Basis for premium rate
1.The premium rate charged by a health insurer for health benefit plans offered in the individual or small employer group market may vary with respect to the particular plan or coverage involved based solely on these characteristics:
(a)Whether the plan or coverage applies to an individual or a family;
(b)Geographic rating area;
(c)Tobacco use, except that the rate shall not vary by a ratio of more than 1.5 to 1 for like individuals who vary in tobacco use; and
(d)Age, except that the rate must not vary by a ratio of more than 3 to 1 for like individuals of different age who are age 21 years or older and that the variation in rate must be actuarially justified for individuals who are under the age of 21 years, consistent with the uniform age rating curve established in the Federal Act. For the purpose of identifying the appropriate age adjustment under this paragraph and the age band defined in the Federal Act to a specific enrollee, the enrollee’s age as of the date of policy issuance or renewal must be used.
2.The provisions of subsection 1:
(a)Apply to a fraternal benefit society organized under chapter 695A of NRS; and
(b)Do not apply to grandfathered plans.
3.As used in this section, “small employer” has the meaning ascribed to it in NRS 689C.095.
Section 687B.500 — Basis for premium rate; exceptions.,