Nevada 2019 Regular Session Status: Passed Senate

SB 235 — Revises provisions relating to health insurance coverage. (BDR 57-734)

Last action — (Pursuant to Joint Standing Rule No. 14.3.3, no further action allowed.)

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  1. ✓
    Introduced
  2. ✓
    In Committee
  3. 3
    Passed Senate
  4. 4
    Passed Assembly
  5. 5
    To Executive
  6. 6
    Enacted

This bill died with 2019 Regular Session. It reached “Passed Senate” and never advanced before the session ended, so it can no longer move — a new version would have to be reintroduced in the current session.

This bill is no longer active — its legislative session has ended, so there is no live prognosis. It would have to be reintroduced in the current session to move again.

Summary

AN ACT relating to insurance; requiring insurers to offer and issue a health benefit plan regardless of the health status of a person; and providing other matters properly relating thereto.

Bill Text

What changed in the latest version

916 added · 708 removed

916 line(s) added, 708 removed.

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S.B.
(Reprinted with amendments adopted on April 10, 2019) FIRST REPRINT S.B.
requiring insurers to offer and issue health insurance coverage regardless of the health status of a person;
requiring insurers to offer and issue a health benefit plan regardless of the health status of a person;
§ 300gg-4) Sections 1, 6, 9, 13, 14, 18, 19 and 23-26 of this insurance coverage regardless of the health status of a person;
§ 300gg-4) Sections 1, 6, 9, 13, 14, 18, 19, 23-25 and 26 of this benefit plan regardless of the health status of a person or group, as applicable;
and (2) prohibit anh insurer from denying, limiting or excluding a benefit or requiring an insured to pay a higher premium, deductible, coinsurance or copay based on the health status of the insured or the covered spouse or dependent of the insured.
andh (2) prohibit an insurer from denying, limiting or excluding a covered benefit or requiring an insured to pay a higher premium, deductible, coinsurance or copay based on the health status of the insured or the covered spouse or dependent of the insured.
Sections 3, 4, 7, 10- 12, 15, 17, 20, 21 and 29 of this bill remove partially duplicative provisions from existing law.
Sections 3, 4, 7, 10-12, 15, 17, 20, 21 and 29 of this bill remove partially duplicative provisions from existing law.
Existing law authorizes certain public officers and employees or the surviving insurance provided by the employer.
Federal regulations authorize a group health benefit plan to include a wellness C.F.R.
If such an insurance plan is considered alth grandfathered plan under the Patient Protection and Affordable Care Act, existing law authorizes such reinstatement to exclude claims for expenses for certain preexisting conditions.
§ 146.121) Sections 6, 9, 14, 18, 23 and 24 of this bill authorize group(45 health benefit plans issued in this State to include such wellness programs under the same conditions as prescribed by federal regulations.
(NRS 287.0205) The Patient Protection and Affordable Care - *SB235* – 2 – Act prohibits a grandfathered group plan from imposing such an exclusion.
- *SB235_R1* – 2 – spouse of such a retired officer or employee who is deceased to reinstate healthg insurance provided by the employer.
(42 U.S.C.
If such an insurance plan is considered a grandfathered plan under the Patient Protection and Affordable Care Act, existing law authorizes such reinstatement to exclude claims for expenses for certain preexisting conditions.
§§ 300gg-3, 18011(a)(4)(B)) Section 27 of this bill removes authorization for certain government insurance plans to exclude claims for preexisting conditions for reinstated coverage in conformance with federal law and sections 6 and 25 of this bill.
(NRS 287.0205) The Patient Protection and Affordable Care Act prohibits a grandfathered group plan from imposing such an exclusion.
Sections 5, 8, 16 and 29 of this bill remove other provisions of existing of this bill make other conforming changes.eexisting condition.
(42 for certain government insurance plans to exclude claims for preexisting conditions for reinstated coverage in conformance with federal law and sections 6 and 25 of this bill.
Sections 2 and 22 THE PEOPLE OF THE STATE OF NEVADA, REPRESENTED IN SENATE AND ASSEMBLY, DO ENACT AS FOLLOWS:
Section 25.5 of this bill authorizes such an insurance plan for only retired officers and employees to exclude claims for preexisting conditions under the same conditions as previously authorized for grandfathered plans.
Sections 5, 8, 16 and based on a preexisting condition.
Sections 2 and 22 of this bill make otherusions conforming changes.
THE PEOPLE OF THE STATE OF NEVADA, REPRESENTED IN SENATE AND ASSEMBLY, DO ENACT AS FOLLOWS:
An insurer shall offer and issue a policy of health insurance to any person regardless of the health status of the person or any dependent of the person.
An insurer shall offer and issue a health benefit plan to any person regardless of the health status of the person or any dependent of the person.
An insurer that offers or issues a policy of health insurance shall not:
An insurer that offers or issues a health benefit plan shall not:
(a) Deny, limit or exclude a benefit based on the health status of an insured;
(a) Deny, limit or exclude a covered benefit based on the health status of an insured;
or (b) Require an insured, as a condition of enrollment or renewal, to pay a premium, deductible, copay or coinsurance based on his or her health status which is greater than the premium, deductible, copay or coinsurance charged to a similarly situated insured or the covered dependent of such an insured who does not have such a health status.
or (b) Require an insured, as a condition of enrollment or renewal, to pay a premium, deductible, copay or coinsurance based on his or her health status which is greater than the premium, deductible, copay or coinsurance charged to a similarly situated insured who does not have such a health status.
An insurer that offers or issues a policy of health insurance shall not adjust a premium, deductible, copay or coinsurance for any insured on the basis of genetic information relating to the insured or the covered dependent of the insured.
An insurer that offers or issues a health benefit plan shall not adjust a premium, deductible, copay or coinsurance for any insured on the basis of genetic information relating to the insured or the covered dependent of the insured.
- *SB235_R1* – 3 – 4.
As used in this section, “health benefit plan” has the meaning ascribed to it in NRS 687B.470.
689A.330 If any policy is issued by a domestic insurer for delivery to a person residing in another state, and if the insurance commissioner or corresponding public officer of that other state has informed the Commissioner that the policy is not subject to approval or disapproval by that officer, the Commissioner may by ruling - *SB235* – 3 – require that the policy meet the standards set forth in NRS 689A.030 to 689A.320, inclusive [.] , and section 1 of this act.
689A.330 If any policy is issued by a domestic insurer for delivery to a person residing in another state, and if the insurance commissioner or corresponding public officer of that other state has informed the Commissioner that the policy is not subject to approval or disapproval by that officer, the Commissioner may by ruling require that the policy meet the standards set forth in NRS 689A.030 to 689A.320, inclusive [.] , and section 1 of this act.
or (2) Any genetic information of the insured person or any member of the family of the insured person.] 2.
or member of the family of the insured person.]ured person or any 2.
The provisions of this section do not apply to an insurer who issues a policy of health insurance that provides coverage for long- term care or disability income.
The provisions of this section do not apply to an insurer who term care or disability income.ance that provides coverage for long- 3.
3.
(b) “Genetic test” means a test, including a laboratory test that uses deoxyribonucleic acid extracted from the cells of a person or a diagnostic test, to determine the presence of abnormalities or defici(1) Are inlinkedg torrphysicalus,orhamental disorders or impairments;
(b) “Genetic test” means a test, including a laboratory test that uses deoxyribonucleic acid extracted from the cells of a person or a diagnostic test, to determine the presence of abnormalities or deficiencies, including carrier status, that:
(1) Are linked to physical or mental disorders or impairments;
(b) Require an insured person to disclose whether the insured person or any member of the family of the insured person has taken a genetic test or any genetic information of the insured person or a member of the family of the insured person;
- *SB235_R1* – 4 – (b) Require an insured person to disclose whether the insured person or any member of the family of the insured person has taken a genetic test or any genetic information of the insured person or a member of the family of the insured person;
or - *SB235* – 4 – (2) Any genetic information of the insured person or any member of the family of the insured person.] 2.
or (2) Any genetic information of the insured person or any member of the family of the insured person.] 2.
or (2) Indicate a susceptibility to illness, disease, impairment or any other disorder, whether physical or mental.
or (2) Indicate a susceptibility to illness, disease, impairment or anySec.
Sec.
5.disNRS 689B.275 is hereby amended to read as follows:
5.
NRS 689B.275 is hereby amended to read as follows:
An insurer shall provide to each policyholder, or producer of insurance acting on behalf of a policyholder, on a form approved by the Commissioner, a summary of the coverage provided by each policy of group or blanket health insurance offered by the insurer.
An insurer shall provide to each policyholder, or approved by the Commissioner, a summary of the coverager, on a form provided by each policy of group or blanket health insurance offered by the insurer.
factors, other than claims experienced, which affect changes in rate;
(c) Right of the insurer to change the rate of premium and the factors, other than claims experienced, which affect changes in rate;
3.
- *SB235_R1* – 5 – 3.
- *SB235* – 5 – Sec.
Sec.
A carrier shall offer and issue a policy of group health insurance to any person regardless of the health status of the person or any dependent of the person.
A carrier shall offer and issue a health benefit plan to any group regardless of the health status of the group, any member of the group or any dependent of a member of the group.
(a) Any preexisting medical condition of the person, including, without limitation, any physical or mental illness;
(a) Any preexisting medical condition of a person, including, without limitation, any physical or mental illness;
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(b) The claims history of the person, including, without limitation, any prior health care services received by the person;
(b) The claims history of an insured, including, without limitation, any prior health care services received by the insured;
(c) Genetic information relating to the person;
(c) Genetic information relating to the insured;
and (d) Any increased risk for illness, injury or any other medical condition of the person, including, without limitation, any medical condition caused by an act of domestic violence.
and (d) Any increased risk for illness, injury or any other medical medical condition caused by an act of domestic violence.
2.
any 2.
A carrier that offers or issues a policy of group health insurance shall not:
A carrier that offers or issues a health benefit plan shall not(a) Deny, limit or exclude a covered benefit based on the health status of an insured;
(a) Deny, limit or exclude a benefit based on the health status of an insured;
or (b) Require an insured, as a condition of enrollment or renewal, to pay a premium, deductible, copay or coinsurance based on his or her health status which is greater than the premium, deductible, copay or coinsurance charged to a similarly situated insured who does not have such a health status.
or (b) Require an insured, as a condition of enrollment or renewal, to pay a premium, deductible, copay or coinsurance based on his or her health status which is greater than the premium, deductible, copay or coinsurance charged to a similarly situated insured or the covered dependent of such an insured who doe3.notA carrier that offers or issues a policy of group health insurance shall not adjust a premium, deductible, copay or coinsurance for any insured on the basis of genetic information relating to the insured or the covered dependent of the insured.
3.
A carrier that offers or issues a health benefit plan shall not adjust a premium, deductible, copay or coinsurance for any insured on the basis of genetic information relating to the insured or the covered dependent of the insured.
4.
A carrier that offers or issues a health benefit plan may include in the plan a wellness program that reduces a premium, deductible or copayment based on health status if:
(a) An insured who is eligible to participate in the wellness program is given the opportunity to qualify for the discount at least once each year;
- *SB235_R1* – 6 – (b) The amount of all discounts provided pursuant to such a wellness program does not exceed 30 percent, or if the program is designed to prevent or reduce tobacco use, 50 percent, of the cost of coverage for an insured or an insured and his or her dependents, as applicable, under the plan;
(c) The wellness program is reasonably designed to promote health or prevent disease;
(d) The carrier ensures that the full discount under the wellness program is available to all similarly situated insureds by providing a reasonable alternative standard by which an insured may qualify for the discount which, if based on health status, must accommodate the recommendations of the physician of the insured;
and (e) The plan discloses in all plan materials describing the terms of the wellness program, and in any disclosure that an insured did not satisfy the initial standard to be eligible for the discount, the availability of a reasonable alternative standard described in paragraph (d).
5.
As used in this section, “health benefit plan” has the meaning ascribed to it in NRS 687B.470.
A carrier shall not place any restriction on a person or a dependent of the person as a condition of being a participant in or a beneficiary of a policy of blanket accident and health insurance or group health insurance that is inconsistent with the provisions of this chapter.
A carrier shall not place any restriction on a person or a dependent of the person as a condition of being a health insurance or group health insurance that is inconsistent with the provisions of this chapter.
2.
accident and health insurance or group health insurance pursuant to this chapter shall not establish rules of eligibility [,] which conflict with the provisions of NRS 689B.500, including rules which define applicable waiting periods, for the initial or continued enrollment under a group health plan offered by the carrier that are based on the following factors relating to the employee or a dependent of the employee:
A carrier that offers coverage under a policy of blanket accident and health insurance or group health insurance pursuant to this chapter shall not establish rules of eligibility [,] which conflict with the provisions of NRS 689B.500, including rules which define applicable waiting periods, for the initial or continued enrollment under a group health plan offered by the carrier that are based on the following factors relating to the employee or a dependent of the employee:
(a) Health status.
- *SB235* – 6 – (a) Health status.
3.
- *SB235_R1* – 7 – 3.
5.] 4.
This section does not:
or (c) Preclude a carrier from establishing rules relating to employer contribution or group participation when offering health insurance coverage to small employers in this state.
or employer contribution or group participation when offering health insurance coverage to small employers in this state.
689C.159 The provisions of NRS 689C.156 [and 689C.190] dows:
not apply to health benefit plans offered by a carrier if the carrier makes the health benefit plan available in the small employer market only through a bona fide association.
8.
NRS 689C.159 is hereby amended to read as follows:
689C.159 The provisions of NRS 689C.156 [and 689C.190] do not apply to health benefit plans offered by a carrier if the carrier makes the health benefit plan available in the small employer market only through a bona fide association.
Sec.
A carrier [serving small employers] that issues a health benefit plan shall [not deny, exclude or limit a benefit for a preexisting condition.] offer and issue a health benefit plan to any - *SB235* – 7 – person regardless of the health status of the person or any dependent of the person.
A carrier [serving small employers] that issues a health benefit plan shall [not deny, exclude or limit a benefit for a preexisting condition.] offer and issue a health benefit plan to any small employer regardless of the health status of the employees of the small employer.
(a) Any preexisting medical condition of the person, including, without limitation, any physical or mental illness;
(a) Any preexisting medical condition of an insured, including, without limitation, any physical or mental illness;
(b) The claims history of the person, including, without limitation, any prior health care services received by the person;
(b) The claims history of the insured, including, without limitation, any prior health care services received by the insured;
(c) Genetic information relating to the person;
(c) Genetic information relating to the insured;
and (d) Any increased risk for illness, injury or any other medical condition of the person, including, without limitation, any medical condition caused by an act of domestic violence.
and - *SB235_R1* – 8 – (d) Any increased risk for illness, injury or any other medical condition of the insured, including, without limitation, any medical condition caused by an act of domestic violence.
(a) Deny, limit or exclude a benefit based on the health status of an insured;
(a) Deny, limit or exclude a covered benefit based on the health status of an insured;
or (b) Require an insured, as a condition of enrollment or renewal, to pay a premium, deductible, copay or coinsurance based on his or her health status which is greater than the premium, deductible, copay or coinsurance charged to a similarly situated insured or the covered dependent of such an insured who does not have such a health status.
or (b) Require an insured, as a condition of enrollment or renewal, to pay a premium, deductible, copay or coinsurance based on his or her health status which is greater than the premium, deductible, copay or coinsurance charged to a similarly situated insured who does not have such a health status.
4.
A carrier that offers or issues a health benefit plan may include in the plan a wellness program that reduces a premium, deductible or copayment based on health status if:
(a) An insured who is eligible to participate in the wellness program is given the opportunity to qualify for the discount at least once each year;
(b) The amount of all discounts provided pursuant to such a designed to prevent or reduce tobacco use, 50 percent, of the cost of coverage for an insured or an insured and his or her dep(c) The wellness program is reasonably designed to promote health or prevent disease;
(d) The carrier ensures that the full discount under the wellness program is available to all similarly situated insureds by providing a reasonable alternative standard by which an insured may qualify for the discount which, if based on health status, must accommodate the recommendations of the physician of the insured;
and (e) The plan discloses in all plan materials describing the terms of the wellness program, and in any disclosure that an insured did not satisfy the initial standard to be eligible for the discount, the availability of a reasonable alternative standard described in paragraph (d).
small employer or an eligible employee or a dependent of theon a eligible employee as a condition of being a participant in or a beneficiary of a health benefit plan that is inconsistent with NRS 689C.015 to 689C.355, inclusive.
689C.193 1.
A carrier shall not place any restriction on a small employer or an eligible employee or a dependent of the eligible employee as a condition of being a participant in or a - *SB235_R1* – 9 – beneficiary of a health benefit plan that is inconsistent with NRS 689C.015 to 689C.355, inclusive.
- *SB235* – 8 – (f) Genetic information.
(f) Genetic information.
Except as otherwise provided in NRS 689C.190, the provisions of subsection 1 do not require a carrier to provide particular benefits other than those that would otherwise be provided under the terms of the health benefit plan or coverage.
Except as otherwise provided in NRS 689C.190, the provisions of subsection 1 do not require a carrier to provide particular benefits other than those that would otherwise be provided und4.
4.
th[As a condition of enrollment or continued enrollment under a health benefit plan, a carrier shall not require any person to pay a contribution for a similarly situated person covered by similar coverage on the basis of any factor described in subsection 2 in relation to the person or a dependent of the person.
[As a condition of enrollment or continued enrollment under a health benefit plan, a carrier shall not require any person to pay a premium or contribution that is greater than the premium or contribution for a similarly situated person covered by similar coverage on the basis of any factor described in subsection 2 in relation to the person or a dependent of the person.
(a) “Contribution” means the minimum employer contribution in a health benefit plan.rollment of participants and beneficiaries (b) “Group participation” means the minimum number of participants or beneficiaries that must be enrolled in a health benefit plan in relation to a specified percentage or number of eligible persons or employees of the employer.
(a) “Contribution” means the minimum employer contribution toward the premium for enrollment of participants and beneficiaries in a health benefit plan.
- *SB235_R1* – 10 – (b) “Group participation” means the minimum number of participants or beneficiaries that must be enrolled in a health benefit plan in relation to a specified percentage or number of eligible persons or employees of the employer.
or - *SB235* – 9 – (2) Any genetic information of the insured person or any member of the family of the insured person.] 2.
or (2) Any genetic information of the insured person or any member of the family of the insured person.] 2.
(a) “Genetic information” means any information that is obtained from a genetic test.
obtained from a genetic test.means any information that is (b) “Genetic test” means a test, including a laboratory test that diagnostic test, to determine the presence of abnormalities orn or a deficiencies, including carrier status, that:
(b) “Genetic test” means a test, including a laboratory test that uses deoxyribonucleic acid extracted from the cells of a person or a diagnostic test, to determine the presence of abnormalities or deficiencies, including carrier status, that:
A society shall offer and issue a benefit contract to any dependent of the person.
A society shall offer and issue a health benefit plan to any person regardless of the health status of the person or any - *SB235_R1* – 11 – dependent of the person.
A society that offers or issues a benefit contract shall not:
A society that offers or issues a health benefit plan shall not:
(a) Deny, limit or exclude a benefit based on the health status of an insured;
(a) Deny, limit or exclude a covered benefit based on the health status of an insured;
or (b) Require an insured, as a condition of enrollment or renewal, to pay a premium, deductible, copay or coinsurance based on his or her health status which is greater than the premium, deductible, copay or coinsurance charged to a similarly - *SB235* – 10 – situated insured or the covered dependent of such an insured who does not have such a health status.
or (b) Require an insured, as a condition of enrollment or renewal, to pay a premium, deductible, copay or coinsurance based on his or her health status which is greater than the premium, deductible, copay or coinsurance charged to a similarly situated insured who does not have such a health status.
A society that offers or issues a benefit contract shall not adjust a premium, deductible, copay or coinsurance for any insured on the basis of genetic information relating to the insured or the covered dependent of the insured.
A society that offers or issues a health benefit plan shall not adjust a premium, deductible, copay or coinsurance for any insured on the basis of genetic information relating to the insured or the covered dependent of the insured.
Sec.
meaning ascribed to it in NRS 687B.470.h benefit plan” has the Sec.
Chapter 695B of NRS is hereby amended by adding thereto a new section to read as follows:
Chapter 695B of NRS is hereby amended by adding the1.to An insurer shall offer and issue a health benefit plan to any person regardless of the health status of the person or any dependent of the person.
1.
An insurer shall offer and issue a contract for hospital or medical service to any person regardless of the health status of the person or any dependent of the person.
An insurer that offers or issues a contract for hospital or medical service shall not:
An insurer that offers or issues a health benefit plan shall not:
(a) Deny, limit or exclude a benefit based on the health status of an insured;
(a) Deny, limit or exclude a covered benefit based on the health status of an insured;
or (b) Require an insured, as a condition of enrollment or renewal, to pay a premium, deductible, copay or coinsurance premium, deductible, copay or coinsurance charged to a similarly situated insured or the covered dependent of such an insured who does not have such a health status.
or (b) Require an insured, as a condition of enrollment or renewal, to pay a premium, deductible, copay or coinsurance - *SB235_R1* – 12 – based on his or her health status which is greater than the premium, deductible, copay or coinsurance charged to a similarly situated insured who does not have such a health status.
An insurer that offers or issues a contract for hospital or medical service shall not adjust a premium, deductible, copay or coinsurance for any insured on the basis of genetic information relating to the insured or the covered dependent of the insured.
An insurer that offers or issues a health benefit plan shall not adjust a premium, deductible, copay or coinsurance for any insured on the basis of genetic information relating to the insured or the covered dependent of the insured.
4.
An insurer that offers or issues a health benefit plan may include in the plan a wellness program that reduces a premium, deductible or copayment based on health status if:
(a) An insured who is eligible to participate in the wellness program is given the opportunity to qualify for the discount at least once each year;
(b) The amount of all discounts provided pursuant to such a wellness program does not exceed 30 percent, or if the program is designed to prevent or reduce tobacco use, 50 percent, of the cost of coverage for an insured or an insured and his or her dependents, as applicable, under the plan;
(c) The wellness program is reasonably designed to promote health or prevent disease;
(d) The insurer ensures that the full discount under the wellness program is available to all similarly situated insureds by providing a reasonable alternative standard by which an insured accommodate the recommendations of the physician of thestatus, must insured;
and terms of the wellness program, and in any disclosure that anhe insured did not satisfy the initial standard to be eligible for the discount, the availability of a reasonable alternative standard described in paragraph (d).
5.
As used in this section, “health benefit plan” has the meaning ascribed to it in NRS 687B.470.
and - *SB235* – 11 – (c) A child placed with the subscriber for the purpose of adoption from the moment of placement as certified by the public or private agency making the placement.
and - *SB235_R1* – 13 – (c) A child placed with the subscriber for the purpose of adoption from the moment of placement as certified by the public or private agency making the placement.
4.
child adopted or placed for adoption solely because of a preexistingt condition the child has at the time the child would otherwise become relating to an exclusion for a preexisting condition must comply with NRS 689C.190.
[A corporation shall not restrict the coverage of a dependent child adopted or placed for adoption solely because of a preexisting condition the child has at the time the child would otherwise become relating to an exclusion for a preexisting condition must comply with NRS 689C.190.
A converted contract may provide that during the first contract year the benefits payable under it, together with the benefits payable under the group contract, must not exceed those that would - *SB235* – 12 – have been payable if the subscriber’s coverage under the group contract had remained in effect.
A converted contract may provide that during the first contract year the benefits payable under it, together with the benefits payable under the group contract, must not exceed those that would - *SB235_R1* – 14 – have been payable if the subscriber’s coverage under the group contract had remained in effect.
(b) “Genetic test” means a test, including a laboratory test that uses deoxyribonucleic acid extracted from the cells of a person or a diagnostic test, to determine the presence of abnormalities or defici(1) Are inlinkedg to physicaltusorthamental disorders or impairments;
uses deoxyribonucleic acid extracted from the cells of a person or a diagnostic test, to determine the presence of abnormalities or defici(1) Are inlinkedg to physicaltusorthamental disorders or impairments;
A health maintenance organization shall offer and issue a health care plan to any person regardless of the health status of the person or any dependent of the person.
A health maintenance organization shall offer and issue a health benefit plan to any person regardless of the health status of the person or any dependent of the person.
- *SB235* – 13 – 2.
- *SB235_R1* – 15 – 2.
A health maintenance organization that offers or issues a health care plan shall not:
A health maintenance organization that offers or issues a health benefit plan shall not:
(a) Deny, limit or exclude a benefit based on the health status of an enrollee;
(a) Deny, limit or exclude a covered benefit based on the health status of an enrollee;
or (b) Require an enrollee, as a condition of enrollment or renewal, to pay a premium, deductible, copay or coinsurance based on his or her health status which is greater than the premium, deductible, copay or coinsurance charged to a similarly situated enrollee or the covered dependent of such an enrollee who does not have such a health status.
or (b) Require an enrollee, as a condition of enrollment or renewal, to pay a premium, deductible, copay or coinsurance based on his or her health status which is greater than the premium, deductible, copay or coinsurance charged to a similarly situated enrollee who does not have such a health status.
A health maintenance organization that offers or issues a health care plan shall not adjust a premium, deductible, copay or coinsurance for any enrollee on the basis of genetic information relating to the enrollee or the covered dependent of the enrollee.
A health maintenance organization that offers or issues a health benefit plan shall not adjust a premium, deductible, copay or coinsurance for any enrollee on the basis of genetic information relating to the enrollee or the covered dependent of the enrollee.
4.
A health maintenance organization that offers or issues a health benefit plan may include in the plan a wellness program that reduces a premium, deductible or copayment based on health status if:
(a) An enrollee who is eligible to participate in the wellness program is given the opportunity to qualify for the discount at least once each year;
(b) The amount of all discounts provided pursuant to such a wellness program does not exceed 30 percent, or if the program is of coverage for an enrollee or an enrollee and his or her the cost dependents, as applicable, under the plan;
health or prevent disease;m is reasonably designed to promote (d) The health maintenance organization ensures that the full discount under the wellness program is available to all similarly situated enrollees by providing a reasonable alternative standard by which an enrollee may qualify for the discount which, if based on health status, must accommodate the recommendations of the physician of the enrollee;
and (e) The plan discloses in all plan materials describing the terms of the wellness program, and in any disclosure that an enrollee did not satisfy the initial standard to be eligible for the discount, the availability of a reasonable alternative standard described in paragraph (d).
5.
As used in this section, “health benefit plan” has the meaning ascribed to it in NRS 687B.470.
Except as otherwise provided in this chapter or in specific provisions of this title, the provisions of this title are not applicable to any health maintenance organization granted a certificate of authority under this chapter.
Except as otherwise provided in this chapter or in specific provisions of this title, the provisions of this title are not applicable to any health maintenance organization granted a - *SB235_R1* – 16 – certificate of authority under this chapter.
chapter shall not be deemed to be practicing medicine and is exempt from the provisions of chapter 630 of NRS.
3.
Any health maintenance organization authorized under this chapter shall not be deemed to be practicing medicine and is exempt from the provisions of chapter 630 of NRS.
5.
695C.1708, 695C.1731, 695C.17345, 695C.1735, 695C.1745 andive, 695C.1757 and section 18 of this act apply to a health maintenance care to recipients of Medicaid under the State Plan for Medicaid.
The provisions of NRS 695C.1694 to 695C.1698, inclusive, 695C.1708, 695C.1731, 695C.17345, 695C.1735, 695C.1745 and 695C.1757 and section 18 of this act apply to a health maintenance - *SB235* – 14 – organization that provides health care services through managed care to recipients of Medicaid under the State Plan for Medicaid.
(a) The birth of a newly born child;
- *SB235_R1* – 17 – (a) The birth of a newly born child;
children placed for adoption consists of preventive health care services as well as coverage of injury or sickness, including the necessary care and treatment of medically diagnosed congenital defects and birth abnormalities and, within the limits of the policy, necessary transportation costs from place of birth to the nearest specialized treatment center under major medical policies, and with respect to basic policies to the extent such costs are charged by the treatment center.
3.
The coverage for newly born and adopted children and children placed for adoption consists of preventive health care services as well as coverage of injury or sickness, including the necessary care and treatment of medically diagnosed congenital defects and birth abnormalities and, within the limits of the policy, necessary transportation costs from place of birth to the nearest specialized treatment center under major medical policies, and with respect to basic policies to the extent such costs are charged by the treatment center.
5.] For covered services provided to the child, the health maintenance organization shall reimburse noncontracted providers of health care to an amount equal to the average amount of payment - *SB235* – 15 – for which the organization has agreements, contracts or arrangements for those covered services.
5.] For covered services provided to the child, the health of health care to an amount equal to the average amount of payment for which the organization has agreements, contracts or arrSec.
Sec.
(b) “Genetic test” means a test, including a laboratory test which uses deoxyribonucleic acid extracted from the cells of a person or a diagnostic test, to determine the presence of abnormalities or deficiencies, including carrier status, that:
- *SB235_R1* – 18 – (b) “Genetic test” means a test, including a laboratory test which uses deoxyribonucleic acid extracted from the cells of a person or a diagnostic test, to determine the presence of abnormalities or deficiencies, including carrier status, that:
or (2) Indicate a susceptibility to illness, disease, impairment or anySec.
or (2) Indicate a susceptibility to illness, disease, impairment or any other disorder, whether physical or mental.
Sec.
(b) The health maintenance organization issues evidence of coverage or uses a schedule of charges for health care services which do not comply with the requirements of NRS 695C.1691 to 695C.200, inclusive, and section 18 of this act, or 695C.207;
(b) The health maintenance organization issues evidence of coverage or uses a schedule of charges for health care services which do not comply with the requirements of NRS 695C.1691 to 695(c) The health care plan does not furnish comprehensive health care services as provided for in NRS 695C.060;
(c) The health care plan does not furnish comprehensive health care services as provided for in NRS 695C.060;
organization:mmissioner certifies that the health maintenance (1) Does not meet the requirements of subsection 1 of NRS 695C.080;
- *SB235* – 16 – (d) The Commissioner certifies that the health maintenance organization:
(1) Does not meet the requirements of subsection 1 of NRS 695C.080;
and (2) Conducting external reviews of adverse determinations that comply with the provisions of NRS 695G.241 to 695G.310, inclusive;
and - *SB235_R1* – 19 – (2) Conducting external reviews of adverse determinations that comply with the provisions of NRS 695G.241 to 695G.310, inclusive;
coverage required by NRS 695C.1691;
(j) The health maintenance organization fails to provide the coverage required by NRS 695C.1691;
ortion fails to provide the (k) The health maintenance organization has otherwise failed to comply substantially with the provisions of this chapter.
or (k) The health maintenance organization has otherwise failed to comply substantially with the provisions of this chapter.
If the certificate of authority of a health maintenance organization is revoked, the organization shall proceed, immediately following the effective date of the order of revocation, to wind up its affairs and shall conduct no further business except as may be essential to the orderly conclusion of the affairs of the organization.
If the certificate of authority of a health maintenance organization is revoked, the organization shall proceed, immediately following the effective date of the order of revocation, to wind up its essential to the orderly conclusion of the affairs of the organization.
The Commissioner may, by written order, permit such further operation of the organization as the Commissioner may find to be in - *SB235* – 17 – the best interest of enrollees to the end that enrollees are afforded the greatest practical opportunity to obtain continuing coverage for health care.
operation of the organization as the Commissioner may find to be in the best interest of enrollees to the end that enrollees are afforded the greatest practical opportunity to obtain continuing coverage for health care.
A prepaid limited health service organization shall offer and issue evidence of coverage to any person regardless of the health status of the person or any dependent of the person.
A prepaid limited health service organization shall offer and issue a health benefit plan to any person regardless of the health status of the person or any dependent of the person.
2.
- *SB235_R1* – 20 – 2.
A prepaid limited health service organization that offers or issues evidence of coverage shall not:
A prepaid limited health service organization that offers or issues a health benefit plan shall not:
(a) Deny, limit or exclude a benefit based on the health status of an enrollee;
(a) Deny, limit or exclude a covered benefit based on the health status of an enrollee;
or (b) Require an enrollee, as a condition of enrollment or renewal, to pay a premium, deductible, copay or coinsurance based on his or her health status which is greater than the premium, deductible, copay or coinsurance charged to a similarly situated enrollee or the covered dependent of such an enrollee who doe3.notA prepaid limited health service organization that offers or issues evidence of coverage shall not adjust a premium, deductible, copay or coinsurance for any enrollee on the basis of genetic information relating to the enrollee or the covered dependent of the enrollee.
or (b) Require an enrollee, as a condition of enrollment or renewal, to pay a premium, deductible, copay or coinsurance based on his or her health status which is greater than the premium, deductible, copay or coinsurance charged to a similarly situated enrollee who does not have such a health status.
3.
A prepaid limited health service organization that offers or issues a health benefit plan shall not adjust a premium, deductible, copay or coinsurance for any enrollee on the basis of genetic information relating to the enrollee or the covered dependent of the enrollee.
4.
A prepaid limited health service organization that offers or issues a health benefit plan may include in the plan a wellness program that reduces a premium, deductible or copayment based on health status if:
(a) An enrollee who is eligible to participate in the wellness program is given the opportunity to qualify for the discount at least once each year;
(b) The amount of all discounts provided pursuant to such a wellness program does not exceed 30 percent, or if the program is of coverage for an enrollee or an enrollee and his or her the cost dependents, as applicable, under the plan;
health or prevent disease;m is reasonably designed to promote (d) The prepaid limited health service organization ensures that the full discount under the wellness program is available to all similarly situated enrollees by providing a reasonable alternative standard by which an enrollee may qualify for the discount which, if based on health status, must accommodate the recommendations of the physician of the enrollee;
and (e) The plan discloses in all plan materials describing the terms of the wellness program, and in any disclosure that an enrollee did not satisfy the initial standard to be eligible for the discount, the availability of a reasonable alternative standard described in paragraph (d).
5.
As used in this section, “health benefit plan” has the meaning ascribed to it in NRS 687B.470.
A managed care organization shall offer and issue a health care plan to any person regardless of the health status of the person or any dependent of the person.
A managed care organization shall offer and issue a health benefit plan to any person regardless of the health status of the - *SB235_R1* – 21 – person or any dependent of the person.
and - *SB235* – 18 – (d) Any increased risk for illness, injury or any other medical condition of the person, including, without limitation, any medical condition caused by an act of domestic violence.
and (d) Any increased risk for illness, injury or any other medical condition of the person, including, without limitation, any medical condition caused by an act of domestic violence.
A managed care organization that offers or issues a health care plan shall not:
A managed care organization that offers or issues a health benefit plan shall not:
(a) Deny, limit or exclude a benefit based on the health status of an insured;
(a) Deny, limit or exclude a covered benefit based on the health status of an insured;
or (b) Require an insured, as a condition of enrollment or renewal, to pay a premium, deductible, copay or coinsurance based on his or her health status which is greater than the premium, deductible, copay or coinsurance charged to a similarly situated insured or the covered dependent of such an insured who does not have such a health status.
or (b) Require an insured, as a condition of enrollment or renewal, to pay a premium, deductible, copay or coinsurance based on his or her health status which is greater than the premium, deductible, copay or coinsurance charged to a similarly situated insured who does not have such a health status.
A managed care organization that offers or issues a health care plan shall not adjust a premium, deductible, copay or coinsurance for any insured on the basis of genetic information relating to the insured or the covered dependent of the insured.
A managed care organization that offers or issues a health benefit plan shall not adjust a premium, deductible, copay or coinsurance for any insured on the basis of genetic information relating to the insured or the covered dependent of the insured.
benefit plan may include in the plan a wellness program thatealth reduces a premium, deductible or copayment based on health sta(a) An insured who is eligible to participate in the wellness program is given the opportunity to qualify for the discount at least once each year;
(b) The amount of all discounts provided pursuant to such a wellness program described in this subsection does not exceed 30 percent, or if the program is designed to prevent or reduce tobacco use, 50 percent, of the cost of coverage for an insured or an insured and his or her dependents, as applicable, under the plan;
(c) The wellness program is reasonably designed to promote health or prevent disease;
(d) The managed care organization ensures that the full discount under the wellness program is available to all similarly situated insureds by providing a reasonable alternative standard by which an insured may qualify for the discount which, if based on health status, must accommodate the recommendations of the physician of the insured;
and (e) The plan discloses in all plan materials describing the terms of the wellness program, and in any disclosure that an - *SB235_R1* – 22 – insured did not satisfy the initial standard to be eligible for the discount, the availability of a reasonable alternative standard described in paragraph (d).
5.
As used in this section, “health benefit plan” has the meaning ascribed to it in NRS 687B.470.
(a) Adopt and carry into effect a system of group life, accident or health insurance, or any combination thereof, for the benefit of its officers and employees, and the dependents of officers and employees who elect to accept the insurance and who, where from their compensation for the payment of premiums on thections insurance.
(a) Adopt and carry into effect a system of group life, accident or health insurance, or any combination thereof, for the benefit of its officers and employees, and the dependents of officers and employees who elect to accept the insurance and who, where necessary, have authorized the governing body to make deductions from their compensation for the payment of premiums on the insurance.
(b) Purchase group policies of life, accident or health insurance, or any combination thereof, for the benefit of such officers and employees, and the dependents of such officers and employees, as have authorized the purchase, from insurance companies authorized to transact the business of such insurance in the State of Nevada, and, where necessary, deduct from the compensation of officers and employees the premiums upon insurance and pay the deductions upon the premiums.
(b) Purchase group policies of life, accident or health insurance, or any combination thereof, for the benefit of such officers and employees, and the dependents of such officers and employees, as have authorized the purchase, from insurance companies authorized to transact the business of such insurance in the State of Nevada, and, where necessary, deduct from the compensation of officers and upon the premiums.iums upon insurance and pay the deductions (c) Provide group life, accident or health coverage through a contributions to the maintenance of the fund from the compensation of officers and employees and pay the deductions into the fund.
(c) Provide group life, accident or health coverage through a self-insurance reserve fund and, where necessary, deduct contributions to the maintenance of the fund from the compensation of officers and employees and pay the deductions into the fund.
The money must be deposited in a state or - *SB235* – 19 – national bank or credit union authorized to transact business in the State of Nevada.
The money must be deposited in a state or national bank or credit union authorized to transact business in the State of Nevada.
The provisions of NRS 687B.408, 689B.030 to 689B.050, inclusive, [and] 689B.287 and 689B.500 apply to coverage provided pursuant to this paragraph, except that the provisions of NRS 689B.0378 and 689B.03785 only apply to coverage for active officers and employees of the governing body, or the dependents of such officers and employees.
The provisions of NRS 687B.408, 689B.030 to 689B.050, inclusive, [and] 689B.287 and 689B.500 apply to coverage provided pursuant to this paragraph, except that the provisions of NRS 689B.0378 , [and] 689B.03785 and 689B.500 - *SB235_R1* – 23 – only apply to coverage for active officers and employees of the governing body, or the dependents of such officers and employees.
In any county in which a legal services organization exists, municipal corporation, political subdivision, public corporation or other local governmental agency of the State of Nevada in the county, may enter into a contract with the legal services organization pursuant to which the officers and employees of the legal services organization, and the dependents of those officers and employees, are eligible for any life, accident or health insurance provided pursuant to this section to the officers and employees, and the dependents of the officers and employees, of the county, school district, municipal corporation, political subdivision, public corporation or other local governmental agency.
In any county in which a legal services organization exists, the governing body of the county, or of any school district, municipal corporation, political subdivision, public corporation or other local governmental agency of the State of Nevada in the county, may enter into a contract with the legal services organization pursuant to which the officers and employees of the legal services organization, and the dependents of those officers and employees, are eligible for any life, accident or health insurance provided pursuant to this section to the officers and employees, and district, municipal corporation, political subdivision, publicchool corporation or other local governmental agency.
4.
officers and employees of the legal services organization:on 3, the (a) Shall be deemed, solely for the purposes of this section, to be officers and employees of the county, school district, municipal corporation, political subdivision, public corporation or other local governmental agency with which the legal services organization has contracted;
If a contract is entered into pursuant to subsection 3, the officers and employees of the legal services organization:
and (b) Must be required by the contract to pay the premiums or contributions for all insurance which they elect to accept or of which they authorize the purchase.
(a) Shall be deemed, solely for the purposes of this section, to be officers and employees of the county, school district, municipal corporation, political subdivision, public corporation or other local governmental agency with which the legal services organization has contracted;
and - *SB235* – 20 – (b) Must be required by the contract to pay the premiums or contributions for all insurance which they elect to accept or of which they authorize the purchase.
6.
- *SB235_R1* – 24 – 6.
25.5.
NRS 287.0205 is hereby amended to read as follows:
287.0205 1.
A public officer or employee of any county, school district, municipal corporation, political subdivision, public corporation or other local governmental agency of the State of Nevada who has retired pursuant to NRS 1A.350 or 1A.480, or 286.510 or 286.620, or is enrolled in a retirement program provided pursuant to NRS 286.802, or the surviving spouse of such a retired public officer or employee who is deceased, may, except as otherwise provided in NRS 287.0475, in any even-numbered year, reinstate any insurance, except life insurance, that, at the time of reinstatement, is provided by the last public employer of the retired public officer or employee to the active officers and employees and their dependents of that public employer:
(a) Pursuant to NRS 287.010, 287.015, 287.020 or paragraph (b), (c) or (d) of subsection 1 of NRS 287.025;
or (b) Under the Public Employees’ Benefits Program, if the last public employer of the retired officer or employee participates in the Public Employees’ Benefits Program pursuant to paragraph (a) of subsection 1 of NRS 287.025.
must be requested by:
pursuant to paragraph (a) of subsection 1 (a) Giving written notice of the intent of the public officer or public employer of the public officer or employee not later thanast January 31 of an even-numbered year;
(b) Accepting the public employer’s current program or plan of insurance and any subsequent changes thereto;
and (c) Except as otherwise provided in paragraph (b) of subsection 4 of NRS 287.023, paying any portion of the premiums or contributions of the public employer’s program or plan of insurance, in the manner set forth in NRS 1A.470 or 286.615, which is due from the date of reinstatement and not paid by the public employer.
 The last public employer shall give the insurer notice of the reinstatement not later than March 31 of the year in which the public officer or employee or surviving spouse gives notice of the intent to reinstate the insurance.
3.
Reinstatement pursuant to paragraph (b) of subsection 1 must be requested pursuant to NRS 287.0475.
4.
If a plan provides coverage only to retired public officers and employees and dependents thereof, reinstatement of insurance pursuant to subsection 1 may exclude claims for expenses related - *SB235_R1* – 25 – to any condition for which medical advice, treatment or consultation was rendered within 12 months before the reinstatement.
5.
The last public employer of a retired officer or employee who reinstates insurance, except life insurance, which was provided to the retired officer or employee and the retired officer’s or employee’s dependents at the time of retirement pursuant to NRS 287.010, 287.015, 287.020 or paragraph (b), (c) or (d) of subsection 1 of NRS 287.025 shall, for the purpose of establishing actuarial data to determine rates and coverage for such persons, commingle the claims experience of such persons with the claims experience of active and retired officers and employees and their dependents who participate in that group insurance, plan of benefits or medical and hospital service.
Sec.
287.04335 If the Board provides health insurance through a plan of self-insurance, it shall comply with the provisions of NRS 687B.409, 689B.255, 695G.150, 695G.160, 695G.162, 695G.164, 695G.1645, 695G.1665, 695G.167, 695G.170 to 695G.173, inclusive, 695G.177, 695G.200 to 695G.230, inclusive, 695G.241 to 695G.310, inclusive, and 695G.405, and section 24 of this act in the same manner as an insurer that is licensed pursuant to title 57 of NRS is required to comply with those provisions.
287.04335 If the Board provides health insurance through a plan of self-insurance, it shall comply with the provisions of NRS 687B.409, 689B.255, 695G.150, 695G.160, 695G.162, 695G.164, 695G.1645, 695G.1665, 695G.167, 695G.170 to 695G.173, inclusive, 695G.177, 695G.200 to 695G.230, inclusive, 695G.241 to 695G.310, inclusive, and 695G.405, and section 24 of this act in the same manner as an insurer that is licensed pursuant to title 57 of NRSSec.
Sec.
- *SB235* – 21 – Sec.
Sec.
any preparatory administrative tasks that are necessary to carry out the provisions of this act;
- *SB235_R1* – 26 – 1.
and 2.
Upon passage and approval for the purpose of performing the provisions of this act;
andtasks that are necessary to carry out 2.
695F.480 Organization prohibited from restricting coverage of child based on preexisting condition if person who is for child.or group coverage adopts or assumes legal obligation H - *SB235*
695F.480 Organization prohibited from restricting coverage of child based on preexisting condition if person who is eligible for group coverage adopts or assumes legal obligation for child.
H - *SB235_R1*
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Amendments

1 amendment

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Action History

  1. (Pursuant to Joint Standing Rule No. 14.3.3, no further action allowed.)

  2. In Assembly. Read first time. Referred to Committee on Commerce and Labor. To committee.

  3. Read third time. Passed, as amended. Title approved, as amended. (Yeas: 21, Nays: None.) To Assembly.

  4. From printer. To engrossment. Engrossed. First reprint.

  5. Read second time. Amended. (Amend. No. 62.) To printer.

  6. From committee: Amend, and do pass as amended.

  7. From printer. To committee.

  8. Read first time. Referred to Committee on Health and Human Services. To printer.

Sponsors

  • Senate Committee on Health and Human Services · Primary

Sponsorship breakdown

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1 sponsors · 0 co-sponsors · 66 not signed on

Sponsors (1)

  • Senate Committee on Health and Human Services

Co-sponsors (0)

None.

Not signed on (66)

66 members have not signed on to this bill.

Show all 66 →

"Not signed on" means a member has not sponsored or co-sponsored this bill — it does not imply opposition. Members flagged Voted No have a recorded No vote on this bill.

Whip count is in markup. Polling the chamber and every recorded vote this session. Only the first open is slow. It’s instant for you after this. Calling the roll · Tallying · Engrossing

Subjects

healthcare health-insurance
Cross-referencing the record. Reading this bill against every other bill in the corpus by meaning, not keywords. Only the first open is slow. It’s instant for you after this. Matching · Ranking · Engrossing

Frequently asked questions

What does SB 235 do?
AN ACT relating to insurance; requiring insurers to offer and issue a health benefit plan regardless of the health status of a person; and providing other matters properly relating thereto.
Who sponsors SB 235?
SB 235 is sponsored by Senate Committee on Health and Human Services.
What is the current status of SB 235?
This bill died with 2019 Regular Session. It reached “Passed Senate” and never advanced before the session ended, so it can no longer move — a new version would have to be reintroduced in the current session.
Where can I track SB 235?
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