NRS 695G.155
Requirements regarding issuance of health benefit plans and adjustment of costs.
1.
A managed care organization shall offer and issue a health benefit plan to any person regardless of the health status of the person or any dependent of the person. Such health status includes, without limitation:(a)
Any preexisting medical condition of the person, including, without limitation, any physical or mental illness;(b)
The claims history of the person, including, without limitation, any prior health care services received by the person;(c)
Genetic information relating to the person; and(d)
Any increased risk for illness, injury or any other medical condition of the person, including, without limitation, any medical condition caused by an act of domestic violence.2.
A managed care organization that offers or issues a health benefit plan shall not:(a)
Deny, limit or exclude a covered benefit based on the health status of an insured; or(b)
Require an insured, as a condition of enrollment or renewal, to pay a premium, deductible, copay or coinsurance based on his or her health status which is greater than the premium, deductible, copay or coinsurance charged to a similarly situated insured who does not have such a health status.3.
A managed care organization that offers or issues a health benefit plan shall not adjust a premium, deductible, copay or coinsurance for any insured on the basis of genetic information relating to the insured or the covered dependent of the insured.4.
A managed care organization that offers or issues a health benefit plan may include in the plan a wellness program that reduces a premium, deductible or copayment based on health status if:(a)
An insured who is eligible to participate in the wellness program is given the opportunity to qualify for the discount at least once each year;(b)
The amount of all discounts provided pursuant to such a wellness program does not exceed 30 percent, or if the program is designed to prevent or reduce tobacco use, 50 percent, of the cost of coverage for an insured or an insured and his or her dependents, as applicable, under the plan;(c)
The wellness program is reasonably designed to promote health or prevent disease;(d)
The managed care organization ensures that the full discount under the wellness program is available to all similarly situated insureds by providing a reasonable alternative standard by which an insured may qualify for the discount which, if based on health status, must accommodate the recommendations of the physician of the insured; and(e)
The plan discloses in all plan materials describing the terms of the wellness program, and in any disclosure that an insured did not satisfy the initial standard to be eligible for the discount, the availability of a reasonable alternative standard described in paragraph (d).5.
As used in this section, “health benefit plan” has the meaning ascribed to it in NRS 687B.470.
Source:
Section 695G.155 — Requirements regarding issuance of health benefit plans and adjustment of costs., https://www.leg.state.nv.us/NRS/NRS-695G.html#NRS695GSec155.