Nac: Chapter 287 - Programs For Public Employees

Link to law: http://www.leg.state.nv.us/nac/NAC-287.html
Published: 2015

[Rev. 12/7/2015 1:00:11 PM]

 

This chapter of NAC has changes

which have been adopted but have not been codified; you can see those changes

by viewing the following regulation(s) on the Nevada Register of Administrative

Regulations: R013-15

[NAC-287 Revised Date: 9-14]

CHAPTER 287 - PROGRAMS FOR PUBLIC EMPLOYEES

GROUP INSURANCE

General Provisions

287.005            Definitions.

287.0056          “Biennial employee” defined.

287.011            “Certifying agency” defined.

287.021            “Continuous employment” defined.

287.025            “Day” defined.

287.035            “Dependent” defined.

287.055            “Health insurance” defined.

287.059            “Initial date of hire” defined.

287.065            “Medicare” defined.

287.085            “Open enrollment” defined.

287.090            “Opt-out plan” defined.

287.095            “Participant” defined.

287.100            “Plan year” defined.

287.126            “Public employer” defined.

287.135            “Retired officer or employee”

defined.

287.141            “Subsidy” defined.

287.143            “Tier of coverage” defined.

287.145            “Vendor” defined.

287.150            “Full-time employment” interpreted.

287.155            Date of receipt of required

notices.

287.160            Determination of late submission of

documents or information.

Board of the Public Employees’ Benefits Program

287.170            Chair: Duty; voting.

287.172            Vice Chair: Election; duty.

287.174            Meetings: Agenda.

287.176            Meetings: Approval of actions;

motions; rules of conduct.

287.178            Meetings: Minutes; transcript.

287.190            Advisory opinions: Request; action

by Executive Officer; appeal.

287.192            Advisory opinions: Oral opinion

prohibited; effect of response by electronic mail or oral response.

287.194            Petitions for declaratory orders.

287.196            Petitions for adoption, filing,

amendment or repeal of regulations.

Participation in Public Employees’ Benefits Program

287.310            Prerequisites to participation;

fees; establishment of rates; provision to agency of report on history of

claims.

287.3105          Persons eligible to participate in

Program.

287.311            Dependents: Enrollment and

disenrollment.

287.312            Dependents: Eligibility of child of

participant, spouse or domestic partner.

287.3125          Dependents: Terms and conditions of

certain changes.

287.313            Responsibility for final

determinations concerning eligibility.

287.314            Provision of information about

Program to participants, representatives of participating public agencies and

employees of Program.

287.317            Participating public agency to

notify Program of appointment of persons eligible to participate in Program or

of termination of appointment; enrollment.

287.318            Enrollment forms: Required

information.

287.319            Notification of change of address

by participant to Program.

287.320            Withdrawal from Program: Procedure;

termination of coverage; limitation on reentry; eligibility of certain officers

and employees after exclusion of group; liability of Program.

Option of Group to Leave Public Employees’ Benefits Program

287.355            Procedure for applying to leave

Program.

287.357            Application to leave Program:

Contents.

287.359            Application to leave Program:

Deadline for submission; duties of Board.

287.361            Application to leave Program:

Considerations for approval or denial; basis for findings by Board.

287.363            Approval of application by Board:

Format and contents of decision; responsibilities of and noncompliance by

group.

287.365            Denial of application by Board:

Format and contents of decision.

287.367            Denial of application by Board:

Procedure for reconsideration.

287.368            Denial of request for

reconsideration: Appeal.

287.369            Effective date of departure from

Program; coverage by Program until departure.

287.371            Eligibility of officer or employee

to join opt-out plan; ineligibility of officer or employee to continue

participation in opt-out plan.

287.373            Notification of Program regarding

certain changes in status and court orders.

287.375            Eligibility for coverage under

opt-out plan: Administration of requirements by Program; compliance with

determinations of Program.

287.376            Participation in Program by certain

persons eligible for coverage under or participating in opt-out plan

prohibited; exceptions.

287.379            Options for coverage under opt-out

plan: Annual notification of Program; effective period.

287.381            Premiums or contributions for

participants in opt-out plans: General administrative duties of Program.

287.383            Premiums or contributions for

participants in opt-out plans: Requirements for billing.

287.385            Premiums or contributions for

participants in opt-out plans: Remittance or transfer of payments; nonpayment

by participant.

287.386            Liability of Program and opt-out

plan for expense or claim of officer or employee or retired officer or

employee, or dependent thereof.

287.387            Administrative fee: Establishment

by Program; calculation; notice.

287.389            Duties of Program: Accounting for

and remittance of payments; monthly reports.

Option of Group to Reenter Public Employees’ Benefits Program

287.400            Procedure for applying to reenter

Program.

Payment of Premiums and Contributions; Coverage

287.420            Payment of premiums or

contributions by public employer: Date due; penalty.

287.430            Direct payment of premiums or

contributions: Date due; cancellation of coverage.

287.440            Payment of premiums or

contributions by retired officers and employees.

287.450            Employees on leave without pay:

Payment of premiums or contributions; eligibility for coverage as dependent of

participant; coverage upon return to work.

287.460            Officers and employees on leave

because of injuries in course of employment: Payment of premiums or

contributions; reports of change in status; coverage of dependents upon return

to work.

287.470            Overpayment or underpayment of

premiums or contributions.

287.485            Subsidy for retired officer or

employee: Report required to obtain subsidy; audit of service credit required;

billing; commencement of payment; adjustment of amount of subsidy; assumption

of liability for service credit earned.

287.490            Subsidy for retired officer or

employee: Calculation of amount of payment.

287.500            Coverage of seasonal employees and

biennial employees.

287.510            Coverage of persons returning to

work with previous employer within 1 year after leaving employment.

287.515            Coverage of retired participants

upon reemployment.

287.520            Coverage of person qualified as

both employee and dependent; change of status from employee to dependent.

287.530            Coverage of retired person, spouse,

domestic partner or surviving dependent: Generally.

287.540            Coverage of participating employee

of State who reenrolls upon retirement or total disability; coverage of

nonparticipating employee of State.

287.542            Coverage of participating employee

of local governmental agency who retires on or before September 1, 2008, and

reenrolls upon retirement or total disability.

287.544            Coverage of nonparticipating

employee of local governmental agency who retires on or before September 1,

2008, and enrolls upon retirement or total disability.

287.546            Coverage of participating employee

of local governmental agency who retires after September 1, 2008, and reenrolls

upon retirement or total disability.

287.548            Coverage of nonparticipating

employee of local governmental agency who retires after September 1, 2008.

Claims

287.600            Definitions.

287.601            “Adverse determination” defined.

287.602            “Appeals Manager” defined.

287.603            “Claims Administrator” defined.

287.608            Claims Administrator or vendor

required to be independent contractor.

287.610            Period for submission.

287.620            Assumption regarding availability

of benefits under Medicare; coordination under Medicare.

287.660            Notification of adverse

determination; grounds for appeal.

287.670            Appeal of adverse determination:

Requirements; duties of Appeals Manager.

287.680            Appeal of decision of Appeals

Manager: Requirements; duties of Executive Officer or designee.

287.690            Request for external review.

287.695            Request for expedited review by

Claims Administrator.

DEFERRED COMPENSATION

287.700            Definitions.

287.705            Purpose.

287.710            Recordkeepers: Selection and

removal.

287.715            Recordkeepers: Procedures for

selection.

287.730            Appointment of subcommittee to

review proposals for position of recordkeeper and make recommendations; general

meeting of Committee regarding applicants; negotiation of changes to accepted

proposals.

287.735            Investment consultants: Selection

and removal.

PROVISION OF HEALTH INSURANCE THROUGH PLAN OF SELF-INSURANCE

287.750            System for resolving complaints of

insureds: Requirements for approval and annual report.

TRUST FUND FOR FUTURE RETIREMENT BENEFITS OF LOCAL

GOVERNMENTAL EMPLOYEES

287.760            Definitions.

287.762            “Benefits plan” defined.

287.764            “Board of trustees” defined.

287.766            “Governing body” defined.

287.768            “Local government” defined.

287.770            “Professional fund manager”

defined.

287.772            “Retirement benefits” defined.

287.774            “Trust fund” defined.

287.776            Resolution to establish trust fund;

periodic reports.

287.778            Board of trustees: Appointment and

terms of members.

287.780            Board of trustees: Selection and

duties of chair and vice chair; meetings; quorum; voting.

287.782            Board of trustees: Restrictions.

287.784            Board of trustees: Compensation of

members; staffing; provision for expenses.

287.786            Determination of annual

contributions; annual budgeting and auditing.

287.788            Contract with professional fund

manager; investment plan.

287.790            Deposit and investment of assets;

maintenance as separate account; prohibited uses; reimbursement of

administrative expenses.

287.792            Requests for transfers of money.

 

GROUP INSURANCE

General Provisions

      NAC 287.005  Definitions. (NRS 287.043)  As used

in NAC 287.005 to 287.695,

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

in NAC 287.0056 to 287.145,

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

     [Com. on Group Ins., Broker of Record Reg. § 2, eff. 2-5-82]—(NAC

A 1-22-86; A by Com. to Admin. Pub. Employees’ Deferred Comp. Prog., 9-13-91; A

by Com. on Benefits, 5-4-92; 10-3-96; A by Bd. of Pub. Employees’ Benefits

Prog. by R126-00, 12-22-2000, eff. 1-1-2001; R097-03, 9-24-2003; R154-03, 3-22-2004;

R089-05, 6-28-2006; R126-07, 1-30-2008; R016-08, 8-26-2008, eff. 7-1-2009; R002-12,

6-29-2012)

      NAC 287.0056  “Biennial employee” defined. (NRS 287.043)  “Biennial

employee” means an employee whose position of employment is only authorized for

4 to 6 months every other year and who plans to return to the same or a similar

position for the next period during which such a position is authorized.

     (Added to NAC by Bd. of Pub. Employees’ Benefits Prog.

by R089-05, eff. 6-28-2006)

      NAC 287.011  “Certifying agency” defined. (NRS 287.043)  “Certifying

agency” means:

     1.  Except as otherwise provided in

subsection 2, for officers and employees of the State and local governmental

agencies, the Public Employees’ Retirement System.

     2.  For members of the professional staff of

the Nevada System of Higher Education, a retirement program for professional

employees offered by or through the Nevada System of Higher Education.

     (Added to NAC by Bd. of Pub. Employees’ Benefits Prog.

by R154-03, eff. 3-22-2004; A by R089-05, 6-28-2006)

      NAC 287.021  “Continuous employment” defined. (NRS 287.043)  “Continuous

employment”:

     1.  Includes a break in employment of less

than 1 year; and

     2.  Does not include a break in employment of

1 year or more.

     (Added to NAC by Bd. of Pub. Employees’ Benefits Prog.

by R107-09, eff. 4-20-2010)

      NAC 287.025  “Day” defined. (NRS 287.043)  “Day”

means a calendar day.

     (Added to NAC by Bd. of Pub. Employees’ Benefits Prog.

by R154-03, eff. 3-22-2004)

      NAC 287.035  “Dependent” defined. (NRS 122A.100, 287.043)  “Dependent”

includes, without limitation:

     1.  One spouse from a marriage pursuant to

law or one domestic partner as defined in NRS 122A.030; and

     2.  Any person described in NAC 287.312,

Ê who is

determined to be eligible for coverage pursuant to NAC

287.313.

     (Added to NAC by Bd. of Pub. Employees’ Benefits Prog.

by R126-00, 12-22-2000, eff. 1-1-2001; A by R016-08, 8-26-2008, eff. 7-1-2009;

R107-09, 4-20-2010; R107-09, 4-20-2010, eff. 7-1-2010; R109-12, 12-20-2012;

R047-13, 10-23-2013)

      NAC 287.055  “Health insurance” defined. (NRS 287.043)  “Health

insurance” means insurance coverage for medical, dental, vision, prescription

drugs and the treatment of mental health or substance abuse.

     (Added to NAC by Bd. of Pub. Employees’ Benefits Prog.

by R126-00, 12-22-2000, eff. 1-1-2001; A by R109-12, 12-20-2012)

      NAC 287.059  “Initial date of hire” defined. (NRS 287.043)  “Initial

date of hire” means the first date on which service credit is earned by a

participant during the participant’s last period of continuous employment with

a public employer, as determined by the appropriate certifying agency.

     (Added to NAC by Bd. of Pub. Employees’ Benefits Prog.

by R107-09, eff. 4-20-2010)

      NAC 287.065  “Medicare” defined. (NRS 287.043)  “Medicare”

has the meaning ascribed to it in NRS

439B.130.

     (Added to NAC by Com. on Benefits, eff. 5-4-92)—(Substituted

in revision for NAC 287.0075)

      NAC 287.085  “Open enrollment” defined. (NRS 287.043)  “Open

enrollment” means the event in which participants in the Program may change

elections offered by the Program concerning coverage and dependents.

     (Added to NAC by Bd. of Pub. Employees’ Benefits Prog.

by R126-00, 12-22-2000, eff. 1-1-2001; A by R097-03, 9-24-2003; R023-09, 11-25-2009;

R002-12, 6-29-2012)

      NAC 287.090  “Opt-out plan” defined. (NRS 287.043)  “Opt-out

plan” means an alternative plan to provide life, accident or health insurance,

or any combination thereof, for a group which is approved by the Board pursuant

to NRS 287.0479.

     (Added to NAC by Bd. of Pub. Employees’ Benefits Prog.

by R097-03, eff. 9-24-2003; A by R002-12, 6-29-2012)

      NAC 287.095  “Participant” defined. (NRS 287.043)  “Participant”

includes the following persons who are eligible to participate in the Program:

     1.  An officer or employee of a participating

public agency;

     2.  A retired officer or employee whose last

employer is a participating public agency;

     3.  A retired officer or employee whose last

employer is not a participating public agency who has been covered continuously

by the Program as a retiree since November 30, 2008;

     4.  A surviving dependent of a deceased

officer or employee of a participating public agency who was covered by the

Program at the time of death of the deceased officer or employee if the

deceased officer or employee had 10 years or more of service credit, as determined

by the appropriate certifying agency, and is deemed to be retired pursuant to NRS 286.676;

     5.  A surviving dependent of a deceased

retired officer or employee described in subsection 2 or 3 if the dependent was

covered by the Program at the time of death of the retired officer or employee;

     6.  A surviving spouse of a deceased retired

public officer or employee who chooses to reinstate insurance pursuant to NRS 287.0475;

     7.  A surviving spouse of a police officer,

firefighter or official member of a volunteer fire department who was killed in

the line of duty;

     8.  A surviving child of a police officer,

firefighter or official member of a volunteer fire department who was killed in

the line of duty;

     9.  A biennial employee;

     10.  A Legislator whose term of office has

not expired; and

     11.  A person who has elected to continue

coverage pursuant to the Public Health Service Act, 42 U.S.C. § 300bb-1(a).

     (Added to NAC by Com. on Benefits, eff. 5-4-92; A by

Bd. of Pub. Employees’ Benefits Prog. by R126-00, 12-22-2000, eff. 1-1-2001;

R154-03, 3-22-2004; R089-05, 6-28-2006; R016-08, 8-26-2008, eff. 7-1-2009; R109-12,

12-20-2012)

      NAC 287.100  “Plan year” defined. (NRS 287.043)  “Plan

year” means the period set forth by the Board in which Program benefits and

rates are offered for enrollment.

     (Added to NAC by Bd. of Pub. Employees’ Benefits Prog.

by R126-00, 12-22-2000, eff. 1-1-2001; A by R067-03, 9-24-2003; R023-09, 11-25-2009)

      NAC 287.126  “Public employer” defined. (NRS 287.043)  “Public

employer” means the State or a local governmental agency.

     (Added to NAC by Bd. of Pub. Employees’ Benefits Prog.

by R154-03, eff. 3-22-2004)

      NAC 287.135  “Retired officer or employee” defined. (NRS 287.043)  “Retired

officer or employee” means an officer or employee of a public employer who:

     1.  Has met the requirements to receive, and

is receiving any distribution of, benefits from:

     (a) The Judges’ Retirement System;

     (b) The Public Employees’ Retirement System (PERS);

     (c) The Legislators’ Retirement System;

     (d) A retirement program for professional employees

offered by or through the Nevada System of Higher Education, including, without

limitation, a retirement plan alternative provided pursuant to NRS 286.802, a tax sheltered

annuity or a deferred compensation plan; or

     (e) A long-term disability plan of the public

employer; and

     2.  Has a total of at least 5 years of

full-time service credit from all his or her public employers as determined by

the appropriate certifying agency, excluding any service credit purchased

pursuant to NRS 1A.310, 218C.370 or 286.300.

     (Added to NAC by Com. on Benefits, eff. 5-4-92; A by

Bd. of Pub. Employees’ Benefits Prog. by R126-00, 12-22-2000, eff. 1-1-2001;

R062-03, 9-24-2003; R154-03, 3-22-2004; R089-05, 6-28-2006; R126-07, 1-30-2008;

R109-12, 12-20-2012)

      NAC 287.141  “Subsidy” defined. (NRS 287.043)  “Subsidy”

means a portion of the cost of premiums or contributions for group insurance

provided by the Program which is paid by:

     1.  The State pursuant to NRS 287.046; or

     2.  A local governmental agency pursuant to

paragraph (b) of subsection 4 of NRS

287.023.

     (Added to NAC by Bd. of Pub. Employees’ Benefits Prog.

by R154-03, eff. 3-22-2004; A by R126-07, 1-30-2008)

      NAC 287.143  “Tier of coverage” defined. (NRS 287.043)  “Tier of

coverage” means the category of rates and premiums or contributions for

coverage that correspond to:

     1.  An eligible participant only; or

     2.  An eligible participant and one or more

eligible dependents.

     (Added to NAC by Bd. of Pub. Employees’ Benefits Prog.

by R089-05, eff. 6-28-2006)

      NAC 287.145  “Vendor” defined. (NRS 287.043)  “Vendor”

means a person who provides products or services to the Program or its

participants and dependents, including, but not limited to, an insurance

broker, a consultant, an insurer, a health maintenance organization, a physical

or mental health care provider, a case management or utilization management

company, a dental or vision care provider, a hospital, a medical facility, a

certified public accountant, an actuary, an attorney specializing in health

care, a health care auditor, a health educator, a pharmacy or pharmacy benefit

manager and a preferred provider organization. The term does not include an

opt-out plan.

     (Added to NAC by Com. on Benefits, eff. 5-4-92; A by

Bd. of Pub. Employees’ Benefits Prog. by R126-00, 12-22-2000, eff. 1-1-2001;

R097-03, 9-24-2003; R154-03, 3-22-2004; R016-08, 8-26-2008, eff. 7-1-2009; R002-12,

6-29-2012; R109-12, 12-20-2012)

      NAC 287.150  “Full-time employment” interpreted. (NRS 287.043, 287.045)  As used

in NRS 287.045, the Board

interprets “full-time employment” to mean the employment, election or

appointment by a participating public agency of a person who:

     1.  In any calendar month, works as a public

employee or officer at least 80 hours. The Board will consider such full-time

employment to commence at the beginning of the month in which the public

employee or officer works 80 hours.

     2.  Is elected or appointed as a public

officer who receives any compensation regardless of the number of hours worked.

The Board will consider such full-time employment to commence at the beginning

of the month in which the person’s term of service or term of office begins.

     (Added to NAC by Com. on Benefits, eff. 5-4-92; A by

Bd. of Pub. Employees’ Benefits Prog. by R126-00, 12-22-2000, eff. 1-1-2001;

R154-03, 3-22-2004; R089-05, 6-28-2006; R126-07, 1-30-2008; R109-12, 12-20-2012)

      NAC 287.155  Date of receipt of required notices. (NRS 287.043)  A person

shall be deemed to have received any notice required pursuant to this chapter

or chapter 287 of NRS 5 days after the

notice is mailed, by first-class mail, to that person’s last known address,

unless the Executive Officer or an authorized designee thereof waives this

provision because of extenuating circumstances that are sufficient to justify

the waiver.

     (Added to NAC by Bd. of Pub. Employees’ Benefits Prog.

by R089-05, eff. 6-28-2006)

      NAC 287.160  Determination of late submission of documents or information. (NRS 287.043)  Any

form, application, claim or other document or information that is required to

be submitted to the Program, Executive Officer or Board on or before a specific

date will be considered late if the form, application, claim or other document

or information is not:

     1.  Received by the Program, Executive

Director or Board, as applicable, before 5 p.m. on that date; or

     2.  Postmarked on or before that date.

     (Added to NAC by Bd. of Pub. Employees’ Benefits Prog.

by R089-05, eff. 6-28-2006)

Board of the Public Employees’ Benefits Program

      NAC 287.170  Chair: Duty; voting. (NRS 287.043)

     1.  The Chair shall preside over the meetings

of the Board.

     2.  Unless the Chair is required to abstain

from voting or is otherwise disqualified from participating in a matter before

the Board:

     (a) If the Chair does not vote on the matter, it

will be presumed that the Chair voted with the prevailing majority of members

of the Board who voted on the matter.

     (b) The Chair shall vote in the case of a tie.

     (Added to NAC by Bd. of Pub. Employees’ Benefits Prog.

by R089-05, eff. 6-28-2006)

      NAC 287.172  Vice Chair: Election; duty. (NRS 287.043)

     1.  At the first meeting of each plan year,

the Board will elect from its members a Vice Chair.

     2.  The Vice Chair shall serve as the Chair

in the absence of the Chair.

     (Added to NAC by Bd. of Pub. Employees’ Benefits Prog.

by R089-05, eff. 6-28-2006)

      NAC 287.174  Meetings: Agenda. (NRS 287.043)

     1.  The Chair shall determine the agenda of a

meeting of the Board.

     2.  Any member of the Board may submit to the

Executive Officer, or in his or her absence, the Operations Officer of the

Program appointed pursuant to NRS

287.0426, a request for a matter to be placed on the agenda of a meeting of

the Board.

     (Added to NAC by Bd. of Pub. Employees’ Benefits Prog.

by R089-05, eff. 6-28-2006)

      NAC 287.176  Meetings: Approval of actions; motions; rules of conduct. (NRS 287.043)

     1.  All action by the Board must be approved

by a majority of the members of the Board who are present at the meeting. A tie

vote constitutes a rejection of the question or matter before the Board.

     2.  Any motion made by a member of the Board

requires a second to the motion for consideration of the motion by the Board.

     3.  Robert’s Rules of Order govern the

general conduct of meetings of the Board.

     (Added to NAC by Bd. of Pub. Employees’ Benefits Prog.

by R089-05, eff. 6-28-2006)

      NAC 287.178  Meetings: Minutes; transcript. (NRS 287.0415, 287.043)

     1.  The minutes of each meeting of the Board

must be distributed to each member of the Board.

     2.  A transcript of a meeting posted to the

Internet website of the Board pursuant to NRS 287.0415 will remain posted on

the Internet website of the Board for at least 6 months after posting. During

the period in which the transcript of the meeting is posted on the Internet

website of the Board, a person may request a hard copy of the transcript.

     3.  The Board may charge the person a fee for

the transcript that does not exceed the actual cost of the Board to provide the

copy of the transcript.

     (Added to NAC by Bd. of Pub. Employees’ Benefits Prog.

by R089-05, eff. 6-28-2006; A by R109-12, 12-20-2012)

      NAC 287.190  Advisory opinions: Request; action by Executive Officer; appeal. (NRS 233B.120, 287.043)

     1.  Except as otherwise provided in

subsection 3, a person may request that the Executive Officer issue an advisory

opinion concerning the applicability of any provision of NRS 287.0402 to 287.049, inclusive, that pertains

to the jurisdiction of the Board or any regulation adopted by the Board

pursuant thereto. Any request for an advisory opinion concerning the

applicability of any provision of NRS

287.0402 to 287.049,

inclusive, that pertains to the jurisdiction of a public agency or public

officer other than the Board or any regulation adopted by the public agency or

public officer must be submitted to that public agency or public officer.

     2.  A request for an advisory opinion

pursuant to subsection 1 must be in writing and set forth:

     (a) The name and address of the person requesting

the advisory opinion;

     (b) A clear and concise statement of the specific

question for which the advisory opinion is being sought; and

     (c) A statement of the facts that support the

advisory opinion being sought.

     3.  A person may not request an advisory

opinion concerning a question or matter that is an issue in a review or an

appeal of a claim or in a pending administrative, civil or criminal proceeding

in which the person is a party or otherwise involved.

     4.  The Executive Officer shall review a

request for an advisory opinion and issue a response within 30 days after

receiving the request.

     5.  An advisory opinion issued by the

Executive Officer must be limited to the facts and circumstances set forth in

the request.

     6.  An advisory opinion issued by the

Executive Officer is appealable to the Board in the same manner as any other

appealable decision.

     (Added to NAC by Bd. of Pub. Employees’ Benefits Prog.

by R089-05, eff. 6-28-2006)

      NAC 287.192  Advisory opinions: Oral opinion prohibited; effect of response by

electronic mail or oral response. (NRS 233B.120, 287.043)  The

Executive Officer shall not render an oral advisory opinion to a request for an

advisory opinion. A response by electronic mail or an oral response, including,

without limitation, a response given over the telephone, to a request for an

advisory opinion that is given by the Executive Officer, a member of the Board

or staff of the Board are not decisions or official advisory opinions pursuant

to this section.

     (Added to NAC by Bd. of Pub. Employee’s Benefits Prog.

by R089-05, eff. 6-28-2006)

      NAC 287.194  Petitions for declaratory orders.

(NRS 233B.120, 287.043)

     1.  Except as otherwise provided in

subsection 3, a person may file a petition with the Executive Officer

requesting that the Board issue a declaratory order concerning the

applicability of any provision of NRS

287.0402 to 287.049,

inclusive, that pertains to the jurisdiction of the Board or any regulation

adopted by the Board pursuant thereto. Any petition for a declaratory order

concerning the jurisdiction of a public agency or public officer other than the

Board or any regulation adopted by the public agency or public officer must be

submitted to that public agency or public officer.

     2.  A petition for a declaratory order filed

pursuant to subsection 1 must include, without limitation:

     (a) The name and address of the petitioner;

     (b) The reason for requesting the declaratory

order;

     (c) A statement of the facts that support the

petition for a declaratory order; and

     (d) A clear and concise statement of the question

or matter to be decided by the Board.

     3.  A person may not file a petition for a

declaratory order concerning a question or matter that is an issue in a review

or an appeal of a claim or in a pending administrative, civil or criminal

proceeding in which the person is a party or otherwise involved.

     4.  The Executive Officer shall notify the

Chair of the petition for a declaratory order not later than 10 days after the

petition is received by the Executive Officer.

     5.  The Board may:

     (a) Conduct a hearing to determine issues of fact

or to hear arguments relating to a petition for a declaratory order and may

enter reasonable orders that govern the conduct of the hearing.

     (b) Request that the petitioner provide additional

information or arguments relating to the petition.

     (c) Issue a declaratory order based on the contents

of the petition and any material submitted with the petition.

     (d) Consider relevant actions that have been issued

by the Board or any other entity which apply or interpret the statute or regulation

in question.

     (e) Consider any other information that the Board

determines is relevant to the question or matter to be decided by the Board.

     6.  The Board will notify the petitioner in

writing within 10 days after any action taken by the Board concerning the

petition.

     (Added to NAC by Bd. of Pub. Employees’ Benefits Prog.

by R089-05, eff. 6-28-2006)

      NAC 287.196  Petitions for adoption, filing, amendment or repeal of

regulations. (NRS

233B.100, 287.043)

     1.  Any person who wishes to petition for the

adoption, filing, amendment or repeal of a regulation that the Board is

authorized to adopt, file, amend or repeal must file a petition with the

Executive Officer.

     2.  A petition for the adoption, filing,

amendment or repeal of a regulation must include, without limitation:

     (a) The name and address of the petitioner;

     (b) A clear and concise statement, including, if

applicable, the proposed language, of the regulation to be adopted, filed,

amended or repealed;

     (c) The reason for petitioning for the adoption,

filing, amendment or repeal of the regulation; and

     (d) The statutory authority for the adoption,

filing, amendment or repeal of the regulation.

     3.  The Executive Officer may refuse to act

upon a petition for the adoption, filing, amendment or repeal of a regulation

if the petition does not contain the information required by subsection 2.

     4.  The Executive Officer shall notify the

petitioner in writing of his or her decision with regard to the petition within

30 days after the petition is filed.

     (Added to NAC by Bd. of Pub. Employees’ Benefits Prog.

by R089-05, eff. 6-28-2006)

Participation in Public Employees’ Benefits Program

      NAC 287.310  Prerequisites to participation; fees; establishment of rates;

provision to agency of report on history of claims. (NRS 287.043)

     1.  To participate in group coverage or

insurance provided by the Program, a local governmental agency, through its

governing body, must provide to the Program:

     (a) A nonrefundable application fee of $250, plus

$2.25 per participant for any application involving 100 or more participants.

     (b) A nonrefundable fee to be deposited in the Fund

for the Public Employees’ Benefits Program created pursuant to NRS 287.0435 for the purpose of

funding the reserve maintained by the Program to stabilize rates. The Executive

Officer or a designee thereof shall calculate the amount of the nonrefundable

fee by:

          (1) Dividing the funded reserve maintained by

the Program to stabilize rates on the date on which the local governmental

agency submitted its application to participate in the Program by the total

number of participants in the Program on that date; and

          (2) Multiplying the number determined pursuant

to subparagraph (1) by the total number of officers and employees of the local

governmental agency who enroll in the Program on the effective date of

participation by the local governmental agency in the Program.

Ê The fee, or

if installment payments are authorized by the Program, the first installment

payment of the fee, must be paid by the effective date of participation by the

local governmental agency in the Program.

     (c) If the local governmental agency has 100 or

more participants, information, as determined by the actuary of the Program,

sufficient to make an actuarial determination as to the appropriate rates for

the local governmental agency, including, without limitation, the 3 most recent

years of claims history data of the local governmental agency, if any exists,

in an electronic format that is compatible with the actuarial services of the

Program.

     (d) The residential zip code, gender, age and

current selection for coverage of:

          (1) The eligible members, regardless of

current enrollment, of the local governmental agency; and

          (2) Those members that are currently enrolled

in the group plan of the local governmental agency and their respective number

of enrolled dependents.

     (e) An interlocal contract executed pursuant to NRS 287.043, on a form provided by

the Program. Effective November 30, 2008, such an interlocal contract must

include a provision that requires the local governmental agency to participate

in the Program for at least 4 years before the local governmental agency may

withdraw from the Program in accordance with NAC

287.320.

     (f) A statement that all terminal fees and costs

associated with the previous health plan will be paid by that local

governmental agency group.

     2.  The actuary for, and the members of the

staff of, the Board shall review the request and establish the initial rates

for the requesting local governmental agency as follows:

     (a) For a local governmental agency with less than

100 participants, the requesting local governmental agency will not be rated

separately from those same or similar participating local governmental

agencies.

     (b) For a local governmental agency with 100 or

more participants:

          (1) If, upon review of the claims experience

of participating local governmental agency groups or the past claims history of

the requesting local governmental agency, the actuary for the Board determines

the experience for the requesting local governmental agency does not exceed 105

percent of the appropriate rate for the same or similar participating local

governmental agency groups, the requesting local governmental agency will not

be rated separately from those same or similar participating local governmental

agency groups.

          (2) If the claims experience for the

requesting local governmental agency exceeds 105 percent of the appropriate

rate for the same or similar participating local governmental agency groups,

the actuary for the Program and a member of the staff will submit a written

report, with recommended rates, to the Board. The recommended rates must equal

the difference of the premium or contribution for participating local

governmental agency groups and the cost of the experience of the requesting

local governmental agency.

          (3) If the requesting local governmental

agency has no claims experience, the rates will be equal to 105 percent of the

standard rate for a participating local governmental agency that has no

separate rating applied.

Ê Rates

established pursuant to subparagraphs (2) and (3) apply until the end of the

plan year immediately following the year in which the rates were established,

at which time the actuary for, and the members of the staff of, the Board shall

review the claims experience of the requesting local governmental group to

determine an appropriate rate or whether the standard rate should be applied.

     3.  For a participating local governmental

agency, the Executive Officer or the designee shall provide, upon written

request from the participating local governmental agency, the history of claims

for that participating local governmental agency. The Executive Officer or the

designee shall charge for each report the actual cost of providing the report.

The report must include:

     (a) A summary of the medical, prescription and

dental claims paid by the self-funded plan for each month covered by the

report; and

     (b) A summary of the monthly premiums or

contributions paid during the period covered by the report.

Ê The Executive

Officer or the designee shall provide the report within 90 days after receipt

of the request.

     (Added to NAC by Com. on Group Ins., eff. 5-27-86; A by

Com. on Benefits, 5-4-92; A by Bd. of Pub. Employees’ Benefits Prog. by R126-00,

12-22-2000, eff. 1-1-2001; R154-03, 3-22-2004; R126-07, 1-30-2008; R017-08, 6-17-2008)

      NAC 287.3105  Persons eligible to participate in Program. (NRS 287.043, 42

U.S.C. § 300gg-7)

     1.  Except as otherwise provided in

subsection 2 of NRS 287.045,

every state officer or employee is eligible to participate in the Program on

the first day of the month following the completion of 60 days of full-time

employment.

     2.  Every officer or employee who is employed

by a participating local governmental agency on a permanent and full-time basis

on the date on which the participating local governmental agency enters into an

agreement to participate in the Program pursuant to paragraph (a) of subsection

1 of NRS 287.025, and every

officer or employee who commences employment with that participating local

governmental agency after that date, is eligible to participate in the Program

on the first day of the month following the completion of 60 days of full-time

employment, unless that officer or employee is excluded pursuant to

sub-subparagraph (III) of subparagraph (2) of paragraph (h) of subsection 2 of NRS 287.043.

     3.  Every member of the Senate and Assembly

is eligible to participate in the Program on the first day of the month

following the 60th day after the member’s initial term of office begins.

     (Added to NAC by Bd. of Pub. Employees’ Benefits Prog.

by R101-13, 2-26-2014, eff. 5-1-2014)

      NAC 287.311  Dependents: Enrollment and disenrollment. (NRS 122A.100, 287.043)

     1.  Except as otherwise provided in NAC 287.312, a participant who desires or is required

to enroll or disenroll a person in the Program as a dependent as a result of a

life event that qualifies the participant to amend his or her coverage outside

the period of open enrollment must, within 60 days after the date on which the

dependent becomes eligible to participate or loses his or her eligibility to

participate in the Program:

     (a) Execute a declaration of enrollment

electronically through the Internet website of the Board or by submitting a

form prescribed by the Program pursuant to NAC 287.318,

under penalty of perjury and subject to the provisions of NRS 686A.290 and 686A.291.

     (b) Submit copies of any supporting documentation

required to establish or terminate the dependent’s eligibility to participate

in the Program as a dependent as requested by the Program.

     2.  Except as otherwise provided in

subsections 3 and 4, if a participant fails to enroll or disenroll a person in

the Program as a dependent within 60 days after the date on which the dependent

becomes eligible to participate or loses his or her eligibility to participate

in the Program, the participant may not enroll or disenroll the person in the

Program as a dependent until the next period of open enrollment.

     3.  The Program will enroll a person as a

dependent of a participant in accordance with an order to obtain health

insurance for his or her child pursuant to NRS 31A.350.

     4.  The Program will disenroll a person as a

dependent of a participant on the date on which the dependent becomes deceased.

     (Added to NAC by Bd. of Pub. Employees’ Benefits Prog.

by R016-08, 8-26-2008, eff. 7-1-2009; A by R107-09, 4-20-2010, eff. 7-1-2010;

R109-12, 12-20-2012)

      NAC 287.312  Dependents: Eligibility of child of participant, spouse or

domestic partner. (NRS 122A.100, 287.043)

     1.  To determine whether the child of a

participant or of his or her spouse or domestic partner who is incapable of

self-support because of a physical or mental disability continues to be

eligible for coverage by the Program, the Executive Officer or his or her designee:

     (a) Shall require submission by a physician who

provides care to the child of a written statement on a form prescribed by the

Board indicating that the child has a mental or physical impairment which

causes the child to be incapable of self-sustaining employment and to depend on

the participant or his or her spouse or domestic partner primarily for support.

The written statement required by this paragraph must be prepared by the

physician within 90 days before the statement is provided to the Program.

     (b) May require:

          (1) Submission of periodic updates regarding

the physical or mental disability of the child by the participant or his or her

spouse or domestic partner;

          (2) Submission of the child to a mental or

physical examination conducted by a physician selected by and at the expense of

the Program; and

          (3) Any other documentation required by the

Program that demonstrates financial support of the child by the participant or

his or her spouse or domestic partner.

     2.  Persons who are eligible for coverage as

a dependent may include:

     (a) Biological children;

     (b) Adopted children;

     (c) Children placed in the residence of the

participant for adoption;

     (d) Stepchildren; and

     (e) Any other person who:

          (1) Bears a relationship described in 26

U.S.C. § 152(c)(2) to the participant or his or her spouse or domestic partner;

          (2) Is unmarried;

          (3) Has not attained the age set forth in 45

C.F.R. § 147.120(a);

          (4) Either resides with the participant or is

enrolled in a program of secondary education or an independently accredited

program of postsecondary education, including, without limitation, a college,

university, community or junior college, graduate school or accredited trade or

business school, on a full-time basis;

          (5) Satisfies one of the following conditions:

               (I) Is currently under a permanent legal

guardianship of the participant or his or her spouse or domestic partner

pursuant to chapter 159 of NRS; or

               (II) Was eligible to be claimed as a

dependent on the federal income tax return of the participant or his or her

spouse or domestic partner for the immediately preceding calendar year; and

          (6) Is in a relationship with the participant

or his or her spouse or domestic partner that is similar to a child-parent

relationship. The participant or his or her spouse or domestic partner must

complete and submit to the Program an affidavit attesting to the fact of the

relationship.

     3.  A foster child of a participant or his or

her spouse or domestic partner is not eligible for coverage as a dependent.

     (Added to NAC by Bd. of Pub. Employees’ Benefits Prog.

by R126-00, 12-22-2000, eff. 1-1-2001; A by R154-03, 3-22-2004; R089-05, 6-28-2006;

R126-07, 1-30-2008; R016-08, 8-26-2008, eff. 7-1-2009; R107-09, 4-20-2010; R107-09,

4-20-2010, eff. 7-1-2010; R002-12, 6-29-2012; R047-13, 10-23-2013)

      NAC 287.3125  Dependents: Terms and conditions of certain changes. (NRS 287.043)  Except

during a period of open enrollment, the right to change coverage or insurance

for a dependent or to add or change dependents is governed by the terms and

conditions of any applicable plan, insurance policy or law.

     (Added to NAC by Bd. of Pub. Employees’ Benefits Prog.

by R016-08, 8-26-2008, eff. 7-1-2009)

      NAC 287.313  Responsibility for final determinations concerning eligibility. (NRS 287.043)  The

Executive Officer or a designee thereof shall make all final determinations

concerning eligibility:

     1.  To become a participant in the Program

pursuant to NRS 287.045.

     2.  As a dependent.

     (Added to NAC by Bd. of Pub. Employees’ Benefits Prog.

by R089-05, eff. 6-28-2006; A by R016-08, 8-26-2008, eff. 7-1-2009)

      NAC 287.314  Provision of information about Program to participants,

representatives of participating public agencies and employees of Program. (NRS 287.043)

     1.  The Executive Officer or a designee

thereof shall provide information about the Program to participants,

representatives of participating public agencies and employees of the Program.

     2.  The information required to be provided

pursuant to subsection 1 must include, without limitation:

     (a) Procedures, forms and instructions relating to

enrollment and participation in the Program;

     (b) Forms and instructions relating to enrollment

through the Internet website of the Program; and

     (c) A summary of the benefits available through the

Program.

     3.  The Executive Officer or a designee

thereof shall make the information about the Program described in subsection 2

available on:

     (a) An Internet website established and maintained

by the Program for participants and representatives of participating public agencies;

and

     (b) An Intranet site relating to the internal

management of the Program for employees of the Program.

     4.  A notice that explains how to access the

information on the Internet website of the Program and how to request a written

copy of the information required to be provided pursuant to subsection 2 must

be provided electronically or by first-class mail, to the last electronic mail

or mailing address provided by a participant, to:

     (a) A new participant within 7 days after the

Program is notified of the employment of the participant with a participating

public agency; and

     (b) All participants annually, at least 75 days

before the first day of the following plan year.

     (Added to NAC by Com. on Benefits, eff. 10-3-96; A by

Bd. of Pub. Employees’ Benefits Prog. by R126-00, 12-22-2000, eff. 1-1-2001;

R154-03, 3-22-2004; R089-05, 6-28-2006; R107-09, 4-20-2010; R108-12, 12-20-2012)

      NAC 287.317  Participating public agency to notify Program of appointment of

persons eligible to participate in Program or of termination of appointment;

enrollment. (NRS

287.043)

     1.  A participating public agency shall

notify the Program in a format prescribed by the Program upon:

     (a) Appointing to the participating public agency a

person who will be eligible to participate in the Program pursuant to NRS 287.045, so the Program may

provide the required information about the Program to the employee pursuant to NAC 287.314; or

     (b) The termination of an appointment to the

participating public agency,

Ê within 15

days after the employee’s first or last day of employment with the

participating public agency, as applicable.

     2.  The employee shall enroll in the Program:

     (a) Electronically through the Internet website of

the Board; or

     (b) By submitting the completed enrollment forms to

the Program,

Ê and

submitting any supporting documents to the Program.

     3.  If the employee fails to enroll in the

Program pursuant to subsection 2 before the first day of eligibility for

coverage of the employee or 30 days after the first day of employment of the

employee with the participating public agency, whichever occurs later, the

employee only will be enrolled in the base plan.

     4.  As used in this section, “base plan”

means the plan designated by the Board as the default plan for the plan year,

as described in the plan documents.

     (Added to NAC by Com. on Benefits, eff. 10-3-96; A by

Bd. of Pub. Employees’ Benefits Prog. by R126-00, 12-22-2000, eff. 1-1-2001;

R154-03, 3-22-2004; R089-05, 6-28-2006; R126-07, 1-30-2008; R107-09, 4-20-2010;

R109-12, 12-20-2012)

      NAC 287.318  Enrollment forms: Required information. (NRS 287.043)  Enrollment

forms that are submitted to the Program must include, without limitation:

     1.  The name, address, social security

number, if any, and signature of the person who is enrolling in the Program;

and

     2.  The name and social security number, if

any, of any dependent that the person chooses to cover under the Program.

     (Added to NAC by Bd. of Pub. Employees’ Benefits Prog.

by R089-05, eff. 6-28-2006; A by R109-12, 12-20-2012)

      NAC 287.319  Notification of change of address by participant to Program. (NRS 287.043)  A

participant shall notify the Program within 30 days after a change of address

of the participant.

     (Added to NAC by Bd. of Pub. Employees’ Benefits Prog.

by R089-05, eff. 6-28-2006; A by R107-09, 4-20-2010)

      NAC 287.320  Withdrawal from Program: Procedure; termination of coverage;

limitation on reentry; eligibility of certain officers and employees after

exclusion of group; liability of Program. (NRS 287.043)

     1.  A participating local governmental agency

which intends to terminate its interlocal contract and withdraw from the

Program must give a written notice to the Executive Officer of the Program at

least 60 days before the date on which it intends to withdraw. The effective

date of withdrawal is the last day of the month in which the 60-day period

expires.

     2.  Effective November 30, 2008, if a

participating local governmental agency withdraws from the Program:

     (a) Coverage provided for all active officers and

employees of the local governmental agency terminates on the date on which the

local governmental agency withdraws from the Program.

     (b) Except for retired officers and employees who

were enrolled in the Program on November 30, 2008, and continue their

participation in the Program, coverage provided for all retired officers and

employees of the local governmental agency terminates on the date on which the

local governmental agency withdraws from the Program. If a retired officer or

employee whose coverage by the Program terminates pursuant to this paragraph

qualifies as a dependent of a participant, the termination of coverage pursuant

to this paragraph is a qualifying status change for the retired officer or

employee.

     3.  Unless waived by the Board, a

participating local governmental agency that withdraws from the Program may not

reenter the Program for 3 years after the date on which it withdraws.

     4.  If a group of officers and employees of a

participating local governmental agency who are eligible for health coverage

from a health and welfare plan or trust that arose out of collective bargaining

under chapter 288 of NRS or a trust

established pursuant to 29 U.S.C. § 186 is excluded from participation in the

Program on or after November 30, 2008:

     (a) Except for retired officers and employees who

were enrolled in the Program on November 30, 2008, and continue their

participation in the Program, all retired officers and employees who were

members of the group will be excluded from participation in the Program;

     (b) Active officers and employees in the group are

not eligible to participate in the Program after retirement; and

     (c) All active and retired officers and employees

of the local governmental agency that are not members of the group are eligible

to continue their participation in the Program until the date on which the

participating local governmental agency terminates its participation in the

Program.

     5.  Except for retired officers and employees

who were enrolled in the Program on November 30, 2008, and continue their

participation in the Program, the Program is not liable for any expenses or

claims of an officer or employee or retired officer or employee, or any

dependents thereof, of the withdrawing local governmental agency or excluded

group incurred after the effective date of the withdrawal of the local

governmental agency or exclusion of the group from the Program.

     (Added to NAC by Com. on Group Ins., eff. 5-27-86; A by

Com. on Benefits, 5-4-92; A by Bd. of Pub. Employees’ Benefits Prog. by R126-00,

12-22-2000, eff. 1-1-2001; R154-03, 3-22-2004; R126-07, 1-30-2008; R108-12, 12-20-2012)

Option of Group to Leave Public Employees’ Benefits

Program

      NAC 287.355  Procedure for applying to leave Program. (NRS 287.043, 287.0479)  A group

may apply to leave the Program in accordance with NRS 287.0479 by:

     1.  Providing to the Executive Officer a

letter of intent, which states the desire of the group to leave the Program

entirely and forego all benefits of the Program; and

     2.  Submitting to the Board a completed

application and 15 copies thereof.

     (Added to NAC by Bd. of Pub. Employees’ Benefits Prog.

by R097-03, eff. 9-24-2003)

      NAC 287.357  Application to leave Program: Contents. (NRS 287.043, 287.0479)  An

application to leave the Program must include, without limitation:

     1.  A copy of the plan of benefits to be

offered under the proposed opt-out plan, including, without limitation, a

description of:

     (a) The benefits to be provided under the proposed

opt-out plan;

     (b) The manner for determining eligibility for

benefits under the proposed opt-out plan; and

     (c) The circumstances under which any participant

in the proposed opt-out plan, including, without limitation, active and retired

officers and employees, may lose coverage under the proposed opt-out plan.

     2.  A description of the manner in which

initial eligibility for benefits under the proposed opt-out plan will be

determined, including, without limitation, whether members of the group will

experience any gap in coverage during the period between when the group leaves

the Program and coverage is available for the group under the proposed opt-out

plan.

     3.  The proposed effective date of the

departure of the group from the Program, which must coincide with the start

date of a plan year.

     4.  The name of the group.

     5.  A list of the proposed participants in

the proposed opt-out plan, including, without limitation, the name, social

security number and date of birth of each proposed participant.

     6.  The federal tax identification number of

the proposed opt-out plan.

     7.  A copy of the contract pursuant to which

the members of the group will receive coverage from the proposed opt-out plan.

The contract must include, without limitation, the amount of premiums or

contributions that will be required to maintain coverage for the members of the

group under the proposed opt-out plan.

     8.  Evidence establishing that the proposed

opt-out plan is or will be operated pursuant to such sound accounting and

financial management practices as to ensure that the group will continue to

receive adequate benefits. Such evidence must include, without limitation:

     (a) Financial statements;

     (b) Audits of financial statements of the proposed

opt-out plan, if any, for the 2 years immediately preceding the date of

application, which must reflect unqualified opinions by the persons who

performed the audits of the financial statements concerning the financial

soundness of the proposed opt-out plan; and

     (c) Any other information requested by the Board or

determined by the group to be relevant to the evaluation of the:

          (1) Financial management practices of the

proposed opt-out plan; or

          (2) Financial soundness of the proposed

opt-out plan.

     9.  A completed Business Associate Agreement

that is consistent with the federal Health Insurance Portability and

Accountability Act of 1996, Public Law 104-191, as amended, and is in a form

acceptable to the Board, or a certification that the opt-out plan is a covered

entity under and complies with all federal privacy regulations.

     10.  If the proposed opt-out plan is secured

from an insurer, a copy of the current certificate of authority issued by the

Commissioner of Insurance to the insurer which indicates that the insurer is

authorized to provide the coverage proposed to be offered under the proposed

opt-out plan in this State.

     11.  The name and contact information of a

representative of the group who will be available to answer questions from the

Board concerning the application.

     (Added to NAC by Bd. of Pub. Employees’ Benefits Prog.

by R097-03, eff. 9-24-2003; A by R089-05, 6-28-2006; R002-12, 6-29-2012)

      NAC 287.359  Application to leave Program: Deadline for submission; duties of

Board. (NRS

287.043, 287.0479)

     1.  To apply to leave the Program, a group

must submit an application to the Board on or before the first day of the 10th

month before the proposed effective date of the departure of the group from the

Program.

     2.  If additional information is required to

process any application, the Board will notify the representative of the group

who is designated pursuant to NAC 287.357.

     3.  The Board will provide an opportunity

for:

     (a) A representative of the Program to present

arguments for or against the approval of an application.

     (b) The representative of the group who is

designated pursuant to NAC 287.357 to present

arguments that support the approval of an application.

     4.  The Board will approve or deny each

application received pursuant to subsection 1 not later than the 15th day of

the sixth month before the proposed effective date of the departure of the

group from the Program.

     5.  The Board will notify each applicant of

the date and time of the meeting during which the Board will render a decision

on the application of the applicant.

     (Added to NAC by Bd. of Pub. Employees’ Benefits Prog.

by R097-03, eff. 9-24-2003; A by R089-05, 6-28-2006; R023-09, 11-25-2009; R002-12,

6-29-2012)

      NAC 287.361  Application to leave Program: Considerations for approval or

denial; basis for findings by Board. (NRS 287.043, 287.0479)

     1.  In determining whether to approve or deny

an application to leave the Program, the Board:

     (a) Shall consider whether:

          (1) The departure of the group from the

Program would cause an increase of more than 5 percent in the costs of premiums

or contributions for the remaining participants in the Program;

          (2) The proposed opt-out plan is financially

sound and operated pursuant to sound accounting and financial management

practices;

          (3) The proposed opt-out plan provides

adequate benefits at the time of application that includes offering the same

coverage to active officers and employees and retired officers and employees

using rates based on the commingled experience of all active and retired

participants; and

          (4) The group applying to leave the Program,

and the members thereof, meet the requirements set forth in subsection 3 of NRS 287.0479.

     (b) May consider:

          (1) Whether the cumulative impact of a group

leaving the Program on the costs of premiums or contributions for the remaining

participants in the Program is so detrimental as to cause a significant

negative impact on the Program;

          (2) Whether the current financial condition of

the Program is such that the departure of the group would constitute a

significant negative impact on the Program;

          (3) Whether the departure of the group is

administratively feasible;

          (4) Whether independent, actuarial or other

reviews obtained by the Board indicate that the departure of the group will

cause a significant negative impact on the Program; and

          (5) Any other information that the Board deems

relevant.

     2.  Findings by the Board concerning the

considerations described in subsection 1 must be based exclusively on

substantial evidence.

     (Added to NAC by Bd. of Pub. Employees’ Benefits Prog.

by R097-03, eff. 9-24-2003; A by R089-05, 6-28-2006; R002-12, 6-29-2012)

      NAC 287.363  Approval of application by Board: Format and contents of

decision; responsibilities of and noncompliance by group. (NRS 287.043, 287.0479)

     1.  A decision of the Board to approve an

application to leave the Program will be in writing and will include, without

limitation, the effective date of departure of the group from the Program and

the dates for completion of any administrative tasks necessary to effect the

departure of the group.

     2.  If the Board approves the application of

a group to leave the Program, the approval will be conditioned upon completion

of the following actions:

     (a) The group must submit to the Board a completed

release and waiver of rights agreement, in a form acceptable to the Board,

obtained from and signed by each member of the group.

     (b) A contract, in a form acceptable to the Board,

must be executed between the Program and the proposed opt-out plan of the

group. The contract must set forth the terms of coverage for the group,

provisions for the payment of premiums or contributions of participants to the

opt-out plan and such other details necessary to effect departure of the group

from the Program.

     3.  On or before the 25th day of the fourth

month before the effective date of the departure of the group from the Program

established pursuant to NAC 287.369:

     (a) The completed release and waiver of rights

agreement must be submitted to the Board; and

     (b) The contract between the Program and the

proposed opt-out plan of the group must be executed between the Program and the

proposed opt-out plan of the group.

     4.  If a group whose application to leave the

Program has been approved by the Board fails to comply with the requirements of

this section or any provision of the decision of the Board to approve the

application of the group, the Board may declare the contract between the

Program and the opt-out plan of the group void.

     (Added to NAC by Bd. of Pub. Employees’ Benefits Prog.

by R097-03, eff. 9-24-2003; A by R023-09, 11-25-2009; R002-12, 6-29-2012)

      NAC 287.365  Denial of application by Board: Format and contents of decision. (NRS 287.043, 287.0479)  A

decision of the Board to deny an application of a group to leave the Program

will be in writing and will include, without limitation:

     1.  The reasons of the Board for denying the

application.

     2.  The findings of the Board on the

mandatory criteria for review set forth in paragraph (a) of subsection 1 of NAC 287.361.

     3.  The findings of the Board on any of the

optional criteria for review set forth in paragraph (b) of subsection 1 of NAC 287.361 that the Board considered in reaching its

decision.

     4.  A statement that any data, information or

report on which the Board relied to make its decision to deny the application

is available to the group upon request.

     (Added to NAC by Bd. of Pub. Employees’ Benefits Prog.

by R097-03, eff. 9-24-2003; A by R089-05, 6-28-2006)

      NAC 287.367  Denial of application by Board: Procedure for reconsideration. (NRS 287.043, 287.0479)  A group

whose application to leave the Program has been denied by the Board may file a

request for reconsideration with the Board not later than 40 days after the

denial. The request may include any additional information that the group

determines is relevant to reconsideration. The Board will hold a

reconsideration hearing and render its decision within 30 days after receiving

the request.

     (Added to NAC by Bd. of Pub. Employees’ Benefits Prog.

by R097-03, eff. 9-24-2003)

      NAC 287.368  Denial of request for reconsideration: Appeal. (NRS 287.043, 287.0479)

     1.  A group whose request for reconsideration

with the Board has been denied pursuant to NAC 287.367

may file an appeal with the Hearings Division of the Department of

Administration.

     2.  On the same date on which a group files

an appeal with the Hearings Division pursuant to subsection 1, the group must

provide a copy of the appeal to the Executive Officer. Within 30 days after the

Executive Officer receives a copy of the appeal, the Executive Officer shall

transmit to the Hearings Division a copy of:

     (a) The decision of the Board to deny the

application of a group to leave the Program that was prepared pursuant to NAC 287.365; and

     (b) The record from the hearing conducted pursuant

to NAC 287.367.

     3.  A hearing officer of the Hearings

Division shall review the decision of the Board. Review of the decision of the

Board is confined to the information provided to the Hearings Division pursuant

to subsection 2, except that in cases concerning alleged irregularities in

procedure before the Board that are not shown in the decision or the record,

the hearing officer may receive evidence concerning the irregularities.

     4.  The burden of proof is on the group to

show that the decision of the Board to deny the application of the group is

invalid pursuant to subsection 6.

     5.  The hearing officer shall not substitute

his or her judgment for that of the Board as to any criteria, data, information

or report on which the Board relied to make its decision to:

     (a) Deny the application of the group to leave the

Program; or

     (b) Deny the request for reconsideration of the

application of the group to leave the Program.

     6.  The hearing officer may remand or affirm

the decision of the Board to deny the application of the group to leave the

Program or set it aside in whole or in part if the decision of the Board is:

     (a) In violation of constitutional or statutory

provisions;

     (b) In excess of the statutory authority of the

Board;

     (c) Made upon unlawful procedure;

     (d) Affected by other error of law;

     (e) Clearly erroneous in view of the reliable,

probative and substantial evidence in the information provided to the Hearings

Division pursuant to subsection 2; or

     (f) Arbitrary or capricious or characterized by

abuse of discretion.

     7.  The decision of the hearing officer made

pursuant to subsection 6 is final and not subject to judicial review.

     (Added to NAC by Bd. of Pub. Employees’ Benefits Prog.

by R089-05, eff. 6-28-2006)

      NAC 287.369  Effective date of departure from Program; coverage by Program

until departure. (NRS 287.043, 287.0479)

     1.  The effective date of departure from the

Program of a group whose application has been approved by the Board pursuant to

NRS 287.0479 is the first day

of the plan year that is at least 120 days after the date on which the Board

approves the application.

     2.  The Program shall provide coverage to

participants in a group that has been approved by the Board to leave the

Program until the effective date of departure of the group from the Program set

forth in the decision of the Board approving the application of the group to

leave the Program.

     (Added to NAC by Bd. of Pub. Employees’ Benefits Prog.

by R097-03, eff. 9-24-2003; A by R002-12, 6-29-2012)

      NAC 287.371  Eligibility of officer or employee to join opt-out plan;

ineligibility of officer or employee to continue participation in opt-out plan.

(NRS

287.043, 287.0479)

     1.  If an officer or employee is eligible to

join an opt-out plan at the commencement of his or her employment, the officer

or employee must, upon commencing employment:

     (a) Elect to join the opt-out plan; or

     (b) Decline coverage under the opt-out plan.

     2.  If an officer or employee becomes

eligible to join an opt-out plan after the commencement of his or her

employment, the officer or employee must, at the time of his or her

eligibility:

     (a) Elect to join the opt-out plan; or

     (b) Decline coverage under the opt-out plan.

Ê If the

officer or employee is a member of the Program at the time he or she becomes

eligible to join the opt-out plan, the officer or employee shall terminate

coverage by the Program.

     3.  Except as otherwise provided in

subsection 4, if an officer or employee in an opt-out plan becomes ineligible

to continue participation in the opt-out plan, the officer or employee must

terminate coverage by the opt-out plan and:

     (a) If the officer or employee is eligible to join

a different opt-out plan:

          (1) Elect to join the other opt-out plan,

subject to the requirements for enrollment in the opt-out plan; or

          (2) Decline coverage under the other opt-out

plan.

     (b) If the officer or employee is eligible to join

the Program:

          (1) Elect to join the Program, subject to the

requirements for enrollment of the Program; or

          (2) Decline coverage under the Program.

     4.  If an officer or employee in an opt-out

plan becomes ineligible to continue participation in the opt-out plan because

he or she is no longer employed by a participating public agency, the officer

or employee may elect to continue coverage under the opt-out plan pursuant to

the Public Health Service Act, 42 U.S.C. § 300bb-1 et seq. or the Consolidated

Omnibus Budget Reconciliation Act, Public Law 99-272, as applicable.

     5.  It is the responsibility of an officer or

employee who is eligible to join an opt-out plan or who is ineligible to

continue participation in the opt-out plan or the administrator of the opt-out

plan to notify the Program of the eligibility or ineligibility, as applicable,

of the officer or employee to participate in an opt-out plan. Failure to

provide such notification to the Program may result in the ineligibility of the

employee to participate in an opt-out plan or the Program, as applicable. Such

notification must be given to the Program within 60 days after the officer or

employee has become:

     (a) Eligible to join an opt-out plan; or

     (b) Ineligible to continue participation in an

opt-out plan,

Ê as

applicable.

     6.  The Program shall not consider a decision

by an officer or employee to join an opt-out plan to be a declination of

coverage.

     7.  No lapse in coverage may occur to an

officer or employee when he or she changes coverage pursuant to this section.

     (Added to NAC by Bd. of Pub. Employees’ Benefits Prog.

by R097-03, eff. 9-24-2003; A by R002-12, 6-29-2012)

      NAC 287.373  Notification of Program regarding certain changes in status and

court orders. (NRS

287.043, 287.0479)

     1.  Within 15 calendar days after a change in

the status of a participant in an opt-out plan that affects the rate of his or

her premium or contribution, the opt-out plan shall notify the Program of that

change in an electronic format acceptable to the Program.

     2.  If an officer or employee has declined

participation in an opt-out plan, the officer or employee shall notify the

Program within 60 days after the officer or employee has:

     (a) Been ordered to obtain health insurance for his

or her child pursuant to NRS

31A.350; or

     (b) A change in life status or the addition of a

dependent that initiates eligibility for both the declined employee and any

affected dependent.

     (Added to NAC by Bd. of Pub. Employees’ Benefits Prog.

by R097-03, eff. 9-24-2003; A by R002-12, 6-29-2012)

      NAC 287.375  Eligibility for coverage under opt-out plan: Administration of

requirements by Program; compliance with determinations of Program. (NRS 287.043, 287.0479)

     1.  The Program shall administer the

requirements for eligibility for coverage set forth in this chapter and chapter 287 of NRS for participants in

opt-out plans, including, without limitation:

     (a) Processing notice of termination, workers’

compensation leave, military leave, family and medical leave and leave without

pay and any related changes that affect coverage.

     (b) Processing an order for an officer or employee

to obtain health insurance for his or her child pursuant to NRS 31A.350.

     2.  An opt-out plan shall comply with

determinations of eligibility made by the Program regarding participants in the

opt-out plan.

     (Added to NAC by Bd. of Pub. Employees’ Benefits Prog.

by R097-03, eff. 9-24-2003)

      NAC 287.376  Participation in Program by certain persons eligible for coverage

under or participating in opt-out plan prohibited; exceptions. (NRS 287.043, 287.0479)

     1.  A retired officer or employee, and any dependent

thereof, who is eligible for coverage under an opt-out plan at the time of his

or her retirement may not elect to participate in the Program unless the group

which participates in the opt-out plan applies to reenter the Program pursuant

to NAC 287.400.

     2.  When a participant in an opt-out plan

becomes a survivor of a deceased officer or employee, the participant:

     (a) May remain covered by the opt-out plan; and

     (b) May not join the Program.

     (Added to NAC by Bd. of Pub. Employees’ Benefits Prog.

by R002-12, eff. 6-29-2012)

      NAC 287.379  Options for coverage under opt-out plan: Annual notification of

Program; effective period. (NRS 287.043, 287.0479)  At least

90 days before the commencement of a new plan year of an opt-out plan, the

opt-out plan shall notify the Program of the options for coverage that will be

offered to participants in the opt-out plan during that plan year, including,

without limitation, the schedules of the rates for premiums or contributions in

accordance with the tiers of coverage established by the Program. Such options

for coverage and schedules of rates must remain in effect throughout the entire

new plan year.

     (Added to NAC by Bd. of Pub. Employees’ Benefits Prog.

by R097-03, eff. 9-24-2003)

      NAC 287.381  Premiums or contributions for participants in opt-out plans:

General administrative duties of Program. (NRS 287.043, 287.0479)

     1.  The Program shall maintain the rates for

premiums or contributions for participants in each opt-out plan separately in

its information system.

     2.  The Program shall calculate the State’s

share of the costs of premiums or contributions for participants in an opt-out

plan pursuant to NRS 287.046 in

the same manner as for participants in the Program.

     3.  The difference between the amount of the

premium or contribution of a participant in an opt-out plan and the amount paid

by the State toward the premium or contribution of the participant pursuant to NRS 287.046 must be assessed to the

participant.

     4.  If the amount paid by the State toward

the premium or contribution of a participant in an opt-out plan pursuant to NRS 287.046 exceeds the amount of

the premium or contribution for that participant, the Program shall retain the

balance.

     (Added to NAC by Bd. of Pub. Employees’ Benefits Prog.

by R097-03, eff. 9-24-2003)

      NAC 287.383  Premiums or contributions for participants in opt-out plans:

Requirements for billing. (NRS 287.043, 287.0479)  The

Program shall bill on a monthly basis:

     1.  Each payroll center that deducts and pays

the premium or contribution for a participant in an opt-out plan from the

salary or monthly retirement allowance, as applicable, of the participant for

the amount of the premiums or contributions for such participants based on the

schedule of rates for premiums or contributions for that opt-out plan.

     2.  Each participant in an opt-out plan that

is responsible for the paying of his or her premium or contribution directly.

     3.  The Retired Employees’ Group Insurance

Budget Account in the State Retirees’ Health and Welfare Benefits Fund created

by NRS 287.0436 for the portion

of the amount of the premiums or contributions for participants in an opt-out

plan who retired from the service of the State that is paid by the State

pursuant to subsection 2 of NRS

287.046. The Program shall identify separately the portion of the amount

billed to the State pursuant to this subsection that is attributable to

participants in each opt-out plan.

     4.  The Active Employee Group Insurance

Subsidy Account established pursuant to subsection 7 of NRS 287.044 within the Agency Fund

for the Payroll of the State created by NRS 227.130 for the portion of the

amount of the premiums or contributions for participants in an opt-out plan

that is paid by the State pursuant to subsection 1 of NRS 287.044. The Program shall

identify separately the portion of the amount billed to the State pursuant to

this subsection that is attributable to participants in each opt-out plan.

     (Added to NAC by Bd. of Pub. Employees’ Benefits Prog.

by R097-03, eff. 9-24-2003; A by R002-12, 6-29-2012)

      NAC 287.385  Premiums or contributions for participants in opt-out plans:

Remittance or transfer of payments; nonpayment by participant. (NRS 287.043, 287.0479)

     1.  A payroll center shall remit by the 25th

of each month to the Program the amount of the premiums or contributions for

participants in opt-out plans that is billed to the payroll center for that

month by the Program pursuant to subsection 1 of NAC

287.383. The payroll center shall identify separately the portion of each

such payment to the Program that is attributable to participants in each

opt-out plan.

     2.  A participant of an opt-out plan that is

billed directly by the Program pursuant to subsection 2 of NAC 287.383 for his or her premiums or contributions

shall remit the amount of the premium or contribution within 30 days after he

or she was billed.

     3.  The amount of the premiums or

contributions for participants in an opt-out plan for which the Retired

Employees’ Group Insurance Budget Account is billed each month pursuant to

subsection 3 of NAC 287.383 must be transferred to

the Program by the 25th day of each month, subject to adequate funding in that

Account.

     4.  The amount of the premiums or

contributions for participants in an opt-out plan for which the Active Employee

Group Insurance Subsidy Account is billed each month pursuant to subsection 4

of NAC 287.383 must be transferred to the Program

by the 25th day of each month, subject to adequate funding in that Account.

     5.  The Program shall notify an opt-out plan

of the nonpayment of a premium or contribution by a participant in the opt-out

plan who is billed by the Program for his or her premiums or contributions

directly or through a payroll center. The Program shall not initiate

termination of coverage of such a participant.

     (Added to NAC by Bd. of Pub. Employees’ Benefits Prog.

by R097-03, eff. 9-24-2003; A by R002-12, 6-29-2012)

      NAC 287.386  Liability of Program and opt-out plan for expense or claim of

officer or employee or retired officer or employee, or dependent thereof. (NRS 287.043, 287.0479)

     1.  The Program is not liable for any expense

or claim of an officer or employee or retired officer or employee, or any

dependent thereof, who is a member of a group that is covered by an opt-out

plan if the expense or claim is incurred after the date on which the officer or

employee or retired officer or employee becomes eligible for coverage by the

opt-out plan.

     2.  An opt-out plan is not liable for any

expense or claim of an officer or employee or retired officer or employee, or

any dependent thereof, who is eligible for coverage by the Program if the

expense or claim is incurred after the date on which the officer or employee or

retired officer or employee becomes eligible for coverage by the Program.

     (Added to NAC by Bd. of Pub. Employees’ Benefits Prog.

by R002-12, eff. 6-29-2012)

      NAC 287.387  Administrative fee: Establishment by Program; calculation;

notice. (NRS

287.043, 287.0479)

     1.  To recoup the administrative costs

incurred by the Program related to opt-out plans, the Program shall, for each

fiscal year, establish a monthly per capita administrative fee to be charged to

each opt-out plan for each participant in the opt-out plan.

     2.  The administrative fee charged to each

opt-out plan each month pursuant to subsection 1 must be based on the number of

participants in the opt-out plan during that month.

     3.  The per capita administrative fee must be

calculated by:

     (a) Subtracting from the amount of the annual

budget of the Program:

          (1) Consulting fees incurred by the Program for

health benefits for participants in the Program;

          (2) Fully insured costs of the Program;

          (3) Administrative costs for the plan of

self-insurance of the Program;

          (4) Expenses for claims made by participants

in the plan of self-insurance of the Program;

          (5) Reserve expenses for the plan of

self-insurance of the Program; and

          (6) Any other costs incurred by the Program

that the Program deems to be unrelated to participants in opt-out plans.

     (b) Dividing the number determined pursuant to

paragraph (a) by the total number of persons who are participating in the

Program or in an opt-out plan during the 10th month of the fiscal year

immediately preceding the fiscal year for which the fee is being established.

     (c) Dividing the number determined pursuant to

paragraph (b) by 12.

     4.  The administrative fee must be calculated

and provided in writing to each opt-out plan not later than 60 days before the

beginning of each fiscal year.

     (Added to NAC by Bd. of Pub. Employees’ Benefits Prog.

by R097-03, eff. 9-24-2003)

      NAC 287.389  Duties of Program: Accounting for and remittance of payments;

monthly reports. (NRS 287.043, 287.0479)

     1.  The Program shall:

     (a) Account for all payments for premiums or

contributions for participants in opt-out plans that are actually received each

month by the Program pursuant to NAC 287.385; and

     (b) Remit all such payments monthly to the

applicable opt-out plan less the amount of the monthly administrative fee

charged to the opt-out plan by the Program pursuant to NAC

287.387.

     2.  The Program shall provide a monthly

report to each opt-out plan, which includes, without limitation, for that

month:

     (a) The details of the payments for premiums or

contributions for participants in the opt-out plan; and

     (b) The calculation of the administrative fee.

     (Added to NAC by Bd. of Pub. Employees’ Benefits Prog.

by R097-03, eff. 9-24-2003)

Option of Group to Reenter Public Employees’ Benefits

Program

      NAC 287.400  Procedure for applying to reenter Program. (NRS 287.043, 287.0479)  A group

that was approved to leave the Program pursuant to NRS 287.0479 may apply to reenter

the Program by submitting to the Board a completed application on a form

prescribed by the Board at least 90 days before the commencement of the plan

year in which reentry is desired. The application must include, without

limitation:

     1.  A nonrefundable application fee of

$250.00, plus $2.25 per participant in the opt-out plan.

     2.  A nonrefundable fee to be deposited in

the Fund for the Public Employees’ Benefits Program created pursuant to NRS 287.0435 for the purpose of

funding the reserve maintained by the Program to stabilize rates. The Executive

Officer or his or her designee shall calculate the amount of the nonrefundable

fee by:

     (a) Dividing the funded reserve maintained by the

Program to stabilize rates on the date on which the application was submitted

by the total number of participants in the Program on that date; and

     (b) Multiplying the number determined pursuant to

paragraph (a) by the total number of participants in the opt-out plan who will

reenter the Program.

Ê The fees or

the first installment payment of the fees, if installment payments are

authorized by the Program, must be paid by the effective date of reentry.

     3.  The name, gender, age, residential zip

code and current selection for coverage of:

     (a) Each eligible participant in the opt-out plan,

regardless of whether the eligible participant is enrolled in the opt-out plan;

and

     (b) Each participant who is currently enrolled in

the opt-out plan and their respective number of enrolled dependents.

     4.  A statement that all terminal fees and

costs associated with the opt-out plan will be paid by the participants in the

opt-out plan who will reenter the Program.

     (Added to NAC by Bd. of Pub. Employees’ Benefits Prog.

by R002-12, eff. 6-29-2012)

Payment of Premiums and Contributions; Coverage

      NAC 287.420  Payment of premiums or contributions by public employer: Date

due; penalty. (NRS

287.043, 287.046)

     1.  The total of the premiums or

contributions which is billed by the Program and is owed by a public employer

which:

     (a) Employs an officer or employee;

     (b) Is legally responsible for the surviving spouse

or child of a police officer, firefighter or volunteer firefighter killed in

the line of duty; or

     (c) Pays a subsidy for any of its retired officers

or employees,

Ê for the

officer, employee, surviving spouse or child, or retired officer or employee

who elects to participate in the Program and the respective premium or

contribution, if any, which is deducted from his or her compensation must be

received by the Program by the 25th of each month.

     2.  If a public employer does not pay the

amount billed by the Program, the Program shall determine if a penalty that is

based on the amount actually paid should be assessed. If the total payments

made by the public employer were less than the amount billed to the public

employer, the Program may, for good cause shown, assess a monthly compounded

penalty of 1.5 percent of the unpaid balance, which will include, without

limitation, any unpaid subsidies, penalties or adjustments.

     3.  For the purposes of this section, if the

25th day of the month is a Saturday, Sunday or legal holiday, the payment of a

premium or contribution is timely if it is received on the next day which is

not a Saturday, Sunday or legal holiday.

     (Added to NAC by Com. on Group Ins., eff. 5-27-86; A 12-17-87;

A by Com. on Benefits, 5-4-92; A by Bd. of Pub. Employees’ Benefits Prog. by

R126-00, 12-22-2000, eff. 1-1-2001; R154-03, 3-22-2004; R107-09, 4-20-2010)

      NAC 287.430  Direct payment of premiums or contributions: Date due;

cancellation of coverage. (NRS 287.043, 287.046)  A

person, other than a person who elects to continue coverage pursuant to the

Public Health Service Act, 42 U.S.C. § 300bb-1(a), who:

     1.  Enrolls, reenrolls, joins or is

continuing coverage in the Program; and

     2.  Is responsible for the payment of the

premium or contribution for group insurance directly to the Program or an

insurer,

Ê shall pay the

premium or contribution to the Program or insurer, as appropriate, no later

than the date which is 30 days after the due date of the payment, as determined

by the Program. If the total amount of the premium or contribution is not

received by that date, the coverage will be cancelled effective on the last day

of the month that the coverage was fully paid unless the particular contract of

coverage or insurance for which payment is being made otherwise provides.

     (Added to NAC by Com. on Group Ins., eff. 5-27-86; A 12-17-87;

A by Com. on Benefits, 5-4-92; A by Bd. of Pub. Employees’ Benefits Prog. by

R126-00, 12-22-2000, eff. 1-1-2001; R154-03, 3-22-2004; R089-05, 6-28-2006;

R107-09, 4-20-2010)

      NAC 287.440  Payment of premiums or contributions by retired officers and

employees. (NRS

287.043, 287.046)

     1.  Except as otherwise provided in subsection

2, retired officers and employees shall pay their premiums or contributions

directly to the Program.

     2.  Retired officers and employees who

receive a retirement benefit from the Public Employees’ Retirement System shall

pay their premiums or contributions to the Program through an automatic

deduction from that benefit unless the:

     (a) Retirement benefit is less than the premium or

contribution; or

     (b) Coverage of the retired officer or employee is

provided through the Program by an individual medical care plan offered through

an exchange to supplement Medicare.

     (Added to NAC by Com. on Benefits, eff. 5-4-92; A by

Bd. of Pub. Employees’ Benefits Prog. by R126-00, 12-22-2000, eff. 1-1-2001;

R154-03, 3-22-2004; R089-05, 6-28-2006; R107-09, 4-20-2010; R002-12, 6-29-2012)

      NAC 287.450  Employees on leave without pay: Payment of premiums or

contributions; eligibility for coverage as dependent of participant; coverage

upon return to work. (NRS 287.043, 287.046)

     1.  A participating public agency that

employs an employee who is on leave without pay shall not pay any amount of the

cost of premiums or contributions that is due the Program for group insurance

for that employee unless the employee is compensated for a combination of work

actually performed and accrued annual leave or sick leave, if the total is at

least 80 hours per month for each month that coverage or insurance is provided.

     2.  An employee who is on approved leave

without pay:

     (a) May continue coverage or insurance for himself

or herself and any of his or her eligible dependents:

          (1) If the amount of the paycheck of the

employee is more than the cost of the premium or contribution, by having the

cost of the premium or contribution deducted from his or her paycheck; or

          (2) If the amount of the paycheck of the

employee is less than the cost of the premium or contribution, by paying the

cost of the premium or contribution directly to the Program.

     (b) Is not eligible for coverage or insurance as a

dependent of a participant.

     (c) Is not eligible for coverage or insurance if

the employee elects not to pay the premium or contribution for coverage or

insurance.

     3.  If an employee who is on approved leave

without pay elects not to pay the premium or contribution for coverage and

insurance from the Program and returns to work:

     (a) Within 1 year after the last day of his or her

coverage from the Program, the employee is not required to complete 90 days of

full-time employment before being eligible to participate in the Program.

     (b) One year or more after taking leave without

pay, the employee is eligible to participate in the Program on the first day of

the month following 90 days of full-time employment.

     4.  An employee who is on approved leave

without pay may, at the time he or she returns to work, obtain coverage and

insurance for any dependent who was previously covered.

     (Added to NAC by Com. on Benefits, eff. 5-4-92; A by

Bd. of Pub. Employees’ Benefits Prog. by R126-00, 12-22-2000, eff. 1-1-2001;

R154-03, 3-22-2004; R126-07, 1-30-2008; R016-08, 8-26-2008, eff. 7-1-2009; R107-09,

4-20-2010)

      NAC 287.460  Officers and employees on leave because of injuries in course of

employment: Payment of premiums or contributions; reports of change in status;

coverage of dependents upon return to work. (NRS 287.043, 287.0439, 287.0445)

     1.  An officer or employee of a participating

public agency who:

     (a) Is on leave because he or she was injured in

the course of employment;

     (b) Receives compensation for a temporary total

disability pursuant to NRS

616C.475; and

     (c) Was a participant in the Program at the time of

the injury,

Ê may continue

coverage or insurance for himself or herself and any of his or her eligible

dependents by having the cost of the premium or contribution deducted from his

or her paycheck if the amount of the paycheck is more than the cost of the

premium or contribution or, if the amount of the paycheck is less than the cost

of the premium or contribution, by paying the cost of the premium or

contribution directly to the Program. The officer or employee shall report the

change of status to the participating public agency that employs him or her

when he or she takes leave and when he or she returns to work. Within 15 days

after notification of such a change of status by the officer or employee, the

participating public agency shall report to the Program, on a form prescribed

by the Program, the change of status of the officer or employee.

     2.  If the officer or employee does not pay

for coverage or insurance for his or her dependent while on leave and returns

to work within 1 year after the last day of his or her coverage from the

Program, the dependent may be covered.

     (Added to NAC by Com. on Benefits, eff. 5-4-92; A by

Bd. of Pub. Employees’ Benefits Prog. by R126-00, 12-22-2000, eff. 1-1-2001;

R154-03, 3-22-2004; R089-05, 6-28-2006; R126-07, 1-30-2008)

      NAC 287.470  Overpayment or underpayment of premiums or contributions. (NRS 287.043, 287.046)

     1.  The provisions of this section apply if

an overpayment or underpayment of a premium or contribution occurs because of:

     (a) A clerical error by the Program or a

participating public agency;

     (b) A change of coverage or a change in the working

status of a participating officer or employee; or

     (c) The failure of a participant to give timely

notice that a dependent is ineligible for coverage.

     2.  If a participating public agency makes an

overpayment of premiums or contributions, it may deduct the amount of the

overpayment from the payment of premiums or contributions otherwise due for the

following month. Any such deduction for a period greater than 1 month must:

     (a) Be approved in advance by the Program; and

     (b) Equal the amount of the overpayment without

provision for interest.

     3.  The participating public agency shall pay

any money due a participant because of an overpayment of premiums or

contributions.

     4.  If a participating public agency makes an

underpayment of premiums or contributions, it must add the amount of the

underpayment to the payment of premiums or contributions otherwise due for the

following month. Any such additions for a period greater than 1 month must:

     (a) Be approved in advance by the Program; and

     (b) Equal the amount of the underpayment without

provision for interest.

     5.  Any money owed by a participant because

of an underpayment of premiums or contributions must be collected from the

participant and paid by the participating public agency.

     6.  As used in this section, “overpayment of

premiums or contributions” does not include the payment of premiums or

contributions for the month in which the employment of a participant

terminated, regardless of the date on which the termination occurs.

     (Added to NAC by Com. on Benefits, eff. 5-4-92; A by

Bd. of Pub. Employees’ Benefits Prog. by R126-00, 12-22-2000, eff. 1-1-2001;

R154-03, 3-22-2004; R016-08, 8-26-2008, eff. 7-1-2009)

      NAC 287.485  Subsidy for retired officer or employee: Report required to

obtain subsidy; audit of service credit required; billing; commencement of

payment; adjustment of amount of subsidy; assumption of liability for service

credit earned. (NRS 287.043, 287.046)

     1.  To obtain a subsidy, a retired officer or

employee who participates in the Program must report to the Program, on a form

prescribed by the Program, each public employer with which he or she earned

service credit and the period of service with each such public employer.

     2.  The Executive Officer or a designee

thereof shall request an audit from the appropriate certifying agency to

determine the initial date of hire of a retired officer or employee and the

years and months of service credit earned by the retired officer or employee

with each public employer of the retired officer or employee during the period

of that employment. Such a request must be made within 14 days after the later

of:

     (a) The receipt of the report made to the Program

pursuant to subsection 1; or

     (b) The date of the retirement of the retired officer

or employee.

     3.  For the purposes of subsections 1 and 2,

service credit:

     (a) Must be computed in the manner set forth in NRS 286.495 or 286.501, as applicable;

     (b) Must include any service credit that has been

restored by the repayment of contributions that the retired officer or employee

had withdrawn from the Public Employees’ Retirement System pursuant to NRS 286.430; and

     (c) Must not include any service credit that was

purchased pursuant to NRS 1A.310

or 286.300.

     4.  Except as otherwise provided in

subsection 5, the Executive Officer or a designee thereof shall not submit a

bill to a public employer for a subsidy for a retired officer or employee until

an audit requested pursuant to subsection 2 for the retired officer or employee

is received by the Program.

     5.  If an audit requested pursuant to

subsection 2 is received after the date on which coverage of the retired

officer or employee becomes effective, the Executive Officer or a designee

thereof shall submit to the previous public employer of the retired officer or

employee a bill for the subsidy incurred between the date on which coverage of

the retired officer or employee became effective and the date on which the audit

was received.

     6.  A public employer shall commence payment

of its subsidy for a retired officer or employee upon receipt of the bill for

the subsidy.

     7.  If, after receiving an audit requested

pursuant to subsection 2, the Program receives any additional audit for the

retired officer or employee for whom the original audit was conducted:

     (a) The Program shall adjust the amount to be

billed to the retired officer or employee and to the previous public employer

of the retired officer or employee according to the years and months of service

credit reported in the most recent audit; and

     (b) Any such adjustment will be effective on the

first day of the month after the receipt by the Program of the most recent

audit.

     8.  A public employer or other entity may

assume from a public employer the liability for the years and months of service

credit earned by a retired officer or employee if the public employer assuming

the liability submits a written certification to the Program containing:

     (a) The name and social security number of the

retired officer or employee;

     (b) The dates during which the service credit for

which the public employer or other entity is assuming liability was earned by

the retired officer or employee;

     (c) A statement acknowledging that the public

employer or other entity is assuming the liability associated with the dates

listed pursuant to paragraph (b);

     (d) A signature of the director or chief executive

officer of the public employer or other entity assuming liability, or a

designee of the director or chief executive officer of the public employer or

other entity assuming liability; and

     (e) The name, title and contact information of the

person who signed the certification.

     9.  If a public employer with which a retired

officer or employee earned service credit ceases to exist as a public employer,

the public employer that has the most direct jurisdictional association with

the public employer that ceases to exist, as determined by the Executive

Officer, shall assume liability for the years and months of service credit

earned by the retired officer or employee with the public employer that ceases

to exist.

     10.  The results reported in an audit

received by the Program pursuant to the provisions of this section may not be

appealed.

     (Added to NAC by Bd. of Pub. Employees’ Benefits Prog.

by R154-03, eff. 3-22-2004; A by R089-05, 6-28-2006; R126-07, 1-30-2008; R107-09,

4-20-2010; R108-12, 12-20-2012)

      NAC 287.490  Subsidy for retired officer or employee: Calculation of amount of

payment. (NRS

287.043, 287.046)

     1.  Except as otherwise provided in

subsection 2, the amount of the subsidy that must be paid by each public

employer with which a retired officer or employee was employed is calculated in

the manner set forth in NRS 287.046.

     2.  Each public employer with which the

retired officer or employee was employed shall pay an amount of the total

subsidy for the retired officer or employee equal to the proportion that the

service credit earned by the retired officer or employee with that public

employer bears to the total service credit earned by the retired officer or

employee with all public employers with which the retired officer or employee

was employed. The amount of the total subsidy must be based on the cumulative

total years and months of service by the retired officer or employer for all public

employers with which the retired officer or employee was employed.

     (Added to NAC by Bd. of Pub. Employees’ Benefits Prog.

by R154-03, 3-22-2004, eff. 7-1-2004; A by R126-07, 1-30-2008)

      NAC 287.500  Coverage of seasonal employees and biennial employees. (NRS 287.043, 287.045, 287.0467)

     1.  If a seasonal employee returns to work

with a participating public agency, the participating public agency shall

determine if the employee participated in the Program or was eligible to

participate during his or her previous employment with the participating public

agency.

     2.  A seasonal employee who was eligible to

participate in the Program during his or her previous employment with a

participating public agency and who returns to work within 1 year after the

termination of employment is eligible to participate in the Program on the

first day of the month following his or her return to work.

     3.  A seasonal employee who returns to work 1

year or more after the termination of his or her previous employment is

eligible to participate in the Program:

     (a) If the first day after the completion of 90

days of full-time employment is the first day of a month, on the first day

after the completion of 90 days of full-time employment; or

     (b) If the first day after the completion of 90

days of full-time employment is not the first day of a month, on the first day

of the month immediately following the completion of 90 days of full-time

employment.

     4.  A biennial employee who was working for a

participating state agency is not subject to any waiting period upon

reenrollment if the biennial employee:

     (a) Is returning to the same or a similar position

as held during the previous biennial employment period; and

     (b) Continues to pay his or her full premium or

contribution and allowable administrative fees as required by NRS 287.0467 for the enrolled

coverage between biennial employment periods.

     (Added to NAC by Com. on Benefits, eff. 5-4-92; A by

Bd. of Pub. Employees’ Benefits Prog. by R126-00, 12-22-2000, eff. 1-1-2001;

R154-03, 3-22-2004; R089-05, 6-28-2006; R126-07, 1-30-2008)

      NAC 287.510  Coverage of persons returning to work with previous employer

within 1 year after leaving employment. (NRS 287.043, 287.045)  If a

person other than a retired officer or employee returns to work for a

participating public agency with which the person was previously employed

within 1 year after leaving employment:

     1.  The person may select any coverage and

insurance offered to participants in the Program at the time that the person

returns to work; and

     2.  Coverage and insurance for the person is

effective:

     (a) If the effective date of reemployment is on the

first day of a month, on the effective date of reemployment; or

     (b) If the effective date of reemployment is not on

the first day of a month, on the first day of the month immediately following

the effective date of reemployment.

     (Added to NAC by Com. on Group Ins., eff. 5-27-86; A by

Bd. of Pub. Employees’ Benefits Prog. by R126-00, 12-22-2000, eff. 1-1-2001;

R154-03, 3-22-2004; R089-05, 6-28-2006; R126-07, 1-30-2008)

      NAC 287.515  Coverage of retired participants upon reemployment. (NRS 287.043, 287.045)

     1.  Except as otherwise provided in this

section, a person who participates in the Program as a retired officer or

employee and who returns to full-time employment with a participating public

agency is eligible to participate in the Program as an active officer or

employee:

     (a) If the effective date of reemployment is on the

first day of a month, on the effective date of reemployment; or

     (b) If the effective date of reemployment is not on

the first day of a month, on the first day of the month immediately following

the effective date of reemployment.

     2.  If a person who participates in the

Program as a retired justice or judge accepts reemployment as a justice of the

Supreme Court or district judge pursuant to NRS 1A.370, the person is

eligible to participate in the Program as an active justice or judge, as

applicable:

     (a) If the first day after the completion of 90

days of full-time employment is on the first day of a month, on the first day

after the completion of 90 days of full-time employment; or

     (b) If the first day after the completion of 90

days of full-time employment is not on the first day of a month, on the first

day of the month immediately following the completion of 90 days of full-time

employment.

     3.  Except as otherwise required by federal

law, a retired officer or employee who returns to full-time employment with a

participating public agency to fill a position which has been designated as a

position for which there is a critical labor shortage pursuant to NRS 286.523 and who continues to

receive allowances under the retirement system of which he or she is a member

is eligible to participate in the Program in the same manner as he or she

participated before returning to full-time employment. Except for a retired

officer or employee who was enrolled in the Program on November 30, 2008, and

continues his or her participation in the Program, coverage of a retired

officer or employee who returns to full-time employment with a participating

local governmental agency pursuant to this subsection terminates on the date on

which the participating local governmental agency terminates its participation

in the Program.

     4.  A retired officer or employee who returns

to full-time employment with a participating state agency to fill a position

which has been designated as a position for which there is a critical labor

shortage pursuant to NRS 286.523

and who discontinues receiving allowances under the retirement system of which

he or she is a member is eligible to participate in the Program as an active

officer or employee:

     (a) If the effective date of reemployment is on the

first day of a month, on the effective date of reemployment; or

     (b) If the effective date of reemployment is not on

the first day of a month, on the first day of the month immediately following

the effective date of reemployment.

     5.  A retired officer or employee who returns

to full-time employment with a participating local governmental agency to fill

a position which has been designated as a position for which there is a

critical labor shortage pursuant to NRS

286.523 and who discontinues receiving allowances under the retirement system

of which he or she is a member is eligible to participate in the Program as an

active officer or employee:

     (a) If the effective date of reemployment is on the

first day of a month, on the effective date of reemployment; or

     (b) If the effective date of reemployment is not on

the first day of a month, on the first day of the month immediately following

the effective date of reemployment.

Ê Except for a

retired officer or employee who was enrolled in the Program on November 30,

2008, and continues his or her participation in the Program, coverage of a

retired officer or employee pursuant to this subsection terminates on the date

on which the participating local governmental agency with which the retired

officer or employee returns to full-time employment terminates its

participation in the Program.

     (Added to NAC by Bd. of Pub. Employees’ Benefits Prog.

by R089-05, eff. 6-28-2006; A by R126-07, 1-30-2008; R108-12, 12-20-2012)

      NAC 287.520  Coverage of person qualified as both employee and dependent;

change of status from employee to dependent. (NRS 287.043)

     1.  Except as otherwise provided in NAC 287.530, if a person qualifies to be covered by

the Program as both an employee and a dependent, the person:

     (a) If the person is a spouse or domestic partner:

          (1) May be covered by the Program as an

employee; and

          (2) May not be covered by the Program as a

dependent.

     (b) If the person is a child, may be covered by the

Program as an employee or dependent.

     2.  If a participating officer or employee

changes his or her status to that of a dependent because he or she no longer

qualifies as an employee, he or she must enroll as a dependent within 60 days

after losing status as an employee to be eligible for coverage and insurance as

a dependent. If a participant complies with the requirements of this

subsection, his or her coverage or insurance is not limited by any waiting

period that would otherwise apply.

     (Added to NAC by Com. on Group Ins., eff. 5-27-86; A by

Com. on Benefits, 5-4-92; A by Bd. of Pub. Employees’ Benefits Prog. by R126-00,

12-22-2000, eff. 1-1-2001; R002-12, 6-29-2012)

      NAC 287.530  Coverage of retired person, spouse, domestic partner or surviving

dependent: Generally. (NRS 122A.100, 287.043)

     1.  If the participant and his or her spouse

or domestic partner are retired officers or employees who retired before July

1, 2004, and elect to participate in the Program, one may elect to be the

dependent of the other. A spouse or a domestic partner who elected to be the

dependent pursuant to this subsection may elect to become a primary insured

during open enrollment. If the retired officer or employee designated as the

primary insured dies, the spouse or domestic partner who elected to be the

dependent becomes the primary insured.

     2.  A person who retires on or after July 1,

2004, and who is eligible to participate in the Program as a primary insured

may not elect to be a dependent of his or her spouse or domestic partner who is

a primary insured in the Program.

     3.  A surviving spouse or domestic partner

who:

     (a) Retired before July 1, 2004;

     (b) Is enrolled in the Program as a surviving

dependent; and

     (c) Is eligible to participate in the Program as a

primary insured,

Ê may elect to

change his or her status to retiree status during open enrollment. A person who

chooses such an election pursuant to this subsection must meet the requirements

of NAC 287.485 to be eligible for a subsidy.

     4.  A person who is a surviving dependent of

a deceased officer or employee of a participating public agency, or a deceased

retired officer or employee, and who, at the time of his or her death, was a

participant under the Program, may maintain the coverage or insurance from the

Program if:

     (a) The surviving dependent receives retirement

benefits from which premiums or contributions can be deducted or such dependent

pays the premium or contribution directly to the Program; and

     (b) Within 60 days after the date of death of the

participant, the surviving dependent:

          (1) Notifies the last public employer of the

deceased participant that the surviving dependent intends to enroll in or

continue coverage by reenrolling in the Program; and

          (2) Enrolls or reenrolls, as appropriate, in

the Program.

     5.  Continued coverage provided to a

surviving dependent who reenrolls in the Program in accordance with this

section may not be changed until the next period of open enrollment.

     6.  If the surviving spouse or domestic

partner has a dependent who is not covered under the Program at the time of

death of the officer or employee of a participating public agency, or retired

officer or employee, or acquires a dependent by marriage, adoption or birth,

the dependent is not eligible for coverage or insurance.

     7.  A retired officer or employee who wishes

to enroll or reenroll in the Program more than 60 days after his or her

official date of retirement or total disability must comply with the

requirements of NRS 287.0475.

     (Added to NAC by Com. on Group Ins., eff. 5-27-86; A by

Com. on Benefits, 5-4-92; A by Bd. of Pub. Employees’ Benefits Prog. by R126-00,

12-22-2000, eff. 1-1-2001; R154-03, 3-22-2004; R126-07, 1-30-2008; R016-08, 8-26-2008,

eff. 7-1-2009; R107-09, 4-20-2010; R107-09, 4-20-2010, eff. 7-1-2010)

      NAC 287.540  Coverage of participating

employee of State who reenrolls upon retirement or total disability; coverage

of nonparticipating employee of State. (NRS

287.043)

     1.  A person who:

     (a) At the time of retirement or total disability,

was:

          (1) Employed by a participating state agency;

and

          (2) A participant in the Program; and

     (b) Within 60 days after the official date of retirement

or total disability reenrolls in the Program,

Ê will have

uninterrupted benefits and is not subject to any waiting period.

     2.  A person described in subsection 1 may

select any coverage and insurance offered to participants in the Program at the

time of reenrollment pursuant to paragraph (b) of subsection 1.

     3.  A person who, at the time of retirement

or total disability, was:

     (a) Employed by a participating state agency; and

     (b) Not a participant in the Program,

Ê may only

reinstate in the Program pursuant to the provisions of NRS 287.0475.

     4.  Coverage provided to a person described

in subsection 1 or 3 will continue until he or she chooses to terminate or

decline the coverage. If the person chooses to terminate or decline the

coverage, he or she may subsequently only reinstate in the Program pursuant to

the provisions of NRS 287.0475.

     (Added to NAC by Bd. of Pub. Employees’ Benefits Prog.

by R126-07, eff. 1-30-2008; A by R108-12, 12-20-2012)

      NAC 287.542  Coverage of participating employee of local governmental agency

who retires on or before September 1, 2008, and reenrolls upon retirement or

total disability. (NRS 287.043)

     1.  A person who:

     (a) Is a retired officer or employee on or before

September 1, 2008;

     (b) At the time of retirement or total disability,

was:

          (1) Employed by a participating local

governmental agency; and

          (2) A participant in the Program; and

     (c) Within 60 days after the official date of

retirement or total disability:

          (1) Notifies the participating local

governmental agency that employed him or her at the time of retirement or total

disability of his or her intent to continue coverage in the Program; and

          (2) Reenrolls in the Program,

Ê will have

uninterrupted benefits and is not subject to any waiting period.

     2.  Coverage provided to a person described

in subsection 1:

     (a) May be changed by the person at the time of

reenrollment pursuant to subparagraph (2) of paragraph (c) of subsection 1.

     (b) Continues until the person chooses to terminate

or decline the coverage. If the person chooses to terminate or decline the

coverage after November 30, 2008, the person may subsequently only reinstate in

the Program pursuant to NRS 287.023

and 287.0475.

     (Added to NAC by Bd. of Pub. Employees’ Benefits Prog.

by R126-07, eff. 1-30-2008)

      NAC 287.544  Coverage of nonparticipating employee of local governmental

agency who retires on or before September 1, 2008, and enrolls upon retirement

or total disability. (NRS 287.043)

     1.  A person who:

     (a) Is a retired officer or employee on or before

September 1, 2008;

     (b) At the time of retirement or total disability:

          (1) Was employed by a participating local

governmental agency; and

          (2) Was not a participant in the Program; and

     (c) Within 60 days after the official date of

retirement or total disability:

          (1) Notifies the participating local

governmental agency that employed him or her at the time of retirement or total

disability of his or her intent to enroll in the Program; and

          (2) Enrolls in the Program,

Ê is subject to

a 60-day waiting period.

     2.  Coverage provided to a person described

in subsection 1 continues until the person chooses to terminate or decline the

coverage. If the person chooses to terminate or decline the coverage after

November 30, 2008, the person may subsequently only reinstate in the Program

pursuant to NRS 287.023 and 287.0475.

     (Added to NAC by Bd. of Pub. Employees’ Benefits Prog.

by R126-07, eff. 1-30-2008)

      NAC 287.546  Coverage of participating employee of local governmental agency

who retires after September 1, 2008, and reenrolls upon retirement or total

disability. (NRS

287.043)

     1.  A person who:

     (a) Becomes a retired officer or employee after

September 1, 2008;

     (b) At the time of retirement or total disability,

was:

          (1) Employed by a participating local

governmental agency; and

          (2) A participant in the Program; and

     (c) Within 60 days after the official date of

retirement or total disability reenrolls in the Program,

Ê will have

uninterrupted benefits and is not subject to any waiting period.

     2.  Continued coverage provided to a person

described in subsection 1 may be changed by the person at the time of

reenrollment pursuant to paragraph (c) of subsection 1.

     3.  Coverage of a person pursuant to this

section terminates on the date on which the participating local governmental

agency that employed the person at the time of retirement or total disability

terminates its participation in the Program.

     (Added to NAC by Bd. of Pub. Employees’ Benefits Prog.

by R126-07, eff. 1-30-2008; A by R108-12, 12-20-2012)

      NAC 287.548  Coverage of nonparticipating employee of local governmental

agency who retires after September 1, 2008. (NRS 287.043)

     1.  A person who:

     (a) Becomes a retired officer or employee after

September 1, 2008; and

     (b) At the time of retirement or total disability:

          (1) Was employed by a participating local

governmental agency; and

          (2) Was not a participant in the Program,

Ê may only

reinstate in the Program pursuant to the provisions of NRS 287.0475.

     2.  Coverage provided to a person pursuant to

this section terminates on the date on which the participating local

governmental agency that employed the person at the time of retirement or total

disability terminates its participation in the Program.

     (Added to NAC by Bd. of Pub. Employees’ Benefits Prog.

by R126-07, eff. 1-30-2008; A by R108-12, 12-20-2012)

Claims

      NAC 287.600  Definitions. (NRS 287.043)  As used

in NAC 287.600 to 287.695,

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

in NAC 287.601, 287.602

and 287.603 have the meanings ascribed to them in

those sections.

     (Added to NAC by Bd. of Pub. Employees’ Benefits Prog.

by R002-12, eff. 6-29-2012)

      NAC 287.601  “Adverse determination” defined.

(NRS 287.043)  “Adverse

determination” has the meaning ascribed to it in NRS 695G.012.

     (Added to NAC by Bd. of Pub. Employees’ Benefits Prog.

by R002-12, eff. 6-29-2012)

      NAC 287.602  “Appeals Manager” defined. (NRS 287.043)  “Appeals

Manager” means the person designated by the Claims Administrator to review and

decide appeals of the denials of claims pursuant to NAC

287.670.

     (Added to NAC by Bd. of Pub. Employees’ Benefits Prog. by

R002-12, eff. 6-29-2012)

      NAC 287.603  “Claims Administrator” defined. (NRS 287.043)  “Claims

Administrator” means a third-party administrator with which the Program has

entered into a contract pursuant to NRS

287.0434 to administer the claims of participants of the Program.

     (Added to NAC by Bd. of Pub. Employees’ Benefits Prog.

by R002-12, eff. 6-29-2012)

      NAC 287.608  Claims Administrator or vendor required to be independent

contractor. (NRS

287.043)  Any

Claims Administrator or vendor must be an independent contractor pursuant to NRS 333.700.

     (Added to NAC by Bd. of Pub. Employees’ Benefits Prog.

by R002-12, eff. 6-29-2012)

      NAC 287.610  Period for submission. (NRS 287.043)  A claim

made to the Program must be submitted to the Claims Administrator of the

Program not later than 1 year after the date on which the expense reported in

the claim is incurred. A claim submitted after that time will not be paid.

     (Added to NAC by Com. on Group Ins., eff. 9-10-87; A by

Bd. of Pub. Employees’ Benefits Prog. by R126-00, 12-22-2000, eff. 1-1-2001;

R154-03, 3-22-2004; R089-05, 6-28-2006)

      NAC 287.620  Assumption regarding availability of benefits under Medicare;

coordination under Medicare. (NRS 287.043)

     1.  If a medical claim is made by a retired

participant who is 65 years of age or older, the Claims Administrator shall

assume that benefits are available to the participant pursuant to Medicare Part

B. To coordinate benefits under Medicare for the purposes of this subsection,

the Claims Administrator shall use the first day of the month in which the

birthday of the retired participant occurs.

     2.  If the Claims Administrator receives

notification that a retired participant who is less than 65 years of age is

eligible for benefits pursuant to Medicare Part B, the Claims Administrator

shall coordinate benefits under Medicare using the first day of the month in

which he or she receives notification that the retired participant is eligible

for such benefits.

     (Added to NAC by Com. on Benefits, eff. 5-4-92; A by

Bd. of Pub. Employees’ Benefits Prog. by R108-12, 12-20-2012)

      NAC 287.660  Notification of adverse determination; grounds for appeal. (NRS 287.043)

     1.  The Claims Administrator shall notify a

participant of an adverse determination of a claim of the participant or his or

her dependent. Such notification must:

     (a) Be in writing;

     (b) Explain the reason for the adverse

determination;

     (c) Include the specific provision of the

applicable plan of the Program used by the Claims Administrator as the basis

for the adverse determination;

     (d) If the adverse determination is made as a

result of a lack of information, request any additional information necessary

to reverse the adverse determination; and

     (e) Explain the process for initiating an appeal of

the adverse determination pursuant to NAC 287.670.

     2.  A participant may appeal an adverse

determination if the participant feels the claim was not adjudicated pursuant

to the current terms and conditions of the Program.

     (Added to NAC by Com. on Group Ins., eff. 3-9-88; A by

Bd. of Pub. Employees’ Benefits Prog. by R126-00, 12-22-2000, eff. 1-1-2001;

R016-08, 8-26-2008, eff. 7-1-2009; R002-12, 6-29-2012)

      NAC 287.670  Appeal of adverse determination: Requirements; duties of Appeals

Manager. (NRS

287.043)

     1.  Except as otherwise provided in NAC 287.695, to initiate an appeal of an adverse

determination of a claim, a participant must submit a written request to the

Claims Administrator within 180 days after the date on which the participant

received the notification of the adverse determination that is required

pursuant to NAC 287.660. A request for an appeal of

an adverse determination must include:

     (a) The name of the participant;

     (b) The social security number or member

identification number of the participant;

     (c) A copy of the explanation of benefits related

to the claim that was provided to the participant by the Claims Administrator;

     (d) A copy of the claim that was submitted to the

Claims Administrator from the vendor; and

     (e) A statement setting forth the reasons the

adverse determination is being appealed.

     2.  The Appeals Manager of the Claims

Administrator shall:

     (a) Review the appeal of an adverse determination

to decide if the claim was adjudicated pursuant to the:

          (1) Current terms and conditions of the

Program; and

          (2) Contract between the Program and

applicable vendor; and

     (b) Within 20 days after receiving the request for

an appeal, advise the participant in writing of:

          (1) The decision of the Appeals Manager,

setting forth the reasons therefor;

          (2) The specific provision of the applicable

plan of the Program used by the Appeals Manager as the basis for the decision;

and

          (3) The process by which the participant may

appeal the decision of the Appeals Manager pursuant to NAC

287.680.

     3.  As used in this section, “member

identification number” means the number assigned to a participant by the

Program.

     (Added to NAC by Com. on Group Ins., eff. 3-9-88; A by

Bd. of Pub. Employees’ Benefits Prog. by R126-00, 12-22-2000, eff. 1-1-2001;

R154-03, 3-22-2004; R126-07, 1-30-2008; R016-08, 8-26-2008, eff. 7-1-2009; R002-12,

6-29-2012)

      NAC 287.680  Appeal of decision of Appeals Manager: Requirements; duties of

Executive Officer or designee. (NRS 287.043)

     1.  Except as otherwise provided in NAC 287.695, if a participant in the Program is

unsatisfied with the decision of the Appeals Manager made pursuant to NAC 287.670, the participant may file an appeal with

the Executive Officer or a designee thereof. Such an appeal must be in writing

and be filed within 35 days after the participant’s receipt of the decision of

the Appeals Manager. Such an appeal must include all supporting documentation,

including, without limitation, a copy of the request for an appeal of the

adverse determination submitted to the Claims Administrator pursuant to NAC 287.670, a copy of the decision of the Appeals

Manager concerning the adverse determination and any other information provided

to the Claims Administrator by the participant.

     2.  The Executive Officer or the designee

shall:

     (a) Review the material submitted by the

participant to decide if the claim was adjudicated pursuant to the:

          (1) Current terms and conditions of the

Program; and

          (2) Contract between the Program and

applicable vendor; and

     (b) Within 30 days after receipt of the

participant’s appeal, notify the participant in writing of:

          (1) The decision of the Executive Officer or

the designee, setting forth the reasons therefor;

          (2) The specific provision of the applicable

plan of the Program used by the Executive Officer or the designee as a basis

for the decision; and

          (3) The process by which the participant may

request an external review of the adverse determination pursuant to NAC 287.690.

     (Added to NAC by Com. on Group Ins., eff. 3-9-88; A by

Com. on Benefits, 5-4-92; A by Bd. of Pub. Employees’ Benefits Prog. by R126-00,

12-22-2000, eff. 1-1-2001; R154-03, 3-22-2004; R126-07, 1-30-2008; R002-12, 6-29-2012)

      NAC 287.690  Request for external review. (NRS 287.043)  If a

participant in the Program is not satisfied with the decision of the Executive

Officer or the designee on the appeal made by the participant pursuant to NAC 287.680, the participant may request an external

review of the adverse determination conducted by an independent review

organization pursuant to NRS

695G.241 to 695G.310,

inclusive.

     (Added to NAC by Com. on Group Ins., eff. 3-9-88; A by

Com. on Benefits, 5-4-92; A by Bd. of Pub. Employees’ Benefits Prog. by R126-00,

12-22-2000, eff. 1-1-2001; R154-03, 3-22-2004; R089-05, 6-28-2006; R126-07, 1-30-2008;

R002-12, 6-29-2012)

      NAC 287.695  Request for expedited review by Claims Administrator. (NRS 287.043)

     1.  In addition to the expedited procedure

set forth in NRS 695G.271 and 695G.275, a participant may

submit a request, verbally or in writing, to the Claims Administrator for an

expedited review of an adverse determination under the circumstances set forth

in NRS 695G.271 and 695G.275.

     2.  Any information related to such a request

for an expedited review may be transmitted between the participant and the

Claims Administrator by telephone, facsimile or other expeditious method of

communication.

     3.  The Claims Administrator shall notify the

participant in writing of its determination on the request for an expedited

review within 72 hours after the request was made to the Claims Administrator.

     (Added to NAC by Bd. of Pub. Employees’ Benefits Prog.

by R002-12, eff. 6-29-2012)

DEFERRED COMPENSATION

      NAC 287.700  Definitions. (NRS 287.330)  As used

in NAC 287.700 to 287.735,

inclusive, unless the context otherwise requires:

     1.  “Committee” means the Committee

established to administer the Program.

     2.  “Investment consultant” means a private

person, corporation, institution or other entity that provides advice on

investments and operations of the Program, including, without limitation,

advice provided for the purposes of paragraph (a) of subsection 3 of NRS 287.330 and NAC 287.735.

     3.  “Program” means the Public Employees’

Deferred Compensation Program authorized by NRS 287.250 to 287.370, inclusive.

     4.  “Recordkeeper” means a corporation,

institution or other entity that offers investment options and other services

which are necessary to the administration of the Program and to the proper

investment of the money of the employees who are participants in the Program.

The term does not include a private person.

     (Added to NAC by Com. to Admin. Pub. Employees’ Deferred

Comp. Prog., eff. 9-13-91; A by R066-13, 12-23-2013)

      NAC 287.705  Purpose. (NRS 287.330)  The

purpose of NAC 287.705 to 287.735,

inclusive, is to set forth the procedures for the selection of investment

consultants and recordkeepers for the Program.

     (Added to NAC by Com. to Admin. Pub. Employees’ Deferred

Comp. Prog., eff. 9-13-91; A by R015-98, 5-29-98; R066-13, 12-23-2013)

      NAC 287.710  Recordkeepers: Selection and removal. (NRS 287.330)

     1.  The Committee will select recordkeepers

for the Program. The Committee will contract with more than one recordkeeper if

the Committee deems it necessary and in the best interests of the participants.



     2.  The selection of recordkeepers will be

made as often as the Committee deems necessary, but not less frequently than

every fifth year.

     3.  Recordkeepers serve at the pleasure of

the Committee and are subject to removal at any time by a majority vote of the

Committee.

     (Added to NAC by Com. to Admin. Pub. Employees’

Deferred Comp. Prog., eff. 9-13-91; A by R015-98, 5-29-98; R066-13, 12-23-2013)

      NAC 287.715  Recordkeepers: Procedures for selection. (NRS 287.330)  In

selecting a recordkeeper, the Committee will follow the procedures set forth in

chapter 333 of NRS, the applicable

regulations and the State Administrative Manual.

     (Added to NAC by Com. to Admin. Pub. Employees’

Deferred Comp. Prog., eff. 9-13-91; A by R015-98, 5-29-98; R066-13, 12-23-2013)

      NAC 287.730  Appointment of subcommittee to review proposals for position of

recordkeeper and make recommendations; general meeting of Committee regarding

applicants; negotiation of changes to accepted proposals. (NRS 287.330)

     1.  The Chair shall, if he or she deems it

appropriate, appoint a subcommittee to review the proposals from applicants for

the position of recordkeeper and make recommendations to the full Committee.

     2.  The Chair shall call a general meeting of

the Committee to:

     (a) Accept information from appropriate sources

pertaining to any applicant.

     (b) Conduct interviews of the applicants.

     (c) Select one or more of the applicants for

appointment as a recordkeeper.

     3.  Acceptance of an applicant’s proposal

does not preclude the Committee from negotiating specific changes to the

proposal which are in the best interests of the State of Nevada.

     (Added to NAC by Com. to Admin. Pub. Employees’

Deferred Comp. Prog., eff. 9-13-91; A by R015-98, 5-29-98; R066-13, 12-23-2013)

      NAC 287.735  Investment consultants: Selection and removal. (NRS 287.330)

     1.  The Committee will select such investment

consultants as are necessary to provide services needed for the selection of

recordkeepers and for the administration of the Program and the investment of

the money of the participants.

     2.  Such an investment consultant serves at

the pleasure of the Committee and may be removed from the position at any time

by a majority vote of the Committee.

     (Added to NAC by Com. to Admin. Pub. Employees’

Deferred Comp. Prog., eff. 9-13-91; A by R015-98, 5-29-98; R066-13, 12-23-2013)

PROVISION OF HEALTH INSURANCE THROUGH PLAN OF

SELF-INSURANCE

      NAC 287.750  System for resolving complaints of insureds: Requirements for

approval and annual report. (NRS 679B.130)  If the

Board of the Public Employees’ Benefits Program provides health insurance

through a plan of self-insurance:

     1.  To obtain approval of a system for

resolving complaints of insureds under the plan of self-insurance from the

Commissioner of Insurance as required pursuant to NRS 287.04335 and 695G.200, the Board must submit

to the Division of Insurance of the Department of Business and Industry:

     (a) The name and title of the employee responsible

for the system for resolving complaints;

     (b) A description of the procedure used to notify

an insured of the decision regarding his or her complaint; and

     (c) A copy of the explanation of rights and

procedures that will be provided to insureds.

     2.  The Board shall submit its annual report

regarding its system for resolving complaints to the Commissioner of Insurance

as required pursuant to NRS

287.04335 and 695G.220 on

or before February 1 of each year. The Board shall retain a copy of the annual

report for 3 years or until the next examination of the system for resolving

complaints is conducted by the Division pursuant to NRS 287.04335 and 695G.200, whichever is longer.

     3.  The Board is not required to include in

the annual report information concerning an oral inquiry by an insured relating

to a misunderstanding or miscommunication if the misunderstanding or

miscommunication was resolved within 1 working day after the inquiry was made.

If the misunderstanding or miscommunication was not resolved within 1 working

day, the Board shall report the misunderstanding or miscommunication as a

complaint in the annual report.

     (Added to NAC by Comm’r of Insurance by R008-02, eff. 5-23-2002)

TRUST FUND FOR FUTURE RETIREMENT BENEFITS OF LOCAL

GOVERNMENTAL EMPLOYEES

      NAC 287.760  Definitions. (NRS 287.017)  As used

in NAC 287.760 to 287.792,

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

in NAC 287.762 to 287.774,

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

     (Added to NAC by Com. on Local Gov’t Finance by R089-08,

eff. 9-18-2008)

      NAC 287.762  “Benefits plan” defined. (NRS 287.017)  “Benefits

plan” has the meaning ascribed to it in NRS 287.017.

     (Added to NAC by Com. on Local Gov’t Finance by R089-08,

eff. 9-18-2008)

      NAC 287.764  “Board of trustees” defined. (NRS 287.017)  “Board

of trustees” means the persons appointed by a governing body to administer a

trust fund established pursuant to NRS

287.017.

     (Added to NAC by Com. on Local Gov’t Finance by R089-08,

eff. 9-18-2008)

      NAC 287.766  “Governing body” defined. (NRS 287.017)  “Governing

body” means the governing body of a local government.

     (Added to NAC by Com. on Local Gov’t Finance by R089-08,

eff. 9-18-2008)

      NAC 287.768  “Local government” defined. (NRS 287.017)  “Local

government” has the meaning ascribed to it in NRS 287.017.

     (Added to NAC by Com. on Local Gov’t Finance by R089-08,

eff. 9-18-2008)

      NAC 287.770  “Professional fund manager” defined. (NRS 287.017)  “Professional

fund manager” means a person or entity that provides investment management

services, including, without limitation, the implementation of investment

strategies and the management of an investment portfolio.

     (Added to NAC by Com. on Local Gov’t Finance by R089-08,

eff. 9-18-2008)

      NAC 287.772  “Retirement benefits” defined. (NRS 287.017)  “Retirement

benefits” has the meaning ascribed to it in NRS 287.017.

     (Added to NAC by Com. on Local Gov’t Finance by R089-08,

eff. 9-18-2008)

      NAC 287.774  “Trust fund” defined. (NRS 287.017)  “Trust

fund” means a trust fund established pursuant to NRS 287.017.

     (Added to NAC by Com. on Local Gov’t Finance by R089-08,

eff. 9-18-2008)

      NAC 287.776  Resolution to establish trust fund; periodic reports. (NRS 287.017)

     1.  A trust fund must be established by a

resolution of the governing body, which must include specific statements

regarding:

     (a) The purpose of the trust fund;

     (b) A statement that all contributions to the trust

fund, including any interest and income earned on the money in the trust fund,

are held in trust, are irrevocable and may be used only to:

          (1) Provide, for the benefit of retired

employees of that local government and the spouses and dependents of those

employees, retirement benefits in accordance with the benefits plan of that

local government; and

          (2) Pay any reasonable administrative expenses

incident to the provision of those benefits and the administration of the trust

fund;

     (c) The sources of the money expected to be

deposited in the trust fund;

     (d) The appointment by the governing body of a

board of trustees, including, without limitation, the number of members of the

board of trustees and their terms of office, as determined pursuant to NAC 287.778;

     (e) A statement that the powers, duties, rights and

obligations of the board of trustees will conform to the requirements of NRS 287.017 and NAC 287.760 to 287.792,

inclusive;

     (f) A statement that, except as otherwise provided

in paragraph (h) of subsection 2 of NRS

287.017, no other money will be commingled with the money in the trust fund

and that the trust fund will be maintained as a separate account; and

     (g) A statement that the money in the trust fund

will not be used to finance debt of the local government and will not be

available for loans to other funds of the local government.

     2.  A copy of the resolution adopted pursuant

to subsection 1 must be filed with the Department of Taxation within 30 days

after its adoption by the governing body. The Department of Taxation shall

report at least annually to the Committee on Local Government Finance regarding

the trust funds established during the reporting period.

     (Added to NAC by Com. on Local Gov’t Finance by R089-08,

eff. 9-18-2008)

      NAC 287.778  Board of trustees: Appointment and terms of members. (NRS 287.017)

     1.  In appointing a board of trustees:

     (a) If the assets of the trust fund will only be

deposited in the Retirement Benefits Investment Fund pursuant to subparagraph

(1) of paragraph (g) of subsection 2 of NRS 287.017, the governing body

shall appoint at least three but not more than five persons to the board of

trustees, including:

          (1) One or more persons who each have a

combination of education and experience in finance or economics that totals 5

years or more;

          (2) A public officer or employee of the local

government who manages the fiscal affairs of the local government; and

          (3) A beneficiary of the benefits plan of the

local government.

     (b) If the assets of the trust fund will be

invested only in investments authorized for a local government pursuant to

subparagraph (2) of paragraph (g) of subsection 2 of NRS 287.017, or in such investments

and deposited in the Retirement Benefits Investment Fund pursuant to

subparagraph (1) of paragraph (g) of subsection 2 of NRS 287.017, the governing body

shall appoint at least three but not more than five persons to the board of

trustees, including:

          (1) One or more persons who each have a

combination of education and experience in finance or economics that totals 5

years or more;

          (2) A public officer or employee of the local

government who manages the fiscal affairs of the local government; and

          (3) A beneficiary of the benefits plan of the

local government who has a combination of education and experience in finance

or economics that totals 5 years or more.

     (c) If the assets of the trust fund qualify to be

invested pursuant to subsection 2 of NAC 287.790,

the governing body shall appoint five persons to the board of trustees,

including:

          (1) Two persons who have experience in the

securities exchange market;

          (2) A public officer or employee of the local

government who manages the fiscal affairs of the local government;

          (3) A person who is not an employee of the

local government, who has a combination of education and experience in finance

or economics that totals 7 years or more; and

          (4) A beneficiary of the benefits plan of the

local government who has a combination of education and experience in finance

or economics that totals 7 years or more.

     2.  A person may not be appointed to the

board of trustees pursuant to this section if the person:

     (a) Has a substantial financial interest in the

ownership or negotiation of the securities or other financial instruments in

which the assets of the trust fund are invested.

     (b) Is a member of the governing body that

established the trust fund.

     3.  A resolution adopted by two or more

governing bodies to form a pooled trust pursuant to paragraph (h) of subsection

2 of NRS 287.017 may include a

provision for appointment of a member of the board of trustees of a

participating governing body as a member of the board of trustees of the pooled

trust.

     4.  The term of a member of a board of

trustees appointed pursuant to this section must be at least 2 years, but not

more than 4 years.

     5.  The governing body may reappoint a member

of the board of trustees, and may alter the composition of the board of trustees

determined pursuant to subsection 1 if required pursuant to NAC 287.790.

     (Added to NAC by Com. on Local Gov’t Finance by R089-08,

eff. 9-18-2008)

      NAC 287.780  Board of trustees: Selection and duties of chair and vice chair;

meetings; quorum; voting. (NRS 287.017)

     1.  The members of a board of trustees shall

select a chair and vice chair from the members of the board of trustees.

     2.  The chair of the board of trustees shall:

     (a) Preside at all meetings of the board of

trustees; and

     (b) Perform the duties incident to the office and

such other duties as may be prescribed by the board of trustees from time to

time.

     3.  The vice chair shall:

     (a) Perform such duties as from time to time may be

assigned to him or her by the chair or by the board of trustees; and

     (b) In the absence of the chair, or in the event of

the chair’s inability or refusal to act, as determined by the majority of the

board of trustees, perform the duties of the chair.

     4.  The board of trustees shall meet

quarterly or at the call of the chair when business is presented. The governing

body may remove a member of the board of trustees if the member fails to attend

two consecutive meetings or any three meetings during a calendar year.

     5.  The board of trustees shall comply with

the provisions of chapter 241 of NRS.

     6.  A majority of the members of the board of

trustees constitutes a quorum for all purposes.

     7.  Any member of the board of trustees may

request a roll call vote of record.

     (Added to NAC by Com. on Local Gov’t Finance by R089-08,

eff. 9-18-2008)

      NAC 287.782  Board of trustees: Restrictions. (NRS 287.017)

     1.  The board of trustees may not negotiate

or otherwise determine the retirement benefits provided to the beneficiaries of

the trust fund.

     2.  A member of the board of trustees may not

bind the board of trustees by word or action unless the board of trustees has,

in its corporate capacity, designated such member as its agent for a specific

purpose and for that purpose only.

     3.  The earnings of the trust fund shall not

inure to the benefit of any member of the board of trustees except that a

member of the board of trustees may be a beneficiary of the trust fund through

participation in his or her employer’s benefits plan.

     4.  A member of the board of trustees shall

not be interested, directly or indirectly, as principal, partner, agent or

otherwise in any contract entered into or expenditure authorized by the board

of trustees, or in the profits or results thereof.

     (Added to NAC by Com. on Local Gov’t Finance by R089-08,

eff. 9-18-2008)

      NAC 287.784  Board of trustees: Compensation of members; staffing; provision

for expenses. (NRS

287.017)

     1.  A governing body may provide for the

payment to members of the board of trustees of:

     (a) Compensation of not more than $80 for each day

or portion of a day that the member is actually engaged in the work of the

board of trustees; and

     (b) The per diem allowance and travel expenses

normally provided for officers and employees of the local government, if any,

for each day or portion of a day that the member is actually engaged in the

work of the board of trustees.

     2.  The governing body shall provide to the

board of trustees the staff necessary to assist the board of trustees in

carrying out its powers and duties, including, without limitation, staff to

organize and provide notice of the meetings of the board of trustees, take the

minutes of such meetings, receive and disseminate financial reports of the professional

fund managers of the trust fund, if any, and prepare financial reports and

budgets for the board of trustees.

     3.  The governing body shall provide for the

necessary and reasonable expenses of the board of trustees, including, without

limitation, the costs of the annual audit required pursuant to NAC 287.786.

     (Added to NAC by Com. on Local Gov’t Finance by R089-08,

eff. 9-18-2008)

      NAC 287.786  Determination of annual contributions; annual budgeting and

auditing. (NRS

287.017)

     1.  The governing body shall annually inform

the board of trustees of the amount of the contributions that the governing

body expects to make to the trust fund. In determining such a contribution, the

governing body may:

     (a) Commission actuarial studies that estimate the

liabilities of the benefits plan of the local government for the ensuing 5

fiscal years; or

     (b) Use an alternative method of calculation that

is allowed by generally accepted accounting principles and which is performed

or commissioned by the governing body.

Ê The results

of any such studies or calculations must be completed before March 1 of each

year in order that the amount of the contributions to the trust fund is

determined before completion of the tentative budget of the board of trustees

for submission to the governing body pursuant to subsection 2.

     2.  The board of trustees shall annually

submit a tentative budget to the governing body for its consideration, approval

and inclusion in the tentative and final budgets of the governing body. The

tentative budget submitted by the board of trustees must incorporate the amount

of contributions determined pursuant to subsection 1. The governing body may

modify the tentative budget of the board of trustees at its discretion.

     3.  The board of trustees shall cause the

trust fund to be audited annually. The books, records and accounts of the trust

fund may be audited by the same person or entity that audits the books, records

and accounts of the local government. The governing body shall incorporate the

results of the audit into the annual audit report of the local government.

     (Added to NAC by Com. on Local Gov’t Finance by R089-08,

eff. 9-18-2008)

      NAC 287.788  Contract with professional fund manager; investment plan. (NRS 287.017)  

     1.  The board of trustees may contract with a

professional fund manager if the assets of the trust fund are invested:

     (a) In an investment which is authorized for a

local government pursuant to subparagraph (2) of paragraph (g) of subsection 2

of NRS 287.017.

     (b) Pursuant to subsection 2 of NAC 287.790.

     2.  Unless all the assets of the trust fund

will only be deposited in the Retirement Benefits Investment Fund pursuant to

subparagraph (1) of paragraph (g) of subsection 2 of NRS 287.017, the board of trustees

shall develop an investment plan for the trust fund in consultation with a

professional fund manager, if the board has entered into a contract with such a

person pursuant to subsection 1, or with any other investment management

advisor retained by the board of trustees. The investment plan must be approved

as to its conformity with this subsection by the Committee on Local Government

Finance before the investment of any assets of the trust fund. The investment

plan must:

     (a) Include formal investment policies consistent

with the requirements of NRS 287.017

and NAC 287.760 to 287.792,

inclusive, including, without limitation, policies governing acceptable risks,

diversification requirements and the fundamental processes for regulating the

investment of the assets of the trust fund.

     (b) Include processes governing the selection and

monitoring of the staff and any professional fund manager or other investment

management advisor assisting the board of trustees in the administration of the

trust fund that are sufficient to ensure such staff, professional fund managers

and other advisors have appropriate expertise and exhibit appropriate fiduciary

behavior for such positions.

     (c) Include appropriate investment training for

members of the board of trustees and staff to ensure that they are

knowledgeable in the prevailing investment practices.

     (d) Include travel policies for participation in

investment training for members of the board of trustees and staff that support

the need for training and are defensible in the context of the interests of the

public and the beneficiaries of the trust fund.

     (e) Include an organizational plan for the

selection and retention of competent investment expertise among the staff and

in professional fund managers and other advisors, and incorporate a competitive

process for the selection of both staff and professional fund managers and

advisors.

     (f) Provide for the development of and annual

review by the board of trustees of the asset allocation strategy of the

investment plan and the positioning of classes of assets in the investment

portfolio of the trust fund in light of general market trends and valuations.

     (g) Provide, on at least an annual basis, for a

formal evaluation of the role or potential role of passive or indexed

investment strategies applicable to the investment portfolio of the trust fund,

and of appropriate strategies to minimize the costs of the administration of

the trust fund, including, without limitation, the costs of transactions,

professional fund managers and other advisors and investment training.

     (h) Provide for a periodic review of

investment-related practices, including, without limitation, services provided

by brokers and unconventional investment strategies, in the context of

fiduciary standards and the interests of economy.

     (i) Establish formal benchmarks for the performance

of the portfolio and managed accounts that are specific to the assigned role of

the manager of the portfolio or account.

     (j) Provide for the regular evaluation of the

performance of the portfolio using consistent, documented and reliable

disciplines, and establish clear criteria and procedures for selection and

termination of investments by managers.

     (k) Provide for regular communications on

investment results to the governing body in a clear and intelligible format.

     3.  Approval by the Committee on Local

Government Finance of the investment plan required in subsection 2 does not

create or establish any fiduciary responsibility between the Committee on Local

Government Finance and the trust fund or its beneficiaries.

     (Added to NAC by Com. on Local Gov’t Finance by R089-08,

eff. 9-18-2008)

      NAC 287.790  Deposit and investment of assets; maintenance as separate

account; prohibited uses; reimbursement of administrative expenses. (NRS 287.017)

     1.  Except as otherwise provided in

subsection 4, if the market value of the investment portfolio of a trust fund

at the end of a fiscal year is $100,000,000 or less, the assets of the trust

fund may only be:

     (a) Deposited in the Retirement Benefits Investment

Fund pursuant to subparagraph (1) of paragraph (g) of subsection 2 of NRS 287.017; and

     (b) Invested in any investment which is authorized

for a local government pursuant to subparagraph (2) of paragraph (g) of

subsection 2 of NRS 287.017.

     2.  Except as otherwise provided in

subsection 4, if the market value of the investment portfolio in a trust fund

at the end of a fiscal year is more than $100,000,000, the assets of the trust

fund may be:

     (a) Deposited in the Retirement Benefits Investment

Fund pursuant to subparagraph (1) of paragraph (g) of subsection 2 of NRS 287.017;

     (b) Invested in any investment which is authorized

for a local government pursuant to subparagraph (2) of paragraph (g) of

subsection 2 of NRS 287.017; and

     (c) Invested in any stocks or other equity

securities or bonds or other debt securities which meet the requirements of

subparagraph (3) of paragraph (g) of subsection 2 of NRS 287.017.

     3.  If the market value of the investment

portfolio of a trust fund that is invested pursuant to subsection 2 falls below

$100,000,000 at the end of a fiscal year, the board of trustees:

     (a) Is not required to liquidate any investments

described in paragraph (c) of subsection 2.

     (b) Shall invest the assets of the trust fund in

the manner set forth in subsection 1 until the market value of the portfolio is

more than $100,000,000.

     4.  The assets of a pooled trust authorized

pursuant to paragraph (h) of subsection 2 of NRS 287.017 may only be deposited

in the Retirement Benefits Investment Fund established pursuant to NRS 355.220.

     5.  All interest, earnings, dividends and

distributions received from the investment of assets in the trust fund, minus

the expenses charged for such investments, must be deposited into the trust

fund.

     6.  Except as otherwise provided in paragraph

(h) of subsection 2 of NRS 287.017,

the trust fund must be maintained as a separate account, and no other money may

be commingled with the money in the trust fund.

     7.  Money in the trust fund must not be used

to finance the debt of the local government and must not be used for loans to

other funds of the local government.

     8.  Reasonable charges may be assessed to the

trust fund for reimbursement of the direct expenses incurred by the board of

trustees in administering the trust fund.

     (Added to NAC by Com. on Local Gov’t Finance by R089-08,

eff. 9-18-2008)

      NAC 287.792  Requests for transfers of money. (NRS 287.017)

     1.  Except as otherwise provided in

subsection 2, the board of trustees shall, upon request of the governing body,

transfer money from the trust fund to an account designated by the governing

body not later than 10 business days after the first day of the month following

receipt of the request by the board of trustees. A request by the governing

body pursuant to this subsection must include, without limitation:

     (a) An explanation of the manner in which the

proposed transfer will be used to fulfill the requirements of the benefits plan

of the local government;

     (b) A copy of the budget of the local government

for the current fiscal year, which demonstrates that expenditures for

retirement benefits are authorized by the governing body pursuant to an

agreement between the local government and its employees;

     (c) Minutes of the meeting of the governing body at

which the transfer was proposed; and

     (d) The signature of the chairperson of the

governing body.

     2.  If the request by the governing body does

not meet the requirements of this section, the board of trustees may delay

transfer of the money until the governing body has complied with the

requirements.

     (Added to NAC by Com. on Local Gov’t Finance by R089-08,

eff. 9-18-2008)
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