SB 87 — Revises provisions governing the Nevada Life and Health Insurance Guaranty Association. (BDR 57-219)

- *SB87_R1* – 6 – (3) A stop-loss group insurance plan;

80th Session (2019) – 6 – (g) A portion of a policy or contract to the extent that the assessments required by NRS 686C.230 with respect to the policy or contract are preempted by federal law.

or damages.)(5) A claim for penalties or consequential or incidental (i)damages. A contractual agreement that establishes the member book value for participants in a defined-contribution benefit plan by reference to a portfolio of assets owned by the benefit plan or its trustee, which in each case is not an affiliate of the member insurer.

(i) A contractual agreement that establishes the member insurer’s obligation to provide a guarantee based on accounting at book value for participants in a defined-contribution benefit plan by reference to a portfolio of assets owned by the benefit plan or its trustee, which in each case is not an affiliate of the member insurer.

- *SB87_R1* – 7 – (k) An unallocated annuity contract other than an annuity owned by a governmental retirement plan established under section 401, 403(b) or 457 of the Internal Revenue Code, 26 U.S.C.

80th Session (2019) – 7 – 2.

686C.100 “Member insurer” means an insurer which is licensed or holds a certificate of authority to transact in this state any kind of insurance for which coverage is provided in this chapter [and] or a health maintenance organization which holds athisa chapter certificate of authority to operate in this State.

The term includes an insurer or health maintenance organization whose license or certificate of authority in this state has been suspended, revoked, not renewed or voluntarily withdrawn.

An organization similar to any of those listed in subsections 1 to [7,] 6, inclusive.

- *SB87_R1* – 8 – Sec.

A citizen of the United States who is a resident of a 80th Session (2019) – 8 – foreign country or of a territory or insular possession subject to the jurisdiction of the United States which does not have an association similar to the Association created by this chapter shall be deemed to be a resident of the state of domicile of the member insurer that issued the policy or contract.

After the expiration of 60 days after the approval of the summary document by the Commissioner, [an] a member insurer may not deliver a policy or contract to the [owner of the] policy or contract owner, certificate holder or enrollee unless the summary document is delivered to the policy or contract owner , certificate holder or enrollee at the time of delivery of the policy or contract.

The document must also be available upon request by the policy or contract owner [of a policy.] , certificate holder or enrollee.

(b) Prominently warn the [owner of the] policy or contract owner, certificate holder or enrollee that the Association may not - *SB87_R1* – 9 – cover the policy or contract or, if coverage is available, it will be subject to substantial limitations and exclusions and conditioned on continued residence in this State;

80th Session (2019) – 9 – (d) State that the member insurer and its agents are prohibited by law from using the existence of the Association for the purpose of sales, solicitation or inducement to purchase any form of insurance [;] or coverage offered by a health maintenance organization;

686C.130Sec. NRS1.

There14. is hereby created a nonprofit legal entity to be known as the Nevada Life and Health Insurance Guaranty the Association as a condition of their authority to transact insurance or operate a health maintenance organization, as applicable, in this state.

NRS 686C.130 is hereby amended to read as follows:

686C.130 1.

There is hereby created a nonprofit legal entity to be known as the Nevada Life and Health Insurance Guaranty Association.

All member insurers shall be and remain members of the Association as a condition of their authority to transact insurance or operate a health maintenance organization, as applicable, in this state.

The Association is under the immediate supervision of the Commissioner and is subject to the applicable provisions of the - *SB87_R1* – 10 – Nevada Insurance Code.

80th Session (2019) – 10 – Sec.

In determining voting rights at the organizational meeting, each member insurer is entitled to one vote in person or by proxy.

If the Board of Directors is not selected within 60 days after notice of the organizational meeting, the Commissioner may appoint the initial members to represent member insurers in addition to the publicalpublic representatives.

- *SB87_R1* – 11 – 2.

Provide such money, pledges, loans, notes, guarantees or other means as are proper to effectuate subsection 1, and assure 80th Session (2019) – 11 – payment of the contractual obligations of the impaired insurer pending action under subsection 1.

[1.] (a) With respect to [life and health insurance] covered policies [and annuities,] or contracts, ensure payment of benefits [for premiums identical to the premiums and benefits, except for terms of conversion and renewability, which] that would have been claimspayable incurredunder withthe respectpolicies to:ntractsor contracts of the insolvent insurer, for [(a)]claims (1)incurred A group policy or contract, not later than the earlier of no event less than 30 days, after the date when the Associationbut in becomes obligated with respect toto: that policy or contract.

[(a)] (1) A group policy or contract, not later than the earlier of the next renewal date under the policy or contract or 45 days, but in no event less than 30 days, after the date when the Association becomes obligated with respect to that policy or contract.

(c) With respect to nongroup life [and] insurance, health insurance or annuity policies [and annuities,] or contracts, make available substitute coverage on an individual basis, in accordance with the provisions of subsection [4,] 2, to each known insured or annuitant, or owner if other than the insured , enrollee or annuitant, -80th *SB87_R1*Session (2019) – 12 – and to each natural person formerly insured, formerly an enrollee or formerly an annuitant, under a group policy or contract who is not eligible for replacement group coverage, if the insured , enrollee or annuitant had a right under law or the terminated policy , contract or annuity to convert coverage to individual coverage or to continue an individual policy , contract or annuity in force until a specified age or for a specified period, during which the member insurer had no right unilaterally to make changes in any provision of the policy , contract or annuity or had a right only to make changes in premium by class.

[and the court in the insolvent or impaired insurer’s state which has jurisdiction over the conservation, rehabilitation or liquidation of the insurer.] The Association may adopt alternative policies or contracts of various types for future issuance without regard to any particular impairment or insolvency.

minimum2. statutory provisions required in this state and provide the benefits that are not unreasonable in relation to the premium charged.

An alternative policy or contract must contain at least the minimum statutory provisions required in this state and provide benefits that are not unreasonable in relation to the premium charged.

If the Association elects to reissue terminated coverage at a rate of premium different from that charged under the terminated policy [,] or contract, the premium must be set by the Association at an actuarially justified amount in accordance with the amount of 80th Session (2019) – 13 – insurance provided and the age and class of risk, subject to approval - *SB87_R1* – 13 – by the Commissioner [and the court described in] pursuant to subsection 1.

686C.160Sec. NRSIn carrying out its responsibilities under NRS:

686C.152,21. the Association may, subject to approval by a court of thi1.staImpose permanent liens on policies and contracts in connection with any guarantee, assumption or reinsurance if the Association finds that the amounts which can be assessed under this chapter are less than the amounts needed to ensure full and prompt performance of the Association’s duties or that the economic or financial conditions as they affect member insurers are sufficiently adverse that the imposition of such permanent liens is in the public interest.

NRS 686C.160 is hereby amended to read as follows:

686C.160 In carrying out its responsibilities under NRS 686C.152, the Association may, subject to approval by a court of this state:

1.

Impose permanent liens on policies and contracts in connection with any guarantee, assumption or reinsurance if the Association finds that the amounts which can be assessed under this chapter are less than the amounts needed to ensure full and prompt performance of the Association’s duties or that the economic or financial conditions as they affect member insurers are sufficiently adverse that the imposition of such permanent liens is in the public interest.

In addition, in the event of a temporary moratorium or charge imposed by the court in the insolvent or impaired insurer’s state which has jurisdiction over the 80th Session (2019) – 14 – conservation, rehabilitation or liquidation of the insurer on such payment or lending, or on any other right to withdraw money held in conjunction with policies or contracts, the Association may defer - *SB87_R1* – 14 – such payment, lending or withdrawal for the period of the moratorium or charge, except for claims covered by the Association to be paid in accordance with a procedure for cases of hardship established by the liquidator or rehabilitator and approved by the court.

The amount so remitted is a distribution of the NRS.tsassets of the member insurer for the purposes of chapter 696B of Sec.NRS.

Sec.

686C.190 The Association has standing:

To appear or intervene before a court or agency in another state which has jurisdiction over an impaired or insolvent insurer for which the Association is or may become obligated, or over any 80th Session (2019) – 15 – person or property against whom or which the Association may have rights through subrogation or otherwise.

A person receiving benefits under this chapter shall be deemed to have assigned his or her rights under, and any - *SB87_R1* – 15 – causes of action against any person for losses arising under, resulting from or otherwise relating to, the covered policy or contract to the Association to the extent of the benefits received because of this chapter, whether the benefits are payments of or on account of contractual obligations, continuation of coverage or provision of substitute or alternative coverages.

In addition to the rights provided under subsections 1 and 2, the Association has all rights of subrogation at common law and any other equitable or legal remedy which would have been available to the impaired or insolvent insurer or the owner, beneficiary or payee of a policy or contract , a certificate holder or an enrollee with respect to the policy or contract, including, in the case of a structured settlement annuity, any rights of the owner, beneficiary or payee of the annuity, to the extent of benefits received under this chapter, against a person originally or by succession responsible for the losses arising from the personal injury relating to the annuity or payment for it, except any such person responsible solely by reason of serving as an assignee under section 130 of the Internal Revenue Code, 26 U.S.C.

§ 130.nee130. under section 130 of the Internal Revenue 4.

4.

If the Association has provided benefits with respect to a covered obligation and a person recovers amounts as to which the Association has rights under subsections 1 to 4, inclusive, the person 80th Session (2019) – 16 – shall pay to the Association the portion of the recovery attributable to the policies or contracts or portions thereof covered by the Association.

- *SB87_R1* – 16 – (a) The contractual obligations for which the member insurer is liable or would have been liable if it were not an impaired or insolvent insurer;

(d) With respect to each payee of a structured settlement annuity, or beneficiary or beneficiaries of the payee if deceased, $250,000 in present value of benefits from the annuity in theased,the aggregate, including any net cash for surrender or withdrawal;

or (e) With respect to each participant in a governmental retirement plan covered by an unallocated annuity contract which is owned byentby a governmental retirement plan established under section 401, 403(b) or 457 of the Internal Revenue Code, 26 U.S.C.

80th Session (2019) – 17 – (a) With respect to any one life or person under paragraphs (b) to (e), inclusive, of subsection 1:

- *SB87_R1* – 17 – (b) With respect to one owner of several nongroup policies of life insurance, whether the owner is a natural person or an organization and whether the persons insured are officers, managers, employees or other persons, more than $5,000,000 in benefits, regardless of the number of policies and contracts held by the owner.

As used in this section, “health benefit plan” has the meaSec.meaning ascribed to it in NRS 687B.470.

Sec.

out1. the provisions and purposes of this chapter.ry or proper to carry 2.

Enter into such contracts as are necessary or proper to carry out the provisions and purposes of this chapter.

2.

80th Session (2019) – 18 – 4.

Exercise, for the purposes of this chapter and to the extent approved by the Commissioner, the powers of a domestic life or health insurer [,] or health maintenance organization, but in no case may the Association issue insurance policies or annuities other - *SB87_R1* – 18 – than those issued to perform its contractual obligations under this chapter.

elect2. to succeed to the rights and obligations of the member insurer which accrue on or after the coverage date and relate to policies or one or more agreements for indemnity reinsurance entered into by any the member insurer as ceding insurer and selected by the Association.

At any time after the coverage date, the Association may elect to succeed to the rights and obligations of the member insurer which accrue on or after the coverage date and relate to policies or contracts covered, in whole or in part, by the Association under any one or more agreements for indemnity reinsurance entered into by the member insurer as ceding insurer and selected by the Association.

The election must be effected 80th Session (2019) – 19 – by a notice to the receiver, rehabilitator or liquidator and the affected reinsurers.

(b) The Association is entitled to any amount payable by the reinsurer under each agreement with respect to losses or events that - *SB87_R1* – 19 – occur in periods after the coverage date and relate to policies or contracts covered in whole or in part by the Association, but upon receipt of any such amount, the Association is obligated to pay, to the beneficiary under the policy or contract on account of which the amount was paid, that portion of the amount received by the Association that exceeds the benefits paid by the Association on account of the policy or contract less the retention by the impaired or insolvent [member] insurer applicable to the loss or event.

(d) The reinsurer may not terminate an agreement for reinsurance insofar as it relates to policies or contracts covered by the Association in whole or in part, or set off any unpaid premium due for a period before the coverage date against the amount due the Association, if the Association, within 60 days after the election, pays the premiums due for periods both before and after thelection,the coverage date which relate to such policies or contracts.

and3. the Association and the other insurer so agree, the other insurerr, succeeds to the rights and obligations of the Association under subsection 2 effective as of the agreed date, whether or not the Association has made the election described in subsection 2, except that:

If the Association transfers its obligation to another insurer, and the Association and the other insurer so agree, the other insurer succeeds to the rights and obligations of the Association under subsection 2 effective as of the agreed date, whether or not the 80th Session (2019) – 20 – Association has made the election described in subsection 2, except that:

The provisions of this section supersede an affected agreement for reinsurance which provides for or requires payment of proceeds of reinsurance, on account of a loss or event that occurs after the coverage date, to the receiver, rehabilitator or liquidator of - *SB87_R1* – 20 – the insolvent [member] insurer.

To facilitate the earliest practicable decision about whether to assume any of the contracts of reinsurance, and to protect the financial position of the estate, the receiver and each reinsurer of the ceding member insurer shall make available upon request to the delinquencyAssociation proceedings:ossibleas soon as possible after commencement of formal (a)delinquency Copiesproceedings: of in-force contracts of reinsurance and all related files and records relevant to the determination of whether such contracts should be assumed;

80th Session (2019) – 21 – (a) Copies of in-force contracts of reinsurance and all related files and records relevant to the determination of whether such contracts should be assumed;

The Association may charge policies or [annuities] contracts covered in part by the Association, through reasonable allocation methods, the costs for reinsurance in excess of the - *SB87_R1* – 21 – obligations of the Association and shall provide notice and an accounting of these changes to the liquidator.

(c) Within 30 days after the Association’s election, the Association and each reinsurer under the contracts assumed by the Association shall calculate the net balance due to or from the Association pursuant to each reinsurance contract on the election date with respect to policies or [annuities] contracts covered, in whole or in part, by the Association, which calculation must give full credit to all items paid by either the member insurer or its pay the receiver any amounts due for losses or events before ther shall date of the orderreinsurer ofbefore liquidation, subject to any set-off for premiums shall pay any remaining balance due to the other,election indate. each case within 5 days after the completion of the aforementioned calculation.

The reinsurer shall pay the receiver any amounts due for losses or events before the date of the order of liquidation, subject to any set-off for premiums 80th Session (2019) – 22 – unpaid for periods before the date, and the Association or reinsurer shall pay any remaining balance due to the other, in each case within days after the completion of the aforementioned calculation.

(d) If the Association or receiver, on the Association’s behalf, within 60 days after the election date, pays the unpaid premiums due for periods both before and after the election date that relate to policies or [annuities] contracts covered, in whole or in part, by the Association, the reinsurer is not entitled to terminate the reinsurance contracts for failure to pay premiums insofar as the reinsurance contracts relate to policies or [annuities] contracts covered, in whole or in part, by the Association, and is not entitled to set off any unpaid amounts due pursuant to the other contracts, or unpaid - *SB87_R1* – 22 – amounts due from parties other than the Association, against amounts due to the Association.

Except as otherwise provided in NRS 686C.130 to 686C.226, inclusive, nothing in NRS 686C.224 to 686C.2249, inclusive, shall alter or modify the terms and conditions of 2.yany rNothingreinsurance incontract. this section shall:

(a)80th AbrogateSession or(2019) limit– any23 rights– of2. any reinsurer to claim that it is (b) Give a [policyholder] policy or contract owner, certificate holder, enrollee or beneficiary an independent cause of action against a reinsurer that is not otherwise set forth in the reinsurance contract;

Nothing in this section shall:

(a) Abrogate or limit any rights of any reinsurer to claim that it is entitled to rescind a reinsurance contract;

(b) Give a [policyholder] policy or contract owner, certificate holder, enrollee or beneficiary an independent cause of action against a reinsurer that is not otherwise set forth in the reinsurance contract;

- *SB87_R1* – 23 – Sec.

4..[3.

ExceptAssessments] as80th otherwiseSession provided(2019) in– subsection24 5,– assessments4. in Class B against member insurers for each account and subaccount this State by each assessed member insurer on policies or contracts covered by each account or subaccount for the 3 most recent calendar years for which information is available preceding the year in which the insurer became impaired or insolvent bears to premiums received on business in this State for those calendar years by all assessed member insurers.

Except as otherwise provided in subsection 5, assessments in Class B against member insurers for each account and subaccount must be in the proportion that the premiums received on business in this State by each assessed member insurer on policies or contracts covered by each account or subaccount for the 3 most recent calendar years for which information is available preceding the year in which the insurer became impaired or insolvent bears to premiums received on business in this State for those calendar years by all assessed member insurers.

- *SB87_R1* – 24 – (b) The Health Account the remainder of an assessment in Class B for long-term care insurance written by an impaired or insolvent insurer that is not allocated to the Life and Annuity Account pursuant to paragraph (a).

The Association shall notify each member insurer of its anticipated prorated share of an assessment authorized but not yet called within 180 days after it is authorized.

(1)80th Include,Session without(2019) limitation,– premiums25 for– health(1) mainte(2)Include, Dowithout notlimitation, include premiums for disabilityhealth incomemaintenance andorganization long-termcoverage; care insurance.

isand (2) Do not ainclude memberpremiums insurerfor describeddisability inincome paragraphand (a).mberlong-term insurercare Sec.insurance.

(b) Primarily provide health insurance if the member insurer is not a member insurer described in paragraph (a).

Sec.

- *SB87_R1* – 25 – (a) The Life and Annuity Account [for Life Insurance and Annuities] and each of its subaccounts;

80th Session (2019) – 26 – 5.

If the maximum assessment for a subaccount of the Life and Annuity Account [for Life Insurance and Annuities] in any 1 year does not provide an amount sufficient to carry out the responsibilities of the Association, then pursuant to subsection [3] 4 of NRS 686C.240, the Board shall assess the other subaccount for [3] 4 the necessary additional amount, subject to the maximum stated in sub6.subsection 2.

6.

686C.270 It is proper for any member insurer, in determining its rates of premium and dividends to owners of policies or - *SB87_R1* – 26 – contracts as to any kind of insurance or coverage offered by a health maintenance organization within the scope of this chapter, to consider the amount reasonably necessary to meet its obligations for assessment under this chapter.

A member insurer may offset against its liability for premium tax to this state, accrued with respect to business transacted in a calendar year, an amount equal to 20 percent of the amount certified pursuant to subsection 1 in each of the 5 calendar 80th Session (2019) – 27 – years following the year in which the assessment was paid.

A member insurer that is exempt from its liability for premium tax described in subsection 2 may recoup its assessments under this chapter by imposing a surcharge on its premiums in an amount approved by the Commissioner.

The Commissioner shall approve such a surcharge upon determining that the amount of the surcharge is reasonably calculated to recoup the assessments over a reasonable period of time.

Any sum acquired by refund from the Association pursuant to NRS 686C.260 which previously had been written off by the contributing member insurer and offset against premium taxes as provided in subsection 2 must be paid to the Department of Taxation and deposited by it with the State Treasurer for credit to the State - *SB87_R1* – 27 – General Fund.

The regulations continue in force until modified by the Commissioner or 80th Session (2019) – 28 – superseded by a plan submitted by the Association and approved by the Commissioner.

(b) Establish the amount and method of reimbursing members of the(c)the EstablishBoard regularof placesDirectors andunder timesNRS for686C.140. meetings of the Board.

(d)(c) Establish proceduresregular forplaces recordsand totimes befor keptmeetings of all financial tra(e) Establish the proceduresBoard. whereby selections for the Board will be made and submitted to the Commissioner.

(d) Establish procedures for records to be kept of all financial transactions of the Association, its agents and the Board.

(e) Establish the procedures whereby selections for the Board will be made and submitted to the Commissioner.

The plan of operation may provide that any or all powers and duties of the Association, except those under subsection 3 of NRS 686C.220 and NRS 686C.230 to 686C.285, inclusive, are delegated to a corporation, Association or other organization which - *SB87_R1* – 28 – performs or will perform functions similar to those of this Association, or its equivalent, in two or more states.

80th Session (2019) – 29 – (a) Shall, upon request of the Board of Directors, provide the Association with a statement of the premiums in this and any other appropriate states for each member insurer.

(c) Must, in any liquidation or rehabilitation involving a rehabilitator.rdomestic member insurer, be appointed as the liquidator or 2.rehabilitator.

The2. Commissioner may suspend or revoke, after notice and a health maintenance organization in this state , as applicable, ofate any member insurer which fails to pay an assessment when due or fails to comply with the plan of operation.

The Commissioner may suspend or revoke, after notice and hearing, the certificate of authority to transact insurance or operate a health maintenance organization in this state , as applicable, of any member insurer which fails to pay an assessment when due or fails to comply with the plan of operation.

The forfeiture may not exceed 5 percent of the unpaid assessment per month, but no forfeiture may be less than $100 per month.

The Commissioner shall notify the commissioners of insurance of all the other states within 30 days - *SB87_R1* – 29 – after the Commissioner takes any of the following actions against a member insurer:

80th Session (2019) – 30 – 2.

The Commissioner shall furnish to the Board the ratios of the “Insurance Regulatory Information System” developed by the National Association of Insurance Commissioners and listings of companies not included in those ratios, and the Board may use the information contained therein in carrying out its duties and responsibilities under this chapter.

Such reports and the information contained therein must be kept confidential by the Board until such timSec.time as made public by the Commissioner or other lawful authority.

Sec.

NRS 686C.310 is hereby amended to read as follows:ity.follows:

- *SB87_R1* – 30 – 4.

80th Session (2019) – 31 – 2.

Assets of the impaired or insolvent insurer attributable to covered policies or contracts must be used to continue all covered policies andiesand or contracts and pay all contractual obligations of the impaired or coveredinsolvent policiesinsurer [,] or contracts, as usedrequired inby this subsection,chapter. are that proportion of the assets which the reserves that should have been established for covered policies or contracts bear to the reserves that should have been established for all policies [of insurance] or contracts written by the impaired or insolvent insurer.

Assets attributable to covered policies [,] or contracts, as used in this subsection, are that proportion of the assets which the reserves that should have been established for covered policies or contracts bear to the reserves that should have been established for all policies [of insurance] or contracts written by the impaired or insolvent insurer.

If the liquidator has not, within 120 days after a final determination of insolvency of [an] a member insurer by the court in the insolvent or impaired insurer’s state which has jurisdiction over the conservation, rehabilitation or liquidation of the member insurer, made an application to the court for the approval of a proposal to disburse assets out of marshaled assets to guaranty associations having obligations because of the insolvency, the - *SB87_R1* – 31 – Association is entitled to make application to the court for approval of its own proposal to disburse those assets.

Before the termination of any proceeding for liquidation, rehabilitation or conservation, the court may take into consideration the contributions of the respective parties, including the Association, the shareholders [and] , policy or contract owners [of policies and 80th Session (2019) – 32 – contracts] , certificate holders and enrollees of the impaired or insolvent insurer, and any other party with a bona fide interest, in making an equitable distribution of the ownership of the impaired or insolvent insurer.

If an order for liquidation or rehabilitation of [an] a member insurer domiciled in this state has been entered, the receiver appointed under such order is entitled to recover on behalf of the member insurer, from any affiliate that controlled it, the amount of distributions, other than stock dividends paid by the member insurer on its capital stock, made at any time during the 5 years preceding the petition for liquidation or rehabilitation, subject to 2.e lNo distribution is recoverable if the memberlimitations insurerof showssubsections that2, when3 paid the distribution was lawful and reasonable,4. and that the member insurer did not know and could not reasonably have known that the distribution might adversely affect the ability of the member insurer to fulfill its contractual obligations.

2.

No distribution is recoverable if the member insurer shows that when paid the distribution was lawful and reasonable, and that the member insurer did not know and could not reasonably have known that the distribution might adversely affect the ability of the member insurer to fulfill its contractual obligations.

- *SB87_R1* – 32 – 5.

80th Session (2019) – 33 – Sec.

Except as otherwise provided in this section, the term includes catastrophic health insurance policies and a policy that pays on a cost-incurred bas2.basis.

2.

(a) Coverage that is only for accident or disability income ins(b)insurance, Coverageor issuedany ascombination athereof; supplement to liability insurance;

(b) Coverage issued as a supplement to liability insurance;

The term does not include the following benefits if the benefits are provided under a separate policy, certificate or contract - *SB87_R1* – 33 – of insurance or are otherwise not an integral part of a health benefit plan:

80th Session (2019) – 34 – (b) Benefits for long-term care, nursing home care, home health care or community-based care, or any combination thereof;

(b) Coverage supplemental to the coverage provided pursuant to the Civilian Health and Medical Program of Uniformed Services, to CHAMPUS, 10 U.S.C.

and (c) Similar supplemental coverage provided under a group health plan.] has the meaning ascribed to it in NRS 687B.470.

-80th *SB87_R1*Session (2019) – 3435 – 3.

On or before February 1 of each year, a nonprofit organization that advocates on behalf of patients or funds medical research in this State and has received a payment, donation, subsidy or anything else of value from a manufacturer, third party or pharmacy benefit manager or a trade or advocacy group for manufacturers, third parties or pharmacy benefit managers during the immediately preceding calendar year shall:

If the nonprofit organization does not maintain an Internet website that is accessible 80th Session (2019) – 36 – to the public, the nonprofit organization shall submit the report compiled pursuant to paragraph (a) to the Department.

- *SB87_R1* – 35 – 2.

(b) Shall not collect or attempt to collect from the patient or other responsible party more than the sum of the amounts of any or deductible, copayment or coinsurance payable by or on behalf of the pat(c)patient Shallunder notthe collectpolicy orof attempthealth toinsurance. collect that amount from:

(c) Shall not collect or attempt to collect that amount from:

80th Session (2019) – 37 – 3.

- *SB87_R1* – 36 – (a) Amounts owed to the hospital which are not covered under the policy of health insurance;

-~~~~~ *SB87_R1*19 –80th 37Session –(2019) TEXT OF REPEALED SECTIONS provision of insurance, indemnity or reimbursement againstor cost of hospital, medical and dental services;

required provisions.

1.

A corporation organized under this chapter shall contract with an insurance company licensed in this State or authorized to do business in this State for the provision of insurance, indemnity or reimbursement against the cost of hospital services, medical services and dental services which are provided by the corporation.

2.

The contract of insurance required by subsection 1 must include a provision that, in the case of the insolvency or impairment of the corporation, the insurance company will pay all claims made be paid to the corporation for the insured.

The contract of insurance required by subsection 1 must specifically provide for the:

(a) Continuation of benefits to each insured for the period for which a premium has been or will be paid to the corporation for the insured until the expiration or termination of the insured’s contract with the corporation;

(b) Continuation of benefits for each insured who is receiving inpatient services in a medical facility or facility for the dependent at the time of the insolvency or impairment of the corporation until the inpatient services are no longer medically necessary and the insured is discharged from the medical facility or facility for the dep(c) Payment of a provider of health care not affiliated with the corporation who provided medically necessary services to an insured, as described in the insured’s contract with the corporation, the insured’s policy or the insured’s evidence of coverage.

3.

As used in this section:

(a) “Facility for the dependent” has the meaning ascribed to it in NRS 449.0045.

(b) “Impairment” means that a corporation organized under this chapter is not insolvent and has been:

(1) Deemed to be impaired pursuant to NRS 695B.150;

or (2) Placed under an order of rehabilitation or conservation by a c(c) “Insolvency” or “insolvent” means that a corporation organized under this chapter has been:

(1) Deemed to be insolvent pursuant to NRS 695B.150;

- *SB87_R1* – 38 – (2) Declared insolvent by a court of competent jurisdiction;

or (3) Placed under an order of liquidation by a court of competent jurisdiction.

(d) “Medical facility” has the meaning ascribed to it in NRS 449.0151.

(e) “Medically necessary” has the meaning ascribed to it in NRS 695G.055.

(f) “Provider of health care” has the meaning ascribed to it in NRS 629.031.

695C.3175 Required contract with insurance company for provision of insurance, indemnity or reimbursement against cost of health care services;

required provisions.

insurance company licensed in this State or authorized to doh an business in this State for the provision of insurance, indemnity or reimbursement against the cost of health care services which are provided by the health maintenance organization.

2.

The contract of insurance required by subsection 1 must include a provision that, in the case of the insolvency or impairment of the health maintenance organization, the insurance company will pay all claims made by an enrollee for the period for which a premium has been or will be paid to the health maintenance organization for the enrollee.

The contract of insurance required by subsection 1 must specifically provide for the:

which a premium has been or will be paid to the health maintenancer organization for the enrollee until the expiration or termination of the enrollee’s contract with the health maintenance organization;

(b) Continuation of benefits for each enrollee who is receiving inpatient services in a medical facility or facility for the dependent at the time of the insolvency or impairment of the health maintenance organization until the inpatient services are no longer medically necessary and the enrollee is discharged from the medical facility or facility for the dependent;

and (c) Payment of a provider of health care not affiliated with the health maintenance organization who provided medically necessary coverage.to an enrollee, as described in the enrollee’s evidence of 3.

As used in this section:

(a) “Facility for the dependent” has the meaning ascribed to it in NRS 449.0045.

(b) “Impairment” means that a health maintenance organization is not insolvent and has been:

(1) Deemed to be impaired pursuant to NRS 695C.318;

or - *SB87_R1* – 39 – (2) Placed under an order of rehabilitation or conservation by a c(c) “Insolvency” or “insolvent” means that a health maintenance organization has been:

(1) Deemed to be insolvent pursuant to NRS 695C.318;

(2) Declared insolvent by a court of competent jurisdiction;

or (3) Placed under an order of liquidation by a court of competent jurisdiction.

(d) “Medical facility” has the meaning ascribed to it in NRS 449.0151.

(e) “Medically necessary” has the meaning ascribed to it in NRS 695G.055.

NRS 629.031.ider of health care” has the meaning ascribed to it in 695C.3185 Plan for continuation of benefits if health maintenance organization becomes insolvent or impaired;

approval by Commissioner;

contents.

1.

Each health maintenance organization shall develop, submit to the Commissioner for approval and, after such approval, put into effect a plan to provide for the continuation of benefits to enrollees in the event of the insolvency or impairment of the health maintenance organization, including, without limitation, the benefits described in subsection 2 of NRS 695C.3175.

A plan developed pursuant to this subsection must include, without limitation:

requirements of NRS 695C.3175;

andch complies with the (b) Provisions in each contract between the health maintenance organization and a provider which obligate the provider, in the event of the health maintenance organization’s insolvency or impairment, to provide all covered services as described in the contract to enrollees through the periods of time described in subsection 2 of NRS 695C.3175.

2.

Before approving a plan submitted pursuant to subsection 1, the Commissioner may require the health maintenance organization to include in the plan:

(a) Reserves or additional reserves for protection against ins(b) Letters of credit acceptable to the Commissioner;

and (c) Any other arrangements determined by the Commissioner to be appropriate to ensure the continuation of benefits as described in subsection 2 of NRS 695C.3175 to enrollees.

H - *SB87_R1*