Plan for continuation of benefits if health maintenance organization becomes insolvent or impaired; approval by Commissioner; contents. [Effective through December 31, 2019.]

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1. Each health maintenance organization shall develop, submit to the Commissioner for approval and, after such approval, put into effect a plan to provide for the continuation of benefits to enrollees in the event of the insolvency or impairment of the health maintenance organization, including, without limitation, the benefits described in subsection 2 of NRS 695C.3175. A plan developed pursuant to this subsection must include, without limitation:

(a) A contract of insurance which complies with the requirements of NRS 695C.3175; and

(b) Provisions in each contract between the health maintenance organization and a provider which obligate the provider, in the event of the health maintenance organization’s insolvency or impairment, to provide all covered services as described in the contract to enrollees through the periods of time described in subsection 2 of NRS 695C.3175.

2. Before approving a plan submitted pursuant to subsection 1, the Commissioner may require the health maintenance organization to include in the plan:

(a) Reserves or additional reserves for protection against insolvency or impairment;

(b) Letters of credit acceptable to the Commissioner; and

(c) Any other arrangements determined by the Commissioner to be appropriate to ensure the continuation of benefits as described in subsection 2 of NRS 695C.3175 to enrollees.

(Added to NRS by 2017, 2392; R 2019, 1110, effective January 1, 2020)


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