Chapter 695F - Prepaid Limited Health Service Organizations
- CERTIFICATE OF AUTHORITY
- ELIGIBILITY FOR COVERAGE
- 695F.440 - Effect of eligibility for medical assistance under Medicaid; assignment of rights to state agency.
- 695F.450 - Organization prohibited from asserting certain grounds to deny enrollment of child pursuant to order if parent is insured.
- 695F.460 - Certain accommodations to be made when child is covered under evidence of coverage of noncustodial parent.
- 695F.470 - Organization to authorize enrollment of child of parent who is required by order to provide medical coverage under certain circumstances; termination of coverage of child.
- 695F.480 - Organization prohibited from restricting coverage of child based on preexisting condition if person who is eligible for group coverage adopts or assumes legal obligation for child.
- GENERAL PROVISIONS
- 695F.010 - Definitions.
- 695F.020 - “Enrollee” defined.
- 695F.030 - “Evidence of coverage” defined.
- 695F.040 - “Limited health service” defined.
- 695F.043 - “Medicaid” defined.
- 695F.047 - “Order for medical coverage” defined.
- 695F.050 - “Prepaid limited health service organization” defined.
- 695F.060 - “Provider” defined.
- 695F.070 - “Subscriber” defined.
- 695F.080 - General applicability of title 57 of NRS.
- 695F.090 - Applicable statutory provisions.
- MISCELLANEOUS PROVISIONS
- 695F.400 - License required to apply, procure, negotiate or place for another any policy or contract of organization.
- 695F.410 - Confidentiality and disclosure of information.
- 695F.420 - Certain insurers and organizations may exclude coverage duplicated pursuant to this chapter.
- 695F.430 - Provision of services excluded from practice of any healing arts; solicitation excluded from statutory provisions regarding solicitation or advertising by practitioner of healing art.
- OPERATION
- 695F.150 - Evidence of coverage: Issuance; contents; amendment.
- 695F.153 - Coverage for prescription drugs: Provision of notice and information regarding use of formulary.
- 695F.156 - Coverage for prescription drug previously approved for medical condition of enrollee.
- 695F.160 - Rates and charges: Reasonableness.
- 695F.170 - Procedure for modification of rates, charges, benefits, organization, operations, documents or services.
- 695F.180 - Investments.
- 695F.190 - Requirements for reserve.
- 695F.200 - Maintenance of capital account and surety.
- 695F.210 - Maintenance of fidelity bond or deposit in lieu of bond.
- 695F.215 - Required contract with insurance company for provision of insurance, indemnity or reimbursement against cost of health care services.
- 695F.220 - Contract between organization and provider or subcontractor for provision of services to enrollees.
- 695F.230 - Establishment of system for resolution of complaints.
- REGULATION AND ENFORCEMENT
- 695F.300 - Regulations of Commissioner.
- 695F.310 - Examination of affairs of organization.
- 695F.320 - Reports to Commissioner; fine and suspension for noncompliance.
- 695F.330 - Payment of tax.
- 695F.340 - Fees.
- 695F.350 - Suspension or revocation of certificate of authority.
- 695F.360 - Violations of chapter: Order to cease and desist; fine.