Nrs: Chapter 687B - Contracts Of Insurance

Link to law: https://www.leg.state.nv.us/NRS/NRS-687B.html
Published: 2015

Subscribe to a Global-Regulation Premium Membership Today!

Key Benefits:

Subscribe Now
[Rev. 2/11/2015 11:51:31

AM--2014R2]

CHAPTER 687B - CONTRACTS OF INSURANCE

NRS 687B.010        Scope.



NRS 687B.015        “Binder”

defined.

NRS 687B.021        Signatures.

NRS 687B.030        Waiver

of payment of premium.

NRS 687B.040        Insurable

interest: Personal insurance.

NRS 687B.050        Insurable

interest: Exception when certain institutions designated beneficiary.

NRS 687B.060        Insurable

interest: Property.

NRS 687B.070        Power

to contract: Purchase of insurance and annuities by minors.

NRS 687B.080        Consent

of insured to life or health insurance required; exceptions; notice of

application for or request to increase coverage of insurance upon life of

another required.

NRS 687B.090        Alteration

of application: Life and health insurance.

NRS 687B.100        Application

as evidence.

NRS 687B.110        Representations

in applications.

NRS 687B.113        Control

of cost of health care: Provisions encouraging use of certain services and

facilities.

NRS 687B.117        Control

of cost of health care: Insurer required to use three or more practices that

control cost in administering benefits.

NRS 687B.120        Filing

and approval of forms.

NRS 687B.122        Readability

of policies: Applicability of requirements.

NRS 687B.124        Readability

of policies: Flesch test; style, arrangement and overall appearance; index or

table of contents.

NRS 687B.126        Readability

of policies: Filing policy for Commissioner’s approval; exceptions to score

requirements on Flesch test.

NRS 687B.128        Readability

of policies: Approval by Commissioner.

NRS 687B.130        Grounds

for disapproval.

NRS 687B.140        Standard

provisions.

NRS 687B.145        Provisions

in policies of casualty insurance: Proration of recovery or benefits; uninsured

and underinsured motorist coverage; coverage for medical expenses; insurer not

entitled to subrogation upon payment made because of underinsured vehicle

coverage.

NRS 687B.147        Exclusion,

reduction or limitation of certain coverage in motor vehicle insurance policies

allowed; conditions; form and contents of disclosure.

NRS 687B.150        Inclusion

of portion of charter or bylaws.

NRS 687B.160        Execution

of policies.

NRS 687B.170        Underwriters’

and combination policies.

NRS 687B.180        Validity

and construction of noncomplying forms.

NRS 687B.182        Binders:

Issuance; effective dates.

NRS 687B.183        Binders:

Forms; required statement; delivery.

NRS 687B.184        Binders:

Form and premium for policy issued as replacement.

NRS 687B.185        Binders:

Prohibition of use to lower premiums.

NRS 687B.186        Binders:

Proof of insurance coverage.

NRS 687B.187        Binders:

Disapproval of insurer.

NRS 687B.190        Delivery

of policy.

NRS 687B.200        Assignability.

NRS 687B.210        Payment

discharges insurer.

NRS 687B.220        Forms

for proof of loss to be furnished.

NRS 687B.225        Requirements

for contracts for payment of cost of medical or dental care which require prior

authorization of care.

NRS 687B.240        Administration

of claims not waiver.

NRS 687B.250        Payment

not to constitute admission of liability or waiver of defenses.

NRS 687B.255        Insurer

to pay claim with negotiable instrument.

NRS 687B.260        Exemption

of proceeds of certain policies.

NRS 687B.270        Exemption

of proceeds: Health insurance.

NRS 687B.280        Exemption

of proceeds: Group insurance.

NRS 687B.290        Exemption

of proceeds: Annuities; assignability of rights.

NRS 687B.300        Retention

of proceeds of policy by insurer.

NRS 687B.310        Cancellations

and nonrenewals; scope of application.

NRS 687B.320        Midterm

cancellation; exception.

NRS 687B.325        Industrial

insurance policies: Midterm cancellation; notice to policyholder.

NRS 687B.330        Anniversary

cancellation.

NRS 687B.340        Nonrenewals.

NRS 687B.345        Annual

review of coverage and benefits provided in policy.

NRS 687B.350        Renewal

with altered terms.

NRS 687B.355        Information

about claims paid on behalf of policyholder; regulations.

NRS 687B.360        Information

about grounds.

NRS 687B.370        Information

about applying for insurance through certain plans; exception.

NRS 687B.380        Immunity.

NRS 687B.385        Cancellation,

nonrenewal or increase in premium due to claims for which insured was not at

fault prohibited.

NRS 687B.390        Cancellation

or nonrenewal on sole basis of age, residence, race, color, creed, national

origin, ancestry or occupation prohibited.

NRS 687B.400        Discrimination

on sole basis of age prohibited; burden of proof; exception.

NRS 687B.402        Compliance

with certain federal laws regarding genetic information.

NRS 687B.404        Compliance

with certain federal laws regarding mental health and addiction.

NRS 687B.406        Compliance

with certain federal laws regarding dependent students.

NRS 687B.408        Notifications

required concerning changes related to prescription drugs used for transplanted

organs.

NRS 687B.410        Withdrawal

of insurance for particular class of insureds: Notice; administrative review.

NRS 687B.420        Notice

of proposed cancellation, nonrenewal or alteration of terms of certain policies

or contracts of insurance.

NRS 687B.430        Regulations:

Policies which provide for payment of expenses not covered by Medicare; sale of

more than one policy of health insurance to same person.

NRS 687B.440        Umbrella

policies: Disclosure statement indicating whether policy includes uninsured or

underinsured motorist coverage; form.

NRS 687B.450        Required

medical examination; potentially serious medical condition; notification.

NRS 687B.460        Certificates

of insurance for property or casualty insurance.

NRS 687B.470        Health

benefit plans: “Health benefit plan” defined.

NRS 687B.480        Health

benefit plans: Availability; waiting period; effective date.

NRS 687B.490        Health

benefit plans: Carrier required to demonstrate capacity to adequately deliver

services; Commissioner to determine capacity; annual summary.

NRS 687B.500        Health

benefit plans: Basis for premium rate; exceptions.

_________

_________

 

      NRS 687B.010  Scope.  This chapter

applies to all insurance contracts and annuity contracts other than:

      1.  Reinsurance.

      2.  Policies or contracts not issued for

delivery in this state nor delivered in this state.

      3.  Wet marine and transportation

insurance.

      (Added to NRS by 1971, 1712)

      NRS 687B.015  “Binder” defined.  As

used in this chapter, unless the context otherwise requires, “binder” means an

oral or written contract for temporary insurance which is used when a policy is

not immediately issued to evidence that the coverage attaches at a specified

time and continues until the policy is issued or the risk is declined.

      (Added to NRS by 1983, 1120)

      NRS 687B.021  Signatures.  Unless

otherwise provided by a specific statute, if a signature is required of any

person, the person may provide as the signature of the person:

      1.  An original signature;

      2.  A facsimile signature; or

      3.  An electronic signature pursuant to the

provisions of chapter 719 of NRS.

      (Added to NRS by 2003, 2806)

      NRS 687B.030  Waiver of payment of premium.  With

respect to any kind of insurance and any type of insurance contract, the

insurer may provide for waiver of payment of premium for such causes and

subject to such terms and conditions as may be specified in the contract.

      (Added to NRS by 1971, 1712; A 1981, 1142)

      NRS 687B.040  Insurable interest: Personal insurance.

      1.  Any natural person of competent legal

capacity may procure or effect an insurance contract upon his or her own life

or body for the benefit of any person. But a person shall not procure or cause

to be procured any insurance contract upon the life or body of another

individual unless the benefits under the contract are payable to the person

insured or the personal representatives of the person insured, or to a person

having, at the time when the contract was made, an insurable interest in the

person insured.

      2.  A trust shall not procure, cause to be

procured or hold an insurance contract upon the life of a person unless each

beneficiary of the trust:

      (a) Has an insurable interest in the person

insured; or

      (b) Is a charitable, benevolent, educational or

religious institution, or an agency thereof, and is designated irrevocably as a

beneficiary of the trust.

      3.  If the beneficiary, assignee or other

payee under any contract made in violation of this section receives from the

insurer any benefits thereunder accruing upon the death, disablement or injury

of the person insured, the person insured or the executor or administrator of

the person insured, as the case may be, may maintain an action to recover such

benefits from the person so receiving them.

      4.  As used in this section, “insurable

interest” as to such personal insurance means that every person has an

insurable interest in the life, body and health of himself or herself, and of

other persons as follows:

      (a) In the case of persons related closely by

blood or by law, a substantial interest engendered by love and affection; and

      (b) In the case of other persons, a lawful and

substantial economic interest in having the life, health or bodily safety of

the person insured continue, as distinguished from an interest which would

arise only by, or would be enhanced in value by, the death, disablement or

injury of the person insured.

      5.  Before, on or after January 1, 1972, an

individual party to a contract or option for the purchase or sale of an

interest in a business partnership or firm, or of shares of stock of a

corporation or of an interest in such shares, has an insurable interest in the

life, body and health of each individual party to the contract and for the

purposes of the contract only, in addition to any insurable interest which may

otherwise exist as to the person.

      6.  An insurer is entitled to rely upon all

statements, declarations and representations made by an applicant for insurance

relative to the insurable interest of the applicant in the insured. An insurer

does not incur legal liability except as otherwise set forth in the policy, by

virtue of any untrue statements, declarations or representations so relied upon

in good faith by the insurer.

      (Added to NRS by 1971, 1712; A 1997, 1624; 2009, 1786)

      NRS 687B.050  Insurable interest: Exception when certain institutions

designated beneficiary.

      1.  Life insurance contracts may be entered

into in which the person paying the consideration for the insurance has no

insurable interest in the life of the individual insured, where charitable,

benevolent, educational or religious institutions or their agencies are

designated irrevocably as the beneficiaries thereof.

      2.  In making such contracts the person

paying the premium shall make and sign the application therefor as owner, and

shall designate irrevocably a charitable, benevolent, educational or religious

institution or an agency thereof as the beneficiary or beneficiaries of such

contract. The application shall be signed also by the individual whose life is to

be insured.

      3.  Nothing in this section shall prohibit

any combination of the applicant, premium payer, owner and beneficiary from

being the same person.

      4.  Such a contract shall be valid and

binding among the parties thereto, notwithstanding the absence otherwise of an

insurable interest in the life of the individual insured.

      (Added to NRS by 1971, 1713)

      NRS 687B.060  Insurable interest: Property.

      1.  No contract of insurance of property or

of any interest in property or arising from property shall be enforceable as to

the insurance except for the benefit of persons having an insurable interest in

the things insured as at the time of the loss.

      2.  “Insurable interest” as used in this

section means any actual, lawful and substantial economic interest in the

safety or preservation of the subject of the insurance free from loss,

destruction or pecuniary damage or impairment.

      (Added to NRS by 1971, 1714)

      NRS 687B.070  Power to contract: Purchase of insurance and annuities by

minors.

      1.  Any person of competent legal capacity

may contract for insurance.

      2.  Any minor not less than 16 years of age

may, notwithstanding his or her minority, contract for or own annuities or

insurance, or affirm by novation or otherwise preexisting contracts for

annuities or insurance, upon his or her own life, body, health, property,

liabilities or other interests, or on the person of another in whom the minor

has an insurable interest. Notwithstanding such minority such a minor shall be

deemed competent to exercise all rights and powers with respect to or under:

      (a) Any annuity or insurance contract upon the

minor’s own life, body or health;

      (b) Any contract which such minor effected upon

his or her own property, liabilities or other interests; or

      (c) Any contract effected or owned by the minor

on the person of another, as might be exercised by a person of full legal age.

      3.  Such a minor may at any time surrender

his or her interest in any such contracts and give valid discharge for any

benefit accruing or money payable thereunder. Such a minor shall not, by reason

of his or her minority, be entitled to rescind, avoid or repudiate the

contract, or to rescind, avoid or repudiate any exercise of a right or

privilege thereunder, except that such a minor, not otherwise emancipated,

shall not be bound by any unperformed agreement to pay, by promissory note or

otherwise, any premium on any such annuity or insurance contract.

      4.  All insurance contracts made by a minor

under the age of 16 years shall be made only with the written consent of a

parent or guardian, and the exercise of all contractual rights under such

contracts, or the surrender thereof, or the giving of a valid discharge for any

benefit accruing or money payable thereunder shall have the written consent of

a parent or guardian if made or given while such minor is under the age of 16

years.

      5.  All such contracts made by a minor

which may result in any personal liability for assessment shall have the

written assumption of any such liability by a parent or guardian in

consideration of the issuance of the contract. Such assumption shall be in a

form approved by the Commissioner, reasonably designed to inform the parent or

guardian of the liability thus assumed. Such assumption of liability may be

made a part of and included with any written consent of such parent or guardian

required under the provisions of this section, and it may be provided therein

that such assumption shall cover only up to the anniversary date of the policy

nearest the insured’s birthday upon which the insured attains the age of 18

years.

      6.  Any annuity contract or policy of life

or health insurance procured by or for a minor under subsection 2 or 3, shall

be made payable either to the minor or the estate of the minor or to a person

having an insurable interest in the life of the minor.

      (Added to NRS by 1971, 1714; A 1973, 1581)

      NRS 687B.080  Consent of insured to life or health insurance required;

exceptions; notice of application for or request to increase coverage of

insurance upon life of another required.

      1.  Except as otherwise provided in

subsection 2, no life or health insurance contract upon a person, except a

contract of group life insurance or of group or blanket health insurance, may

be made or effectuated unless at the time of the making of the contract the

person insured, being of competent legal capacity to contract, applies therefor

or has consented thereto in writing.

      2.  The following persons may enter into a

contract for life or health insurance upon another person without the insured’s

written consent:

      (a) A spouse may effectuate such insurance upon

the other spouse.

      (b) Any person having an insurable interest in

the life of a minor, or any person upon whom a minor is dependent for support

and maintenance, may effectuate insurance upon the life of or pertaining to the

minor.

      (c) Family policies may be issued insuring any

two or more members of a family on an application signed by either parent, a

stepparent, a guardian, or by a husband or wife.

      3.  An insurer who receives:

      (a) An application in accordance with subsection

2 for a contract for insurance upon the life of another; or

      (b) A request to increase the existing coverage

upon the life of an insured by a person other than the insured,

Ê shall,

unless the application or request relates to a contract of group life insurance

or of group or blanket health insurance, cause notice of the application or

request to be mailed to the insured at the home or business of the insured

within 48 hours after receiving the application or request.

      (Added to NRS by 1971, 1715; A 1993, 173)

      NRS 687B.090  Alteration of application: Life and health insurance.  No alteration of any written application for

any life or health insurance policy shall be made by any person other than the

applicant without the written consent of the applicant, except that insertions

may be made by the insurer, for administrative purposes only, in such manner as

to indicate clearly that such insertions are not to be ascribed to the

applicant.

      (Added to NRS by 1971, 1715)

      NRS 687B.100  Application as evidence.

      1.  No application for the issuance of any

life or health insurance policy or annuity contract shall be admissible in

evidence in any action relative to such policy or contract, unless a true copy

of the application was attached to or otherwise made a part of the policy or

contract when issued. This subsection does not apply to industrial life

insurance policies.

      2.  If any policy of life or health

insurance delivered in this state is reinstated or renewed, and the insured or

the beneficiary or assignee of the policy makes written request to the insurer

for a copy of the application, if any, for such reinstatement or renewal, the

insurer shall, within 30 days after receipt of such request at its home office,

deliver or mail to the person making such request a copy of such application

reproduced by any legible means. If such copy is not so delivered or mailed

after having been so requested, the insurer shall be precluded from introducing

the application in evidence in any action or proceeding based upon or involving

the policy or its reinstatement or renewal. In the case of such a request from

a beneficiary or assignee, the time within which the insurer is required to

furnish a copy of such application shall not begin to run until after receipt

of evidence satisfactory to the insurer of the beneficiary’s or assignee’s

vested interest in the policy or contract.

      3.  As to kinds of insurance other than

life or health insurance, no application for insurance signed by or on behalf

of the insured shall be admissible in evidence in any action between the

insured and the insurer arising out of the policy so applied for, if the

insurer has failed, at the expiration of 30 days after receipt by the insurer

of written demand therefor by or on behalf of the insured, to furnish to the

insured a copy of such application reproduced by any legible means.

      (Added to NRS by 1971, 1715)

      NRS 687B.110  Representations in applications.  All

statements and descriptions in any application for an insurance policy or

annuity contract, by or in behalf of the insured or annuitant, shall be deemed

to be representations and not warranties. Misrepresentations, omissions,

concealment of facts and incorrect statements shall not prevent a recovery

under the policy or contract unless either:

      1.  Fraudulent;

      2.  Material either to the acceptance of

the risk, or to the hazard assumed by the insurer; or

      3.  The insurer in good faith would either

not have issued the policy or contract, or would not have issued it at the same

premium rate, or would not have issued a policy or contract in as large an

amount, or would not have provided coverage with respect to the hazard

resulting in the loss, if the true facts had been made known to the insurer as

required either by the application for the policy or contract or otherwise.

      (Added to NRS by 1971, 1716)

      NRS 687B.113  Control of cost of health care: Provisions encouraging use of

certain services and facilities.  An

insurer shall include provisions in a policy of health insurance encouraging

the insured’s use, if medically appropriate, of services and facilities that

are the most efficient or that tend to control or reduce the cost of health

care. Any policy or other form filed with the Commissioner pursuant to NRS 687B.120 must specifically indicate which

provisions satisfy the requirements of this section.

      (Added to NRS by 1985, 1227)

      NRS 687B.117  Control of cost of health care: Insurer required to use three or

more practices that control cost in administering benefits.  The Commissioner shall not approve any

proposed policy of health insurance unless the Commissioner determines that the

insurer has adopted and is using three or more practices in administering

benefits that control or reduce the cost of health care.

      (Added to NRS by 1985, 1227)

      NRS 687B.120  Filing and approval of forms.

      1.  Except as otherwise provided in

subsection 2:

      (a) No life or health insurance policy or

contract, annuity contract form, policy form, health care plan or plan for

dental care, whether individual, group or blanket, including those to be issued

by a health maintenance organization, organization for dental care or prepaid

limited health service organization, or application form where a written

application is required and is to be made a part of the policy or contract, or

printed rider or endorsement form or form of renewal certificate, or form of

individual certificate or statement of coverage to be issued under group or

blanket contracts, or by a health maintenance organization, organization for

dental care or prepaid limited health service organization, may be delivered or

issued for delivery in this state, unless the form has been filed with and

approved by the Commissioner.

      (b) As to group insurance policies effectuated

and delivered outside this state but covering persons resident in this state,

the group certificates to be delivered or issued for delivery in this state

must be filed, for informational purposes only, with the Commissioner at the

request of the Commissioner.

      2.  As to group insurance policies to be

issued to a group approved pursuant to NRS

688B.030 or 689B.026, no policies

of group insurance may be marketed to a resident or employer of this State

unless the policy and any form or certificate to be issued pursuant to the

policy has been filed with and approved by the Commissioner.

      3.  Every filing made pursuant to the

provisions of subsection 1 or 2 must be made not less than 45 days in advance

of any delivery pursuant to subsection 1 or marketing pursuant to subsection 2.

At the expiration of 45 days the form so filed shall be deemed approved unless

prior thereto it has been affirmatively approved or disapproved by order of the

Commissioner. Approval of any such form by the Commissioner constitutes a

waiver of any unexpired portion of such waiting period. The Commissioner may

extend by not more than an additional 30 days the period within which the

Commissioner may so affirmatively approve or disapprove any such form, by

giving notice to the insurer of the extension before expiration of the initial

45-day period. At the expiration of any such period as so extended, and in the

absence of prior affirmative approval or disapproval, any such form shall be

deemed approved. The Commissioner may at any time, after notice and for cause

shown, withdraw any such approval.

      4.  Any order of the Commissioner

disapproving any such form or withdrawing a previous approval must state the

grounds therefor and the particulars thereof in such detail as reasonably to

inform the insurer thereof. Any such withdrawal of a previously approved form

is effective at the expiration of such a period, not less than 30 days after

the giving of notice of withdrawal, as the Commissioner in such notice

prescribes.

      5.  The Commissioner may, by order, exempt

from the requirements of this section for so long as the Commissioner deems

proper any insurance document or form or type thereof specified in the order,

to which, in the opinion of the Commissioner, this section may not practicably

be applied, or the filing and approval of which are, in the opinion of the

Commissioner, not desirable or necessary for the protection of the public.

      6.  Appeals from orders of the Commissioner

disapproving any such form or withdrawing a previous approval may be taken as

provided in NRS 679B.310 to 679B.370, inclusive.

      (Added to NRS by 1971, 1716; A 1993, 2398; 1995, 1624; 2011, 3371)

      NRS 687B.122  Readability of policies: Applicability of requirements.

      1.  The provisions of NRS 687B.122 to 687B.128,

inclusive:

      (a) Apply to all policies, certificates or

contracts of life or health insurance, including credit insurance as defined in

NRS 690A.015, delivered or issued for

delivery in this state, including policies, certificates or contracts issued by

fraternal benefit societies and hospital, medical or dental service

corporations, health maintenance organizations and other similar organizations,

and certificates issued pursuant to a policy of group insurance delivered or

issued for delivery in this state, except:

             (1) Any policy which is a security subject

to federal jurisdiction;

             (2) Any policy covering the lives of a

group of 1,000 or more persons as of its date of issuance, other than a group

policy for credit insurance and any certificate issued pursuant to any group

policy;

             (3) Any group annuity which serves to

finance pension, profit-sharing or deferred compensation plans; or

             (4) Any form used in connection with, as a

conversion from, as an addition to or in exchange for a policy delivered or

issued for delivery on a form approved or permitted to be issued before July 1,

1983.

      (b) Are not intended to increase any risk assumed

by an insurer.

      (c) Do not supersede the provisions of this Title

or other law applicable to the delivery or issuance of policies of insurance.

      (d) Are not intended to restrict or discourage

the development of new policies and provisions.

      (e) Do not require standardization of forms for

or provisions of policies.

      2.  Any policy written in a language other

than English shall be deemed to comply with NRS

687B.124 if the insurer certifies that it is translated from a policy

written in English which complies with that section.

      3.  The provisions of NRS 687B.122 to 687B.128,

inclusive, apply to renewals on or after July 1, 1983, of policies delivered or

issued for delivery before that date.

      (Added to NRS by 1981, 927; A 1987, 2286)

      NRS 687B.124  Readability of policies: Flesch test; style, arrangement and

overall appearance; index or table of contents.

      1.  Except as provided by NRS 687B.122, a policy must not be delivered or

issued for delivery in this state on or after July 1, 1983, unless:

      (a) The text of the policy achieves a score of at

least 40 on the Flesch test of reading ease or an equivalent score on any

comparable test which is approved by the Commissioner;

      (b) It is printed, except for pages which contain

specifications, schedules or tables, in not less than 10-point type, one point

leaded;

      (c) The style, arrangement and overall appearance

of the policy give no undue prominence to any portion of the text of or

endorsements or riders to the policy; and

      (d) It contains a table of contents or an index

of the principal sections of the policy if it contains more than 3,000 words or

has more than three pages.

      2.  The score for the Flesch test of

reading ease must be calculated in the following manner:

      (a) If a form contains 10,000 words or less of

text, the entire text must be used as a basis for calculating the score. If it

contains more than 10,000 words, two samples, which are separated from each

other by at least 20 printed lines, of 200 words per page must be used as the

basis for calculating the score.

      (b) The number of words and sentences used in the

basis for the calculation must be counted and the total number of words divided

by the total number of sentences. This figure must be multiplied by 1.015.

      (c) The number of syllables must be counted and

the total divided by the total number of words. This figure must be multiplied

by 84.6.

      (d) The results of the calculations made pursuant

to paragraphs (b) and (c) must be added together and the total must be

subtracted from 206.835.

      (e) The result of the calculation made pursuant

to paragraph (d) is the score for the policy.

      3.  For the purposes of performing the

calculations required by subsection 2:

      (a) A contraction, hyphenated word or numbers and

letters when separated by spaces must be counted as one word;

      (b) A sequence of words which ends with a period,

semicolon or colon, except for headings and captions, must be counted as a

sentence; and

      (c) Where a dictionary shows two or more equally

acceptable pronunciations of a word, the pronunciation containing fewer

syllables may be used.

      4.  As used in this section, “text”

includes all printed matter except:

      (a) The name and address of the insurer, the

name, number or title of the policy, the table of contents or index, captions

and subcaptions and pages which contain specifications, schedules and tables;

and

      (b) Any language of the policy which is drafted

in a particular manner so as to meet the requirements of:

             (1) Any federal or state law or regulation

or any interpretation of a law or regulation by a federal or state agency;

             (2) Any collective bargaining agreement;

             (3) Usage of medical terms; and

             (4) Definitions contained in the policy,

Ê if the

insurer so identifies this language and certifies in writing that it is

excepted by this paragraph.

      5.  An insurer may score riders,

endorsements, applications and other forms as separate forms or as part of the

policy with which they are used.

      (Added to NRS by 1981, 927)

      NRS 687B.126  Readability of policies: Filing policy for Commissioner’s

approval; exceptions to score requirements on Flesch test.

      1.  An insurer shall file a copy of the

policy with the Commissioner accompanied by a certificate signed by an officer

of the insurer stating that the policy meets the score required for reading

ease or stating that the score is lower than the minimum required and

requesting that it be approved in accordance with subsection 2. Upon the

request of the Commissioner, the insurer shall furnish additional information

to verify the accuracy of the certification.

      2.  The Commissioner may approve a policy

which has a score lower than required whenever the Commissioner finds that a

lower score:

      (a) Provides a more accurate reflection of the

readability of a policy;

      (b) Is necessitated by the nature of a particular

type or class of policy; or

      (c) Is caused by language in the policy which is

drafted in a particular manner so as to meet the requirements of any state law,

regulation or interpretation of that law or regulation by a state agency.

      (Added to NRS by 1981, 928)

      NRS 687B.128  Readability of policies: Approval by Commissioner.  A policy which complies with subsection 1 of NRS 687B.124 must be approved by the Commissioner,

notwithstanding any other provision of law which specifies the content of a

policy, if the policy provides the policyholder and claimant with protection at

least equal to that to which they are entitled under those other provisions.

      (Added to NRS by 1981, 929)

      NRS 687B.130  Grounds for disapproval.  The

Commissioner shall disapprove any form filed under NRS

687B.120, or withdraw any previous approval thereof, only on one or more of

the following grounds:

      1.  The form is in any respect in violation

of or does not comply with this Code.

      2.  The form contains, or incorporates by

reference where such incorporation is otherwise permissible, any inconsistent,

ambiguous or misleading clauses, or exceptions and conditions which deceptively

affect the risk purported to be assumed in the general coverage of the

contract, or any provision or provisions prejudicial to the interest of the

insured or policyholder.

      3.  The form has any title, heading or

other indication of its provisions which is misleading, or is printed in such

size of type or manner of reproduction as to be difficult to read.

      4.  As to an individual health insurance

policy, if the benefits provided therein are unreasonable in relation to the premium

charged, or if it contains any unjust, unfair, inequitable or prejudicial

provision or provisions.

      5.  As to a life insurance or individual

health insurance policy, if it contains a provision or provisions such as to

encourage misrepresentation.

      (Added to NRS by 1971, 1717)

      NRS 687B.140  Standard provisions.

      1.  Insurance contracts shall contain such

standard or uniform provisions as are required by the applicable provisions of

this Code pertaining to contracts of particular kinds of insurance. The

Commissioner may waive the required use of a particular provision in a

particular insurance policy form if:

      (a) The Commissioner finds such provision

unnecessary for or unrelated to the protection of the insured and inconsistent

with the purposes of the policy; and

      (b) The policy is otherwise approved by the

Commissioner.

      2.  No policy shall contain any provision

inconsistent with or contradictory to any standard or uniform provision used or

required to be used, but the Commissioner may approve any substitute provision

which is, in the opinion of the Commissioner, not less favorable in any

particular to the insured, owner or beneficiary than the provisions otherwise

required.

      3.  In lieu of the provisions required by

this Code for contracts for particular kinds of insurance, substantially

similar provisions required by the law of the domicile of a foreign or alien

insurer may be used when approved by the Commissioner.

      4.  A policy issued by a domestic insurer

for delivery in another jurisdiction may contain any provision required or

permitted by the laws of such jurisdiction.

      (Added to NRS by 1971, 1718)

      NRS 687B.145  Provisions in policies of casualty insurance: Proration of

recovery or benefits; uninsured and underinsured motorist coverage; coverage

for medical expenses; insurer not entitled to subrogation upon payment made

because of underinsured vehicle coverage.

      1.  Any policy of insurance or endorsement

providing coverage under the provisions of NRS

690B.020 or other policy of casualty insurance may provide that if the

insured has coverage available to the insured under more than one policy or

provision of coverage, any recovery or benefits may equal but not exceed the

higher of the applicable limits of the respective coverages, and the recovery

or benefits must be prorated between the applicable coverages in the proportion

that their respective limits bear to the aggregate of their limits. Any

provision which limits benefits pursuant to this section must be in clear

language and be prominently displayed in the policy, binder or endorsement. Any

limiting provision is void if the named insured has purchased separate coverage

on the same risk and has paid a premium calculated for full reimbursement under

that coverage.

      2.  Except as otherwise provided in

subsection 5, insurance companies transacting motor vehicle insurance in this

State must offer, on a form approved by the Commissioner, uninsured and

underinsured vehicle coverage in an amount equal to the limits of coverage for

bodily injury sold to an insured under a policy of insurance covering the use

of a passenger car. The insurer is not required to reoffer the coverage to the

insured in any replacement, reinstatement, substitute or amended policy, but

the insured may purchase the coverage by requesting it in writing from the

insurer. Each renewal must include a copy of the form offering such coverage.

Uninsured and underinsured vehicle coverage must include a provision which

enables the insured to recover up to the limits of the insured’s own coverage

any amount of damages for bodily injury from the insured’s insurer which the

insured is legally entitled to recover from the owner or operator of the other

vehicle to the extent that those damages exceed the limits of the coverage for

bodily injury carried by that owner or operator. If an insured suffers actual

damages subject to the limitation of liability provided pursuant to NRS 41.035, underinsured vehicle coverage

must include a provision which enables the insured to recover up to the limits

of the insured’s own coverage any amount of damages for bodily injury from the

insured’s insurer for the actual damages suffered by the insured that exceed

that limitation of liability.

      3.  An insurance company transacting motor

vehicle insurance in this State must offer an insured under a policy covering

the use of a passenger car, the option of purchasing coverage in an amount of

at least $1,000 for the payment of reasonable and necessary medical expenses

resulting from an accident. The offer must be made on a form approved by the

Commissioner. The insurer is not required to reoffer the coverage to the

insured in any replacement, reinstatement, substitute or amended policy, but

the insured may purchase the coverage by requesting it in writing from the

insurer. Each renewal must include a copy of the form offering such coverage.

      4.  An insurer who makes a payment to an

injured person on account of underinsured vehicle coverage as described in

subsection 2 is not entitled to subrogation against the underinsured motorist

who is liable for damages to the injured payee. This subsection does not affect

the right or remedy of an insurer under subsection 5 of NRS 690B.020 with respect to uninsured

vehicle coverage. As used in this subsection, “damages” means the amount for which

the underinsured motorist is alleged to be liable to the claimant in excess of

the limits of bodily injury coverage set by the underinsured motorist’s policy

of casualty insurance.

      5.  An insurer need not offer, provide or

make available uninsured or underinsured vehicle coverage in connection with a

general commercial liability policy, an excess policy, an umbrella policy or

other policy that does not provide primary motor vehicle insurance for

liabilities arising out of the ownership, maintenance, operation or use of a

specifically insured motor vehicle.

      6.  As used in this section:

      (a) “Excess policy” means a policy that protects

a person against loss in excess of a stated amount or in excess of coverage

provided pursuant to another insurance contract.

      (b) “Passenger car” has the meaning ascribed to

it in NRS 482.087.

      (c) “Umbrella policy” means a policy that protects

a person against losses in excess of the underlying amount required to be

covered by other policies.

      (Added to NRS by 1979, 1090; A 1981, 15; 1983, 1105; 1989, 1567, 1846; 1991, 1943; 1997, 3032; 2003, 3312)

      NRS 687B.147  Exclusion, reduction or limitation of certain coverage in motor

vehicle insurance policies allowed; conditions; form and contents of

disclosure.  A policy of motor

vehicle insurance covering a private passenger car may be delivered or issued

for delivery in this state if it contains an exclusion, reduction or other

limitation of coverage for the liability of any named insured for bodily injury

to:

      1.  Another named insured; or

      2.  Any member of the household of a named

insured,

Ê unless the

named insured rejects the exclusion, reduction or other limitation of coverage

after full disclosure of the limitation by the insurer on a form approved by

the Commissioner. The form must be written in a manner which is easily

understood, printed in at least 12-point type and contain the statement “I

understand that this policy excludes, reduces and limits coverage for bodily

injury to members of my family and other named insureds, including the

following persons:” (followed by a list of the names of the family members and

other named insureds whose coverage has been excluded, reduced or limited). The

list of names must be handwritten by the insured and followed by the full

signature of the insured. The disclosed exclusion, reduction or other

limitation of coverage continues until the named insured notifies the insurer

in writing of the desire of the insured to reject it. The insurer must disclose

upon renewal of the policy that coverage has been excluded, reduced or limited

and that the named insured has the right to reject the exclusion, reduction or

limitation. The insurer must also disclose to the named insured upon renewal

any additional motor vehicle coverages that the insurer sells. These

disclosures must be written in a form easily understood and printed in at least

12-point type.

      (Added to NRS by 1989, 1851)

      NRS 687B.150  Inclusion of portion of charter or bylaws.

      1.  No policy shall contain any provision

purporting to make any portion of the charter, bylaws or other constituent

document of the insurer (other than the subscriber’s agreement or power of

attorney of a reciprocal insurer) a part of the contract unless such portion is

set forth in full in the policy.

      2.  Any policy provision in violation of

this section is invalid.

      (Added to NRS by 1971, 1718)

      NRS 687B.160  Execution of policies.

      1.  Every insurance policy must be executed

in the name of and on behalf of the insurer by its officer, attorney-in-fact,

employee or representative duly authorized by the insurer.

      2.  Any such executing individual may use,

in lieu of an original signature:

      (a) A facsimile signature; or

      (b) An electronic signature pursuant to the

provisions of chapter 719 of NRS.

      3.  An insurance contract issued before, on

or after January 1, 1972, which is otherwise valid is not rendered invalid by

reason of the apparent execution thereof on behalf of the insurer by the

imprinted facsimile signature of an individual not authorized so to execute as

of the date of the policy.

      (Added to NRS by 1971, 1718; A 1997, 1625; 2003, 2806)

      NRS 687B.170  Underwriters’ and combination policies.

      1.  Two or more authorized insurers may

jointly issue, and shall be jointly and severally liable on, an underwriters’

policy bearing their names. Any one insurer may issue policies in the name of

an underwriter’s department and such policy shall plainly show the true name of

the insurer.

      2.  Two or more insurers may, with the

approval of the Commissioner, issue a combination policy which shall contain

provisions substantially as follows:

      (a) That the insurers executing the policy shall

be severally liable for the full amount of any loss or damage, according to the

terms of the policy, or for specified percentages or amounts thereof,

aggregating the full amount of insurance under the policy; and

      (b) That service of process, or of any notice or

proof of loss required by such policy, upon any of the insurers executing the

policy, shall constitute service upon all such insurers.

      3.  This section does not apply to cosurety

obligations.

      (Added to NRS by 1971, 1719)

      NRS 687B.180  Validity and construction of noncomplying forms.

      1.  A policy delivered or issued for

delivery after January 1, 1972, to any person in this state in violation of

this Code but otherwise binding on the insurer, shall be held valid, but shall

be construed as provided in this Code.

      2.  Any condition, omission or provision

not in compliance with the requirements of this Code and contained in any

policy, rider or endorsement issued after January 1, 1972, and otherwise valid

shall not thereby be rendered invalid but shall be construed and applied in

accordance with such condition, omission or provision as would have applied had

the same been in full compliance with this Code.

      (Added to NRS by 1971, 1719)

      NRS 687B.182  Binders: Issuance; effective dates.

      1.  A binder may be issued only by a

resident or nonresident agent appointed by the insurer which is to issue the

policy.

      2.  Except as provided in subsection 3, a

binder must not be effective for more than 90 days.

      3.  The effective period of a binder may be

extended 30 days at a time with the written approval of the Commissioner.

      (Added to NRS by 1983, 1120)

      NRS 687B.183  Binders: Forms; required statement; delivery.

      1.  All written binders must be made on

forms approved by the Commissioner.

      2.  A binder related to a policy of

insurance which provides coverage of less than $1,000,000 must contain a

statement printed in at least 10-point bold type that any person who refuses to

accept the binder as proof of insurance pursuant to the provisions of NRS 687B.186 is subject to the penalties provided in

that section.

      3.  If a binder is in writing, one copy

must be delivered either in person or by mailing first class to:

      (a) The insured; and

      (b) The insurer providing coverage under the

binder,

Ê within 24

hours after the binder becomes effective.

      (Added to NRS by 1983, 1120; A 1985, 1161)

      NRS 687B.184  Binders: Form and premium for policy issued as replacement.

      1.  A policy which is issued to replace a

binder must include:

      (a) Limits of coverage which are equal to the

limits stated in the binder; and

      (b) An effective date for the policy which is the

same as the effective date of the initial binder.

      2.  The premium for such a policy must

include the charge for the period covered by the binder and that charge must be

in accordance with rates filed with the Commissioner pursuant to chapter 686B of NRS.

      (Added to NRS by 1983, 1120)

      NRS 687B.185  Binders: Prohibition of use to lower premiums.  An insurer may not use a binder as a means to

lower a premium which an insured is charged.

      (Added to NRS by 1983, 1121)

      NRS 687B.186  Binders: Proof of insurance coverage.

      1.  A binder which is issued in accordance

with NRS 687B.182 to 687B.187,

inclusive, shall be deemed a policy for the purpose of proving that a person

has insurance coverage.

      2.  Any party to a contract or other

agreement who refuses to accept such a binder as proof of insurance when that

proof is required by that contract or agreement:

      (a) Shall be fined not more than $500.

      (b) Is liable to the party presenting the binder

as proof of insurance for actual damages sustained therefrom.

      3.  The provisions of this section do not

apply to a binder related to a policy of insurance which provides coverage of

at least $1,000,000.

      (Added to NRS by 1983, 1121; A 1985, 1161)

      NRS 687B.187  Binders: Disapproval of insurer.  NRS 687B.182 to 687B.187,

inclusive, do not prevent the exercise of a right to disapprove of the insurer

or its representative on the basis of:

      1.  The adequacy and terms of the coverage

with respect to the interest of the vendor, lender, lessor or other person

providing a service to the insured;

      2.  The financial standards to be met by

the insurer; or

      3.  The ability of the insurer or its

representative to service the policy.

      (Added to NRS by 1983, 1120)

      NRS 687B.190  Delivery of policy.

      1.  If the original policy is delivered or

is so required to be delivered to or for deposit with any vendor, mortgagee or

pledgee of any motor vehicle, in which policy any interest of the vendee,

mortgagor or pledgor in or with reference to such vehicle is insured, a

duplicate of such policy setting forth the name and address of the insurer,

insurance classification of vehicle, type of coverage, limits of liability,

premiums for the respective coverages and duration of the policy, or memorandum

thereof containing the same such information, shall be delivered by the vendor,

mortgagee or pledgee to each such vendee, mortgagor or pledgor named in the

policy or coming within the group of persons designated in the policy to be so

included. If the policy does not provide coverage of legal liability for injury

to persons or damage to the property of third parties, a statement of such fact

shall be printed, written or stamped conspicuously on the face of such duplicate

policy or memorandum.

      2.  This section does not apply to inland

marine floater policies.

      (Added to NRS by 1971, 1719)

      NRS 687B.200  Assignability.

      1.  The purpose of this section is to

confirm and clarify the right to provide for an assignment by which a person

covered by a life or health insurance policy may divest himself or herself of

all incidents of ownership provided by the policy, including the conversion

privileges of the policy.

      2.  Any person insured under a life or

health insurance policy may make an assignment of all or any part of the

incidents of ownership of the person under the policy, including, but not

limited to, the privilege to have issued to the person an individual policy of

life or health insurance pursuant to the provisions of this Code and the right to

name a beneficiary. Subject to the terms of the policy or agreement between the

insured, the policyholder and the insurer relating to assignment of incidents

of ownership thereunder, such an assignment by an insured, whenever made, is

valid for the purpose of vesting in the assignee all of the incidents of

ownership so assigned. Such an assignment does not prejudice the insurer on

account of any payment it may make or individual policy it may issue prior to

receipt of notice of the assignment.

      3.  This section also applies to contracts

issued by organizations for dental care and nonprofit hospital, medical and

dental service corporations.

      (Added to NRS by 1971, 1720; A 1983, 2029)

      NRS 687B.210  Payment discharges insurer.

      1.  Whenever the proceeds of or payments

under a life or health insurance policy or annuity contract issued before, on

or after January 1, 1972, become payable in accordance with the terms of the

policy or contract, or the exercise of any right or privilege thereunder, and

the insurer makes payment thereof in accordance therewith or in accordance with

any written assignment thereof, the person then designated as being entitled

thereto is entitled to receive the proceeds or payments and to give full

acquittance therefor, and the payments fully discharge the insurer from all

claims under the policy or contract unless, before payment is made, the insurer

has received at its home office written notice by or on behalf of some other

person that the other person claims to be entitled to the payment or some

interest in the policy or contract.

      2.  This section also applies to contracts

issued by organizations for dental care and nonprofit hospital, medical and

dental service corporations.

      (Added to NRS by 1971, 1720; A 1983, 2029; 1997, 1625)

      NRS 687B.220  Forms for proof of loss to be furnished.  Upon receiving due notice of a claim of loss

under an insurance contract issued or assumed by it, an insurer shall promptly

furnish to the insured claimant such forms of proof of loss as it may require, for

completion by such person, but such insurer shall not, by reason of the

requirement so to furnish forms, have any responsibility for or with reference

to the completion of such proof or the manner of any such completion or

attempted completion.

      (Added to NRS by 1971, 1720)

      NRS 687B.225  Requirements for contracts for payment of cost of medical or

dental care which require prior authorization of care.

      1.  Except as otherwise provided in NRS 689A.0405, 689A.0413, 689A.044, 689A.0445, 689B.031, 689B.0313, 689B.0317, 689B.0374, 695B.1912, 695B.1914, 695B.1925, 695B.1942, 695C.1713, 695C.1735, 695C.1745, 695C.1751, 695G.170, 695G.171 and 695G.177, any contract for group,

blanket or individual health insurance or any contract by a nonprofit hospital,

medical or dental service corporation or organization for dental care which

provides for payment of a certain part of medical or dental care may require

the insured or member to obtain prior authorization for that care from the

insurer or organization. The insurer or organization shall:

      (a) File its procedure for obtaining approval of

care pursuant to this section for approval by the Commissioner; and

      (b) Respond to any request for approval by the

insured or member pursuant to this section within 20 days after it receives the

request.

      2.  The procedure for prior authorization

may not discriminate among persons licensed to provide the covered care.

      (Added to NRS by 1983, 2028; A 1985, 2098; 1997, 307, 1729; 1999, 1943; 2007, 3236)

      NRS 687B.240  Administration of claims not waiver.  Without

limitation of any right or defense of an insurer otherwise, none of the

following acts by or on behalf of an insurer shall be deemed to constitute a

waiver of any provision of a policy or of any defense of the insurer

thereunder:

      1.  Acknowledgment of the receipt of notice

of loss or claim under the policy.

      2.  Furnishing forms for reporting a loss

or claim, for giving information relative thereto, or for making proof of loss,

or receiving or acknowledging receipt of any such forms or proofs completed or

uncompleted.

      3.  Investigating any loss or claim under

any policy or engaging in negotiations looking toward a possible settlement of

any such loss or claim.

      (Added to NRS by 1971, 1721)

      NRS 687B.250  Payment not to constitute admission of liability or waiver of

defenses.

      1.  No payment or payments made by any

person, or by an insurer of the person by virtue of a liability insurance

policy, on account of bodily injury or death or damage to or loss of property

of another shall constitute an admission of liability or waiver of defenses as

to such injury, death, loss or damage, or be admissible in evidence in any

action brought against the insured person or the insurer of the person for

damages, indemnity or benefits arising out of such injury, death, loss or

damage, unless pleaded as a defense to the action.

      2.  All such payments shall be credited

upon any settlement made by, or judgment rendered in such an action against,

the payer or the insurer of the payer, and in favor of any person to whom or on

whose account payment was made.

      (Added to NRS by 1971, 1721)

      NRS 687B.255  Insurer to pay claim with negotiable instrument.  If an insurer is required to pay a claim, the

insurer shall pay that claim with an instrument which is immediately

negotiable. An insurer shall be deemed to have complied with the provisions of

this section if the insurer enters into an agreement, with a bank located in

this state, which provides that the bank will accept the insurer’s drafts in as

timely a manner as it accepts the insurer’s checks.

      (Added to NRS by 1989, 1799)

      NRS 687B.260  Exemption of proceeds of certain policies.

      1.  If a policy of insurance, whether

issued before, on or after January 1, 1972, is effected by any person on his or

her own life, or on another life, in favor of a person other than himself or

herself, or, except in cases of transfer with intent to defraud creditors, if a

policy of life insurance is assigned or in any way made payable to any such

person, the lawful beneficiary or assignee thereof, other than the insured or

the person so effecting such insurance or executors or administrators of the

insured or the person so effecting such insurance, is entitled to its proceeds

and avails against the creditors and representatives of the insured and of the

person effecting the same, whether or not the right to change the beneficiary

is reserved or permitted and whether or not the policy is made payable to the

person whose life is insured or to the executors or administrators of such

person if the beneficiary or assignee predeceases the person. Except as

otherwise provided in this subsection, such proceeds and avails are exempt from

all liability for any debt of the beneficiary existing at the time the proceeds

and avails are made available for the use of the beneficiary. Subject to the

statute of limitations, the amount of any premiums for such insurance paid with

intent to defraud creditors, with interest thereon, inures to the benefit of

the creditors from the proceeds of the policy. The insurer issuing the policy

is discharged of all liability thereon by payment of its proceeds in accordance

with its terms, unless, before the payment, the insurer has received written

notice at its home office, by or in behalf of a creditor, of a claim to recover

for transfer made or premiums paid with intent to defraud creditors, with specification

of the amount claimed along with such facts as will assist the insurer to

ascertain the particular policy.

      2.  For the purposes of subsection 1, a

policy shall also be deemed to be payable to a person other than the insured if

and to the extent that a facility-of-payment clause or a similar clause in the

policy permits the insurer to discharge its obligation after the death of the

individual insured by paying the death benefits to a person as permitted by

such a clause.

      3.  This section does not apply to

insurance issued pursuant to this Code to a creditor covering his or her

debtors to the extent that such proceeds are applied to payment of the

obligation for the purpose of which the insurance was so issued.

      (Added to NRS by 1971, 1722; A 1997, 1625)

      NRS 687B.270  Exemption of proceeds: Health insurance.

      1.  Except as otherwise expressly provided

by the policy or contract, the proceeds and avails of all contracts of health

insurance and of provisions providing benefits on account of the disability of

the insured which are supplemental to life insurance or annuity contracts

effected before, on or after January 1, 1972, are exempt from all liability for

any debt of the insured, and from any debt of the beneficiary existing at the

time the proceeds are made available for the use of the beneficiary.

      2.  This section does not apply to

insurance issued pursuant to this Code to a creditor covering his or her

debtors to the extent that such proceeds are applied to payment of the

obligation for the purpose of which the insurance was so issued.

      (Added to NRS by 1971, 1722; A 1997, 1626)

      NRS 687B.280  Exemption of proceeds: Group insurance.

      1.  A policy of group life insurance or

group health insurance or the proceeds thereof payable to the individual

insured or to the beneficiary thereunder shall not be liable, either before or

after payment, to be applied by any legal or equitable process to pay any debt

or liability of such insured individual or his or her beneficiary or of any

other person having a right under the policy. The proceeds thereof, when not

made payable to a named beneficiary or to a third person pursuant to a

facility-of-payment clause, shall not constitute a part of the estate of the

individual insured for the payment of the debts of the individual insured.

      2.  This section does not apply to group

insurance issued pursuant to this Code to a creditor covering his or her

debtors, to the extent that such proceeds are applied to payments of the

obligation for the purpose of which the insurance was so issued.

      (Added to NRS by 1971, 1723)

      NRS 687B.290  Exemption of proceeds: Annuities; assignability of rights.

      1.  The benefits, rights, privileges and

options which under any annuity contract issued prior to or after January 1,

1972, are due or prospectively due the annuitant shall not be subject to

execution nor shall the annuitant be compelled to exercise any such rights,

powers or options, nor shall creditors be allowed to interfere with or

terminate the contract, except as to amounts paid for or as premium on any such

annuity with intent to defraud creditors, with interest thereon, and of which

the creditor has given the insurer written notice at its home office prior to

the making of the payment to the annuitant out of which the creditor seeks to

recover. Any such notice shall specify the amount claimed or such facts as will

enable the insurer to ascertain such amount, and shall set forth such facts as

will enable the insurer to ascertain the annuity contract, the annuitant and

the payment sought to be avoided on the ground of fraud.

      2.  If the contract so provides, the

benefits, rights, privileges or options accruing under such contract to a

beneficiary or assignee shall not be transferable or subject to commutation,

and the same exemptions and exceptions contained in this section for the

annuitant shall apply with respect to such beneficiary or assignee.

      (Added to NRS by 1971, 1723; A 2011, 3571)

      NRS 687B.300  Retention of proceeds of policy by insurer.

      1.  Any life insurer shall have power to

hold payment of proceeds, as has been agreed to in writing by the insurer and

the insured or beneficiary. The insurer shall not be required to segregate

funds so held but may hold them as a part of its general corporate assets.

      2.  The provisions of this section shall

not impair or affect any rights of creditors under NRS

687B.260 or 687B.290.

      (Added to NRS by 1971, 1724)

      NRS 687B.310  Cancellations and nonrenewals; scope of application.

      1.  NRS 687B.310

to 687B.420, inclusive, apply to all binders and

all contracts of insurance the general terms of which are required to be

approved or are subject to disapproval by the Commissioner, except as otherwise

provided by statute or by rule pursuant to subsection 3.

      2.  The contract may provide terms more

favorable to policyholders than are required by NRS

687B.310 to 687B.420, inclusive.

      3.  The Commissioner may by rule exempt

from NRS 687B.310 to 687B.420,

inclusive, classes of insurance contracts where the policyholders do not need

protection against arbitrary termination.

      4.  The rights provided by NRS 687B.310 to 687B.420,

inclusive, are in addition to and do not prejudice any other rights the

policyholder may have at common law or under other statutes.

      5.  NRS 687B.310

to 687B.420, inclusive, do not prevent the

rescission or reformation of any life or health insurance contract not

otherwise denied by the terms of the contract or by any other statute.

      6.  Any notice to an insured required

pursuant to NRS 687B.320 to 687B.350, inclusive, must be personally delivered to

the insured or mailed first class or certified to the insured at the address of

the insured last known by the insurer. The notice must state the effective date

of the cancellation or nonrenewal and be accompanied by a written explanation

of the specific reasons for the cancellation or nonrenewal.

      (Added to NRS by 1971, 1724; A 1971, 1949; 1983, 1121; 1987, 985, 1063; 1993, 2399; 2003, 3313)

      NRS 687B.320  Midterm cancellation; exception.

      1.  Except as otherwise provided in

subsection 3, no insurance policy that has been in effect for at least 70 days

or that has been renewed may be cancelled by the insurer before the expiration

of the agreed term or 1 year from the effective date of the policy or renewal,

whichever occurs first, except on any one of the following grounds:

      (a) Failure to pay a premium when due;

      (b) Conviction of the insured of a crime arising

out of acts increasing the hazard insured against;

      (c) Discovery of fraud or material

misrepresentation in the obtaining of the policy or in the presentation of a

claim thereunder;

      (d) Discovery of:

             (1) An act or omission; or

             (2) A violation of any condition of the

policy,

Ê which

occurred after the first effective date of the current policy and substantially

and materially increases the hazard insured against;

      (e) A material change in the nature or extent of

the risk, occurring after the first effective date of the current policy, which

causes the risk of loss to be substantially and materially increased beyond

that contemplated at the time the policy was issued or last renewed;

      (f) A determination by the Commissioner that

continuation of the insurer’s present volume of premiums would jeopardize the

insurer’s solvency or be hazardous to the interests of policyholders of the

insurer, its creditors or the public; or

      (g) A determination by the Commissioner that the

continuation of the policy would violate, or place the insurer in violation of,

any provision of the Code.

      2.  No cancellation under subsection 1 is

effective until in the case of paragraph (a) of subsection 1 at least 10 days

and in the case of any other paragraph of subsection 1, at least 30 days after

the notice is delivered or mailed to the policyholder.

      3.  The provisions of this section do not

apply to a policy of industrial insurance.

      (Added to NRS by 1971, 1724; A 1987, 986; 2003, 3313)

      NRS 687B.325  Industrial insurance policies: Midterm cancellation; notice to

policyholder.

      1.  No policy of industrial insurance that

has been in effect for at least 70 days or that has been renewed may be

cancelled by the insurer before the expiration of the agreed term or 1 year

after the effective date of the policy or renewal, whichever occurs first,

except on any one of the following grounds:

      (a) A failure by the policyholder to pay a

premium for the policy of industrial insurance when due, including the failure

of the policyholder to remit an amount due because of an endorsement for a

deductible;

      (b) A failure by the policyholder to:

             (1) Report any payroll;

             (2) Allow the insurer to audit any payroll

in accordance with the terms of the policy or any previous policy issued by the

insurer; or

             (3) Pay any additional premium charged

because of an audit of any payroll as required by the terms of the policy or

any previous policy issued by the insurer;

      (c) A material failure by the policyholder to

comply with any federal or state order concerning safety or any written

recommendation of the insurer’s designated representative for loss control;

      (d) A material change in ownership of the

policyholder or any change in the policyholder’s business or operations that:

             (1) Materially increases the hazard for

frequency or severity of loss;

             (2) Requires additional or different

classifications for the calculation of premiums; or

             (3) Contemplates an activity that is

excluded by any reinsurance treaty of the insurer;

      (e) A material misrepresentation made by the

policyholder; or

      (f) A failure by the policyholder to cooperate

with the insurer in conducting an investigation of a claim.

      2.  An insurer shall not cancel a policy of

industrial insurance pursuant to paragraph (a) of subsection 1 except upon 10

days’ written notice submitted by the insurer to the policyholder.

      3.  Except as otherwise provided in this

subsection, an insurer shall not cancel a policy of industrial insurance

pursuant to paragraph (b), (c), (d), (e) or (f) of subsection 1 except upon 30

days’ written notice by the insurer to the policyholder. An insurer is not

required to provide a written notice to a policyholder pursuant to this

subsection if the policyholder and the insurer consent to the cancellation of

the policy of industrial insurance and to the reissuance of another policy of

industrial insurance effective upon a material change in the ownership or

operations of the insured. If the policyholder corrects the condition to the

satisfaction of the insurer within the period specified in the policy of

insurance, the insurer shall not cancel the policy.

      4.  Any written notice submitted to a

policyholder pursuant to this section must be given by first-class mail

addressed to the policyholder at the address of the policyholder set forth in

the policy of industrial insurance. Evidence indicating that a written notice

specified in this section has been mailed is sufficient proof of notice.

      5.  The provisions of this section do not

prohibit, during any period in which a policy of industrial insurance is in

force, any change in the premium rate required or authorized by any law,

regulation or order of the Commissioner, or otherwise agreed upon by the

policyholder and the insurer.

      6.  For the purposes of this section, any

policy of industrial insurance that is written for a term of more than 1 year,

or any policy of industrial insurance with no fixed date of expiration, shall

be deemed to be written for successive periods of 1 year.

      (Added to NRS by 2003, 3310; A 2005, 2134)

      NRS 687B.330  Anniversary cancellation.  A

policy issued for a term longer than 1 year may be cancelled by the insurer by

giving notice of the cancellation:

      1.  For commercial or business policies, 60

days before any anniversary date of the policy.

      2.  For all other policies, 30 days before

any anniversary date of the policy.

      (Added to NRS by 1971, 1725; A 1987, 987)

      NRS 687B.340  Nonrenewals.

      1.  Subject to subsection 2, a policyholder

has a right to have his or her policy renewed, on the terms then being applied

by the insurer to persons, similarly situated, for an additional period

equivalent to the expiring term if the agreed term is 1 year or less, or for 1

year if the agreed term is longer than 1 year, unless:

      (a) At least 60 days for commercial or business

policies; and

      (b) At least 30 days for all other policies,

Ê before the

date of expiration provided in the policy the insurer mails or delivers to the

policyholder a notice of intention not to renew the policy beyond the agreed expiration

date. If an insurer fails to provide a timely notice of nonrenewal, the insurer

shall provide the insured with a policy of insurance on the identical terms as

in the expiring policy.

      2.  This section does not apply if the

policyholder has accepted replacement coverage or has requested or agreed to

nonrenewal, or if the policy is expressly designated as nonrenewable by a

clause approved or deemed to be approved by the Commissioner.

      (Added to NRS by 1971, 1725; A 1971, 1950; 1987, 987)

      NRS 687B.345  Annual review of coverage and benefits provided in policy.  Each insurer who delivers a policy in this

state which is effective for 1 year or more may, for the period in which the

policy is effective, review annually with the policyholder to whom the policy

is delivered the coverage and benefits provided in the policy.

      (Added to NRS by 1995, 1747)

      NRS 687B.350  Renewal with altered terms.

      1.  Except as otherwise provided in

subsection 2, an insurer shall not renew a policy on different terms, including

different rates, unless the insurer notifies the insured in writing of the

different terms or rates at least 30 days before the expiration of the policy.

If the insurer fails to provide adequate and timely notice, the insurer shall

renew the policy at the expiring terms and rates:

      (a) For a period that is equal to the expiring

term if the agreed term is 1 year or less; or

      (b) For 1 year if the agreed term is more than 1

year.

      2.  The provisions of this section do not

apply to a change in the rate for a policy of industrial insurance which is

based on:

      (a) A change to a prospective loss cost filed by

the Advisory Organization pursuant to NRS

686B.177 that is applicable to the risk; or

      (b) A correction based on the experience that is

applicable to the risk in accordance with the Uniform Plan for Rating

Experience filed with the Commissioner pursuant to NRS 686B.177.

      (Added to NRS by 1971, 1725; A 1995, 1747; 2003, 3314; 2007, 3322)

      NRS 687B.355  Information about claims paid on behalf of policyholder;

regulations.

      1.  If a policyholder requests information

for the renewal of his or her policy, an insurer shall provide to the

policyholder information regarding claims paid on behalf of the policyholder.

The information must be provided within 30 working days after the insurer

receives a written request from the policyholder. The insurer may charge the

policyholder a reasonable fee for the information.

      2.  The Commissioner may adopt regulations

to carry out the provisions of subsection 1.

      (Added to NRS by 1991, 2033)

      NRS 687B.360  Information about grounds.  If

a notice of cancellation or nonrenewal under NRS

687B.310 to 687B.420, inclusive, does not

state with reasonable precision the facts on which the insurer’s decision is

based, the insurer shall supply that information within 6 days after receipt of

a written request by the policyholder. No notice is effective unless it

contains adequate information about the policyholder’s right to make such a

request.

      (Added to NRS by 1971, 1725; A 1971, 1950; 1993, 2399; 2003, 3314)

      NRS 687B.370  Information about applying for insurance through certain plans;

exception.  Except for a notice of

cancellation for the failure to pay a premium when due, no notice required

pursuant to NRS 687B.310 to 687B.420, inclusive, is effective unless it contains

adequate instructions enabling the policyholder to apply for insurance through

any voluntary or mandatory risk-sharing plan established pursuant to NRS 686B.180 and 686B.200 existing at the time of the

notice, for which the policyholder may be eligible.

      (Added to NRS by 1971, 1726; A 1985, 577; 1993, 2400; 2003, 3314)

      NRS 687B.380  Immunity.  There is

no liability on the part of and no cause of action of any nature may arise

against any insurer, its authorized representative, its agents, its employees,

or any person furnishing to the insurer information as to reasons for

cancellation or nonrenewal, for any statement made by them in complying with NRS 687B.310 to 687B.420,

inclusive, or for the providing of information pertaining thereto.

      (Added to NRS by 1971, 1726; A 1993, 2400; 2003, 3315)

      NRS 687B.385  Cancellation, nonrenewal or increase in premium due to claims

for which insured was not at fault prohibited.  An

insurer shall not cancel, refuse to renew or increase the premium for renewal

of a policy of motor vehicle insurance covering private passenger cars or

commercial vehicles as a result of any claims made under the policy with

respect to which the insured was not at fault.

      (Added to NRS by 1987, 1063; A 1997, 3033)

      NRS 687B.390  Cancellation or nonrenewal on sole basis of age, residence,

race, color, creed, national origin, ancestry or occupation prohibited.  No insurer shall cancel or refuse to renew an

automobile liability insurance policy solely because of the age, residence,

race, color, creed, national origin, ancestry or occupation of anyone who is an

insured.

      (Added to NRS by 1971, 1726)

      NRS 687B.400  Discrimination on sole basis of age prohibited; burden of proof;

exception.

      1.  No insurer shall refuse to issue,

reduce liability limits of, or increase the premium of any automobile liability

insurance policy issued to a resident of this state for the sole reason that

the policyholder has reached a certain age.

      2.  Where age is a factor in an increase of

rates for an individual policyholder, the increase must be justified to the

Commissioner and the burden of proving justification is on the insurer. If a

medical examination is required for the purpose of a rate increase, such

examination shall be at the expense of the insurer.

      3.  This section does not apply to

applicants and policyholders under the age of 25 years.

      (Added to NRS by 1973, 251)

      NRS 687B.402  Compliance with certain federal laws regarding genetic

information.  An insurer or other

organization providing health coverage pursuant to chapter 689A, 689B,

689C, 695A,

695B, 695C,

695D or 695F

of NRS shall comply with the provisions of the Genetic Information

Nondiscrimination Act of 2008, Public Law 110-233, and any federal regulations

issued pursuant thereto.

      (Added to NRS by 2009, 1785)

      NRS 687B.404  Compliance with certain federal laws regarding mental health and

addiction.  An insurer or other

organization providing health coverage pursuant to chapter 689B, 695A,

695B, 695C

or 695F of NRS shall comply with the

provisions of the Paul Wellstone and Pete Domenici Mental Health Parity and

Addiction Equity Act of 2008, Public Law 110-343, Division C, Title V, Subtitle

B, and any federal regulations issued pursuant thereto.

      (Added to NRS by 2009, 1785)

      NRS 687B.406  Compliance with certain federal laws regarding dependent

students.  An insurer or other

organization providing health coverage pursuant to chapter 689B, 689C,

695A, 695B,

695C or 695F

of NRS shall comply with the provisions of Michelle’s Law, Public Law 110-381,

and any federal regulations issued pursuant thereto.

      (Added to NRS by 2009, 1785)

      NRS 687B.408  Notifications required concerning changes related to

prescription drugs used for transplanted organs.  If

a policy of health insurance issued pursuant to chapter

689A, 689B, 689C, 695A,

695B, 695C

or 695G of NRS includes coverage for a

prescription drug that is necessary for an insured to prevent the rejection of

a transplanted organ, the insurer must notify the insured and, if known, the

physician of the insured who prescribed the drug at least 30 days before a

change in the formulary of the insurer within the plan year which affects that

prescription becomes effective.

      (Added to NRS by 2009, 1785)

      NRS 687B.410  Withdrawal of insurance for particular class of insureds:

Notice; administrative review.

      1.  An insurer which intends to withdraw

from providing insurance for a particular class of insureds shall notify the

Commissioner of that intention at least 60 days before the notice of

cancellation or nonrenewal is delivered or mailed to the insureds.

      2.  Upon receipt of a written request from

an insured, the Division shall, within 15 days after the receipt of the

request, review the ground for cancellation or nonrenewal. If after the review

the Division fails to find that the insurer can demonstrate the grounds for

cancellation or nonrenewal by clear and convincing evidence, the cancellation

or nonrenewal shall be deemed withdrawn by the insurer and the policy

reinstated or renewed. Such a request for review by the Division must be made

within 30 days after the insured receives the notice of cancellation or

nonrenewal.

      (Added to NRS by 1987, 985; A 1991, 1631; 1993, 1918)

      NRS 687B.420  Notice of proposed cancellation, nonrenewal or alteration of

terms of certain policies or contracts of insurance.  An

insurer shall not cancel, fail to renew or renew with altered terms a policy or

contract issued pursuant to chapter 688B, 689A, 689B,

689C, 695A,

695B, 695C,

695D or 695F

of NRS unless notice in writing of the proposal is given to the insured at

least 60 days before the date the proposed action becomes effective. The notice

must include, without limitation, any changes in specific rates by line of

coverage.

      (Added to NRS by 1989, 1248; A 1993, 1982, 2400, 2405)

      NRS 687B.430  Regulations: Policies which provide for payment of expenses not

covered by Medicare; sale of more than one policy of health insurance to same

person.

      1.  The Commissioner may adopt regulations

relating to the form, content and sale of policies of insurance which provide

for the payment of expenses which are not covered by Medicare.

      2.  The Commissioner may adopt regulations

relating to the sale of more than one policy of health insurance to the same

person.

      3.  As used in this section, “Medicare”

means the program of health insurance for aged persons and persons with

disabilities established pursuant to Title XVIII of the Social Security Act (42

U.S.C. §§ 1395 et seq.).

      (Added to NRS by 1993, 2398)

      NRS 687B.440  Umbrella policies: Disclosure statement indicating whether

policy includes uninsured or underinsured motorist coverage; form.

      1.  An insurer offering an umbrella policy

to an individual shall obtain a signed disclosure statement from the individual

indicating whether the umbrella policy includes uninsured or underinsured

vehicle coverage.

      2.  The disclosure statement for an

umbrella policy that includes uninsured or underinsured vehicle coverage must

be on a form provided by the Commissioner or in substantially the following

form:

 

UMBRELLA

POLICY DISCLOSURE STATEMENT

UNINSURED/UNDERINSURED

VEHICLE COVERAGE

 

¨

Your Umbrella Policy does provide coverage in excess of the

limits of the uninsured/underinsured vehicle coverage in your primary

auto insurance only if the requirements for the uninsured/underinsured vehicle

coverage in your underlying auto insurance are maintained. Your

uninsured/underinsured vehicle coverage provided by this umbrella policy is

limited to $........ .

 

I understand and acknowledge the

above disclosure.

 

..................................................                 ...............................

Insured                                                      Date

 

      3.  The disclosure statement for an

umbrella policy that does not include uninsured or underinsured vehicle coverage

must be on a form provided by the commissioner or in substantially the

following form:

 

¨

Your Umbrella Liability Policy does not provide any

uninsured/underinsured vehicle coverage.

 

I understand and acknowledge the

above disclosure.

 

..................................................                 ...............................

Insured                                                      Date

 

      4.  As used in this section, “umbrella

policy” means a policy that protects a person against losses in excess of the

underlying amount required to be covered by other policies.

      (Added to NRS by 1997, 3031; A 1999, 2801)

      NRS 687B.450  Required medical examination; potentially serious medical

condition; notification.

      1.  Except as otherwise provided in this

subsection, if an insurer requires a medical examination of an applicant or an

insured before the issuance, renewal, reinstatement or reevaluation of the

terms of any policy or certificate of insurance or annuity contract, the

insurer shall:

      (a) If the applicant or insured has a primary

care physician, notify:

             (1) The physician of any potentially

serious medical condition that is detected as a result of that medical

examination; and

             (2) The applicant or insured:

                   (I) Of any potentially serious

medical condition that is detected as a result of that medical examination; and

                   (II) That the primary care physician

of the applicant or insured has also been notified of any potentially serious

medical condition detected as a result of that medical examination.

      (b) If the applicant or insured does not have a

primary care physician, notify the applicant or insured of any potentially serious

medical condition that is detected as a result of that medical examination.

Ê Any notice

required pursuant to this section must be sent by registered or certified mail

not later than 30 days after the date on which the potentially serious medical

condition is detected. If the applicant or insured is under the age of 18

years, any notice required pursuant to this section must not be sent to the

applicant or insured, but instead must be sent to a parent or legal guardian of

the applicant or insured.

      2.  The Commissioner may adopt regulations

to carry out the provisions of this section.

      3.  The provisions of this section do not

apply to a policy of workers’ compensation insurance or industrial insurance.

      4.  As used in this section, “potentially

serious medical condition” includes, without limitation, any medical condition

that:

      (a) Is life-threatening or potentially

life-threatening if it is not treated immediately or is not closely monitored;

or

      (b) Causes the insurer to refuse to issue, renew,

reinstate or reevaluate the terms of a policy or certificate of insurance or

annuity contract.

      (Added to NRS by 2007, 249)

      NRS 687B.460  Certificates of insurance for property or casualty insurance.  A certificate of insurance issued regarding a

contract or policy of property or casualty insurance, other than a group master

policy, which is delivered or issued for delivery in this State:

      1.  Does not constitute any part of the

contract or policy of insurance; and

      2.  Does not amend any term or alter or

extend any coverage, exclusion or condition of the contract or policy of

insurance.

      (Added to NRS by 2011, 1834)

      NRS 687B.470  Health benefit plans: “Health benefit plan” defined.

      1.  “Health benefit plan” means a policy,

contract, certificate or agreement offered by a carrier to provide for, deliver

payment for, arrange for the payment of, pay for or reimburse any of the costs

of health care services. Except as otherwise provided in this section, the term

includes catastrophic health insurance policies and a policy that pays on a

cost-incurred basis.

      2.  The term does not include:

      (a) Coverage that is only for accident or

disability income insurance, or any combination thereof;

      (b) Coverage issued as a supplement to liability

insurance;

      (c) Liability insurance, including general

liability insurance and automobile liability insurance;

      (d) Workers’ compensation or similar insurance;

      (e) Coverage for medical payments under a policy

of automobile insurance;

      (f) Credit insurance;

      (g) Coverage for on-site medical clinics;

      (h) Other similar insurance coverage specified

pursuant to the Health Insurance Portability and Accountability Act of 1996,

Public Law 104-191, under which benefits for medical care are secondary or

incidental to other insurance benefits;

      (i) Coverage under a short-term health insurance

policy; and

      (j) Coverage under a blanket student accident and

health insurance policy.

      3.  The term does not include the following

benefits if the benefits are provided under a separate policy, certificate or

contract of insurance or are otherwise not an integral part of a health benefit

plan:

      (a) Limited-scope dental or vision benefits;

      (b) Benefits for long-term care, nursing home

care, home health care or community-based care, or any combination thereof; and

      (c) Such other similar benefits as are specified

in any federal regulations adopted pursuant to the Health Insurance Portability

and Accountability Act of 1996, Public Law 104-191.

      4.  The term does not include the following

benefits if the benefits are provided under a separate policy, certificate or

contract, there is no coordination between the provisions of the benefits and

any exclusion of benefits under any group health plan maintained by the same

plan sponsor, and the benefits are paid for a claim without regard to whether

benefits are provided for such a claim under any group health plan maintained

by the same plan sponsor:

      (a) Coverage that is only for a specified disease

or illness; and

      (b) Hospital indemnity or other fixed indemnity

insurance.

      5.  The term does not include any of the

following, if offered as a separate policy, certificate or contract of

insurance:

      (a) Medicare supplemental health insurance as

defined in section 1882(g)(1) of the Social Security Act, 42 U.S.C. § 1395ss,

as that section existed on July 16, 1997;

      (b) Coverage supplemental to the coverage

provided pursuant to the Civilian Health and Medical Program of Uniformed

Services, CHAMPUS, 10 U.S.C. §§ 1071 et seq.; and

      (c) Similar supplemental coverage provided under

a group health plan.

      (Added to NRS by 2013, 3606)

      NRS 687B.480  Health benefit plans: Availability; waiting period; effective

date.

      1.  All health benefit plans must be made

available in the manner required by 45 C.F.R. § 147.104.

      2.  In addition to the requirements of

subsection 1, any health benefit plan for individuals that is not purchased on

the Silver State Health Insurance Exchange established by NRS 695I.210:

      (a) Must be made available for purchase at any

time during the calendar year;

      (b) Is subject to a waiting period of not more

than 90 days after the date on which the application for coverage was received;

      (c) Is effective upon the first day of the month

immediately succeeding the month in which the waiting period expires; and

      (d) Is not retroactive to the date on which the

application for coverage was received.

      (Added to NRS by 2013, 3607)

      NRS 687B.490  Health benefit plans: Carrier required to demonstrate capacity

to adequately deliver services; Commissioner to determine capacity; annual

summary.

      1.  A carrier that offers coverage in the

group or individual market must, before making any network plan available for

sale in this State, demonstrate the capacity to deliver services adequately by

applying to the Commissioner for the issuance of a network plan and submitting

a description of the procedures and programs to be implemented to meet the

requirements described in subsection 2.

      2.  The Commissioner shall determine,

within 90 days after receipt of the application required pursuant to subsection

1, if the carrier, with respect to the network plan:

      (a) Has demonstrated the willingness and ability

to ensure that health care services will be provided in a manner to ensure both

availability and accessibility of adequate personnel and facilities in a manner

that enhances availability, accessibility and continuity of service;

      (b) Has organizational arrangements established

in accordance with regulations promulgated by the Commissioner; and

      (c) Has a procedure established in accordance

with regulations promulgated by the Commissioner to develop, compile, evaluate

and report statistics relating to the cost of its operations, the pattern of

utilization of its services, the availability and accessibility of its services

and such other matters as may be reasonably required by the Commissioner.

      3.  The Commissioner may certify that the

carrier and the network plan meet the requirements of subsection 2, or may

determine that the carrier and the network plan do not meet such requirements.

Upon a determination that the carrier and the network plan do not meet the

requirements of subsection 2, the Commissioner shall specify in what respects

the carrier and the network plan are deficient.

      4.  A carrier approved to issue a network

plan pursuant to this section must file annually with the Commissioner a

summary of information compiled pursuant to subsection 2 in a manner determined

by the Commissioner.

      5.  The Commissioner shall, not less than

once each year, or more often if deemed necessary by the Commissioner for the

protection of the interests of the people of this State, make a determination

concerning the availability and accessibility of the health care services of

any network plan approved pursuant to this section.

      6.  The expense of any determination made

by the Commissioner pursuant to this section must be assessed against the

carrier and remitted to the Commissioner.

      7.  As used in this section, “network plan”

has the meaning ascribed to it in NRS

689B.570.

      (Added to NRS by 2013, 3607)

      NRS 687B.500  Health benefit plans: Basis for premium rate; exceptions.

      1.  The premium rate charged by a health

insurer for health benefit plans offered in the individual or small group

market may vary with respect to the particular plan or coverage involved based

solely on these characteristics:

      (a) Whether the plan or coverage applies to an

individual or a family;

      (b) Geographic rating area;

      (c) Tobacco use, except that the rate shall not

vary by a ratio of more than 1.5 to 1 for like individuals who vary in tobacco

use; and

      (d) Age, except that the rate must not vary by a

ratio of more than 3 to 1 for like individuals of different age who are age 21

years or older and that the variation in rate must be actuarially justified for

individuals who are under the age of 21 years, consistent with the uniform age

rating curve established in the Federal Act. For the purpose of identifying the

appropriate age adjustment under this paragraph and the age band defined in the

Federal Act to a specific enrollee, the enrollee’s age as of the date of policy

issuance or renewal must be used.

      2.  The provisions of subsection 1:

      (a) Apply to a fraternal benefit society

organized under chapter 695A of NRS; and

      (b) Do not apply to grandfathered plans.

      (Added to NRS by 2013, 3608)