Nev. Admin. Code § 695C.375

Current through December 12, 2024
Section 695C.375 - Prohibited practices
1. No provider-sponsored organization or representative thereof may cause or knowingly permit the use of advertising or solicitation which is untrue or misleading. For purposes of this chapter:
(a) A statement or item of information shall be deemed to be untrue if it does not conform to fact in any respect which is or may be significant to an enrollee of, or person considering enrollment in, a health care plan.
(b) A statement or item of information shall be deemed to be misleading, whether or not it may be literally untrue if, in the total context in which such statement is made or such item of information is communicated, such statement or item of information may be reasonably understood by a reasonable person not possessing special knowledge regarding health care coverage as indicating any benefit or advantage or the absence of any exclusion, limitation or disadvantage of possible significance to an enrollee of, or person considering enrollment in, a health care plan if such benefit or advantage or absence of limitation, exclusion or disadvantage does not in fact exist.
2.NRS 686A.010 to 686A.310, inclusive, must be construed to apply to provider-sponsored organizations and health care plans except to the extent that the nature of provider-sponsored organizations and health care plans render the sections therein clearly inappropriate.
3. An enrollee may not be cancelled or not renewed except for the failure to pay the charge for such coverage or for cause as determined in the master contract.
4. No provider-sponsored organization, unless licensed as an insurer, may use in its name, contracts or literature any of the words "insurance," "casualty," "surety," "mutual" or any other words descriptive of the insurance, casualty or surety business or deceptively similar to the name or description of any insurance or surety corporation doing business in this State.
5. No person not certificated pursuant to this chapter shall use in its name, contracts or literature the phrase "provider-sponsored organization" or the initials "PSO."

Nev. Admin. Code § 695C.375

Added to NAC by Comm'r of Insurance by R148-99, eff. 1-27-2000

NRS 679B.130, 695C.275