Section 695C.1705 - Group health care plan issued to replace discontinued policy or coverage: Requirements; notice of reduction of benefits; statement of benefits; applicability to self-insured employerExcept as otherwise provided in the provisions of NRS 689B.340 to 689B.580, inclusive, and chapter 689C of NRS relating to the portability and accountability of health insurance:
1. A group health care plan issued by a health maintenance organization to replace any discontinued policy or coverage for group health insurance must: (a) Provide coverage for all persons who were covered under the previous policy or coverage on the date it was discontinued; and(b) Except as otherwise provided in subsection 2, provide benefits which are at least as extensive as the benefits provided by the previous policy or coverage, except that benefits may be reduced or excluded to the extent that such a reduction or exclusion was permissible under the terms of the previous policy or coverage, if that plan is issued within 60 days after the date on which the previous policy or coverage was discontinued.
2. If an employer obtains a replacement plan pursuant to subsection 1 to cover the employees of the employer, any benefits provided by the previous policy or coverage may be reduced if notice of the reduction is given to the employees pursuant to NRS 608.1577.3. Any health maintenance organization which issues a replacement plan pursuant to subsection 1 may submit a written request to the insurer which provided the previous policy or coverage for a statement of benefits which were provided under that policy or coverage. Upon receiving such a request, the insurer shall give a written statement to the organization indicating what benefits were provided and what exclusions or reductions were in effect under the previous policy or coverage.4. If an employee or enrollee was a recipient of benefits under the coverage provided pursuant to NRS 695C.1709, the employee or enrollee is not entitled to have issued to him or her by a health maintenance organization a replacement plan unless the employee or enrollee has reported for his or her normal employment for a period of 90 consecutive days after last being eligible to receive any benefits under the coverage provided pursuant to NRS 695C.1709.5. The provisions of this section apply to a self-insured employer who provides health benefits to the employees of the self-insured employer and replaces those benefits with a group health care plan issued by a health maintenance organization.Added to NRS by 1987, 850; A 1989, 1253; 1997, 2958; 2013, 3644Amended by 2013, Ch. 541,§102, eff. 6/12/2013 for the purpose of adopting regulations; and on 1/1/2014 for all other purposes.Added to NRS by 1987, 850; A 1989, 1253; 1997, 2958