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633 of NRS.
(Added to NRS by 2001, 2736; A 2003, 3371)—(Substituted in revision for NRS 695G.270)
CHAPTER 695H - MEDICAL DISCOUNT PLANS
NRS 695H.010 Definitions.
NRS 695H.020 “Administrator” defined.
NRS 695H.030 “Affiliate of an insurer” defined.
NRS 695H.040 “Insurer” defined.
NRS 695H.050 “Medical discount plan” defined.
NRS 695H.060 “Provider of health care” defined.
NRS 695H.070 Medical discount plans under exclusive jurisdiction of Commissioner.
NRS 695H.080 Registration of medical discount plan required; exceptions.
NRS 695H.090 Application for registration; forms; fees; contents; renewal of registration; regulations.
NRS 695H.100 Person responsible for conducting business activities of medical discount plan prohibited from engaging in certain acts.
NRS 695H.110 Required disclosures.
NRS 695H.120 Type size for disclosures.
NRS 695H.130 Net worth.
NRS 695H.140 Examinations; inspection of accounts, books and records by Commissioner.
NRS 695H.150 Records.
NRS 695H.160 Regulations.
NRS 695H.170 Administrative penalty for commission of certain acts.
NRS 695H.180 Penalties.
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NRS 695H.010 Definitions. As used in this chapter, unless the context otherwise requires, the words and terms defined in NRS 695H.020 to 695H.060, inclusive, have the meanings ascribed to them in those sections.
(Added to NRS by 2005, 2101)
NRS 695H.020 “Administrator” defined. “Administrator” means a person authorized pursuant to NRS 683A.0805 to 683A.0893, inclusive, to conduct business in this State as an administrator.
(Added to NRS by 2005, 2101)
NRS 695H.030 “Affiliate of an insurer” defined. “Affiliate of an insurer” means a person who directly, or indirectly through one or more intermediaries, controls, is controlled by or is under common control with an insurer.
(Added to NRS by 2005, 2101)
NRS 695H.040 “Insurer” defined. “Insurer” means any insurer, fraternal benefit society, nonprofit corporation for hospital, medical and dental services, organization for dental care, health maintenance organization or prepaid limited health service organization authorized pursuant to this title to conduct business in this State.
(Added to NRS by 2005, 2101)
NRS 695H.050 “Medical discount plan” defined. “Medical discount plan” means a business arrangement or program evidenced by a membership agreement, contract, card, certificate, device or mechanism in which a person, in exchange for fees, dues, charges or any other form of consideration, offers to provide or provides health care or medical services at a discount from providers of health care who are participating in the business arrangement or program or whom the person advertises as or claims to be participating in the business arrangement or program.
(Added to NRS by 2005, 2101)
NRS 695H.060 “Provider of health care” defined. “Provider of health care” has the meaning ascribed to it in NRS 629.031.
(Added to NRS by 2005, 2101)
NRS 695H.070 Medical discount plans under exclusive jurisdiction of Commissioner. Notwithstanding any other provision of law, the Commissioner has exclusive jurisdiction to regulate medical discount plans in this State.
(Added to NRS by 2005, 2101)
NRS 695H.080 Registration of medical discount plan required; exceptions.
1. Except as otherwise provided in this section, it is unlawful for any person to offer, market, sell or engage in business as a medical discount plan in this State without first registering the medical discount plan pursuant to the provisions of this chapter.
2. An insurer is not required to register any medical discount plan pursuant to the provisions of this chapter unless the insurer offers, markets or sells the medical discount plan in this State for separate consideration.
3. If an affiliate of an insurer offers, markets, sells or engages in business as a medical discount plan in this State, the affiliate is required to register the medical discount plan pursuant to the provisions of this chapter.
4. The provisions of this chapter do not apply to any medical discount plan that offers or provides discounts only on prescriptions.
(Added to NRS by 2005, 2101)
NRS 695H.090 Application for registration; forms; fees; contents; renewal of registration; regulations.
1. An application for registration to engage in business as a medical discount plan must be submitted on a form prescribed by the Commissioner. The form must be signed by an officer or an authorized representative of the applicant. Except as otherwise provided in this section, the application must be accompanied by:
(a) A registration fee of $500.
(b) A copy of the organizational documents of the applicant, if any.
(c) A list of names, addresses, positions of employment and biographical information of each person who is responsible for conducting the business activities of the medical discount plan of the applicant, including, but not limited to, all members of the board of directors, board of trustees, officers and managers. The list must set forth the extent and nature of any contracts or other agreements between any person who is responsible for conducting the business activities of the applicant and the medical discount plan, including disclosure of any possible conflicts of interest.
(d) A complete biographical statement, on a form prescribed by the Commissioner, describing the facilities, employees and services that will be offered by the applicant.
(e) A copy of all forms used for contracts between the applicant and networks of providers of health care regarding the provision of health care or medical services to members.
(f) A copy of the most recent financial statements of the applicant, audited by an independent certified public accountant.
(g) A description of the method of marketing proposed by the applicant.
(h) A description of the procedures for making a complaint to be established and maintained by the applicant.
(i) Any other information required by the Commissioner.
2. Each person who registers a medical discount plan must renew the registration annually before the registration expires. Except as otherwise provided in this section, an application to renew the registration must include:
(a) An annual renewal fee of $500; and
(b) Any information set forth in subsection 1 that the Commissioner requires to be included in the application.
3. An administrator or insurer that registers a medical discount plan is not required to pay the fees for registering or renewing the registration of the medical discount plan pursuant to this section.
4. The Commissioner shall, by regulation, designate the provisions of subsection 1 that shall be deemed satisfied by an administrator, insurer or affiliate of an insurer that has complied with substantially similar requirements pursuant to other provisions of this title.
(Added to NRS by 2005, 2101)
NRS 695H.100 Person responsible for conducting business activities of medical discount plan prohibited from engaging in certain acts. A person who is responsible for conducting the business activities of a medical discount plan may not:
1. Use the word “insurance” or “enrollment” in any advertising or marketing material, brochures or discount cards for the medical discount plan unless approved by the Commissioner;
2. Use in any advertising or marketing material, brochures or discount cards for the medical discount plan the terms “coverage,” “copay,” “preexisting conditions,” “guaranteed issue,” “PPO,” “preferred provider organization” or any other term that could reasonably mislead a person into believing the medical discount plan is a policy of health insurance;
3. Pa
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