Coverage offered through network plan not required to be offered to eligible person who does not reside or work in established geographic service area.
1. An individual carrier that offers coverage through a network plan is not required pursuant to NRS 689A.630 to offer coverage to or accept an application from an eligible person if the eligible person does not reside or work in the established geographic service area or in a geographic area for which the individual carrier is authorized to transact insurance, provided that the coverage is refused or terminated uniformly without regard to any health status-related factor of any eligible person.
2. As used in this section, “network plan” means a health benefit plan offered by a health carrier under which the financing and delivery of medical care is provided, in whole or in part, through a defined set of providers under contract with the carrier. The term does not include an arrangement for the financing of premiums.
Last modified: February 27, 2006