SB 482 — Revises provisions relating to health insurance. (BDR 57-531)
Last action — Chapter 251.
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✓Introduced
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✓In Committee
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✓Passed Senate
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✓Passed Assembly
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✓To Executive
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6Enacted
This bill has been enacted into law. Introduced March 25, 2019. Enacted.
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Summary
AN ACT relating to health insurance; authorizing the Commissioner of Insurance to enter into certain types of interstate compacts; authorizing the Commissioner to allow reciprocal licensure with certain states; authorizing the Commissioner to apply to the Secretary of Health and Human Services for a certain waiver; removing certain waiting period requirements for health benefit plans for individuals not purchased on the Silver State Health Insurance Exchange; and providing other matters properly relating thereto.
Bill Text
What changed in the latest version
533 added · 587 removed533 line(s) added, 587 removed.
REQUIRESSenate TWO-THIRDSBill MAJORITYNo. VOTE (§ 1) (Reprinted with amendments adopted on April 17, 2019) FIRST REPRINT S.B.
482482–Committee SENATEon BHealth ILLNand O.Human Services CHAPTER..........
482–COMMITTEE ON H EALTH AND H UMAN SERVICES (O N BEHALF OF THE LEGISLATIVE COMMITTEE ON HEALTH C ARE) M ARCH 25, 2019 ____________ Referred to Committee on Commerce and Labor SUMMARY—Revises provisions relating to health insurance.
(BDR 57-531) FISCAL NOTE:
Effect on Local Government:
No.
Effect on the State:
Yes.
~ EXPLANATION – Matter in bolded italics is new;
matter between brackets [omitted material] is material to be omitted.
§§ 1011-1015) In 2010, the United States Congress enacted the Patient Protection and Affordable Care Act, through which the United States Congress authorized two or more states to enterct,enter into healthcare choice compacts under which the issuer of any qualified health plan to(2) whichsubmit to the compactjurisdiction appliesof wouldeach besuch requiredstate. to:
(1) be licensed in each state;
or (2) submit to the jurisdiction of each such state.
§ 18053(a)(1)(B)(ii))18053(a)(1)(B)(ii))r Existing law authorizes the Commissioner of Insurance to enter into such compacts with the regulatory officers in other states to further the uniform treatment of authorizesinsurers throughout the CommissionerUnited toStates. enter into such compacts to also ensure:
(NRS 679B.220) Section 2 of this bill authorizes the Commissioner to enter into such compacts to also ensure:
Section 1 of - *SB482_R1* – 2 – this bill authorizes the Commissioner to allow reciprocal licenses to be issued to health carriers that are licensed to do business in Arizona, California, Idaho, of authority to do business in Nevada.
Federal law authorizes a state to apply to the Secretary of Health and Human Services for a waiver of various requirements of the Patient Protection andumanand Affordable Care Act with respect to health insurance coverage in the state for a language into state law by authorizing the Commissioner to apply for such a waiver for a plan year.year beginning on January 1, 2020.
(42 U.S.C.
§ 18502) Section 45 of this bill incorporates this federal language into state law by authorizing the Commissioner to apply for such a waiver for a plan year beginning on January 1, 2020.
Existing law requires any health benefit plan for individuals that is not purchased on the Silver State Health Insurance Exchange to be:
(3) effective upon the first day of the month immediately after the month in which the waiting period ends;
and (4) not retroactive to the date on which the application for - 80th Session (2019) – 2 – coverage was received.
EXPLANATION – Matter in bolded italics is new;
matter between brackets [omitted material] is material to be omitted.
The Commissioner shall communicate on request of the regulatory officer for insurance in any state, province or country any information which it is the duty of the CommissionerCommissionernce by law to ascertain respecting authorized insurers.
- *SB482_R1* – 3 – (b) Exchange with the association or any successor organization any information, not otherwise confidential, relating to applicants and licensees under this title;
Sec.- 80th Session (2019) – 3 – Secs.
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The Commissioner may implement a state plan that meets the waiver requirements in a manner consistent with state and federal law and as approved by the Secretary of Health and Human Services.
as approved by the Secretary of Health and Sec.
The Legislature intends that NRS 686B.010 to 686B.1799, inclusive, and section 45 of this act be liberally construed to achieve the purposes stated in subsection 2, which constitute an aid and guide to interpretation but not an independent sou2.source of power.
2.
(d) Authorize cooperative action among insurers in the rate- making process, and to regulate such cooperation in order to prevent practices that tend to bring about monopoly or to lessen or destroy competition;com(e) Encourage the most efficient and economic marketing practices;
(e) Encourage the most efficient and economic marketing practices;
- *SB482_R1* – 5 – Sec.
For the purposes of this subsection, two or more insurers with common ownership or operating in this - 80th Session (2019) – 4 – State under common ownership constitute a single insurer.
“Rate service organization” means any person, other than an employeeby:loyee of an insurer, who assists insurers in rate making or filing by:(a) Collecting, compiling and furnishing loss or expense statistics;
(a) Collecting, compiling and furnishing loss or expense statistics;
or legal(c) advice.ngAdvising about rate questions, except as an attorney giving 4.legal advice.
“Supplementary4. rate information” includes any manual or minimum premium, policy fee, rating rule, rule of underwritingle, relating to rates and any other information prescribed by regulation of the Commissioner.
“Supplementary rate information” includes any manual or plan of rates, statistical plan, classification, rating schedule, minimum premium, policy fee, rating rule, rule of underwriting relating to rates and any other information prescribed by regulation of the Commissioner.
(b)(c) ContractsLife issuedinsurance byand fraternalcredit benefitlife societies;insurance;ieties;
(c) Life insurance and credit life insurance;
- *SB482_R1* – 6 – (h) Surety insurance;
- 80th Session (2019) – 5 – 2.
Except as otherwise provided in subsection 2, the Commissioner may by rule exempt any person or class of persons or any market segment from any or all of the provisions of NRS 686B.010 to 686B.1799, inclusive, and section 45 of this act if and to the extent that the Commissioner finds their application unnecessaryunn2. to achieve the purposes of those sections.
2.
Except as otherwise provided in subsections 2 to 5, inclusive, each filing and any supporting information filed under NRS 686B.010 to 686B.1799, inclusive, and section 45 of this act must, as soon as filed, be open to public inspection at anysany act reasonable time.
Copies may be obtained by any person on request and2.ponAll rates for health benefit plans available for purchase by individuals and smallupon employerspayment areof considered proprietary and constitute trade secrets, and are not subject to disclosure by the Commissioner to persons outside the Division except as agreed to by the carrier or as ordered by a courtreasonable ofcharge competenttherefor. jurisdiction.
2.
All rates for health benefit plans available for purchase by individuals and small employers are considered proprietary and constitute trade secrets, and are not subject to disclosure by the Commissioner to persons outside the Division except as agreed to by the carrier or as ordered by a court of competent jurisdiction.
The provisions of subsection 2 expire annually on the date 304.ys daysExcept beforein opencases enrollment.of violations of NRS 689A.010 to 689A.740, inclusive, or 689C.015 to 689C.355, inclusive, the unified rate review template and rate filing documentation used by carriers servicing the individual and small employer markets are considered proprietary and constitute a trade secret, and are not subject to disclosure by the Commissioner to persons outside the Division except as agreed to by the carrier or as ordered by a court of competent jurisdiction.
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Except in cases of violations of NRS 689A.010 to 689A.740, inclusive, or 689C.015 to 689C.355, inclusive, the unified rate review template and rate filing documentation used by carriers servicing the individual and small employer markets are considered proprietary and constitute a trade secret, and are not subject to disclosure by the Commissioner to persons outside the Division except as agreed to by the carrier or as ordered by a court of competent jurisdiction.
An insurer providing blanket health insurance in accordance with the provisions of chapter 689B of NRS shall make all information concerning rates available to the Commissioner upon - *SB482_R1* – 7 – request.
Such information is considered proprietary and constitutes a trade secret and is not subject to disclosure by the Commissioner to - 80th Session (2019) – 6 – persons outside the Division except as agreed by the insurer or as ordered by a court of competent jurisdiction.
686B.110the 1.Commissioner shall consider each proposed increase or decrease in the rate of any kind or line of insurance or subdivision thereof filed with the Commissioner pursuant to subsection 1 of NRS 686B.070.
Except as otherwise provided in NRS 686B.112, the Commissioner shall consider each proposed increase or decrease in the rate of any kind or line of insurance or subdivision thereof filed with the Commissioner pursuant to subsection 1 of NRS 686B.070.
decrease2. in any rate pursuant to subsection 1, the Commissioner shall send a written notice of disapproval to the insurer or the rate forth the reasons the proposal is not in compliance with NRSt set 686B.050 or subsection 3 of NRS 686B.070 and must be sent to the insurer or the rate service organization not more than 30 days after the Commissioner determines that the proposal is complete pursuant to subsection 6.
3.If the Commissioner disapproves a proposed increase or decrease in any rate pursuant to subsection 1, the Commissioner shall send a written notice of disapproval to the insurer or the rate service organization that filed the proposal.
UponThe notice must set forth the reasons the proposal is not in compliance with NRS 686B.050 or subsection 3 of NRS 686B.070 and must be sent to the insurer or the rate service organization not more than 30 days after the Commissioner determines that the proposal is complete pursuant to 3.bseUpon receipt of a written notice of disapproval from the Commissioner pursuant to subsection 2 or 6, the insurer or rate service organization may request that the Commissioner reconsider the proposed increase or decrease.
The - *SB482_R1*80th Session (2019) – 87 – Commissioner shall approve or disapprove the proposal upon reconsideration not later than 30 days after receipt of the request for reconsideration and shall notify the insurer or rate service organization of his or her approval or disapproval.
Whenever an insurer has no legally effective rates as a result of the Commissioner’s disapproval of rates or other act, the Commissioner shall on request specify interim rates for the insurer that are high enough to protect the interests of all parties and may order that a specified portion of the premiums be placed in an escrowbecome accountlegally approvedeffective, bythe Commissioner shall order thes escrowed funds or any overcharge in the Commissioner.interim rates to be distributed appropriately, except that refunds to policyholders that are de minimis must not be required.
When new rates become legally effective, the Commissioner shall order the escrowed funds or any overcharge in the interim rates to be distributed appropriately, except that refunds to policyholders that are de minimis must not be required.
or (b) Within a period agreed upon by the insurer and the Commissioner.
a period agreed upon by the insurer and the If the hearing is not held within the period specified in paragraph (a) or (b), or if the Commissioner fails to issue an order concerning the proposed rate for which the hearing is held within 45 days aftergafter the hearing, the proposed rate shall be deemed approved.
6.documents or any other information which must be included in ae proposal to increase or decrease a rate submitted to the Commissioner pursuant to subsection 1.
The Commissioner shall by regulation specify the documents or any other information which must be included in a proposal to increase or decrease a rate submitted to the Commissioner pursuant to subsection 1.
The - 80th Session (2019) – 8 – Commissioner may disapprove the proposal if the insurer or rate service organization fails to provide the documents or other - *SB482_R1* – 9 – information to the Commissioner within 30 days after the insurer or rate service organization receives the notice that the proposal is incomplete.
The Commissioner shall consider each proposed increase or decrease in the rate of a health plan issued pursuant to the provisions of chapter 689A, 689B, 689C, 695B, 695C, 695D orornt to 695F of NRS, including, without limitation, long-term care and Medicare supplement plans, filed with the Commissioner pursuant to subsection 1 of NRS 686B.070.
Whenever an insurer has no legally effective rates as a result of the Commissioner’s disapproval of rates or other act, the Commissioner shall on request specify interim rates for the insurer that are high enough to protect the interests of all parties and may order that a specified portion of the premiums be placed in anndan may escrow account approved by the Commissioner.
When new rates escrowedbecome fundslegally oreffective, any overcharge in the interimCommissioner ratesshall toorder bethe distributed appropriately, except that refunds to policyholders that are de minimis must not be required.
- 80th Session (2019) – 9 – If the hearing is not held within the period specified in paragraph (a) or (b), or if the Commissioner fails to issue an order concerning the proposed rate for which the hearing is held within 45 days after the hearing, the proposed rate shall be deemed approved.
- *SB482_R1* – 10 – 4.
Each such proposal shall be deemed complete upon its filing with the Commissioner, unless the Commissioner, within 15 business days after the proposal is filed with the Commissioner, determines that the proposal is incomplete because the proposal does not comply with the regulations adopted by the Commissioner pursuant to this subsection.
At any hearing which is held by the Commissioner to determine whether rates comply with the provisions of NRS 686B.010 to 686B.1799, inclusive, and section 45 of this act and which involves rates for insurance covering the liability of a practitioner licensed pursuant to chapter 630, 631, 632 or 633 of NRS for a breach of the practitioner’s professional duty toward a patient, if a person is not otherwise authorized pursuant to this title to become a party to the hearing by intervention, the person is entitled to provide testimony at the hearing if, not later than 2 days beforeCommissioner thea datewritten setstatement forwhich thestates:n hearing, the person files with the Com(a)(a) The name and title of the person;tates:person;
- 80th Session (2019) – 10 – (b) The Commissioner shall consider all relevant testimony provided by the person at the hearing in determining whether the rates comply with the provisions of NRS 686B.010 to 686B.1799, inclusive [.] , and section 45 of this act.
A rate service organization and an advisory organization shall not provide any service relating to the rates of any - *SB482_R1* – 11 – insurance subject to NRS 686B.010 to 686B.1799, inclusive, and section 45 of this act and an insurer shall not utilize the services of an organization for such purposes unless the organization has obtained a license pursuant to NRS 686B.140.
organization has 2.
(a) No life or health insurance policy or contract, annuity contract form, policy form, health care plan or plan for dental care, whether individual, group or blanket, including those to be issued by a health maintenance organization, organization for dental care or prepaid limited health service organization, or application form where a written application is required and is to be made a part of the policy or contract, or printed rider or endorsement form or form of renewal certificate, or form of individual certificate or statement of coverage to be issued under group or blanket contracts, or by a health maintenance organization, organization for dental care or prepaid limited health service organization, may be delivered or issued for delivery in this state, unless the form has been filed with and(b) As to individual policies pursuant to paragraph (d) of subsection 2 of NRS 679B.220 or group insurance policies effectuated and approveddelivered byoutside this state but covering persons resident in this state, the [group] certificates to be delivered or issued for delivery in this state must be filed, for informational purposes only, with the Commissioner at the request of the Commissioner.
subsection 2 of NRS 679B.220 or group insurance policiesd) of effectuated and delivered outside this state but covering persons issued for delivery in this state must be filed, for informationalr purposes only, with the Commissioner at the request of the Commissioner.
- 80th Session (2019) – 11 – 3.
The Commissioner may extend by not more than an additional 30 days the period within which the - *SB482_R1* – 12 – Commissioner may so affirmatively approve or disapprove any such form, by giving notice to the insurer of the extension beforebeforeuch expiration of the initial 45-day period.
The Commissioner may, by order, exempt from the requirements of this section for so long as the Commissioner deems proper any insurance document or form or type thereof specified in the order, to which, in the opinion of the Commissioner, this section may not practicably be applied, or the filing and approval of which are, in the opinion of the Commissioner, not desirable or necessary forfor6.he theAppeals protectionfrom orders of the public.Commissioner disapproving any such form or withdrawing a previous approval may be taken as provided in NRS 679B.310 to 679B.370, inclusive.
6.Sec.
Appeals from orders of the Commissioner disapproving any such form or withdrawing a previous approval may be taken as proSec.
687B.480 [1.] All health benefit plans must be made ava[2.blInavailable additionin to the requirementsmanner ofrequired subsection 1, any health benefit plan for individuals that is not purchased on the Silver State Health Insurance Exchange established by NRS45 695I.210:C.F.R.
§ 147.104.
[2.
In addition to the requirements of subsection 1, any health benefit plan for individuals that is not purchased on the Silver State Health Insurance Exchange established by NRS 695I.210:
- 80th Session (2019) – 12 – (c) Is effective upon the first day of the month immediately succeeding the month in which the waiting period expires;
In each rating plan of an insurer that issues a policy of professional liability insurance to a practitioner licensed pursuant to chapter 630 or 633 of NRS, the insurer shall provide for a reduction in the premium for the policy if the practitioner implements a qualified risk management system.
The amount of the - *SB482_R1* – 13 – reduction in the premium must be determined by the Commissioner in accordance with the applicable standards for rates established in NRS 686B.010 to 686B.1799, inclusive [.] , and section 45 of this act.
The Commissioner may collect all information which is pertinent to monitoring whether an insurer that issues professional liability insurance for a practitioner licensed pursuant to chapter 630, 631, 632 or 633 of NRS is complying with the pursuant applicable standards for rates established in NRS 686B.010 to 686B.1799, inclusive [.] , and section 45 of this act.
medical(a) specialty;ofThe amount of gross premiums collected with regard to each (b)medical Informationspecialty; relating to loss ratios;
(d)(b) Information reportedrelating pursuant to NRSloss 679B.430ratios; andd 679B.440.
(c) Information reported pursuant to NRS 690B.260;
and (d) Information reported pursuant to NRS 679B.430 and 679B.440.
- 80th Session (2019) – 13 – (a) Whose rates and credit utilization are materially different from other insurers in the market for professional liability insurance for a practitioner licensed pursuant to chapter 630, 631, 632 or 633 of NRS in this State;
and - *SB482_R1* – 14 – (b) Take any steps permitted by law that are necessary and appropriate to assure the ongoing stability of the market for professional liability insurance for a practitioner licensed pursuant to chapter 630, 631, 632 or 633 of NRS in this State.
On an ongoing basis, the Commissioner may analyze and evaluate the information collected pursuant to this section to determine trends in and measure the health of the market for professional liability insurance for a practitioner licensed pursuant to chapter 630, 631, 632 or 633 of NRS in this State.
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This section and sections 1 to 55, inclusive, 58, 59 and 60 of this act become effective upon passage and approval.
H~~~~~ 19 - *SB482_R1*80th Session (2019)
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- Enrolled As Enrolled Current pdf
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Amendments
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Action History
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Chapter 251.
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Approved by the Governor.
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Enrolled and delivered to Governor.
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In Senate. To enrollment.
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Read third time. Passed. Title approved. (Yeas: 39, Nays: None, Excused: 2, Vacant: 1.) To Senate.
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Taken from General File. Placed on General File for next legislative day.
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Taken from General File. Placed on General File for next legislative day.
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Taken from General File. Placed on General File for next legislative day.
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Read second time.
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From committee: Do pass.
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In Assembly. Read first time. Referred to Committee on Commerce and Labor. To committee.
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From printer. To engrossment. Engrossed. First reprint. Read third time. Passed, as amended. Title approved, as amended. (Yeas: 21, Nays: None.) To Assembly.
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From committee: Amend, and do pass as amended. Placed on Second Reading File. Read second time. Amended. (Amend. No. 318.) To printer.
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Notice of eligibility for exemption.
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From printer. To committee.
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Read first time. Referred to Committee on Commerce and Labor. To printer.
Sponsors
- Senate Committee on Health and Human Services · Primary
Sponsorship breakdown
Export CSV (upgrade) →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.
Subjects
Frequently asked questions
- What does SB 482 do?
- AN ACT relating to health insurance; authorizing the Commissioner of Insurance to enter into certain types of interstate compacts; authorizing the Commissioner to allow reciprocal licensure with certain states; authorizing the Commissioner to apply to the Secretary of Health and Human Services for a certain waiver; removing certain waiting period requirements for health benefit plans for individuals not purchased on the Silver State Health Insurance Exchange; and providing other matters properly relating thereto.
- Who sponsors SB 482?
- SB 482 is sponsored by Senate Committee on Health and Human Services.
- What is the current status of SB 482?
- This bill has been enacted into law. Introduced March 25, 2019. Enacted.
- Where can I track SB 482?
- Track SB 482 free on One Click Politics — get push/email alerts when it moves.
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