General Provisions

NAC 687B.200. Definitions.

NAC 687B.2002. “1990 standardized benefit plan to supplement Medicare” or “1990 standardized benefit plan” defined.

NAC 687B.2003. “2010 standardized benefit plan to supplement Medicare” or “2010 standardized benefit plan” defined.

NAC 687B.201. “Applicant” defined.

NAC 687B.2014. “Certificate” defined.

NAC 687B.2015. “Creditable coverage” defined.

NAC 687B.2018. “Eligible organization” defined.

NAC 687B.202. “Employee welfare benefit plan” defined.

NAC 687B.2024. “Issuer” defined.

NAC 687B.2028. “Medicare” defined.

NAC 687B.203. “Medicare Advantage organization” defined.

NAC 687B.2034. “Medicare Advantage plan” defined.

NAC 687B.2036. “Medicare Part D” defined.

NAC 687B.2037. “Medicare select issuer” defined.

NAC 687B.2039. “PACE program” defined.

NAC 687B.204. “Policy to supplement Medicare” defined.

NAC 687B.2045. “Standardized benefit plan” defined.

NAC 687B.205. Applicability of provisions.

NAC 687B.2053. Eligible persons: Description; prohibited actions by insurers.

NAC 687B.2054. Eligible persons: Subsequent enrollment deemed to be initial enrollment under certain circumstances.

NAC 687B.2055. Eligible persons: Notification required upon occurrence of certain events.

NAC 687B.2056. Guaranteed issue periods for eligible persons; special enrollment period.

NAC 687B.2057. Policies to supplement Medicare to which eligible persons are entitled.

NAC 687B.206. Eligibility for policy to supplement Medicare offered to new enrollees or for certificate offered to new enrollees following certain disenrollment; required policy or certificate; outpatient prescription drug coverage.

NAC 687B.2062. Eligibility for policy to supplement Medicare offered to new enrollees or for certificate offered to new enrollees following certain disenrollment, enrollment and subsequent disenrollment; required policy or certificate.

NAC 687B.2064. Eligibility for policy to supplement Medicare offered to new enrollees or for certificate offered to new enrollees following certain enrollment and subsequent disenrollment; required policy or certificate.

NAC 687B.2068. Policy to supplement Medicare offered to new enrollees or certificate offered to new enrollees: Prohibition against denial of application, placement of condition on issuance or effectiveness, or discrimination in pricing under certain conditions by issuer.

NAC 687B.207. Coverage if application is submitted before or during first 6-month period in which person is both 65 years of age or older and enrolled under Medicare Part B; availability of coverage to all qualified applicants.

NAC 687B.209. Termination of or disenrollment from plan, certificate or policy to supplement Medicare: Requirements for written notification.

NAC 687B.212. Filing and approval of policy forms and certificate forms.

NAC 687B.213. Availability and discontinuance of policy forms and certificate forms.

NAC 687B.215. Definitions and terms used in policy or certificate.

NAC 687B.220. Exclusions from and limitations on coverage and benefits; duplication of benefits provided by Medicare; benefits for outpatient prescription drugs.

NAC 687B.223. Prohibitions regarding genetic information and genetic testing.

NAC 687B.225. Minimum standards for coverage: Policy or certificate advertised, solicited or issued for delivery before July 16, 1992.

NAC 687B.226. Minimum standards for coverage: Policy or certificate advertised, solicited, delivered, issued for delivery or renewed on or after July 16, 1992, and before July 30, 1992.

NAC 687B.227. Policy or certificate advertised, solicited, delivered or issued for delivery or renewed on or after July 30, 1992, and effective before June 1, 2010: General requirements.

NAC 687B.2273. Policy or certificate advertised, solicited, delivered or issued for delivery on or after June 1, 2010: General requirements.

NAC 687B.229. Filing and approval of rates, rating schedule and supporting documentation required.

NAC 687B.230. Rates: Standards for ratios of loss; filing requirements; adjustments; hearing on certain requested increases.

NAC 687B.235. Calculation and payment of refunds and credits.

NAC 687B.240. Provision for renewal or continuation; acceptance of riders and endorsements; prohibited standards for payment of benefits; disclosure and dissemination of information.

NAC 687B.243. Lapse of policy to supplement Medicare or certificate for nonpayment of premium: Notice required before termination of policy or certificate.

NAC 687B.245. Lapse of policy to supplement Medicare or certificate for nonpayment of premium: Designation of person to receive notice of lapse or waiver of designation.

NAC 687B.247. Lapse of policy to supplement Medicare or certificate for nonpayment of premium: Provision for reinstatement of coverage.

NAC 687B.250. Outline of coverage; assistance in understanding health insurance.

NAC 687B.255. Elicitation and dissemination of information regarding existing coverage and its replacement; inclusion of certain statements and questions in application.

NAC 687B.258. Replacement of existing coverage: Limitations on time periods for preexisting conditions, waiting periods, elimination periods and probationary periods.

NAC 687B.260. Policy to supplement Medicare or certificate issued before January 1, 1992: Replacement with standardized benefit plan.

NAC 687B.263. Termination and replacement of coverage under group policy.

NAC 687B.265. Notice of modifications to policy or certificate; compliance with certain notice requirements.

NAC 687B.269. Notice required that certain policies of insurance are not supplementary to Medicare; disclosure of extent to which policy or certificate duplicates coverage of Medicare.

NAC 687B.273. Standards of practice for marketing.

NAC 687B.275. Compensation of agents and other representatives and producers.

NAC 687B.280. Review of proposed advertising.

NAC 687B.282. Recommendations for purchase or replacement; sale of multiple policies or certificates; issuance of policy or certificate to person enrolled in Medicare Part C.

NAC 687B.283. Reporting of multiple policies or certificates.

NAC 687B.286. Compliance with certain provisions of Social Security Act regarding notice and payment of claims.

Standardized Benefit Plans

NAC 687B.290. Availability; minimum benefits.

NAC 687B.295. General requirements.

NAC 687B.300. Standardized Benefit Plan A.

NAC 687B.302. Standardized Benefit Plan B.

NAC 687B.304. Standardized Benefit Plan C.

NAC 687B.306. Standardized Benefit Plan D.

NAC 687B.308. Standardized Benefit Plan E.

NAC 687B.311. Standardized Benefit Plan F or High Deductible Benefit Plan F.

NAC 687B.313. Standardized Benefit Plan G.

NAC 687B.315. Standardized Benefit Plan H.

NAC 687B.317. Standardized Benefit Plan I.

NAC 687B.319. Standardized Benefit Plan J or High Deductible Benefit Plan J.

NAC 687B.320. Standardized Benefit Plan K.

NAC 687B.321. Standardized Benefit Plan L.

NAC 687B.322. Standards for policies to supplement Medicare or certificates effective on or after June 1, 2010.

NAC 687B.323. Requirements regarding policies to supplement Medicare or certificates effective on or after June 1, 2010.

NAC 687B.325. Coverage for short-term services provided to person recovering at home.

NAC 687B.330. Provision of new or innovative benefits.

Medicare Select Policies and Certificates

NAC 687B.340. Definitions.

NAC 687B.342. “Complaint” defined.

NAC 687B.344. “Grievance” defined.

NAC 687B.346. “Medicare select issuer” defined.

NAC 687B.348. “Medicare select policy” and “Medicare select certificate” defined.

NAC 687B.350. “Network provider” defined.

NAC 687B.352. “Provision for a restricted network” defined.

NAC 687B.354. “Service area” defined.

NAC 687B.356. Compliance with regulations required before advertising.

NAC 687B.358. Authorization to offer and approval to issue.

NAC 687B.360. Filing and contents of proposed plan of operation.

NAC 687B.362. Proposed changes to plan of operation; update of list of network providers.

NAC 687B.364. Payment for covered services provided by persons other than network providers.

NAC 687B.366. Full payment required for covered services not available through network provider.

NAC 687B.368. Written disclosure of provisions, restrictions and limitations.

NAC 687B.370. Procedures for hearing complaints and resolving grievances.

NAC 687B.372. Availability of certain policies and certificates offered by Medicare select issuer.

NAC 687B.374. Provision for continuation of coverage; availability of policies to supplement Medicare as continuation of coverage.

NAC 687B.376. Compliance with requests for data for evaluation of Medicare select program.