GENERAL PROVISIONS

NAC 695F.010. Definitions.

NAC 695F.020. “Commissioner” defined.

NAC 695F.030. “Division” defined.

NAC 695F.040. “Limited health service plan” defined.

NAC 695F.050. “Organization” defined.

CERTIFICATE OF AUTHORITY

NAC 695F.100. Application: Contents; certification of financial statements.

NAC 695F.110. Application: Proposed plan of operation.

NAC 695F.120. Application: Submission; incomplete application deemed withdrawn.

NAC 695F.130. Application: Public inspection; notice of pending application or hearing.

NAC 695F.140. Licensure in another state: Application for this State; copy of license; notice of disciplinary action.

NAC 695F.150. Licensure in another state: Contract with providers in contiguous state; approval of plan of operation.

NAC 695F.160. Surety bond.

NAC 695F.170. Hearings and administrative proceedings.

FINANCIAL REQUIREMENTS; INSURANCE; ADVERTISING

NAC 695F.200. Reserves.

NAC 695F.205. Capital account.

NAC 695F.210. Requirements for insurance.

NAC 695F.220. Advertising and solicitation.

SERVICES AND BENEFITS

NAC 695F.250. Geographic area of service: Definition.

NAC 695F.260. Geographic area of service: Expansion.

PROVIDERS OF LIMITED HEALTH SERVICE

NAC 695F.300. Requirements for agreement between provider and organization.

NAC 695F.310. Per capita payments.

NAC 695F.320. List of providers: Submission; changes; excessive reduction.

NAC 695F.330. Restriction of choice of provider.

NAC 695F.340. Copayments.

ADMINISTRATION OF ORGANIZATION

NAC 695F.400. Approval of contract for marketing, enrollment, administration or health care; effect of agreement; licensing of third party.

NAC 695F.430. Segregation and separate treatment of records.

NAC 695F.440. Retention of minutes and of materials used for marketing or advertising.

NAC 695F.450. Annual report.

NAC 695F.455. Filing of reports and financial statements.

NAC 695F.460. Filing of notice for modification of rates, charges, benefits, organization, operations, documents or services.

NAC 695F.470. Summary of coverage: Filing, contents and delivery of disclosure.

NAC 695F.480. Evidence of coverage: Requirements.

NAC 695F.490. Evidence of coverage: Submission of actuarial memorandum.

EMPLOYEE ASSISTANCE PROGRAM

NAC 695F.500. Exemption under certain circumstances of program for abuse of alcohol or other substances.

NAC 695F.510. Burden of proof to claim exemption.

SYSTEM FOR RESOLVING COMPLAINTS OF ENROLLEES

NAC 695F.600. Establishment; scope; examination of system.

NAC 695F.610. Requirements for approval.

NAC 695F.620. Notices: Right of member to file complaint; denial of coverage; clear and comprehensive language.

NAC 695F.630. Annual report: Content; maintenance of records.

NAC 695F.640. Annual report: Submission; resolution of oral inquiry.

NAC 695F.650. Records of complaints: Maintenance; submission of summary; copies.