Information required to be disclosed as part of solicitation and sales materials; information required to be maintained at place of business; actuarial certification required to be filed with Commissioner.
1. As part of its solicitation and sales materials for an individual health benefit plan, an individual carrier shall disclose, to the extent reasonable:
(a) The extent to which premium rates for an individual and his dependent are established or adjusted based upon rating characteristics;
(b) The right of the individual carrier to change premium rates and the factors, other than claims experience, that may affect changes in premium rates;
(c) Any provisions in the individual health benefit plan relating to the renewability of the plan; and
(d) Any provisions in the individual health benefit plan relating to an exclusion for a preexisting condition.
2. For the purposes of this section, an individual carrier shall maintain at its principal place of business a complete and detailed description of its rating practices and underwriting practices, including information and documentation that demonstrate that its rating methods and practices are based upon commonly accepted actuarial assumptions and are in accordance with sound actuarial principles.
3. On or before March 1 of each year, an individual carrier shall file with the Commissioner an actuarial certification that the individual carrier is in compliance with NRS 689A.680 to 689A.700, inclusive, and that the rating methods of the individual carrier are actuarially sound. The certification must be in such a form and must contain such information as specified by the Commissioner. A copy of the certification must be retained by the individual carrier at its principal place of business.
4. As used in this section, “actuarial certification” means a written statement signed by a member of the American Academy of Actuaries or any other person acceptable to the Commissioner that an individual carrier is in compliance with the provisions of NRS 689A.680 to 689A.700, inclusive, based upon an examination conducted by the person which included a review of the appropriate records and the actuarial assumptions and methods used by the individual carrier in establishing premium rates for applicable health benefit plans.
Last modified: February 27, 2006