced by the managing general agent. This

opinion must be made separately from any other required loss reserve

certification.

     3.  The insurer shall, at least once every 6

months, conduct an on-site review of the operations of the managing general

agent for underwriting and processing claims.

     4.  An officer of the insurer, who is not

affiliated with the managing general agent, must have binding authority for all

reinsurance contracts or for the insurer’s participation in insurance or

reinsurance syndicates.

     5.  Within 30 days after appointing or

terminating the contract of a managing general agent, the insurer shall provide

written notice to the Commissioner. Notices of appointment of a managing

general agent must include a statement of the duties that he or she will

perform for the insurer, the lines of insurance for which he or she is to be

authorized to act, and any other information requested by the Commissioner.

     6.  At least once every 3 months, an insurer

shall review its books and records to determine if any producer of insurance

has become a managing general agent. If the insurer determines that the person

has become a managing general agent, the insurer shall promptly notify that

person and the Commissioner of the determination. The insurer and the person

must comply with the provisions of NAC 683A.470 to

683A.550, inclusive, within 30 days after such a

determination by the insurer.

     7.  An insurer shall not appoint to its board

of directors an officer, director, employee or controlling shareholder of its

managing general agents. This subsection does not apply to relationships

governed by chapter 692C of NRS.

     (Added to NAC by Comm’r of Insurance, eff. 9-19-90; A 5-27-92;

R172-01, 7-5-2002)

      NAC 683A.550  Acts of agent deemed to be acts of insurer; examination of agent. (NRS 679B.130)  The acts of the managing general agent are

deemed to be the acts of the insurer on whose behalf it is acting. A managing

general agent may be examined as if it were the insurer.

     (Added to NAC by Comm’r of Insurance, eff. 9-19-90)

      NAC 683A.560  Disciplinary action; rights of policyholders, claimants and

auditors not restricted. (NRS 679B.130)

     1.  If the Commissioner finds after a

hearing, that a person has violated any provision of NAC

683A.450 to 683A.550, inclusive, the

Commissioner will order:

     (a) The revocation or suspension of the person’s

license; and

     (b) The managing general agent to reimburse the

insurer, the rehabilitator, or liquidator of the insurer for any losses

incurred by the insurer and caused by a violation committed by the managing

general agent.

     2.  The Commissioner will take any other

disciplinary action authorized by title 57 of NRS which he or she deems

appropriate under the circumstances.

     3.  NAC 683A.450

to 683A.560, inclusive, are not intended to limit

or restrict the rights of policyholders, claimants and auditors.

     (Added to NAC by Comm’r of Insurance, eff. 9-19-90)

EXTERNAL REVIEW ORGANIZATIONS

Certification

      NAC 683A.600  Application for initial issuance of certificate: Generally. (NRS 679B.130,

683A.3715, 683A.372)  Except

as otherwise provided in NAC 683A.610, an external

review organization applying for the initial issuance of a certificate to

conduct external reviews must submit to the Commissioner, on a form prescribed

by the Commissioner, an application in writing and must provide to the

Commissioner at the time of application:

     1.  A written statement that identifies:

     (a) The number of external reviewers that the

external review organization employs, contracts with or otherwise retains to

conduct external reviews;

     (b) The specialty of each external reviewer;

     (c) Whether each external reviewer is certified by

the entity that regulates his or her specialty; and

     (d) The schedule of fees that the external review

organization will charge to conduct an external review.

     2.  A written summary of the procedures that

the external review organization will use to:

     (a) Ensure that the external review organization

conducts its activities in accordance with NRS 695G.241 to 695G.310, inclusive;

     (b) Ensure that an external reviewer employed,

contracted with or otherwise retained by the external review organization is

qualified to conduct a specific external review;

     (c) Ensure that a determination submitted for

external review is a final adverse determination;

     (d) Ensure that a final review is conducted in a

timely manner in accordance with NRS

695G.251, 695G.261 and 695G.271;

     (e) Ensure that the external review organization

and any employee, agent or contractor of the external review organization does

not have a conflict of interest as set forth in subsection 4 of NRS 683A.371; and

     (f) Submit a copy of the determination regarding an

external review to:

          (1) The insured;

          (2) The physician of the insured;

          (3) The authorized representative of the

insured, if any; and

          (4) The managed care organization.

     3.  A written affidavit that:

     (a) The information contained in the application

and any accompanying materials are complete and correct;

     (b) The external review organization will conduct

external reviews in accordance with NRS

695G.241 to 695G.310,

inclusive;

     (c) The external review organization and any

employee, agent or contractor of the external review organization will avoid a

conflict of interest as set forth in subsection 4 of NRS 683A.371; and

     (d) The external review organization is not

affiliated with:

          (1) A health care plan; or

          (2) A national, state or local trade

association.

     4.  All applicable fees required, including,

without limitation, all applicable fees required pursuant to NAC 683A.640, for the issuance of a certificate to

conduct external reviews.

     (Added to NAC by Comm’r of Insurance by R128-03, eff. 2-12-2004;

A by R103-09, 1-28-2010)

      NAC 683A.610  Application for initial issuance of certificate: Organization

certified or accredited by accrediting body that is nationally recognized. (NRS 679B.130,

683A.3715, 683A.372)  If an

external review organization has been certified or accredited as an external

review organization by an accrediting body that is nationally recognized, an

external review organization applying for the initial issuance of a certificate

to conduct external reviews must submit to the Commissioner, on a form

prescribed by the Commissioner, an application in writing and must provide to

the Commissioner at the time of application:

     1.  Proof that the external review

organization has been certified or accredited as an external review

organization by an accrediting body that is nationally recognized;

     2.  A copy of the certification or

accreditation standards of the accrediting body;

     3.  A copy of the most recent review of the

external review organization conducted by the accrediting body;

     4.  The schedule of fees that the external

review organization will charge to conduct an external review; and

     5.  All applicable fees required, including,

without limitation, all applicable fees required pursuant to NAC 683A.640, for the issuance of a certificate to

conduct external reviews.

     (Added to NAC by Comm’r of Insurance by R128-03, eff. 2-12-2004;

A by R103-09, 1-28-2010)

      NAC 683A.620  Issuance of certificate by Commissioner. (NRS 679B.130,

683A.3715, 683A.372)  Except

as otherwise provided in NAC 683A.650, if an

external review organization applying for the initial issuance of a certificate

to conduct external reviews submits the application and accompanying materials

required pursuant to NAC 683A.600 or 683A.610, the Commissioner will issue the applicant a

certificate to conduct external reviews.

     (Added to NAC by Comm’r of Insurance by R128-03, eff. 2-12-2004)

      NAC 683A.630  Expiration and renewal of certificate. (NRS 679B.130,

683A.3715, 683A.372)

     1.  In accordance with NRS 683A.371, a

certificate to conduct external reviews expires 1 year after the date the

certificate is issued by the Commissioner.

     2.  Except as otherwise provided in NAC 683A.650, the Commissioner will issue a renewal

of a certificate to conduct external reviews if the external review

organization submits to the Commissioner:

     (a) On a form prescribed by the Commissioner, an

application in writing for the renewal of the certificate to conduct external

reviews; and

     (b) All applicable fees required, including,

without limitation, all applicable fees required pursuant to NAC 683A.640, for the renewal of a certificate to

conduct external reviews.

     (Added to NAC by Comm’r of Insurance by R128-03, eff. 2-12-2004;

A by R103-09, 1-28-2010)

      NAC 683A.640  Fees of Commissioner. (NRS 679B.130, 683A.3715, 683A.372)  The

Commissioner will charge and collect:

     1.  Except as otherwise provided in

subsection 2, from an external review organization submitting an application

for the initial issuance of a certificate to conduct external reviews pursuant

to NAC 683A.600 or 683A.610,

a fee of $400.

     2.  From an external review organization

submitting an application for:

     (a) The initial issuance of a certificate to

conduct external reviews pursuant to NAC 683A.600

or 683A.610; and

     (b) The initial issuance of a certificate to

conduct external reviews pursuant to NRS 616A.469 and 616C.363, and the regulations

adopted pursuant thereto,

Ê a fee of

$600.

     3.  From an external review organization

submitting an application for the renewal of a certificate to conduct external

reviews pursuant to NAC 683A.630, a fee of $100.

     4.  From an external review organization, all

applicable fees required pursuant to NRS 680C.110.

     (Added to NAC by Comm’r of Insurance by R128-03, eff. 2-12-2004;

A by R103-09, 1-28-2010)

      NAC 683A.650  Refusal, suspension or revocation of certification: Grounds;

surrender of certificate. (NRS 679B.130, 683A.3715, 683A.372)

     1.  The Commissioner may refuse to issue or

renew, or may suspend or revoke, a certificate to conduct external reviews if

the Commissioner determines that an external review organization:

     (a) Has violated the provisions of NRS 695G.241 to 695G.310, inclusive, or NAC 683A.600 to 683A.670,

inclusive;

     (b) Has had a license, certificate or registration

to operate as an external review organization denied for cause, suspended or

revoked by any other state; or

     (c) Has misrepresented facts on an application

submitted to the Commissioner for the issuance or renewal of a certificate to

conduct external reviews.

     2.  If the Commissioner refuses to renew,

revokes or suspends a certificate to conduct external reviews, the external

review organization shall surrender the certificate to the Commissioner.

     (Added to NAC by Comm’r of Insurance by R128-03, eff. 2-12-2004)

      NAC 683A.660  Duties of organization upon termination of certification or

accreditation by accrediting body that is nationally recognized. (NRS 679B.130,

683A.3715, 683A.372)  An

external review organization issued a certificate to conduct external reviews

by the Commissioner pursuant to NAC 683A.610

shall:

     1.  Notify the Commissioner if the

accrediting body revokes, suspends or otherwise terminates the certification or

accreditation of the external review organization; and

     2.  Provide a copy of the findings of any

review of the external review organization conducted by the accrediting body.

     (Added to NAC by Comm’r of Insurance by R128-03, eff. 2-12-2004)

Conduct of Business

      NAC 683A.670  Fees to conduct external reviews. (NRS 679B.130,

683A.3715, 683A.372)  The fees

an external review organization issued a certificate to conduct external

reviews may charge to conduct external reviews must be reasonable.

     (Added to NAC by Comm’r of Insurance by R128-03, eff. 2-12-2004)

DUTIES OF BROKERS TO CLIENTS

      NAC 683A.700  Definitions. (NRS 679B.130, 686A.015)  As used

in NAC 683A.700 to 683A.718,

inclusive, unless the context otherwise requires, the words and terms defined

in NAC 683A.702 to 683A.712,

inclusive, have the meanings ascribed to them in those sections.

     (Added to NAC by Comm’r of Insurance by R009-05, eff.

10-31-2005)—(Substituted in revision for NAC 686A.352)

      NAC 683A.702  “Affiliate” defined. (NRS 679B.130, 686A.015)  “Affiliate”

means a person that controls, is controlled by, or is under common control

with, a broker. As used in this section, “control” has the meaning ascribed to

it in NRS 692C.050.

     (Added to NAC by Comm’r of Insurance by R009-05, eff.

10-31-2005)—(Substituted in revision for NAC 686A.354)

      NAC 683A.704  “Broker” defined. (NRS 679B.130, 686A.015)

     1.  Except as otherwise provided in

subsection 2, “broker” has the meaning ascribed to it in NRS 683A.321.

     2.  The term does not include a producer of

insurance acting as:

     (a) An intermediary between an insurer and a

client’s broker, including, without limitation, a managing general agent or

wholesale broker; or

     (b) A reinsurance intermediary. As used in this

paragraph, “intermediary” has the meaning ascribed to it in NRS 681A.330.

     (Added to NAC by Comm’r of Insurance by R009-05, eff.

10-31-2005)—(Substituted in revision for NAC 686A.356)

      NAC 683A.706  “Client” defined. (NRS 679B.130, 686A.015)  “Client”

means a natural person, corporation, association, partnership or other legal

entity that is a named insured or seeks the advice of a broker about becoming

an insured or receiving a quotation. The term does not include a person if the

person is only:

     1.  A participant or beneficiary of an

employee benefit plan; or

     2.  Covered by a group or blanket insurance

policy or group annuity contract,

Ê that is sold,

solicited or negotiated by the broker or affiliate.

     (Added to NAC by Comm’r of Insurance by R009-05, eff.

10-31-2005)—(Substituted in revision for NAC 686A.358)

      NAC 683A.708  “Compensation” defined. (NRS 679B.130, 686A.015)  “Compensation”

means consideration in any form for the production of insurance received by a

producer of insurance from an insurer or other source.

     (Added to NAC by Comm’r of Insurance by R009-05, eff.

10-31-2005)—(Substituted in revision for NAC 686A.360)

      NAC 683A.710  “Represents” defined. (NRS 679B.130, 686A.015)  “Represents”

means to act on behalf of a client in relation to an insurance transaction or

potential insurance transaction pursuant to an agreement for compensation.

     (Added to NAC by Comm’r of Insurance by R009-05, eff.

10-31-2005)—(Substituted in revision for NAC 686A.362)

      NAC 683A.712  “Transaction” defined. (NRS 679B.130, 686A.015)  “Transaction”

has the meaning ascribed to it in NRS

679A.130. The term includes:

     1.  The procurement or potential procurement

of insurance.

     2.  The giving of advice concerning matters

related to the procurement of insurance, including, without limitation, the

nature and type of insurance policies, their coverage, terms, duration,

premiums and premium payment arrangements.

     (Added to NAC by Comm’r of Insurance by R009-05, eff.

10-31-2005)—(Substituted in revision for NAC 686A.364)

      NAC 683A.714  Applicability of duties. (NRS 679B.130, 686A.015)  The

duties imposed on a broker in NAC 683A.716:

     1.  Apply to every producer of insurance when

acting as a broker.

     2.  Are in addition to and not in lieu of any

other duty imposed on a broker by the Nevada Insurance Code or the common law

of agency as recognized in this State.

     (Added to NAC by Comm’r of Insurance by R009-05, eff.

10-31-2005)—(Substituted in revision for NAC 686A.366)

      NAC 683A.716  Self-dealing; disclosures concerning compensation and certain

quotes. (NRS 679B.130, 686A.015)  A broker

who represents a client in an insurance transaction:

     1.  Shall not unreasonably place his or her

own interest above the interest of the client.

     2.  Shall, before or simultaneously with a

client’s purchase of insurance, or the consummation of any other insurance

transaction that would entitle the broker to compensation as a result of his or

her representation of the client, disclose to the client:

     (a) That the broker may receive compensation in

some form from an insurer or other source as a result of his or her

representation of the client in the transaction.

     (b) The name and identity of the source of the

compensation and whether the broker has any ownership interest in, or is under

common control with, the person providing the compensation.

     (c) That the compensation received by the broker

may differ depending upon the product and insurer.

     (d) The identity of any other person that the

broker knows, or reasonably ought to know, will receive compensation from the

insurer for assisting the broker in the insurance transaction. As used in this

paragraph, “person” does not include an intermediary, managing general agent or

wholesale broker acting in the normal course of production.

Ê These

disclosures must be followed by a documented acknowledgment by the client and

the broker that clearly indicates the client’s understanding of the contents of

the disclosure statement before or simultaneously with the consummation of the

insurance transaction. In the case of a transaction consummated over the

telephone or by electronic means, the client’s understanding of the disclosure

must be documented by the broker at the time of the transaction and followed by

a documented acknowledgment by the client and the broker.

     3.  Shall, before a client’s purchase of

insurance, disclose to the client the name of each insurer or other person that

supplied the broker with a quote that would reasonably meet the client’s needs.

     (Added to NAC by Comm’r of Insurance by R009-05, eff.

10-31-2005)—(Substituted in revision for NAC 686A.368)

      NAC 683A.718  Effect of violation. (NRS 679B.130, 686A.015)  A

violation of any provision of NAC 683A.716 is:

     1.  An unfair method of competition or an

unfair or deceptive act or practice in the business of insurance in violation

of NRS 686A.020.

     2.  A cause for disciplinary action pursuant

to NRS 683A.451.

     (Added to NAC by Comm’r of Insurance by R009-05, eff.

10-31-2005)—(Substituted in revision for NAC 686A.370)

CONTINUOUS CARE COVERAGE

      NAC 683A.750  “Continuous care coverage” defined. (NRS 679B.130)  As used

in NAC 683A.750 to 683A.780,

inclusive, unless the context otherwise requires, “continuous care coverage”

has the meaning ascribed to it in NRS

681A.022.

     (Added to NAC by Comm’r of Insurance by R077-10, eff.

12-16-2010)

      NAC 683A.760  Licensing required to sell, solicit or negotiate continuous care

coverage. (NRS 679B.130)  A person

who sells, solicits or negotiates continuous care coverage must:

     1.  Be licensed as a producer of accident and

health insurance and as a producer of casualty insurance; or

     2.  Be licensed as a producer of accident and

health insurance and receive approval from the Commissioner to market

continuous care coverage pursuant to NAC 683A.770.

     (Added to NAC by Comm’r of Insurance by R077-10, eff.

12-16-2010)

      NAC 683A.770  Instruction required for approval of request to sell, solicit and

negotiate continuous care coverage. (NRS 679B.130)  A

producer of accident and health insurance may submit to the Commissioner a

written request to sell, solicit and negotiate continuous care coverage. The

Commissioner will approve such a request if, within the 6 months immediately

preceding the date on which the request is submitted, the producer has

successfully completed not less than 8 hours of instruction approved by the

Commissioner for continuous care coverage, including, without limitation,

instruction concerning workers’ compensation insurance and employers’ liability

insurance.

     (Added to NAC by Comm’r of Insurance by R077-10, eff.

12-16-2010)

      NAC 683A.780  Instruction counts toward continuing education hours. (NRS 679B.130)  The

instruction required by NAC 683A.770 may be

counted toward the continuing education hours required by NAC 683A.330.

     (Added to NAC by Comm’r of Insurance by R077-10, eff.

12-16-2010)
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