Nevada Insurance
Sec. § 687B.470
“Health benefit plan” defined.


1.

As used in NRS 687B.470 to 687B.500, inclusive, health benefit plan means a policy, contract, certificate or agreement offered by a carrier to provide for, deliver payment for, arrange for the payment of, pay for or reimburse any of the costs of health care services. Except as otherwise provided in this section, the term includes catastrophic health insurance policies and a policy that pays on a cost-incurred basis.

2.

The term does not include:

(a)

Coverage that is only for accident or disability income insurance, or any combination thereof;

(b)

Coverage issued as a supplement to liability insurance;

(c)

Liability insurance, including general liability insurance and automobile liability insurance;

(d)

Workers compensation or similar insurance;

(e)

Coverage for medical payments under a policy of automobile insurance;

(f)

Credit insurance;

(g)

Coverage for on-site medical clinics;

(h)

Other similar insurance coverage specified pursuant to the Health Insurance Portability and Accountability Act of 1996, Public Law 104-191, under which benefits for medical care are secondary or incidental to other insurance benefits;

(i)

Coverage under a short-term health insurance policy; and

(j)

Coverage under a blanket student accident and health insurance policy.

3.

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

(a)

Limited-scope dental or vision benefits;

(b)

Benefits for long-term care, nursing home care, home health care or community-based care, or any combination thereof; and

(c)

Such other similar benefits as are specified in any federal regulations adopted pursuant to the Health Insurance Portability and Accountability Act of 1996, Public Law 104-191.

4.

The term does not include the following benefits if the benefits are provided under a separate policy, certificate or contract, there is no coordination between the provisions of the benefits and any exclusion of benefits under any group health plan maintained by the same plan sponsor, and the benefits are paid for a claim without regard to whether benefits are provided for such a claim under any group health plan maintained by the same plan sponsor:

(a)

Coverage that is only for a specified disease or illness; and

(b)

Hospital indemnity or other fixed indemnity insurance.

5.

The term does not include any of the following, if offered as a separate policy, certificate or contract of insurance:

(a)

Medicare supplemental health insurance as defined in section 1882(g)(1) of the Social Security Act, 42 U.S.C. 1395ss, as that section existed on July 16, 1997;

(b)

Coverage supplemental to the coverage provided pursuant to the Civilian Health and Medical Program of Uniformed Services, CHAMPUS, 10 U.S.C. 1071 et seq.; and

(c)

Similar supplemental coverage provided under a group health plan.
Source
Last accessed
Nov. 19, 2019