NRS 689A.710 Prohibited acts; denial of application for coverage; regulations; violation may constitute unfair trade practice; applicability of section.

465 words·~2 min read·/nv/chapter-689a-individual-health-insurance/689a-710·

A research copy — for the controlling text, always check the official state or federal source. Not legal advice.

1. Except as otherwise provided in this section, an individual carrier or a producer shall not, directly or indirectly:

(a)Encourage or direct an individual or family to refrain from filing an application for coverage with an individual carrier because of the health status, claims experience, industry, occupation or geographic location of the individual or family.

(b)Encourage or direct an individual or family to seek coverage from another carrier because of the health status, claims experience, industry, occupation or geographic location of the individual or family.

2. The provisions of subsection 1 do not apply to information provided to an individual or family by an individual carrier or a producer relating to the geographic service area or a provision for a restricted network of the individual carrier.

3. An individual carrier shall not, directly or indirectly, enter into any contract, agreement or arrangement with a producer if the contract, agreement or arrangement provides for or results in a variation to the compensation paid to a producer for the sale of a health benefit plan because of the health status, claims experience, industry, occupation or geographic location of the individual at the time that the health benefit plan is issued to or renewed by the individual.

4. An individual carrier shall not terminate, fail to renew, or limit its contract or agreement of representation with a producer for any reason related to the health status, claims experience, industry, occupation or geographic location of an individual at the time that the health benefit plan is issued to or renewed by the individual placed by the producer with the individual carrier.

5. A denial by an individual carrier of an application for coverage from an individual or family must be in writing and must state the reason for the denial.

6. The Commissioner may adopt regulations that set forth additional standards to provide for the fair marketing and broad availability of health benefit plans to individuals or families in this state.

7. A violation of any provision of this section by an individual carrier may constitute an unfair trade practice for the purposes of chapter 686A of NRS.

8. The provisions of this section apply to a third-party administrator if the third-party administrator enters into a contract, agreement or other arrangement with an individual carrier to provide administrative, marketing or other services related to the offering of a health benefit plan to individuals or families in this state.

9. Nothing in this section interferes with the right and responsibility of a producer to advise and represent the best interests of an individual or family who is seeking health insurance coverage from an individual carrier.

Individual Health Insurance Coverage