NRS 689B.550
Carrier prohibited from imposing restriction on participation inconsistent with chapter

  • restrictions on rules of eligibility that may be established.

1.

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.

2.

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, 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.

(b)

Medical condition, including physical and mental illnesses, or both.

(c)

Claims experience.

(d)

Receipt of health care.

(e)

Medical history.

(f)

Genetic information.

(g)

Evidence of insurability, including conditions which arise out of acts of domestic violence.

(h)

Disability.

3.

Except as otherwise provided in NRS 689B.500, the provisions of subsection 1 do not:

(a)

Require a carrier to provide particular benefits other than those that would otherwise be provided under the terms of the blanket health and accident insurance or group health insurance or coverage; or

(b)

Prevent a carrier from establishing limitations or restrictions on the amount, level, extent or nature of the benefits or coverage for similarly situated persons.

4.

As a condition of enrollment or continued enrollment under a policy of blanket accident and health insurance or group health insurance, a carrier shall not require an employee 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 employee or a dependent of the employee.

5.

This section does not:

(a)

Restrict the amount that an employer or employee may be charged for coverage by a carrier;

(b)

Prevent a carrier from establishing premium discounts or rebates or from modifying otherwise applicable copayments or deductibles in return for adherence by the insured person to programs of health promotion and disease prevention; 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.

Source: Section 689B.550 — Carrier prohibited from imposing restriction on participation inconsistent with chapter; restrictions on rules of eligibility that may be established., https://www.­leg.­state.­nv.­us/NRS/NRS-689B.­html#NRS689BSec550.

689B.340
Definitions. 689B.350
“Affiliation period” defined. 689B.355
“Blanket accident and health insurance” defined. 689B.360
“Carrier” defined. 689B.370
“Contribution” defined. 689B.380
“Creditable coverage” defined. 689B.390
“Group health plan” defined. 689B.400
“Group participation” defined. 689B.430
“Open enrollment” defined. 689B.440
“Plan sponsor” defined. 689B.450
“Preexisting condition” defined. 689B.460
“Waiting period” defined. 689B.480
Determination of applicable creditable coverage of person 689B.490
Written certification of coverage required for purpose of determining period of creditable coverage accumulated by person. 689B.500
Requirements regarding issuance of health benefit plans and adjustment of costs. 689B.510
Carrier authorized to modify coverage for insurance product under certain circumstances. 689B.520
Group plan or coverage that includes coverage for maternity care and pediatric care: Required to allow minimum stay in hospital in connection with childbirth 689B.530
Carrier required to permit eligible employee or dependent of employee to enroll for coverage under certain circumstances. 689B.540
Manner and period for enrollment of dependent of covered employee 689B.550
Carrier prohibited from imposing restriction on participation inconsistent with chapter 689B.560
Carrier required to renew coverage at option of plan sponsor 689B.570
Carrier that offers coverage through network plan not required to offer coverage to employer that does not employ enrollees who reside or work in geographic service area for which carrier is authorized to transact insurance. 689B.580
Plan sponsor of governmental plan authorized to elect to exclude governmental plan from compliance with certain statutes
Last Updated

Feb. 5, 2021

§ 689B.550’s source at nv​.us