Applicability; ceding arrangement prohibited in certain circumstances.
1. NRS 689A.470 to 689A.740, inclusive, apply to:
(a) Any health benefit plan that must be made available to eligible persons; and
(b) Any certificate issued to a trust or an association or other similar groupings of persons for coverage of eligible persons,
Ê regardless of the location of delivery of the policy or certificate, if the eligible person pays the premium and is not otherwise covered under the policy or contract pursuant to any federal or state law relating to the continuation of benefits.
2. For the purposes of NRS 689A.470 to 689A.740, inclusive, and except as otherwise provided in subsection 3, two or more individual carriers which are affiliated companies or which are eligible to file a consolidated tax return shall be deemed to be one individual carrier, and any restriction or limitation imposed by NRS 689A.470 to 689A.740, inclusive, applies as if all health benefit plans delivered or issued for delivery to eligible persons in this state by the affiliated individual carriers were issued by one individual carrier.
3. An affiliated individual carrier that is a health maintenance organization having a certificate of authority issued pursuant to the provisions of chapter 695C of NRS may be considered a separate individual carrier for the purposes of NRS 689A.470 to 689A.740, inclusive.
4. Unless otherwise authorized by the Commissioner, an individual carrier shall not enter into any ceding arrangement with respect to a health benefit plan delivered or issued for delivery to any eligible person in this state if the ceding arrangement would result in the ceding individual carrier retaining less than 30 percent of the insurance obligations or risks for that health benefit plan.
Last modified: February 27, 2006