[Rev. 8/22/2014 4:56:49 PM]

[NAC-287 Revised Date: 1-14]

CHAPTER 287 - PROGRAMS FOR PUBLIC EMPLOYEES

GROUP INSURANCE

General Provisions

287.005              Definitions.

287.0056            “Biennial employee” defined.

287.011              “Certifying agency” defined.

287.021              “Continuous employment” defined.

287.025              “Day” defined.

287.035              “Dependent” defined.

287.055              “Health insurance” defined.

287.059              “Initial date of hire” defined.

287.065              “Medicare” defined.

287.085              “Open enrollment” defined.

287.090              “Opt-out plan” defined.

287.095              “Participant” defined.

287.100              “Plan year” defined.

287.126              “Public employer” defined.

287.135              “Retired officer or employee” defined.

287.141              “Subsidy” defined.

287.143              “Tier of coverage” defined.

287.145              “Vendor” defined.

287.150              “Full-time employment” interpreted.

287.155              Date of receipt of required notices.

287.160              Determination of late submission of documents or information.

Board of the Public Employees’ Benefits Program

287.170              Chair: Duty; voting.

287.172              Vice Chair: Election; duty.

287.174              Meetings: Agenda.

287.176              Meetings: Approval of actions; motions; rules of conduct.

287.178              Meetings: Minutes; transcript.

287.190              Advisory opinions: Request; action by Executive Officer; appeal.

287.192              Advisory opinions: Oral opinion prohibited; effect of response by electronic mail or oral response.

287.194              Petitions for declaratory orders.

287.196              Petitions for adoption, filing, amendment or repeal of regulations.

Participation in Public Employees’ Benefits Program

287.310              Prerequisites to participation; fees; establishment of rates; provision to agency of report on history of claims.

287.3105            Persons eligible to participate in Program.

287.311              Dependents: Enrollment and disenrollment.

287.312              Dependents: Eligibility of child of participant, spouse or domestic partner.

287.3125            Dependents: Terms and conditions of certain changes.

287.313              Responsibility for final determinations concerning eligibility.

287.314              Provision of information about Program to participants, representatives of participating public agencies and employees of Program.

287.317              Participating public agency to notify Program of appointment of persons eligible to participate in Program or of termination of appointment; enrollment.

287.318              Enrollment forms: Required information.

287.319              Notification of change of address by participant to Program.

287.320              Withdrawal from Program: Procedure; termination of coverage; limitation on reentry; eligibility of certain officers and employees after exclusion of group; liability of Program.

Option of Group to Leave Public Employees’ Benefits Program

287.355              Procedure for applying to leave Program.

287.357              Application to leave Program: Contents.

287.359              Application to leave Program: Deadline for submission; duties of Board.

287.361              Application to leave Program: Considerations for approval or denial; basis for findings by Board.

287.363              Approval of application by Board: Format and contents of decision; responsibilities of and noncompliance by group.

287.365              Denial of application by Board: Format and contents of decision.

287.367              Denial of application by Board: Procedure for reconsideration.

287.368              Denial of request for reconsideration: Appeal.

287.369              Effective date of departure from Program; coverage by Program until departure.

287.371              Eligibility of officer or employee to join opt-out plan; ineligibility of officer or employee to continue participation in opt-out plan.

287.373              Notification of Program regarding certain changes in status and court orders.

287.375              Eligibility for coverage under opt-out plan: Administration of requirements by Program; compliance with determinations of Program.

287.376              Participation in Program by certain persons eligible for coverage under or participating in opt-out plan prohibited; exceptions.

287.379              Options for coverage under opt-out plan: Annual notification of Program; effective period.

287.381              Premiums or contributions for participants in opt-out plans: General administrative duties of Program.

287.383              Premiums or contributions for participants in opt-out plans: Requirements for billing.

287.385              Premiums or contributions for participants in opt-out plans: Remittance or transfer of payments; nonpayment by participant.

287.386              Liability of Program and opt-out plan for expense or claim of officer or employee or retired officer or employee, or dependent thereof.

287.387              Administrative fee: Establishment by Program; calculation; notice.

287.389              Duties of Program: Accounting for and remittance of payments; monthly reports.

Option of Group to Reenter Public Employees’ Benefits Program

287.400              Procedure for applying to reenter Program.

Payment of Premiums and Contributions; Coverage

287.420              Payment of premiums or contributions by public employer: Date due; penalty.

287.430              Direct payment of premiums or contributions: Date due; cancellation of coverage.

287.440              Payment of premiums or contributions by retired officers and employees.

287.450              Employees on leave without pay: Payment of premiums or contributions; eligibility for coverage as dependent of participant; coverage upon return to work.

287.460              Officers and employees on leave because of injuries in course of employment: Payment of premiums or contributions; reports of change in status; coverage of dependents upon return to work.

287.470              Overpayment or underpayment of premiums or contributions.

287.485              Subsidy for retired officer or employee: Report required to obtain subsidy; audit of service credit required; billing; commencement of payment; adjustment of amount of subsidy; assumption of liability for service credit earned.

287.490              Subsidy for retired officer or employee: Calculation of amount of payment.

287.500              Coverage of seasonal employees and biennial employees.

287.510              Coverage of persons returning to work with previous employer within 1 year after leaving employment.

287.515              Coverage of retired participants upon reemployment.

287.520              Coverage of person qualified as both employee and dependent; change of status from employee to dependent.

287.530              Coverage of retired person, spouse, domestic partner or surviving dependent: Generally.

287.540              Coverage of participating employee of State who reenrolls upon retirement or total disability; coverage of nonparticipating employee of State.

287.542              Coverage of participating employee of local governmental agency who retires on or before September 1, 2008, and reenrolls upon retirement or total disability.

287.544              Coverage of nonparticipating employee of local governmental agency who retires on or before September 1, 2008, and enrolls upon retirement or total disability.

287.546              Coverage of participating employee of local governmental agency who retires after September 1, 2008, and reenrolls upon retirement or total disability.

287.548              Coverage of nonparticipating employee of local governmental agency who retires after September 1, 2008.

Claims

287.600              Definitions.

287.601              “Adverse determination” defined.

287.602              “Appeals Manager” defined.

287.603              “Claims Administrator” defined.

287.608              Claims Administrator or vendor required to be independent contractor.

287.610              Period for submission.

287.620              Assumption regarding availability of benefits under Medicare; coordination under Medicare.

287.660              Notification of adverse determination; grounds for appeal.

287.670              Appeal of adverse determination: Requirements; duties of Appeals Manager.

287.680              Appeal of decision of Appeals Manager: Requirements; duties of Executive Officer or designee.

287.690              Request for external review.

287.695              Request for expedited review by Claims Administrator.

DEFERRED COMPENSATION

287.700              Definitions.

287.705              Purpose.

287.710              Recordkeepers: Selection and removal.

287.715              Recordkeepers: Procedures for selection.

287.730              Appointment of subcommittee to review proposals for position of recordkeeper and make recommendations; general meeting of Committee regarding applicants; negotiation of changes to accepted proposals.

287.735              Investment consultants: Selection and removal.

PROVISION OF HEALTH INSURANCE THROUGH PLAN OF SELF-INSURANCE

287.750              System for resolving complaints of insureds: Requirements for approval and annual report.

TRUST FUND FOR FUTURE RETIREMENT BENEFITS OF LOCAL GOVERNMENTAL EMPLOYEES

287.760              Definitions.

287.762              “Benefits plan” defined.

287.764              “Board of trustees” defined.

287.766              “Governing body” defined.

287.768              “Local government” defined.

287.770              “Professional fund manager” defined.

287.772              “Retirement benefits” defined.

287.774              “Trust fund” defined.

287.776              Resolution to establish trust fund; periodic reports.

287.778              Board of trustees: Appointment and terms of members.

287.780              Board of trustees: Selection and duties of chair and vice chair; meetings; quorum; voting.

287.782              Board of trustees: Restrictions.

287.784              Board of trustees: Compensation of members; staffing; provision for expenses.

287.786              Determination of annual contributions; annual budgeting and auditing.

287.788              Contract with professional fund manager; investment plan.

287.790              Deposit and investment of assets; maintenance as separate account; prohibited uses; reimbursement of administrative expenses.

287.792              Requests for transfers of money.

 

GROUP INSURANCE

General Provisions

      NAC 287.005  Definitions. (NRS 287.043)  As used in NAC 287.005 to 287.695, inclusive, unless the context otherwise requires, the words and terms defined in NAC 287.0056 to 287.145, inclusive, have the meanings ascribed to them in those sections.

     [Com. on Group Ins., Broker of Record Reg. § 2, eff. 2-5-82]—(NAC A 1-22-86; A by Com. to Admin. Pub. Employees’ Deferred Comp. Prog., 9-13-91; A by Com. on Benefits, 5-4-92; 10-3-96; A by Bd. of Pub. Employees’ Benefits Prog. by R126-00, 12-22-2000, eff. 1-1-2001; R097-03, 9-24-2003; R154-03, 3-22-2004; R089-05, 6-28-2006; R126-07, 1-30-2008; R016-08, 8-26-2008, eff. 7-1-2009; R002-12, 6-29-2012)

      NAC 287.0056  “Biennial employee” defined. (NRS 287.043)  “Biennial employee” means an employee whose position of employment is only authorized for 4 to 6 months every other year and who plans to return to the same or a similar position for the next period during which such a position is authorized.

     (Added to NAC by Bd. of Pub. Employees’ Benefits Prog. by R089-05, eff. 6-28-2006)

      NAC 287.011  “Certifying agency” defined. (NRS 287.043)  “Certifying agency” means:

     1.  Except as otherwise provided in subsection 2, for officers and employees of the State and local governmental agencies, the Public Employees’ Retirement System.

     2.  For members of the professional staff of the Nevada System of Higher Education, a retirement program for professional employees offered by or through the Nevada System of Higher Education.

     (Added to NAC by Bd. of Pub. Employees’ Benefits Prog. by R154-03, eff. 3-22-2004; A by R089-05, 6-28-2006)

      NAC 287.021  “Continuous employment” defined. (NRS 287.043)  “Continuous employment”:

     1.  Includes a break in employment of less than 1 year; and

     2.  Does not include a break in employment of 1 year or more.

     (Added to NAC by Bd. of Pub. Employees’ Benefits Prog. by R107-09, eff. 4-20-2010)

      NAC 287.025  “Day” defined. (NRS 287.043)  “Day” means a calendar day.

     (Added to NAC by Bd. of Pub. Employees’ Benefits Prog. by R154-03, eff. 3-22-2004)

      NAC 287.035  “Dependent” defined. (NRS 122A.100, 287.043)  “Dependent” includes, without limitation:

     1.  One spouse from a marriage pursuant to law or one domestic partner as defined in NRS 122A.030; and

     2.  Any person described in NAC 287.312,

Ê who is determined to be eligible for coverage pursuant to NAC 287.313.

     (Added to NAC by Bd. of Pub. Employees’ Benefits Prog. by R126-00, 12-22-2000, eff. 1-1-2001; A by R016-08, 8-26-2008, eff. 7-1-2009; R107-09, 4-20-2010; R107-09, 4-20-2010, eff. 7-1-2010; R109-12, 12-20-2012; R047-13, 10-23-2013)

      NAC 287.055  “Health insurance” defined. (NRS 287.043)  “Health insurance” means insurance coverage for medical, dental, vision, prescription drugs and the treatment of mental health or substance abuse.

     (Added to NAC by Bd. of Pub. Employees’ Benefits Prog. by R126-00, 12-22-2000, eff. 1-1-2001; A by R109-12, 12-20-2012)

      NAC 287.059  “Initial date of hire” defined. (NRS 287.043)  “Initial date of hire” means the first date on which service credit is earned by a participant during the participant’s last period of continuous employment with a public employer, as determined by the appropriate certifying agency.

     (Added to NAC by Bd. of Pub. Employees’ Benefits Prog. by R107-09, eff. 4-20-2010)

      NAC 287.065  “Medicare” defined. (NRS 287.043)  “Medicare” has the meaning ascribed to it in NRS 439B.130.

     (Added to NAC by Com. on Benefits, eff. 5-4-92)—(Substituted in revision for NAC 287.0075)

      NAC 287.085  “Open enrollment” defined. (NRS 287.043)  “Open enrollment” means the event in which participants in the Program may change elections offered by the Program concerning coverage and dependents.

     (Added to NAC by Bd. of Pub. Employees’ Benefits Prog. by R126-00, 12-22-2000, eff. 1-1-2001; A by R097-03, 9-24-2003; R023-09, 11-25-2009; R002-12, 6-29-2012)

      NAC 287.090  “Opt-out plan” defined. (NRS 287.043)  “Opt-out plan” means an alternative plan to provide life, accident or health insurance, or any combination thereof, for a group which is approved by the Board pursuant to NRS 287.0479.

     (Added to NAC by Bd. of Pub. Employees’ Benefits Prog. by R097-03, eff. 9-24-2003; A by R002-12, 6-29-2012)

      NAC 287.095  “Participant” defined. (NRS 287.043)  “Participant” includes the following persons who are eligible to participate in the Program:

     1.  An officer or employee of a participating public agency;

     2.  A retired officer or employee whose last employer is a participating public agency;

     3.  A retired officer or employee whose last employer is not a participating public agency who has been covered continuously by the Program as a retiree since November 30, 2008;

     4.  A surviving dependent of a deceased officer or employee of a participating public agency who was covered by the Program at the time of death of the deceased officer or employee if the deceased officer or employee had 10 years or more of service credit, as determined by the appropriate certifying agency, and is deemed to be retired pursuant to NRS 286.676;

     5.  A surviving dependent of a deceased retired officer or employee described in subsection 2 or 3 if the dependent was covered by the Program at the time of death of the retired officer or employee;

     6.  A surviving spouse of a deceased retired public officer or employee who chooses to reinstate insurance pursuant to NRS 287.0475;

     7.  A surviving spouse of a police officer, firefighter or official member of a volunteer fire department who was killed in the line of duty;

     8.  A surviving child of a police officer, firefighter or official member of a volunteer fire department who was killed in the line of duty;

     9.  A biennial employee;

     10.  A Legislator whose term of office has not expired; and

     11.  A person who has elected to continue coverage pursuant to the Public Health Service Act, 42 U.S.C. § 300bb-1(a).

     (Added to NAC by Com. on Benefits, eff. 5-4-92; A by Bd. of Pub. Employees’ Benefits Prog. by R126-00, 12-22-2000, eff. 1-1-2001; R154-03, 3-22-2004; R089-05, 6-28-2006; R016-08, 8-26-2008, eff. 7-1-2009; R109-12, 12-20-2012)

      NAC 287.100  “Plan year” defined. (NRS 287.043)  “Plan year” means the period set forth by the Board in which Program benefits and rates are offered for enrollment.

     (Added to NAC by Bd. of Pub. Employees’ Benefits Prog. by R126-00, 12-22-2000, eff. 1-1-2001; A by R067-03, 9-24-2003; R023-09, 11-25-2009)

      NAC 287.126  “Public employer” defined. (NRS 287.043)  “Public employer” means the State or a local governmental agency.

     (Added to NAC by Bd. of Pub. Employees’ Benefits Prog. by R154-03, eff. 3-22-2004)

      NAC 287.135  “Retired officer or employee” defined. (NRS 287.043)  “Retired officer or employee” means an officer or employee of a public employer who:

     1.  Has met the requirements to receive, and is receiving any distribution of, benefits from:

     (a) The Judges’ Retirement System;

     (b) The Public Employees’ Retirement System (PERS);

     (c) The Legislators’ Retirement System;

     (d) A retirement program for professional employees offered by or through the Nevada System of Higher Education, including, without limitation, a retirement plan alternative provided pursuant to NRS 286.802, a tax sheltered annuity or a deferred compensation plan; or

     (e) A long-term disability plan of the public employer; and

     2.  Has a total of at least 5 years of full-time service credit from all his or her public employers as determined by the appropriate certifying agency, excluding any service credit purchased pursuant to NRS 1A.310, 218C.370 or 286.300.

     (Added to NAC by Com. on Benefits, eff. 5-4-92; A by Bd. of Pub. Employees’ Benefits Prog. by R126-00, 12-22-2000, eff. 1-1-2001; R062-03, 9-24-2003; R154-03, 3-22-2004; R089-05, 6-28-2006; R126-07, 1-30-2008; R109-12, 12-20-2012)

      NAC 287.141  “Subsidy” defined. (NRS 287.043)  “Subsidy” means a portion of the cost of premiums or contributions for group insurance provided by the Program which is paid by:

     1.  The State pursuant to NRS 287.046; or

     2.  A local governmental agency pursuant to paragraph (b) of subsection 4 of NRS 287.023.

     (Added to NAC by Bd. of Pub. Employees’ Benefits Prog. by R154-03, eff. 3-22-2004; A by R126-07, 1-30-2008)

      NAC 287.143  “Tier of coverage” defined. (NRS 287.043)  “Tier of coverage” means the category of rates and premiums or contributions for coverage that correspond to:

     1.  An eligible participant only; or

     2.  An eligible participant and one or more eligible dependents.

     (Added to NAC by Bd. of Pub. Employees’ Benefits Prog. by R089-05, eff. 6-28-2006)

      NAC 287.145  “Vendor” defined. (NRS 287.043)  “Vendor” means a person who provides products or services to the Program or its participants and dependents, including, but not limited to, an insurance broker, a consultant, an insurer, a health maintenance organization, a physical or mental health care provider, a case management or utilization management company, a dental or vision care provider, a hospital, a medical facility, a certified public accountant, an actuary, an attorney specializing in health care, a health care auditor, a health educator, a pharmacy or pharmacy benefit manager and a preferred provider organization. The term does not include an opt-out plan.

     (Added to NAC by Com. on Benefits, eff. 5-4-92; A by Bd. of Pub. Employees’ Benefits Prog. by R126-00, 12-22-2000, eff. 1-1-2001; R097-03, 9-24-2003; R154-03, 3-22-2004; R016-08, 8-26-2008, eff. 7-1-2009; R002-12, 6-29-2012; R109-12, 12-20-2012)

      NAC 287.150  “Full-time employment” interpreted. (NRS 287.043, 287.045)  As used in NRS 287.045, the Board interprets “full-time employment” to mean the employment, election or appointment by a participating public agency of a person who:

     1.  In any calendar month, works as a public employee or officer at least 80 hours. The Board will consider such full-time employment to commence at the beginning of the month in which the public employee or officer works 80 hours.

     2.  Is elected or appointed as a public officer who receives any compensation regardless of the number of hours worked. The Board will consider such full-time employment to commence at the beginning of the month in which the person’s term of service or term of office begins.

     (Added to NAC by Com. on Benefits, eff. 5-4-92; A by Bd. of Pub. Employees’ Benefits Prog. by R126-00, 12-22-2000, eff. 1-1-2001; R154-03, 3-22-2004; R089-05, 6-28-2006; R126-07, 1-30-2008; R109-12, 12-20-2012)

      NAC 287.155  Date of receipt of required notices. (NRS 287.043)  A person shall be deemed to have received any notice required pursuant to this chapter or chapter 287 of NRS 5 days after the notice is mailed, by first-class mail, to that person’s last known address, unless the Executive Officer or an authorized designee thereof waives this provision because of extenuating circumstances that are sufficient to justify the waiver.

     (Added to NAC by Bd. of Pub. Employees’ Benefits Prog. by R089-05, eff. 6-28-2006)

      NAC 287.160  Determination of late submission of documents or information. (NRS 287.043)  Any form, application, claim or other document or information that is required to be submitted to the Program, Executive Officer or Board on or before a specific date will be considered late if the form, application, claim or other document or information is not:

     1.  Received by the Program, Executive Director or Board, as applicable, before 5 p.m. on that date; or

     2.  Postmarked on or before that date.

     (Added to NAC by Bd. of Pub. Employees’ Benefits Prog. by R089-05, eff. 6-28-2006)

Board of the Public Employees’ Benefits Program

      NAC 287.170  Chair: Duty; voting. (NRS 287.043)

     1.  The Chair shall preside over the meetings of the Board.

     2.  Unless the Chair is required to abstain from voting or is otherwise disqualified from participating in a matter before the Board:

     (a) If the Chair does not vote on the matter, it will be presumed that the Chair voted with the prevailing majority of members of the Board who voted on the matter.

     (b) The Chair shall vote in the case of a tie.

     (Added to NAC by Bd. of Pub. Employees’ Benefits Prog. by R089-05, eff. 6-28-2006)

      NAC 287.172  Vice Chair: Election; duty. (NRS 287.043)

     1.  At the first meeting of each plan year, the Board will elect from its members a Vice Chair.

     2.  The Vice Chair shall serve as the Chair in the absence of the Chair.

     (Added to NAC by Bd. of Pub. Employees’ Benefits Prog. by R089-05, eff. 6-28-2006)

      NAC 287.174  Meetings: Agenda. (NRS 287.043)

     1.  The Chair shall determine the agenda of a meeting of the Board.

     2.  Any member of the Board may submit to the Executive Officer, or in his or her absence, the Operations Officer of the Program appointed pursuant to NRS 287.0426, a request for a matter to be placed on the agenda of a meeting of the Board.

     (Added to NAC by Bd. of Pub. Employees’ Benefits Prog. by R089-05, eff. 6-28-2006)

      NAC 287.176  Meetings: Approval of actions; motions; rules of conduct. (NRS 287.043)

     1.  All action by the Board must be approved by a majority of the members of the Board who are present at the meeting. A tie vote constitutes a rejection of the question or matter before the Board.

     2.  Any motion made by a member of the Board requires a second to the motion for consideration of the motion by the Board.

     3.  Robert’s Rules of Order govern the general conduct of meetings of the Board.

     (Added to NAC by Bd. of Pub. Employees’ Benefits Prog. by R089-05, eff. 6-28-2006)

      NAC 287.178  Meetings: Minutes; transcript. (NRS 287.0415, 287.043)

     1.  The minutes of each meeting of the Board must be distributed to each member of the Board.

     2.  A transcript of a meeting posted to the Internet website of the Board pursuant to NRS 287.0415 will remain posted on the Internet website of the Board for at least 6 months after posting. During the period in which the transcript of the meeting is posted on the Internet website of the Board, a person may request a hard copy of the transcript.

     3.  The Board may charge the person a fee for the transcript that does not exceed the actual cost of the Board to provide the copy of the transcript.

     (Added to NAC by Bd. of Pub. Employees’ Benefits Prog. by R089-05, eff. 6-28-2006; A by R109-12, 12-20-2012)

      NAC 287.190  Advisory opinions: Request; action by Executive Officer; appeal. (NRS 233B.120, 287.043)

     1.  Except as otherwise provided in subsection 3, a person may request that the Executive Officer issue an advisory opinion concerning the applicability of any provision of NRS 287.0402 to 287.049, inclusive, that pertains to the jurisdiction of the Board or any regulation adopted by the Board pursuant thereto. Any request for an advisory opinion concerning the applicability of any provision of NRS 287.0402 to 287.049, inclusive, that pertains to the jurisdiction of a public agency or public officer other than the Board or any regulation adopted by the public agency or public officer must be submitted to that public agency or public officer.

     2.  A request for an advisory opinion pursuant to subsection 1 must be in writing and set forth:

     (a) The name and address of the person requesting the advisory opinion;

     (b) A clear and concise statement of the specific question for which the advisory opinion is being sought; and

     (c) A statement of the facts that support the advisory opinion being sought.

     3.  A person may not request an advisory opinion concerning a question or matter that is an issue in a review or an appeal of a claim or in a pending administrative, civil or criminal proceeding in which the person is a party or otherwise involved.

     4.  The Executive Officer shall review a request for an advisory opinion and issue a response within 30 days after receiving the request.

     5.  An advisory opinion issued by the Executive Officer must be limited to the facts and circumstances set forth in the request.

     6.  An advisory opinion issued by the Executive Officer is appealable to the Board in the same manner as any other appealable decision.

     (Added to NAC by Bd. of Pub. Employees’ Benefits Prog. by R089-05, eff. 6-28-2006)

      NAC 287.192  Advisory opinions: Oral opinion prohibited; effect of response by electronic mail or oral response. (NRS 233B.120, 287.043)  The Executive Officer shall not render an oral advisory opinion to a request for an advisory opinion. A response by electronic mail or an oral response, including, without limitation, a response given over the telephone, to a request for an advisory opinion that is given by the Executive Officer, a member of the Board or staff of the Board are not decisions or official advisory opinions pursuant to this section.

     (Added to NAC by Bd. of Pub. Employee’s Benefits Prog. by R089-05, eff. 6-28-2006)

      NAC 287.194  Petitions for declaratory orders. (NRS 233B.120, 287.043)

     1.  Except as otherwise provided in subsection 3, a person may file a petition with the Executive Officer requesting that the Board issue a declaratory order concerning the applicability of any provision of NRS 287.0402 to 287.049, inclusive, that pertains to the jurisdiction of the Board or any regulation adopted by the Board pursuant thereto. Any petition for a declaratory order concerning the jurisdiction of a public agency or public officer other than the Board or any regulation adopted by the public agency or public officer must be submitted to that public agency or public officer.

     2.  A petition for a declaratory order filed pursuant to subsection 1 must include, without limitation:

     (a) The name and address of the petitioner;

     (b) The reason for requesting the declaratory order;

     (c) A statement of the facts that support the petition for a declaratory order; and

     (d) A clear and concise statement of the question or matter to be decided by the Board.

     3.  A person may not file a petition for a declaratory order concerning a question or matter that is an issue in a review or an appeal of a claim or in a pending administrative, civil or criminal proceeding in which the person is a party or otherwise involved.

     4.  The Executive Officer shall notify the Chair of the petition for a declaratory order not later than 10 days after the petition is received by the Executive Officer.

     5.  The Board may:

     (a) Conduct a hearing to determine issues of fact or to hear arguments relating to a petition for a declaratory order and may enter reasonable orders that govern the conduct of the hearing.

     (b) Request that the petitioner provide additional information or arguments relating to the petition.

     (c) Issue a declaratory order based on the contents of the petition and any material submitted with the petition.

     (d) Consider relevant actions that have been issued by the Board or any other entity which apply or interpret the statute or regulation in question.

     (e) Consider any other information that the Board determines is relevant to the question or matter to be decided by the Board.

     6.  The Board will notify the petitioner in writing within 10 days after any action taken by the Board concerning the petition.

     (Added to NAC by Bd. of Pub. Employees’ Benefits Prog. by R089-05, eff. 6-28-2006)

      NAC 287.196  Petitions for adoption, filing, amendment or repeal of regulations. (NRS 233B.100, 287.043)

     1.  Any person who wishes to petition for the adoption, filing, amendment or repeal of a regulation that the Board is authorized to adopt, file, amend or repeal must file a petition with the Executive Officer.

     2.  A petition for the adoption, filing, amendment or repeal of a regulation must include, without limitation:

     (a) The name and address of the petitioner;

     (b) A clear and concise statement, including, if applicable, the proposed language, of the regulation to be adopted, filed, amended or repealed;

     (c) The reason for petitioning for the adoption, filing, amendment or repeal of the regulation; and

     (d) The statutory authority for the adoption, filing, amendment or repeal of the regulation.

     3.  The Executive Officer may refuse to act upon a petition for the adoption, filing, amendment or repeal of a regulation if the petition does not contain the information required by subsection 2.

     4.  The Executive Officer shall notify the petitioner in writing of his or her decision with regard to the petition within 30 days after the petition is filed.

     (Added to NAC by Bd. of Pub. Employees’ Benefits Prog. by R089-05, eff. 6-28-2006)

Participation in Public Employees’ Benefits Program

      NAC 287.310  Prerequisites to participation; fees; establishment of rates; provision to agency of report on history of claims. (NRS 287.043)

     1.  To participate in group coverage or insurance provided by the Program, a local governmental agency, through its governing body, must provide to the Program:

     (a) A nonrefundable application fee of $250, plus $2.25 per participant for any application involving 100 or more participants.

     (b) A nonrefundable fee to be deposited in the Fund for the Public Employees’ Benefits Program created pursuant to NRS 287.0435 for the purpose of funding the reserve maintained by the Program to stabilize rates. The Executive Officer or a designee thereof shall calculate the amount of the nonrefundable fee by:

          (1) Dividing the funded reserve maintained by the Program to stabilize rates on the date on which the local governmental agency submitted its application to participate in the Program by the total number of participants in the Program on that date; and

          (2) Multiplying the number determined pursuant to subparagraph (1) by the total number of officers and employees of the local governmental agency who enroll in the Program on the effective date of participation by the local governmental agency in the Program.

Ê The fee, or if installment payments are authorized by the Program, the first installment payment of the fee, must be paid by the effective date of participation by the local governmental agency in the Program.

     (c) If the local governmental agency has 100 or more participants, information, as determined by the actuary of the Program, sufficient to make an actuarial determination as to the appropriate rates for the local governmental agency, including, without limitation, the 3 most recent years of claims history data of the local governmental agency, if any exists, in an electronic format that is compatible with the actuarial services of the Program.

     (d) The residential zip code, gender, age and current selection for coverage of:

          (1) The eligible members, regardless of current enrollment, of the local governmental agency; and

          (2) Those members that are currently enrolled in the group plan of the local governmental agency and their respective number of enrolled dependents.

     (e) An interlocal contract executed pursuant to NRS 287.043, on a form provided by the Program. Effective November 30, 2008, such an interlocal contract must include a provision that requires the local governmental agency to participate in the Program for at least 4 years before the local governmental agency may withdraw from the Program in accordance with NAC 287.320.

     (f) A statement that all terminal fees and costs associated with the previous health plan will be paid by that local governmental agency group.

     2.  The actuary for, and the members of the staff of, the Board shall review the request and establish the initial rates for the requesting local governmental agency as follows:

     (a) For a local governmental agency with less than 100 participants, the requesting local governmental agency will not be rated separately from those same or similar participating local governmental agencies.

     (b) For a local governmental agency with 100 or more participants:

          (1) If, upon review of the claims experience of participating local governmental agency groups or the past claims history of the requesting local governmental agency, the actuary for the Board determines the experience for the requesting local governmental agency does not exceed 105 percent of the appropriate rate for the same or similar participating local governmental agency groups, the requesting local governmental agency will not be rated separately from those same or similar participating local governmental agency groups.

          (2) If the claims experience for the requesting local governmental agency exceeds 105 percent of the appropriate rate for the same or similar participating local governmental agency groups, the actuary for the Program and a member of the staff will submit a written report, with recommended rates, to the Board. The recommended rates must equal the difference of the premium or contribution for participating local governmental agency groups and the cost of the experience of the requesting local governmental agency.

          (3) If the requesting local governmental agency has no claims experience, the rates will be equal to 105 percent of the standard rate for a participating local governmental agency that has no separate rating applied.

Ê Rates established pursuant to subparagraphs (2) and (3) apply until the end of the plan year immediately following the year in which the rates were established, at which time the actuary for, and the members of the staff of, the Board shall review the claims experience of the requesting local governmental group to determine an appropriate rate or whether the standard rate should be applied.

     3.  For a participating local governmental agency, the Executive Officer or the designee shall provide, upon written request from the participating local governmental agency, the history of claims for that participating local governmental agency. The Executive Officer or the designee shall charge for each report the actual cost of providing the report. The report must include:

     (a) A summary of the medical, prescription and dental claims paid by the self-funded plan for each month covered by the report; and

     (b) A summary of the monthly premiums or contributions paid during the period covered by the report.

Ê The Executive Officer or the designee shall provide the report within 90 days after receipt of the request.

     (Added to NAC by Com. on Group Ins., eff. 5-27-86; A by Com. on Benefits, 5-4-92; A by Bd. of Pub. Employees’ Benefits Prog. by R126-00, 12-22-2000, eff. 1-1-2001; R154-03, 3-22-2004; R126-07, 1-30-2008; R017-08, 6-17-2008)

      NAC 287.3105  Persons eligible to participate in Program. (NRS 287.043, 42 U.S.C. § 300gg-7)

     1.  Except as otherwise provided in subsection 2 of NRS 287.045, every state officer or employee is eligible to participate in the Program on the first day of the month following the completion of 60 days of full-time employment.

     2.  Every officer or employee who is employed by a participating local governmental agency on a permanent and full-time basis on the date on which the participating local governmental agency enters into an agreement to participate in the Program pursuant to paragraph (a) of subsection 1 of NRS 287.025, and every officer or employee who commences employment with that participating local governmental agency after that date, is eligible to participate in the Program on the first day of the month following the completion of 60 days of full-time employment, unless that officer or employee is excluded pursuant to sub-subparagraph (III) of subparagraph (2) of paragraph (h) of subsection 2 of NRS 287.043.

     3.  Every member of the Senate and Assembly is eligible to participate in the Program on the first day of the month following the 60th day after the member’s initial term of office begins.

     (Added to NAC by Bd. of Pub. Employees’ Benefits Prog. by R101-13, 2-26-2014, eff. 5-1-2014)

      NAC 287.311  Dependents: Enrollment and disenrollment. (NRS 122A.100, 287.043)

     1.  Except as otherwise provided in NAC 287.312, a participant who desires or is required to enroll or disenroll a person in the Program as a dependent as a result of a life event that qualifies the participant to amend his or her coverage outside the period of open enrollment must, within 60 days after the date on which the dependent becomes eligible to participate or loses his or her eligibility to participate in the Program:

     (a) Execute a declaration of enrollment electronically through the Internet website of the Board or by submitting a form prescribed by the Program pursuant to NAC 287.318, under penalty of perjury and subject to the provisions of NRS 686A.290 and 686A.291.

     (b) Submit copies of any supporting documentation required to establish or terminate the dependent’s eligibility to participate in the Program as a dependent as requested by the Program.

     2.  Except as otherwise provided in subsections 3 and 4, if a participant fails to enroll or disenroll a person in the Program as a dependent within 60 days after the date on which the dependent becomes eligible to participate or loses his or her eligibility to participate in the Program, the participant may not enroll or disenroll the person in the Program as a dependent until the next period of open enrollment.

     3.  The Program will enroll a person as a dependent of a participant in accordance with an order to obtain health insurance for his or her child pursuant to NRS 31A.350.

     4.  The Program will disenroll a person as a dependent of a participant on the date on which the dependent becomes deceased.

     (Added to NAC by Bd. of Pub. Employees’ Benefits Prog. by R016-08, 8-26-2008, eff. 7-1-2009; A by R107-09, 4-20-2010, eff. 7-1-2010; R109-12, 12-20-2012)

      NAC 287.312  Dependents: Eligibility of child of participant, spouse or domestic partner. (NRS 122A.100, 287.043)

     1.  To determine whether the child of a participant or of his or her spouse or domestic partner who is incapable of self-support because of a physical or mental disability continues to be eligible for coverage by the Program, the Executive Officer or his or her designee:

     (a) Shall require submission by a physician who provides care to the child of a written statement on a form prescribed by the Board indicating that the child has a mental or physical impairment which causes the child to be incapable of self-sustaining employment and to depend on the participant or his or her spouse or domestic partner primarily for support. The written statement required by this paragraph must be prepared by the physician within 90 days before the statement is provided to the Program.

     (b) May require:

          (1) Submission of periodic updates regarding the physical or mental disability of the child by the participant or his or her spouse or domestic partner;

          (2) Submission of the child to a mental or physical examination conducted by a physician selected by and at the expense of the Program; and

          (3) Any other documentation required by the Program that demonstrates financial support of the child by the participant or his or her spouse or domestic partner.

     2.  Persons who are eligible for coverage as a dependent may include:

     (a) Biological children;

     (b) Adopted children;

     (c) Children placed in the residence of the participant for adoption;

     (d) Stepchildren; and

     (e) Any other person who:

          (1) Bears a relationship described in 26 U.S.C. § 152(c)(2) to the participant or his or her spouse or domestic partner;

          (2) Is unmarried;

          (3) Has not attained the age set forth in 45 C.F.R. § 147.120(a);

          (4) Either resides with the participant or is enrolled in a program of secondary education or an independently accredited program of postsecondary education, including, without limitation, a college, university, community or junior college, graduate school or accredited trade or business school, on a full-time basis;

          (5) Satisfies one of the following conditions:

               (I) Is currently under a permanent legal guardianship of the participant or his or her spouse or domestic partner pursuant to chapter 159 of NRS; or

               (II) Was eligible to be claimed as a dependent on the federal income tax return of the participant or his or her spouse or domestic partner for the immediately preceding calendar year; and

          (6) Is in a relationship with the participant or his or her spouse or domestic partner that is similar to a child-parent relationship. The participant or his or her spouse or domestic partner must complete and submit to the Program an affidavit attesting to the fact of the relationship.

     3.  A foster child of a participant or his or her spouse or domestic partner is not eligible for coverage as a dependent.

     (Added to NAC by Bd. of Pub. Employees’ Benefits Prog. by R126-00, 12-22-2000, eff. 1-1-2001; A by R154-03, 3-22-2004; R089-05, 6-28-2006; R126-07, 1-30-2008; R016-08, 8-26-2008, eff. 7-1-2009; R107-09, 4-20-2010; R107-09, 4-20-2010, eff. 7-1-2010; R002-12, 6-29-2012; R047-13, 10-23-2013)

      NAC 287.3125  Dependents: Terms and conditions of certain changes. (NRS 287.043)  Except during a period of open enrollment, the right to change coverage or insurance for a dependent or to add or change dependents is governed by the terms and conditions of any applicable plan, insurance policy or law.

     (Added to NAC by Bd. of Pub. Employees’ Benefits Prog. by R016-08, 8-26-2008, eff. 7-1-2009)

      NAC 287.313  Responsibility for final determinations concerning eligibility. (NRS 287.043)  The Executive Officer or a designee thereof shall make all final determinations concerning eligibility:

     1.  To become a participant in the Program pursuant to NRS 287.045.

     2.  As a dependent.

     (Added to NAC by Bd. of Pub. Employees’ Benefits Prog. by R089-05, eff. 6-28-2006; A by R016-08, 8-26-2008, eff. 7-1-2009)

      NAC 287.314  Provision of information about Program to participants, representatives of participating public agencies and employees of Program. (NRS 287.043)

     1.  The Executive Officer or a designee thereof shall provide information about the Program to participants, representatives of participating public agencies and employees of the Program.

     2.  The information required to be provided pursuant to subsection 1 must include, without limitation:

     (a) Procedures, forms and instructions relating to enrollment and participation in the Program;

     (b) Forms and instructions relating to enrollment through the Internet website of the Program; and

     (c) A summary of the benefits available through the Program.

     3.  The Executive Officer or a designee thereof shall make the information about the Program described in subsection 2 available on:

     (a) An Internet website established and maintained by the Program for participants and representatives of participating public agencies; and

     (b) An Intranet site relating to the internal management of the Program for employees of the Program.

     4.  A notice that explains how to access the information on the Internet website of the Program and how to request a written copy of the information required to be provided pursuant to subsection 2 must be provided electronically or by first-class mail, to the last electronic mail or mailing address provided by a participant, to:

     (a) A new participant within 7 days after the Program is notified of the employment of the participant with a participating public agency; and

     (b) All participants annually, at least 75 days before the first day of the following plan year.

     (Added to NAC by Com. on Benefits, eff. 10-3-96; A by Bd. of Pub. Employees’ Benefits Prog. by R126-00, 12-22-2000, eff. 1-1-2001; R154-03, 3-22-2004; R089-05, 6-28-2006; R107-09, 4-20-2010; R108-12, 12-20-2012)

      NAC 287.317  Participating public agency to notify Program of appointment of persons eligible to participate in Program or of termination of appointment; enrollment. (NRS 287.043)

     1.  A participating public agency shall notify the Program in a format prescribed by the Program upon:

     (a) Appointing to the participating public agency a person who will be eligible to participate in the Program pursuant to NRS 287.045, so the Program may provide the required information about the Program to the employee pursuant to NAC 287.314; or

     (b) The termination of an appointment to the participating public agency,

Ê within 15 days after the employee’s first or last day of employment with the participating public agency, as applicable.

     2.  The employee shall enroll in the Program:

     (a) Electronically through the Internet website of the Board; or

     (b) By submitting the completed enrollment forms to the Program,

Ê and submitting any supporting documents to the Program.

     3.  If the employee fails to enroll in the Program pursuant to subsection 2 before the first day of eligibility for coverage of the employee or 30 days after the first day of employment of the employee with the participating public agency, whichever occurs later, the employee only will be enrolled in the base plan.

     4.  As used in this section, “base plan” means the plan designated by the Board as the default plan for the plan year, as described in the plan documents.

     (Added to NAC by Com. on Benefits, eff. 10-3-96; A by Bd. of Pub. Employees’ Benefits Prog. by R126-00, 12-22-2000, eff. 1-1-2001; R154-03, 3-22-2004; R089-05, 6-28-2006; R126-07, 1-30-2008; R107-09, 4-20-2010; R109-12, 12-20-2012)

      NAC 287.318  Enrollment forms: Required information. (NRS 287.043)  Enrollment forms that are submitted to the Program must include, without limitation:

     1.  The name, address, social security number, if any, and signature of the person who is enrolling in the Program; and

     2.  The name and social security number, if any, of any dependent that the person chooses to cover under the Program.

     (Added to NAC by Bd. of Pub. Employees’ Benefits Prog. by R089-05, eff. 6-28-2006; A by R109-12, 12-20-2012)

      NAC 287.319  Notification of change of address by participant to Program. (NRS 287.043)  A participant shall notify the Program within 30 days after a change of address of the participant.

     (Added to NAC by Bd. of Pub. Employees’ Benefits Prog. by R089-05, eff. 6-28-2006; A by R107-09, 4-20-2010)

      NAC 287.320  Withdrawal from Program: Procedure; termination of coverage; limitation on reentry; eligibility of certain officers and employees after exclusion of group; liability of Program. (NRS 287.043)

     1.  A participating local governmental agency which intends to terminate its interlocal contract and withdraw from the Program must give a written notice to the Executive Officer of the Program at least 60 days before the date on which it intends to withdraw. The effective date of withdrawal is the last day of the month in which the 60-day period expires.

     2.  Effective November 30, 2008, if a participating local governmental agency withdraws from the Program:

     (a) Coverage provided for all active officers and employees of the local governmental agency terminates on the date on which the local governmental agency withdraws from the Program.

     (b) Except for retired officers and employees who were enrolled in the Program on November 30, 2008, and continue their participation in the Program, coverage provided for all retired officers and employees of the local governmental agency terminates on the date on which the local governmental agency withdraws from the Program. If a retired officer or employee whose coverage by the Program terminates pursuant to this paragraph qualifies as a dependent of a participant, the termination of coverage pursuant to this paragraph is a qualifying status change for the retired officer or employee.

     3.  Unless waived by the Board, a participating local governmental agency that withdraws from the Program may not reenter the Program for 3 years after the date on which it withdraws.

     4.  If a group of officers and employees of a participating local governmental agency who are eligible for health coverage from a health and welfare plan or trust that arose out of collective bargaining under chapter 288 of NRS or a trust established pursuant to 29 U.S.C. § 186 is excluded from participation in the Program on or after November 30, 2008:

     (a) Except for retired officers and employees who were enrolled in the Program on November 30, 2008, and continue their participation in the Program, all retired officers and employees who were members of the group will be excluded from participation in the Program;

     (b) Active officers and employees in the group are not eligible to participate in the Program after retirement; and

     (c) All active and retired officers and employees of the local governmental agency that are not members of the group are eligible to continue their participation in the Program until the date on which the participating local governmental agency terminates its participation in the Program.

     5.  Except for retired officers and employees who were enrolled in the Program on November 30, 2008, and continue their participation in the Program, the Program is not liable for any expenses or claims of an officer or employee or retired officer or employee, or any dependents thereof, of the withdrawing local governmental agency or excluded group incurred after the effective date of the withdrawal of the local governmental agency or exclusion of the group from the Program.

     (Added to NAC by Com. on Group Ins., eff. 5-27-86; A by Com. on Benefits, 5-4-92; A by Bd. of Pub. Employees’ Benefits Prog. by R126-00, 12-22-2000, eff. 1-1-2001; R154-03, 3-22-2004; R126-07, 1-30-2008; R108-12, 12-20-2012)

Option of Group to Leave Public Employees’ Benefits Program

      NAC 287.355  Procedure for applying to leave Program. (NRS 287.043, 287.0479)  A group may apply to leave the Program in accordance with NRS 287.0479 by:

     1.  Providing to the Executive Officer a letter of intent, which states the desire of the group to leave the Program entirely and forego all benefits of the Program; and

     2.  Submitting to the Board a completed application and 15 copies thereof.

     (Added to NAC by Bd. of Pub. Employees’ Benefits Prog. by R097-03, eff. 9-24-2003)

      NAC 287.357  Application to leave Program: Contents. (NRS 287.043, 287.0479)  An application to leave the Program must include, without limitation:

     1.  A copy of the plan of benefits to be offered under the proposed opt-out plan, including, without limitation, a description of:

     (a) The benefits to be provided under the proposed opt-out plan;

     (b) The manner for determining eligibility for benefits under the proposed opt-out plan; and

     (c) The circumstances under which any participant in the proposed opt-out plan, including, without limitation, active and retired officers and employees, may lose coverage under the proposed opt-out plan.

     2.  A description of the manner in which initial eligibility for benefits under the proposed opt-out plan will be determined, including, without limitation, whether members of the group will experience any gap in coverage during the period between when the group leaves the Program and coverage is available for the group under the proposed opt-out plan.

     3.  The proposed effective date of the departure of the group from the Program, which must coincide with the start date of a plan year.

     4.  The name of the group.

     5.  A list of the proposed participants in the proposed opt-out plan, including, without limitation, the name, social security number and date of birth of each proposed participant.

     6.  The federal tax identification number of the proposed opt-out plan.

     7.  A copy of the contract pursuant to which the members of the group will receive coverage from the proposed opt-out plan. The contract must include, without limitation, the amount of premiums or contributions that will be required to maintain coverage for the members of the group under the proposed opt-out plan.

     8.  Evidence establishing that the proposed opt-out plan is or will be operated pursuant to such sound accounting and financial management practices as to ensure that the group will continue to receive adequate benefits. Such evidence must include, without limitation:

     (a) Financial statements;

     (b) Audits of financial statements of the proposed opt-out plan, if any, for the 2 years immediately preceding the date of application, which must reflect unqualified opinions by the persons who performed the audits of the financial statements concerning the financial soundness of the proposed opt-out plan; and

     (c) Any other information requested by the Board or determined by the group to be relevant to the evaluation of the:

          (1) Financial management practices of the proposed opt-out plan; or

          (2) Financial soundness of the proposed opt-out plan.

     9.  A completed Business Associate Agreement that is consistent with the federal Health Insurance Portability and Accountability Act of 1996, Public Law 104-191, as amended, and is in a form acceptable to the Board, or a certification that the opt-out plan is a covered entity under and complies with all federal privacy regulations.

     10.  If the proposed opt-out plan is secured from an insurer, a copy of the current certificate of authority issued by the Commissioner of Insurance to the insurer which indicates that the insurer is authorized to provide the coverage proposed to be offered under the proposed opt-out plan in this State.

     11.  The name and contact information of a representative of the group who will be available to answer questions from the Board concerning the application.

     (Added to NAC by Bd. of Pub. Employees’ Benefits Prog. by R097-03, eff. 9-24-2003; A by R089-05, 6-28-2006; R002-12, 6-29-2012)

      NAC 287.359  Application to leave Program: Deadline for submission; duties of Board. (NRS 287.043, 287.0479)

     1.  To apply to leave the Program, a group must submit an application to the Board on or before the first day of the 10th month before the proposed effective date of the departure of the group from the Program.

     2.  If additional information is required to process any application, the Board will notify the representative of the group who is designated pursuant to NAC 287.357.

     3.  The Board will provide an opportunity for:

     (a) A representative of the Program to present arguments for or against the approval of an application.

     (b) The representative of the group who is designated pursuant to NAC 287.357 to present arguments that support the approval of an application.

     4.  The Board will approve or deny each application received pursuant to subsection 1 not later than the 15th day of the sixth month before the proposed effective date of the departure of the group from the Program.

     5.  The Board will notify each applicant of the date and time of the meeting during which the Board will render a decision on the application of the applicant.

     (Added to NAC by Bd. of Pub. Employees’ Benefits Prog. by R097-03, eff. 9-24-2003; A by R089-05, 6-28-2006; R023-09, 11-25-2009; R002-12, 6-29-2012)

      NAC 287.361  Application to leave Program: Considerations for approval or denial; basis for findings by Board. (NRS 287.043, 287.0479)

     1.  In determining whether to approve or deny an application to leave the Program, the Board:

     (a) Shall consider whether:

          (1) The departure of the group from the Program would cause an increase of more than 5 percent in the costs of premiums or contributions for the remaining participants in the Program;

          (2) The proposed opt-out plan is financially sound and operated pursuant to sound accounting and financial management practices;

          (3) The proposed opt-out plan provides adequate benefits at the time of application that includes offering the same coverage to active officers and employees and retired officers and employees using rates based on the commingled experience of all active and retired participants; and

          (4) The group applying to leave the Program, and the members thereof, meet the requirements set forth in subsection 3 of NRS 287.0479.

     (b) May consider:

          (1) Whether the cumulative impact of a group leaving the Program on the costs of premiums or contributions for the remaining participants in the Program is so detrimental as to cause a significant negative impact on the Program;

          (2) Whether the current financial condition of the Program is such that the departure of the group would constitute a significant negative impact on the Program;

          (3) Whether the departure of the group is administratively feasible;

          (4) Whether independent, actuarial or other reviews obtained by the Board indicate that the departure of the group will cause a significant negative impact on the Program; and

          (5) Any other information that the Board deems relevant.

     2.  Findings by the Board concerning the considerations described in subsection 1 must be based exclusively on substantial evidence.

     (Added to NAC by Bd. of Pub. Employees’ Benefits Prog. by R097-03, eff. 9-24-2003; A by R089-05, 6-28-2006; R002-12, 6-29-2012)

      NAC 287.363  Approval of application by Board: Format and contents of decision; responsibilities of and noncompliance by group. (NRS 287.043, 287.0479)

     1.  A decision of the Board to approve an application to leave the Program will be in writing and will include, without limitation, the effective date of departure of the group from the Program and the dates for completion of any administrative tasks necessary to effect the departure of the group.

     2.  If the Board approves the application of a group to leave the Program, the approval will be conditioned upon completion of the following actions:

     (a) The group must submit to the Board a completed release and waiver of rights agreement, in a form acceptable to the Board, obtained from and signed by each member of the group.

     (b) A contract, in a form acceptable to the Board, must be executed between the Program and the proposed opt-out plan of the group. The contract must set forth the terms of coverage for the group, provisions for the payment of premiums or contributions of participants to the opt-out plan and such other details necessary to effect departure of the group from the Program.

     3.  On or before the 25th day of the fourth month before the effective date of the departure of the group from the Program established pursuant to NAC 287.369:

     (a) The completed release and waiver of rights agreement must be submitted to the Board; and

     (b) The contract between the Program and the proposed opt-out plan of the group must be executed between the Program and the proposed opt-out plan of the group.

     4.  If a group whose application to leave the Program has been approved by the Board fails to comply with the requirements of this section or any provision of the decision of the Board to approve the application of the group, the Board may declare the contract between the Program and the opt-out plan of the group void.

     (Added to NAC by Bd. of Pub. Employees’ Benefits Prog. by R097-03, eff. 9-24-2003; A by R023-09, 11-25-2009; R002-12, 6-29-2012)

      NAC 287.365  Denial of application by Board: Format and contents of decision. (NRS 287.043, 287.0479)  A decision of the Board to deny an application of a group to leave the Program will be in writing and will include, without limitation:

     1.  The reasons of the Board for denying the application.

     2.  The findings of the Board on the mandatory criteria for review set forth in paragraph (a) of subsection 1 of NAC 287.361.

     3.  The findings of the Board on any of the optional criteria for review set forth in paragraph (b) of subsection 1 of NAC 287.361 that the Board considered in reaching its decision.

     4.  A statement that any data, information or report on which the Board relied to make its decision to deny the application is available to the group upon request.

     (Added to NAC by Bd. of Pub. Employees’ Benefits Prog. by R097-03, eff. 9-24-2003; A by R089-05, 6-28-2006)

      NAC 287.367  Denial of application by Board: Procedure for reconsideration. (NRS 287.043, 287.0479)  A group whose application to leave the Program has been denied by the Board may file a request for reconsideration with the Board not later than 40 days after the denial. The request may include any additional information that the group determines is relevant to reconsideration. The Board will hold a reconsideration hearing and render its decision within 30 days after receiving the request.

     (Added to NAC by Bd. of Pub. Employees’ Benefits Prog. by R097-03, eff. 9-24-2003)

      NAC 287.368  Denial of request for reconsideration: Appeal. (NRS 287.043, 287.0479)

     1.  A group whose request for reconsideration with the Board has been denied pursuant to NAC 287.367 may file an appeal with the Hearings Division of the Department of Administration.

     2.  On the same date on which a group files an appeal with the Hearings Division pursuant to subsection 1, the group must provide a copy of the appeal to the Executive Officer. Within 30 days after the Executive Officer receives a copy of the appeal, the Executive Officer shall transmit to the Hearings Division a copy of:

     (a) The decision of the Board to deny the application of a group to leave the Program that was prepared pursuant to NAC 287.365; and

     (b) The record from the hearing conducted pursuant to NAC 287.367.

     3.  A hearing officer of the Hearings Division shall review the decision of the Board. Review of the decision of the Board is confined to the information provided to the Hearings Division pursuant to subsection 2, except that in cases concerning alleged irregularities in procedure before the Board that are not shown in the decision or the record, the hearing officer may receive evidence concerning the irregularities.

     4.  The burden of proof is on the group to show that the decision of the Board to deny the application of the group is invalid pursuant to subsection 6.

     5.  The hearing officer shall not substitute his or her judgment for that of the Board as to any criteria, data, information or report on which the Board relied to make its decision to:

     (a) Deny the application of the group to leave the Program; or

     (b) Deny the request for reconsideration of the application of the group to leave the Program.

     6.  The hearing officer may remand or affirm the decision of the Board to deny the application of the group to leave the Program or set it aside in whole or in part if the decision of the Board is:

     (a) In violation of constitutional or statutory provisions;

     (b) In excess of the statutory authority of the Board;

     (c) Made upon unlawful procedure;

     (d) Affected by other error of law;

     (e) Clearly erroneous in view of the reliable, probative and substantial evidence in the information provided to the Hearings Division pursuant to subsection 2; or

     (f) Arbitrary or capricious or characterized by abuse of discretion.

     7.  The decision of the hearing officer made pursuant to subsection 6 is final and not subject to judicial review.

     (Added to NAC by Bd. of Pub. Employees’ Benefits Prog. by R089-05, eff. 6-28-2006)

      NAC 287.369  Effective date of departure from Program; coverage by Program until departure. (NRS 287.043, 287.0479)

     1.  The effective date of departure from the Program of a group whose application has been approved by the Board pursuant to NRS 287.0479 is the first day of the plan year that is at least 120 days after the date on which the Board approves the application.

     2.  The Program shall provide coverage to participants in a group that has been approved by the Board to leave the Program until the effective date of departure of the group from the Program set forth in the decision of the Board approving the application of the group to leave the Program.

     (Added to NAC by Bd. of Pub. Employees’ Benefits Prog. by R097-03, eff. 9-24-2003; A by R002-12, 6-29-2012)

      NAC 287.371  Eligibility of officer or employee to join opt-out plan; ineligibility of officer or employee to continue participation in opt-out plan. (NRS 287.043, 287.0479)

     1.  If an officer or employee is eligible to join an opt-out plan at the commencement of his or her employment, the officer or employee must, upon commencing employment:

     (a) Elect to join the opt-out plan; or

     (b) Decline coverage under the opt-out plan.

     2.  If an officer or employee becomes eligible to join an opt-out plan after the commencement of his or her employment, the officer or employee must, at the time of his or her eligibility:

     (a) Elect to join the opt-out plan; or

     (b) Decline coverage under the opt-out plan.

Ê If the officer or employee is a member of the Program at the time he or she becomes eligible to join the opt-out plan, the officer or employee shall terminate coverage by the Program.

     3.  Except as otherwise provided in subsection 4, if an officer or employee in an opt-out plan becomes ineligible to continue participation in the opt-out plan, the officer or employee must terminate coverage by the opt-out plan and:

     (a) If the officer or employee is eligible to join a different opt-out plan:

          (1) Elect to join the other opt-out plan, subject to the requirements for enrollment in the opt-out plan; or

          (2) Decline coverage under the other opt-out plan.

     (b) If the officer or employee is eligible to join the Program:

          (1) Elect to join the Program, subject to the requirements for enrollment of the Program; or

          (2) Decline coverage under the Program.

     4.  If an officer or employee in an opt-out plan becomes ineligible to continue participation in the opt-out plan because he or she is no longer employed by a participating public agency, the officer or employee may elect to continue coverage under the opt-out plan pursuant to the Public Health Service Act, 42 U.S.C. § 300bb-1 et seq. or the Consolidated Omnibus Budget Reconciliation Act, Public Law 99-272, as applicable.

     5.  It is the responsibility of an officer or employee who is eligible to join an opt-out plan or who is ineligible to continue participation in the opt-out plan or the administrator of the opt-out plan to notify the Program of the eligibility or ineligibility, as applicable, of the officer or employee to participate in an opt-out plan. Failure to provide such notification to the Program may result in the ineligibility of the employee to participate in an opt-out plan or the Program, as applicable. Such notification must be given to the Program within 60 days after the officer or employee has become:

     (a) Eligible to join an opt-out plan; or

     (b) Ineligible to continue participation in an opt-out plan,

Ê as applicable.

     6.  The Program shall not consider a decision by an officer or employee to join an opt-out plan to be a declination of coverage.

     7.  No lapse in coverage may occur to an officer or employee when he or she changes coverage pursuant to this section.

     (Added to NAC by Bd. of Pub. Employees’ Benefits Prog. by R097-03, eff. 9-24-2003; A by R002-12, 6-29-2012)

      NAC 287.373  Notification of Program regarding certain changes in status and court orders. (NRS 287.043, 287.0479)

     1.  Within 15 calendar days after a change in the status of a participant in an opt-out plan that affects the rate of his or her premium or contribution, the opt-out plan shall notify the Program of that change in an electronic format acceptable to the Program.

     2.  If an officer or employee has declined participation in an opt-out plan, the officer or employee shall notify the Program within 60 days after the officer or employee has:

     (a) Been ordered to obtain health insurance for his or her child pursuant to NRS 31A.350; or

     (b) A change in life status or the addition of a dependent that initiates eligibility for both the declined employee and any affected dependent.

     (Added to NAC by Bd. of Pub. Employees’ Benefits Prog. by R097-03, eff. 9-24-2003; A by R002-12, 6-29-2012)

      NAC 287.375  Eligibility for coverage under opt-out plan: Administration of requirements by Program; compliance with determinations of Program. (NRS 287.043, 287.0479)

     1.  The Program shall administer the requirements for eligibility for coverage set forth in this chapter and chapter 287 of NRS for participants in opt-out plans, including, without limitation:

     (a) Processing notice of termination, workers’ compensation leave, military leave, family and medical leave and leave without pay and any related changes that affect coverage.

     (b) Processing an order for an officer or employee to obtain health insurance for his or her child pursuant to NRS 31A.350.

     2.  An opt-out plan shall comply with determinations of eligibility made by the Program regarding participants in the opt-out plan.

     (Added to NAC by Bd. of Pub. Employees’ Benefits Prog. by R097-03, eff. 9-24-2003)

      NAC 287.376  Participation in Program by certain persons eligible for coverage under or participating in opt-out plan prohibited; exceptions. (NRS 287.043, 287.0479)

     1.  A retired officer or employee, and any dependent thereof, who is eligible for coverage under an opt-out plan at the time of his or her retirement may not elect to participate in the Program unless the group which participates in the opt-out plan applies to reenter the Program pursuant to NAC 287.400.

     2.  When a participant in an opt-out plan becomes a survivor of a deceased officer or employee, the participant:

     (a) May remain covered by the opt-out plan; and

     (b) May not join the Program.

     (Added to NAC by Bd. of Pub. Employees’ Benefits Prog. by R002-12, eff. 6-29-2012)

      NAC 287.379  Options for coverage under opt-out plan: Annual notification of Program; effective period. (NRS 287.043, 287.0479)  At least 90 days before the commencement of a new plan year of an opt-out plan, the opt-out plan shall notify the Program of the options for coverage that will be offered to participants in the opt-out plan during that plan year, including, without limitation, the schedules of the rates for premiums or contributions in accordance with the tiers of coverage established by the Program. Such options for coverage and schedules of rates must remain in effect throughout the entire new plan year.

     (Added to NAC by Bd. of Pub. Employees’ Benefits Prog. by R097-03, eff. 9-24-2003)

      NAC 287.381  Premiums or contributions for participants in opt-out plans: General administrative duties of Program. (NRS 287.043, 287.0479)

     1.  The Program shall maintain the rates for premiums or contributions for participants in each opt-out plan separately in its information system.

     2.  The Program shall calculate the State’s share of the costs of premiums or contributions for participants in an opt-out plan pursuant to NRS 287.046 in the same manner as for participants in the Program.

     3.  The difference between the amount of the premium or contribution of a participant in an opt-out plan and the amount paid by the State toward the premium or contribution of the participant pursuant to NRS 287.046 must be assessed to the participant.

     4.  If the amount paid by the State toward the premium or contribution of a participant in an opt-out plan pursuant to NRS 287.046 exceeds the amount of the premium or contribution for that participant, the Program shall retain the balance.

     (Added to NAC by Bd. of Pub. Employees’ Benefits Prog. by R097-03, eff. 9-24-2003)

      NAC 287.383  Premiums or contributions for participants in opt-out plans: Requirements for billing. (NRS 287.043, 287.0479)  The Program shall bill on a monthly basis:

     1.  Each payroll center that deducts and pays the premium or contribution for a participant in an opt-out plan from the salary or monthly retirement allowance, as applicable, of the participant for the amount of the premiums or contributions for such participants based on the schedule of rates for premiums or contributions for that opt-out plan.

     2.  Each participant in an opt-out plan that is responsible for the paying of his or her premium or contribution directly.

     3.  The Retired Employees’ Group Insurance Budget Account in the State Retirees’ Health and Welfare Benefits Fund created by NRS 287.0436 for the portion of the amount of the premiums or contributions for participants in an opt-out plan who retired from the service of the State that is paid by the State pursuant to subsection 2 of NRS 287.046. The Program shall identify separately the portion of the amount billed to the State pursuant to this subsection that is attributable to participants in each opt-out plan.

     4.  The Active Employee Group Insurance Subsidy Account established pursuant to subsection 7 of NRS 287.044 within the Agency Fund for the Payroll of the State created by NRS 227.130 for the portion of the amount of the premiums or contributions for participants in an opt-out plan that is paid by the State pursuant to subsection 1 of NRS 287.044. The Program shall identify separately the portion of the amount billed to the State pursuant to this subsection that is attributable to participants in each opt-out plan.

     (Added to NAC by Bd. of Pub. Employees’ Benefits Prog. by R097-03, eff. 9-24-2003; A by R002-12, 6-29-2012)

      NAC 287.385  Premiums or contributions for participants in opt-out plans: Remittance or transfer of payments; nonpayment by participant. (NRS 287.043, 287.0479)

     1.  A payroll center shall remit by the 25th of each month to the Program the amount of the premiums or contributions for participants in opt-out plans that is billed to the payroll center for that month by the Program pursuant to subsection 1 of NAC 287.383. The payroll center shall identify separately the portion of each such payment to the Program that is attributable to participants in each opt-out plan.

     2.  A participant of an opt-out plan that is billed directly by the Program pursuant to subsection 2 of NAC 287.383 for his or her premiums or contributions shall remit the amount of the premium or contribution within 30 days after he or she was billed.

     3.  The amount of the premiums or contributions for participants in an opt-out plan for which the Retired Employees’ Group Insurance Budget Account is billed each month pursuant to subsection 3 of NAC 287.383 must be transferred to the Program by the 25th day of each month, subject to adequate funding in that Account.

     4.  The amount of the premiums or contributions for participants in an opt-out plan for which the Active Employee Group Insurance Subsidy Account is billed each month pursuant to subsection 4 of NAC 287.383 must be transferred to the Program by the 25th day of each month, subject to adequate funding in that Account.

     5.  The Program shall notify an opt-out plan of the nonpayment of a premium or contribution by a participant in the opt-out plan who is billed by the Program for his or her premiums or contributions directly or through a payroll center. The Program shall not initiate termination of coverage of such a participant.

     (Added to NAC by Bd. of Pub. Employees’ Benefits Prog. by R097-03, eff. 9-24-2003; A by R002-12, 6-29-2012)

      NAC 287.386  Liability of Program and opt-out plan for expense or claim of officer or employee or retired officer or employee, or dependent thereof. (NRS 287.043, 287.0479)

     1.  The Program is not liable for any expense or claim of an officer or employee or retired officer or employee, or any dependent thereof, who is a member of a group that is covered by an opt-out plan if the expense or claim is incurred after the date on which the officer or employee or retired officer or employee becomes eligible for coverage by the opt-out plan.

     2.  An opt-out plan is not liable for any expense or claim of an officer or employee or retired officer or employee, or any dependent thereof, who is eligible for coverage by the Program if the expense or claim is incurred after the date on which the officer or employee or retired officer or employee becomes eligible for coverage by the Program.

     (Added to NAC by Bd. of Pub. Employees’ Benefits Prog. by R002-12, eff. 6-29-2012)

      NAC 287.387  Administrative fee: Establishment by Program; calculation; notice. (NRS 287.043, 287.0479)

     1.  To recoup the administrative costs incurred by the Program related to opt-out plans, the Program shall, for each fiscal year, establish a monthly per capita administrative fee to be charged to each opt-out plan for each participant in the opt-out plan.

     2.  The administrative fee charged to each opt-out plan each month pursuant to subsection 1 must be based on the number of participants in the opt-out plan during that month.

     3.  The per capita administrative fee must be calculated by:

     (a) Subtracting from the amount of the annual budget of the Program:

          (1) Consulting fees incurred by the Program for health benefits for participants in the Program;

          (2) Fully insured costs of the Program;

          (3) Administrative costs for the plan of self-insurance of the Program;

          (4) Expenses for claims made by participants in the plan of self-insurance of the Program;

          (5) Reserve expenses for the plan of self-insurance of the Program; and

          (6) Any other costs incurred by the Program that the Program deems to be unrelated to participants in opt-out plans.

     (b) Dividing the number determined pursuant to paragraph (a) by the total number of persons who are participating in the Program or in an opt-out plan during the 10th month of the fiscal year immediately preceding the fiscal year for which the fee is being established.

     (c) Dividing the number determined pursuant to paragraph (b) by 12.

     4.  The administrative fee must be calculated and provided in writing to each opt-out plan not later than 60 days before the beginning of each fiscal year.

     (Added to NAC by Bd. of Pub. Employees’ Benefits Prog. by R097-03, eff. 9-24-2003)

      NAC 287.389  Duties of Program: Accounting for and remittance of payments; monthly reports. (NRS 287.043, 287.0479)

     1.  The Program shall:

     (a) Account for all payments for premiums or contributions for participants in opt-out plans that are actually received each month by the Program pursuant to NAC 287.385; and

     (b) Remit all such payments monthly to the applicable opt-out plan less the amount of the monthly administrative fee charged to the opt-out plan by the Program pursuant to NAC 287.387.

     2.  The Program shall provide a monthly report to each opt-out plan, which includes, without limitation, for that month:

     (a) The details of the payments for premiums or contributions for participants in the opt-out plan; and

     (b) The calculation of the administrative fee.

     (Added to NAC by Bd. of Pub. Employees’ Benefits Prog. by R097-03, eff. 9-24-2003)

Option of Group to Reenter Public Employees’ Benefits Program

      NAC 287.400  Procedure for applying to reenter Program. (NRS 287.043, 287.0479)  A group that was approved to leave the Program pursuant to NRS 287.0479 may apply to reenter the Program by submitting to the Board a completed application on a form prescribed by the Board at least 90 days before the commencement of the plan year in which reentry is desired. The application must include, without limitation:

     1.  A nonrefundable application fee of $250.00, plus $2.25 per participant in the opt-out plan.

     2.  A nonrefundable fee to be deposited in the Fund for the Public Employees’ Benefits Program created pursuant to NRS 287.0435 for the purpose of funding the reserve maintained by the Program to stabilize rates. The Executive Officer or his or her designee shall calculate the amount of the nonrefundable fee by:

     (a) Dividing the funded reserve maintained by the Program to stabilize rates on the date on which the application was submitted by the total number of participants in the Program on that date; and

     (b) Multiplying the number determined pursuant to paragraph (a) by the total number of participants in the opt-out plan who will reenter the Program.

Ê The fees or the first installment payment of the fees, if installment payments are authorized by the Program, must be paid by the effective date of reentry.

     3.  The name, gender, age, residential zip code and current selection for coverage of:

     (a) Each eligible participant in the opt-out plan, regardless of whether the eligible participant is enrolled in the opt-out plan; and

     (b) Each participant who is currently enrolled in the opt-out plan and their respective number of enrolled dependents.

     4.  A statement that all terminal fees and costs associated with the opt-out plan will be paid by the participants in the opt-out plan who will reenter the Program.

     (Added to NAC by Bd. of Pub. Employees’ Benefits Prog. by R002-12, eff. 6-29-2012)

Payment of Premiums and Contributions; Coverage

      NAC 287.420  Payment of premiums or contributions by public employer: Date due; penalty. (NRS 287.043, 287.046)

     1.  The total of the premiums or contributions which is billed by the Program and is owed by a public employer which:

     (a) Employs an officer or employee;

     (b) Is legally responsible for the surviving spouse or child of a police officer, firefighter or volunteer firefighter killed in the line of duty; or

     (c) Pays a subsidy for any of its retired officers or employees,

Ê for the officer, employee, surviving spouse or child, or retired officer or employee who elects to participate in the Program and the respective premium or contribution, if any, which is deducted from his or her compensation must be received by the Program by the 25th of each month.

     2.  If a public employer does not pay the amount billed by the Program, the Program shall determine if a penalty that is based on the amount actually paid should be assessed. If the total payments made by the public employer were less than the amount billed to the public employer, the Program may, for good cause shown, assess a monthly compounded penalty of 1.5 percent of the unpaid balance, which will include, without limitation, any unpaid subsidies, penalties or adjustments.

     3.  For the purposes of this section, if the 25th day of the month is a Saturday, Sunday or legal holiday, the payment of a premium or contribution is timely if it is received on the next day which is not a Saturday, Sunday or legal holiday.

     (Added to NAC by Com. on Group Ins., eff. 5-27-86; A 12-17-87; A by Com. on Benefits, 5-4-92; A by Bd. of Pub. Employees’ Benefits Prog. by R126-00, 12-22-2000, eff. 1-1-2001; R154-03, 3-22-2004; R107-09, 4-20-2010)

      NAC 287.430  Direct payment of premiums or contributions: Date due; cancellation of coverage. (NRS 287.043, 287.046)  A person, other than a person who elects to continue coverage pursuant to the Public Health Service Act, 42 U.S.C. § 300bb-1(a), who:

     1.  Enrolls, reenrolls, joins or is continuing coverage in the Program; and

     2.  Is responsible for the payment of the premium or contribution for group insurance directly to the Program or an insurer,

Ê shall pay the premium or contribution to the Program or insurer, as appropriate, no later than the date which is 30 days after the due date of the payment, as determined by the Program. If the total amount of the premium or contribution is not received by that date, the coverage will be cancelled effective on the last day of the month that the coverage was fully paid unless the particular contract of coverage or insurance for which payment is being made otherwise provides.

     (Added to NAC by Com. on Group Ins., eff. 5-27-86; A 12-17-87; A by Com. on Benefits, 5-4-92; A by Bd. of Pub. Employees’ Benefits Prog. by R126-00, 12-22-2000, eff. 1-1-2001; R154-03, 3-22-2004; R089-05, 6-28-2006; R107-09, 4-20-2010)

      NAC 287.440  Payment of premiums or contributions by retired officers and employees. (NRS 287.043, 287.046)

     1.  Except as otherwise provided in subsection 2, retired officers and employees shall pay their premiums or contributions directly to the Program.

     2.  Retired officers and employees who receive a retirement benefit from the Public Employees’ Retirement System shall pay their premiums or contributions to the Program through an automatic deduction from that benefit unless the:

     (a) Retirement benefit is less than the premium or contribution; or

     (b) Coverage of the retired officer or employee is provided through the Program by an individual medical care plan offered through an exchange to supplement Medicare.

     (Added to NAC by Com. on Benefits, eff. 5-4-92; A by Bd. of Pub. Employees’ Benefits Prog. by R126-00, 12-22-2000, eff. 1-1-2001; R154-03, 3-22-2004; R089-05, 6-28-2006; R107-09, 4-20-2010; R002-12, 6-29-2012)

      NAC 287.450  Employees on leave without pay: Payment of premiums or contributions; eligibility for coverage as dependent of participant; coverage upon return to work. (NRS 287.043, 287.046)

     1.  A participating public agency that employs an employee who is on leave without pay shall not pay any amount of the cost of premiums or contributions that is due the Program for group insurance for that employee unless the employee is compensated for a combination of work actually performed and accrued annual leave or sick leave, if the total is at least 80 hours per month for each month that coverage or insurance is provided.

     2.  An employee who is on approved leave without pay:

     (a) May continue coverage or insurance for himself or herself and any of his or her eligible dependents:

          (1) If the amount of the paycheck of the employee is more than the cost of the premium or contribution, by having the cost of the premium or contribution deducted from his or her paycheck; or

          (2) If the amount of the paycheck of the employee is less than the cost of the premium or contribution, by paying the cost of the premium or contribution directly to the Program.

     (b) Is not eligible for coverage or insurance as a dependent of a participant.

     (c) Is not eligible for coverage or insurance if the employee elects not to pay the premium or contribution for coverage or insurance.

     3.  If an employee who is on approved leave without pay elects not to pay the premium or contribution for coverage and insurance from the Program and returns to work:

     (a) Within 1 year after the last day of his or her coverage from the Program, the employee is not required to complete 90 days of full-time employment before being eligible to participate in the Program.

     (b) One year or more after taking leave without pay, the employee is eligible to participate in the Program on the first day of the month following 90 days of full-time employment.

     4.  An employee who is on approved leave without pay may, at the time he or she returns to work, obtain coverage and insurance for any dependent who was previously covered.

     (Added to NAC by Com. on Benefits, eff. 5-4-92; A by Bd. of Pub. Employees’ Benefits Prog. by R126-00, 12-22-2000, eff. 1-1-2001; R154-03, 3-22-2004; R126-07, 1-30-2008; R016-08, 8-26-2008, eff. 7-1-2009; R107-09, 4-20-2010)

      NAC 287.460  Officers and employees on leave because of injuries in course of employment: Payment of premiums or contributions; reports of change in status; coverage of dependents upon return to work. (NRS 287.043, 287.0439, 287.0445)

     1.  An officer or employee of a participating public agency who:

     (a) Is on leave because he or she was injured in the course of employment;

     (b) Receives compensation for a temporary total disability pursuant to NRS 616C.475; and

     (c) Was a participant in the Program at the time of the injury,

Ê may continue coverage or insurance for himself or herself and any of his or her eligible dependents by having the cost of the premium or contribution deducted from his or her paycheck if the amount of the paycheck is more than the cost of the premium or contribution or, if the amount of the paycheck is less than the cost of the premium or contribution, by paying the cost of the premium or contribution directly to the Program. The officer or employee shall report the change of status to the participating public agency that employs him or her when he or she takes leave and when he or she returns to work. Within 15 days after notification of such a change of status by the officer or employee, the participating public agency shall report to the Program, on a form prescribed by the Program, the change of status of the officer or employee.

     2.  If the officer or employee does not pay for coverage or insurance for his or her dependent while on leave and returns to work within 1 year after the last day of his or her coverage from the Program, the dependent may be covered.

     (Added to NAC by Com. on Benefits, eff. 5-4-92; A by Bd. of Pub. Employees’ Benefits Prog. by R126-00, 12-22-2000, eff. 1-1-2001; R154-03, 3-22-2004; R089-05, 6-28-2006; R126-07, 1-30-2008)

      NAC 287.470  Overpayment or underpayment of premiums or contributions. (NRS 287.043, 287.046)

     1.  The provisions of this section apply if an overpayment or underpayment of a premium or contribution occurs because of:

     (a) A clerical error by the Program or a participating public agency;

     (b) A change of coverage or a change in the working status of a participating officer or employee; or

     (c) The failure of a participant to give timely notice that a dependent is ineligible for coverage.

     2.  If a participating public agency makes an overpayment of premiums or contributions, it may deduct the amount of the overpayment from the payment of premiums or contributions otherwise due for the following month. Any such deduction for a period greater than 1 month must:

     (a) Be approved in advance by the Program; and

     (b) Equal the amount of the overpayment without provision for interest.

     3.  The participating public agency shall pay any money due a participant because of an overpayment of premiums or contributions.

     4.  If a participating public agency makes an underpayment of premiums or contributions, it must add the amount of the underpayment to the payment of premiums or contributions otherwise due for the following month. Any such additions for a period greater than 1 month must:

     (a) Be approved in advance by the Program; and

     (b) Equal the amount of the underpayment without provision for interest.

     5.  Any money owed by a participant because of an underpayment of premiums or contributions must be collected from the participant and paid by the participating public agency.

     6.  As used in this section, “overpayment of premiums or contributions” does not include the payment of premiums or contributions for the month in which the employment of a participant terminated, regardless of the date on which the termination occurs.

     (Added to NAC by Com. on Benefits, eff. 5-4-92; A by Bd. of Pub. Employees’ Benefits Prog. by R126-00, 12-22-2000, eff. 1-1-2001; R154-03, 3-22-2004; R016-08, 8-26-2008, eff. 7-1-2009)

      NAC 287.485  Subsidy for retired officer or employee: Report required to obtain subsidy; audit of service credit required; billing; commencement of payment; adjustment of amount of subsidy; assumption of liability for service credit earned. (NRS 287.043, 287.046)

     1.  To obtain a subsidy, a retired officer or employee who participates in the Program must report to the Program, on a form prescribed by the Program, each public employer with which he or she earned service credit and the period of service with each such public employer.

     2.  The Executive Officer or a designee thereof shall request an audit from the appropriate certifying agency to determine the initial date of hire of a retired officer or employee and the years and months of service credit earned by the retired officer or employee with each public employer of the retired officer or employee during the period of that employment. Such a request must be made within 14 days after the later of:

     (a) The receipt of the report made to the Program pursuant to subsection 1; or

     (b) The date of the retirement of the retired officer or employee.

     3.  For the purposes of subsections 1 and 2, service credit:

     (a) Must be computed in the manner set forth in NRS 286.495 or 286.501, as applicable;

     (b) Must include any service credit that has been restored by the repayment of contributions that the retired officer or employee had withdrawn from the Public Employees’ Retirement System pursuant to NRS 286.430; and

     (c) Must not include any service credit that was purchased pursuant to NRS 1A.310 or 286.300.

     4.  Except as otherwise provided in subsection 5, the Executive Officer or a designee thereof shall not submit a bill to a public employer for a subsidy for a retired officer or employee until an audit requested pursuant to subsection 2 for the retired officer or employee is received by the Program.

     5.  If an audit requested pursuant to subsection 2 is received after the date on which coverage of the retired officer or employee becomes effective, the Executive Officer or a designee thereof shall submit to the previous public employer of the retired officer or employee a bill for the subsidy incurred between the date on which coverage of the retired officer or employee became effective and the date on which the audit was received.

     6.  A public employer shall commence payment of its subsidy for a retired officer or employee upon receipt of the bill for the subsidy.

     7.  If, after receiving an audit requested pursuant to subsection 2, the Program receives any additional audit for the retired officer or employee for whom the original audit was conducted:

     (a) The Program shall adjust the amount to be billed to the retired officer or employee and to the previous public employer of the retired officer or employee according to the years and months of service credit reported in the most recent audit; and

     (b) Any such adjustment will be effective on the first day of the month after the receipt by the Program of the most recent audit.

     8.  A public employer or other entity may assume from a public employer the liability for the years and months of service credit earned by a retired officer or employee if the public employer assuming the liability submits a written certification to the Program containing:

     (a) The name and social security number of the retired officer or employee;

     (b) The dates during which the service credit for which the public employer or other entity is assuming liability was earned by the retired officer or employee;

     (c) A statement acknowledging that the public employer or other entity is assuming the liability associated with the dates listed pursuant to paragraph (b);

     (d) A signature of the director or chief executive officer of the public employer or other entity assuming liability, or a designee of the director or chief executive officer of the public employer or other entity assuming liability; and

     (e) The name, title and contact information of the person who signed the certification.

     9.  If a public employer with which a retired officer or employee earned service credit ceases to exist as a public employer, the public employer that has the most direct jurisdictional association with the public employer that ceases to exist, as determined by the Executive Officer, shall assume liability for the years and months of service credit earned by the retired officer or employee with the public employer that ceases to exist.

     10.  The results reported in an audit received by the Program pursuant to the provisions of this section may not be appealed.

     (Added to NAC by Bd. of Pub. Employees’ Benefits Prog. by R154-03, eff. 3-22-2004; A by R089-05, 6-28-2006; R126-07, 1-30-2008; R107-09, 4-20-2010; R108-12, 12-20-2012)

      NAC 287.490  Subsidy for retired officer or employee: Calculation of amount of payment. (NRS 287.043, 287.046)

     1.  Except as otherwise provided in subsection 2, the amount of the subsidy that must be paid by each public employer with which a retired officer or employee was employed is calculated in the manner set forth in NRS 287.046.

     2.  Each public employer with which the retired officer or employee was employed shall pay an amount of the total subsidy for the retired officer or employee equal to the proportion that the service credit earned by the retired officer or employee with that public employer bears to the total service credit earned by the retired officer or employee with all public employers with which the retired officer or employee was employed. The amount of the total subsidy must be based on the cumulative total years and months of service by the retired officer or employer for all public employers with which the retired officer or employee was employed.

     (Added to NAC by Bd. of Pub. Employees’ Benefits Prog. by R154-03, 3-22-2004, eff. 7-1-2004; A by R126-07, 1-30-2008)

      NAC 287.500  Coverage of seasonal employees and biennial employees. (NRS 287.043, 287.045, 287.0467)

     1.  If a seasonal employee returns to work with a participating public agency, the participating public agency shall determine if the employee participated in the Program or was eligible to participate during his or her previous employment with the participating public agency.

     2.  A seasonal employee who was eligible to participate in the Program during his or her previous employment with a participating public agency and who returns to work within 1 year after the termination of employment is eligible to participate in the Program on the first day of the month following his or her return to work.

     3.  A seasonal employee who returns to work 1 year or more after the termination of his or her previous employment is eligible to participate in the Program:

     (a) If the first day after the completion of 90 days of full-time employment is the first day of a month, on the first day after the completion of 90 days of full-time employment; or

     (b) If the first day after the completion of 90 days of full-time employment is not the first day of a month, on the first day of the month immediately following the completion of 90 days of full-time employment.

     4.  A biennial employee who was working for a participating state agency is not subject to any waiting period upon reenrollment if the biennial employee:

     (a) Is returning to the same or a similar position as held during the previous biennial employment period; and

     (b) Continues to pay his or her full premium or contribution and allowable administrative fees as required by NRS 287.0467 for the enrolled coverage between biennial employment periods.

     (Added to NAC by Com. on Benefits, eff. 5-4-92; A by Bd. of Pub. Employees’ Benefits Prog. by R126-00, 12-22-2000, eff. 1-1-2001; R154-03, 3-22-2004; R089-05, 6-28-2006; R126-07, 1-30-2008)

      NAC 287.510  Coverage of persons returning to work with previous employer within 1 year after leaving employment. (NRS 287.043, 287.045)  If a person other than a retired officer or employee returns to work for a participating public agency with which the person was previously employed within 1 year after leaving employment:

     1.  The person may select any coverage and insurance offered to participants in the Program at the time that the person returns to work; and

     2.  Coverage and insurance for the person is effective:

     (a) If the effective date of reemployment is on the first day of a month, on the effective date of reemployment; or

     (b) If the effective date of reemployment is not on the first day of a month, on the first day of the month immediately following the effective date of reemployment.

     (Added to NAC by Com. on Group Ins., eff. 5-27-86; A by Bd. of Pub. Employees’ Benefits Prog. by R126-00, 12-22-2000, eff. 1-1-2001; R154-03, 3-22-2004; R089-05, 6-28-2006; R126-07, 1-30-2008)

      NAC 287.515  Coverage of retired participants upon reemployment. (NRS 287.043, 287.045)

     1.  Except as otherwise provided in this section, a person who participates in the Program as a retired officer or employee and who returns to full-time employment with a participating public agency is eligible to participate in the Program as an active officer or employee:

     (a) If the effective date of reemployment is on the first day of a month, on the effective date of reemployment; or

     (b) If the effective date of reemployment is not on the first day of a month, on the first day of the month immediately following the effective date of reemployment.

     2.  If a person who participates in the Program as a retired justice or judge accepts reemployment as a justice of the Supreme Court or district judge pursuant to NRS 1A.370, the person is eligible to participate in the Program as an active justice or judge, as applicable:

     (a) If the first day after the completion of 90 days of full-time employment is on the first day of a month, on the first day after the completion of 90 days of full-time employment; or

     (b) If the first day after the completion of 90 days of full-time employment is not on the first day of a month, on the first day of the month immediately following the completion of 90 days of full-time employment.

     3.  Except as otherwise required by federal law, a retired officer or employee who returns to full-time employment with a participating public agency to fill a position which has been designated as a position for which there is a critical labor shortage pursuant to NRS 286.523 and who continues to receive allowances under the retirement system of which he or she is a member is eligible to participate in the Program in the same manner as he or she participated before returning to full-time employment. Except for a retired officer or employee who was enrolled in the Program on November 30, 2008, and continues his or her participation in the Program, coverage of a retired officer or employee who returns to full-time employment with a participating local governmental agency pursuant to this subsection terminates on the date on which the participating local governmental agency terminates its participation in the Program.

     4.  A retired officer or employee who returns to full-time employment with a participating state agency to fill a position which has been designated as a position for which there is a critical labor shortage pursuant to NRS 286.523 and who discontinues receiving allowances under the retirement system of which he or she is a member is eligible to participate in the Program as an active officer or employee:

     (a) If the effective date of reemployment is on the first day of a month, on the effective date of reemployment; or

     (b) If the effective date of reemployment is not on the first day of a month, on the first day of the month immediately following the effective date of reemployment.

     5.  A retired officer or employee who returns to full-time employment with a participating local governmental agency to fill a position which has been designated as a position for which there is a critical labor shortage pursuant to NRS 286.523 and who discontinues receiving allowances under the retirement system of which he or she is a member is eligible to participate in the Program as an active officer or employee:

     (a) If the effective date of reemployment is on the first day of a month, on the effective date of reemployment; or

     (b) If the effective date of reemployment is not on the first day of a month, on the first day of the month immediately following the effective date of reemployment.

Ê Except for a retired officer or employee who was enrolled in the Program on November 30, 2008, and continues his or her participation in the Program, coverage of a retired officer or employee pursuant to this subsection terminates on the date on which the participating local governmental agency with which the retired officer or employee returns to full-time employment terminates its participation in the Program.

     (Added to NAC by Bd. of Pub. Employees’ Benefits Prog. by R089-05, eff. 6-28-2006; A by R126-07, 1-30-2008; R108-12, 12-20-2012)

      NAC 287.520  Coverage of person qualified as both employee and dependent; change of status from employee to dependent. (NRS 287.043)

     1.  Except as otherwise provided in NAC 287.530, if a person qualifies to be covered by the Program as both an employee and a dependent, the person:

     (a) If the person is a spouse or domestic partner:

          (1) May be covered by the Program as an employee; and

          (2) May not be covered by the Program as a dependent.

     (b) If the person is a child, may be covered by the Program as an employee or dependent.

     2.  If a participating officer or employee changes his or her status to that of a dependent because he or she no longer qualifies as an employee, he or she must enroll as a dependent within 60 days after losing status as an employee to be eligible for coverage and insurance as a dependent. If a participant complies with the requirements of this subsection, his or her coverage or insurance is not limited by any waiting period that would otherwise apply.

     (Added to NAC by Com. on Group Ins., eff. 5-27-86; A by Com. on Benefits, 5-4-92; A by Bd. of Pub. Employees’ Benefits Prog. by R126-00, 12-22-2000, eff. 1-1-2001; R002-12, 6-29-2012)

      NAC 287.530  Coverage of retired person, spouse, domestic partner or surviving dependent: Generally. (NRS 122A.100, 287.043)

     1.  If the participant and his or her spouse or domestic partner are retired officers or employees who retired before July 1, 2004, and elect to participate in the Program, one may elect to be the dependent of the other. A spouse or a domestic partner who elected to be the dependent pursuant to this subsection may elect to become a primary insured during open enrollment. If the retired officer or employee designated as the primary insured dies, the spouse or domestic partner who elected to be the dependent becomes the primary insured.

     2.  A person who retires on or after July 1, 2004, and who is eligible to participate in the Program as a primary insured may not elect to be a dependent of his or her spouse or domestic partner who is a primary insured in the Program.

     3.  A surviving spouse or domestic partner who:

     (a) Retired before July 1, 2004;

     (b) Is enrolled in the Program as a surviving dependent; and

     (c) Is eligible to participate in the Program as a primary insured,

Ê may elect to change his or her status to retiree status during open enrollment. A person who chooses such an election pursuant to this subsection must meet the requirements of NAC 287.485 to be eligible for a subsidy.

     4.  A person who is a surviving dependent of a deceased officer or employee of a participating public agency, or a deceased retired officer or employee, and who, at the time of his or her death, was a participant under the Program, may maintain the coverage or insurance from the Program if:

     (a) The surviving dependent receives retirement benefits from which premiums or contributions can be deducted or such dependent pays the premium or contribution directly to the Program; and

     (b) Within 60 days after the date of death of the participant, the surviving dependent:

          (1) Notifies the last public employer of the deceased participant that the surviving dependent intends to enroll in or continue coverage by reenrolling in the Program; and

          (2) Enrolls or reenrolls, as appropriate, in the Program.

     5.  Continued coverage provided to a surviving dependent who reenrolls in the Program in accordance with this section may not be changed until the next period of open enrollment.

     6.  If the surviving spouse or domestic partner has a dependent who is not covered under the Program at the time of death of the officer or employee of a participating public agency, or retired officer or employee, or acquires a dependent by marriage, adoption or birth, the dependent is not eligible for coverage or insurance.

     7.  A retired officer or employee who wishes to enroll or reenroll in the Program more than 60 days after his or her official date of retirement or total disability must comply with the requirements of NRS 287.0475.

     (Added to NAC by Com. on Group Ins., eff. 5-27-86; A by Com. on Benefits, 5-4-92; A by Bd. of Pub. Employees’ Benefits Prog. by R126-00, 12-22-2000, eff. 1-1-2001; R154-03, 3-22-2004; R126-07, 1-30-2008; R016-08, 8-26-2008, eff. 7-1-2009; R107-09, 4-20-2010; R107-09, 4-20-2010, eff. 7-1-2010)

      NAC 287.540  Coverage of participating employee of State who reenrolls upon retirement or total disability; coverage of nonparticipating employee of State. (NRS 287.043)

     1.  A person who:

     (a) At the time of retirement or total disability, was:

          (1) Employed by a participating state agency; and

          (2) A participant in the Program; and

     (b) Within 60 days after the official date of retirement or total disability reenrolls in the Program,

Ê will have uninterrupted benefits and is not subject to any waiting period.

     2.  A person described in subsection 1 may select any coverage and insurance offered to participants in the Program at the time of reenrollment pursuant to paragraph (b) of subsection 1.

     3.  A person who, at the time of retirement or total disability, was:

     (a) Employed by a participating state agency; and

     (b) Not a participant in the Program,

Ê may only reinstate in the Program pursuant to the provisions of NRS 287.0475.

     4.  Coverage provided to a person described in subsection 1 or 3 will continue until he or she chooses to terminate or decline the coverage. If the person chooses to terminate or decline the coverage, he or she may subsequently only reinstate in the Program pursuant to the provisions of NRS 287.0475.

     (Added to NAC by Bd. of Pub. Employees’ Benefits Prog. by R126-07, eff. 1-30-2008; A by R108-12, 12-20-2012)

      NAC 287.542  Coverage of participating employee of local governmental agency who retires on or before September 1, 2008, and reenrolls upon retirement or total disability. (NRS 287.043)

     1.  A person who:

     (a) Is a retired officer or employee on or before September 1, 2008;

     (b) At the time of retirement or total disability, was:

          (1) Employed by a participating local governmental agency; and

          (2) A participant in the Program; and

     (c) Within 60 days after the official date of retirement or total disability:

          (1) Notifies the participating local governmental agency that employed him or her at the time of retirement or total disability of his or her intent to continue coverage in the Program; and

          (2) Reenrolls in the Program,

Ê will have uninterrupted benefits and is not subject to any waiting period.

     2.  Coverage provided to a person described in subsection 1:

     (a) May be changed by the person at the time of reenrollment pursuant to subparagraph (2) of paragraph (c) of subsection 1.

     (b) Continues until the person chooses to terminate or decline the coverage. If the person chooses to terminate or decline the coverage after November 30, 2008, the person may subsequently only reinstate in the Program pursuant to NRS 287.023 and 287.0475.

     (Added to NAC by Bd. of Pub. Employees’ Benefits Prog. by R126-07, eff. 1-30-2008)

      NAC 287.544  Coverage of nonparticipating employee of local governmental agency who retires on or before September 1, 2008, and enrolls upon retirement or total disability. (NRS 287.043)

     1.  A person who:

     (a) Is a retired officer or employee on or before September 1, 2008;

     (b) At the time of retirement or total disability:

          (1) Was employed by a participating local governmental agency; and

          (2) Was not a participant in the Program; and

     (c) Within 60 days after the official date of retirement or total disability:

          (1) Notifies the participating local governmental agency that employed him or her at the time of retirement or total disability of his or her intent to enroll in the Program; and

          (2) Enrolls in the Program,

Ê is subject to a 60-day waiting period.

     2.  Coverage provided to a person described in subsection 1 continues until the person chooses to terminate or decline the coverage. If the person chooses to terminate or decline the coverage after November 30, 2008, the person may subsequently only reinstate in the Program pursuant to NRS 287.023 and 287.0475.

     (Added to NAC by Bd. of Pub. Employees’ Benefits Prog. by R126-07, eff. 1-30-2008)

      NAC 287.546  Coverage of participating employee of local governmental agency who retires after September 1, 2008, and reenrolls upon retirement or total disability. (NRS 287.043)

     1.  A person who:

     (a) Becomes a retired officer or employee after September 1, 2008;

     (b) At the time of retirement or total disability, was:

          (1) Employed by a participating local governmental agency; and

          (2) A participant in the Program; and

     (c) Within 60 days after the official date of retirement or total disability reenrolls in the Program,

Ê will have uninterrupted benefits and is not subject to any waiting period.

     2.  Continued coverage provided to a person described in subsection 1 may be changed by the person at the time of reenrollment pursuant to paragraph (c) of subsection 1.

     3.  Coverage of a person pursuant to this section terminates on the date on which the participating local governmental agency that employed the person at the time of retirement or total disability terminates its participation in the Program.

     (Added to NAC by Bd. of Pub. Employees’ Benefits Prog. by R126-07, eff. 1-30-2008; A by R108-12, 12-20-2012)

      NAC 287.548  Coverage of nonparticipating employee of local governmental agency who retires after September 1, 2008. (NRS 287.043)

     1.  A person who:

     (a) Becomes a retired officer or employee after September 1, 2008; and

     (b) At the time of retirement or total disability:

          (1) Was employed by a participating local governmental agency; and

          (2) Was not a participant in the Program,

Ê may only reinstate in the Program pursuant to the provisions of NRS 287.0475.

     2.  Coverage provided to a person pursuant to this section terminates on the date on which the participating local governmental agency that employed the person at the time of retirement or total disability terminates its participation in the Program.

     (Added to NAC by Bd. of Pub. Employees’ Benefits Prog. by R126-07, eff. 1-30-2008; A by R108-12, 12-20-2012)

Claims

      NAC 287.600  Definitions. (NRS 287.043)  As used in NAC 287.600 to 287.695, inclusive, unless the context otherwise requires, the words and terms defined in NAC 287.601, 287.602 and 287.603 have the meanings ascribed to them in those sections.

     (Added to NAC by Bd. of Pub. Employees’ Benefits Prog. by R002-12, eff. 6-29-2012)

      NAC 287.601  “Adverse determination” defined. (NRS 287.043)  “Adverse determination” has the meaning ascribed to it in NRS 695G.012.

     (Added to NAC by Bd. of Pub. Employees’ Benefits Prog. by R002-12, eff. 6-29-2012)

      NAC 287.602  “Appeals Manager” defined. (NRS 287.043)  “Appeals Manager” means the person designated by the Claims Administrator to review and decide appeals of the denials of claims pursuant to NAC 287.670.

     (Added to NAC by Bd. of Pub. Employees’ Benefits Prog. by R002-12, eff. 6-29-2012)

      NAC 287.603  “Claims Administrator” defined. (NRS 287.043)  “Claims Administrator” means a third-party administrator with which the Program has entered into a contract pursuant to NRS 287.0434 to administer the claims of participants of the Program.

     (Added to NAC by Bd. of Pub. Employees’ Benefits Prog. by R002-12, eff. 6-29-2012)

      NAC 287.608  Claims Administrator or vendor required to be independent contractor. (NRS 287.043)  Any Claims Administrator or vendor must be an independent contractor pursuant to NRS 333.700.

     (Added to NAC by Bd. of Pub. Employees’ Benefits Prog. by R002-12, eff. 6-29-2012)

      NAC 287.610  Period for submission. (NRS 287.043)  A claim made to the Program must be submitted to the Claims Administrator of the Program not later than 1 year after the date on which the expense reported in the claim is incurred. A claim submitted after that time will not be paid.

     (Added to NAC by Com. on Group Ins., eff. 9-10-87; A by Bd. of Pub. Employees’ Benefits Prog. by R126-00, 12-22-2000, eff. 1-1-2001; R154-03, 3-22-2004; R089-05, 6-28-2006)

      NAC 287.620  Assumption regarding availability of benefits under Medicare; coordination under Medicare. (NRS 287.043)

     1.  If a medical claim is made by a retired participant who is 65 years of age or older, the Claims Administrator shall assume that benefits are available to the participant pursuant to Medicare Part B. To coordinate benefits under Medicare for the purposes of this subsection, the Claims Administrator shall use the first day of the month in which the birthday of the retired participant occurs.

     2.  If the Claims Administrator receives notification that a retired participant who is less than 65 years of age is eligible for benefits pursuant to Medicare Part B, the Claims Administrator shall coordinate benefits under Medicare using the first day of the month in which he or she receives notification that the retired participant is eligible for such benefits.

     (Added to NAC by Com. on Benefits, eff. 5-4-92; A by Bd. of Pub. Employees’ Benefits Prog. by R108-12, 12-20-2012)

      NAC 287.660  Notification of adverse determination; grounds for appeal. (NRS 287.043)

     1.  The Claims Administrator shall notify a participant of an adverse determination of a claim of the participant or his or her dependent. Such notification must:

     (a) Be in writing;

     (b) Explain the reason for the adverse determination;

     (c) Include the specific provision of the applicable plan of the Program used by the Claims Administrator as the basis for the adverse determination;

     (d) If the adverse determination is made as a result of a lack of information, request any additional information necessary to reverse the adverse determination; and

     (e) Explain the process for initiating an appeal of the adverse determination pursuant to NAC 287.670.

     2.  A participant may appeal an adverse determination if the participant feels the claim was not adjudicated pursuant to the current terms and conditions of the Program.

     (Added to NAC by Com. on Group Ins., eff. 3-9-88; A by Bd. of Pub. Employees’ Benefits Prog. by R126-00, 12-22-2000, eff. 1-1-2001; R016-08, 8-26-2008, eff. 7-1-2009; R002-12, 6-29-2012)

      NAC 287.670  Appeal of adverse determination: Requirements; duties of Appeals Manager. (NRS 287.043)

     1.  Except as otherwise provided in NAC 287.695, to initiate an appeal of an adverse determination of a claim, a participant must submit a written request to the Claims Administrator within 180 days after the date on which the participant received the notification of the adverse determination that is required pursuant to NAC 287.660. A request for an appeal of an adverse determination must include:

     (a) The name of the participant;

     (b) The social security number or member identification number of the participant;

     (c) A copy of the explanation of benefits related to the claim that was provided to the participant by the Claims Administrator;

     (d) A copy of the claim that was submitted to the Claims Administrator from the vendor; and

     (e) A statement setting forth the reasons the adverse determination is being appealed.

     2.  The Appeals Manager of the Claims Administrator shall:

     (a) Review the appeal of an adverse determination to decide if the claim was adjudicated pursuant to the:

          (1) Current terms and conditions of the Program; and

          (2) Contract between the Program and applicable vendor; and

     (b) Within 20 days after receiving the request for an appeal, advise the participant in writing of:

          (1) The decision of the Appeals Manager, setting forth the reasons therefor;

          (2) The specific provision of the applicable plan of the Program used by the Appeals Manager as the basis for the decision; and

          (3) The process by which the participant may appeal the decision of the Appeals Manager pursuant to NAC 287.680.

     3.  As used in this section, “member identification number” means the number assigned to a participant by the Program.

     (Added to NAC by Com. on Group Ins., eff. 3-9-88; A by Bd. of Pub. Employees’ Benefits Prog. by R126-00, 12-22-2000, eff. 1-1-2001; R154-03, 3-22-2004; R126-07, 1-30-2008; R016-08, 8-26-2008, eff. 7-1-2009; R002-12, 6-29-2012)

      NAC 287.680  Appeal of decision of Appeals Manager: Requirements; duties of Executive Officer or designee. (NRS 287.043)

     1.  Except as otherwise provided in NAC 287.695, if a participant in the Program is unsatisfied with the decision of the Appeals Manager made pursuant to NAC 287.670, the participant may file an appeal with the Executive Officer or a designee thereof. Such an appeal must be in writing and be filed within 35 days after the participant’s receipt of the decision of the Appeals Manager. Such an appeal must include all supporting documentation, including, without limitation, a copy of the request for an appeal of the adverse determination submitted to the Claims Administrator pursuant to NAC 287.670, a copy of the decision of the Appeals Manager concerning the adverse determination and any other information provided to the Claims Administrator by the participant.

     2.  The Executive Officer or the designee shall:

     (a) Review the material submitted by the participant to decide if the claim was adjudicated pursuant to the:

          (1) Current terms and conditions of the Program; and

          (2) Contract between the Program and applicable vendor; and

     (b) Within 30 days after receipt of the participant’s appeal, notify the participant in writing of:

          (1) The decision of the Executive Officer or the designee, setting forth the reasons therefor;

          (2) The specific provision of the applicable plan of the Program used by the Executive Officer or the designee as a basis for the decision; and

          (3) The process by which the participant may request an external review of the adverse determination pursuant to NAC 287.690.

     (Added to NAC by Com. on Group Ins., eff. 3-9-88; A by Com. on Benefits, 5-4-92; A by Bd. of Pub. Employees’ Benefits Prog. by R126-00, 12-22-2000, eff. 1-1-2001; R154-03, 3-22-2004; R126-07, 1-30-2008; R002-12, 6-29-2012)

      NAC 287.690  Request for external review. (NRS 287.043)  If a participant in the Program is not satisfied with the decision of the Executive Officer or the designee on the appeal made by the participant pursuant to NAC 287.680, the participant may request an external review of the adverse determination conducted by an independent review organization pursuant to NRS 695G.241 to 695G.310, inclusive.

     (Added to NAC by Com. on Group Ins., eff. 3-9-88; A by Com. on Benefits, 5-4-92; A by Bd. of Pub. Employees’ Benefits Prog. by R126-00, 12-22-2000, eff. 1-1-2001; R154-03, 3-22-2004; R089-05, 6-28-2006; R126-07, 1-30-2008; R002-12, 6-29-2012)

      NAC 287.695  Request for expedited review by Claims Administrator. (NRS 287.043)

     1.  In addition to the expedited procedure set forth in NRS 695G.271 and 695G.275, a participant may submit a request, verbally or in writing, to the Claims Administrator for an expedited review of an adverse determination under the circumstances set forth in NRS 695G.271 and 695G.275.

     2.  Any information related to such a request for an expedited review may be transmitted between the participant and the Claims Administrator by telephone, facsimile or other expeditious method of communication.

     3.  The Claims Administrator shall notify the participant in writing of its determination on the request for an expedited review within 72 hours after the request was made to the Claims Administrator.

     (Added to NAC by Bd. of Pub. Employees’ Benefits Prog. by R002-12, eff. 6-29-2012)

DEFERRED COMPENSATION

      NAC 287.700  Definitions. (NRS 287.330)  As used in NAC 287.700 to 287.735, inclusive, unless the context otherwise requires:

     1.  “Committee” means the Committee established to administer the Program.

     2.  “Investment consultant” means a private person, corporation, institution or other entity that provides advice on investments and operations of the Program, including, without limitation, advice provided for the purposes of paragraph (a) of subsection 3 of NRS 287.330 and NAC 287.735.

     3.  “Program” means the Public Employees’ Deferred Compensation Program authorized by NRS 287.250 to 287.370, inclusive.

     4.  “Recordkeeper” means a corporation, institution or other entity that offers investment options and other services which are necessary to the administration of the Program and to the proper investment of the money of the employees who are participants in the Program. The term does not include a private person.

     (Added to NAC by Com. to Admin. Pub. Employees’ Deferred Comp. Prog., eff. 9-13-91; A by R066-13, 12-23-2013)

      NAC 287.705  Purpose. (NRS 287.330)  The purpose of NAC 287.705 to 287.735, inclusive, is to set forth the procedures for the selection of investment consultants and recordkeepers for the Program.

     (Added to NAC by Com. to Admin. Pub. Employees’ Deferred Comp. Prog., eff. 9-13-91; A by R015-98, 5-29-98; R066-13, 12-23-2013)

      NAC 287.710  Recordkeepers: Selection and removal. (NRS 287.330)

     1.  The Committee will select recordkeepers for the Program. The Committee will contract with more than one recordkeeper if the Committee deems it necessary and in the best interests of the participants.

     2.  The selection of recordkeepers will be made as often as the Committee deems necessary, but not less frequently than every fifth year.

     3.  Recordkeepers serve at the pleasure of the Committee and are subject to removal at any time by a majority vote of the Committee.

     (Added to NAC by Com. to Admin. Pub. Employees’ Deferred Comp. Prog., eff. 9-13-91; A by R015-98, 5-29-98; R066-13, 12-23-2013)

      NAC 287.715  Recordkeepers: Procedures for selection. (NRS 287.330)  In selecting a recordkeeper, the Committee will follow the procedures set forth in chapter 333 of NRS, the applicable regulations and the State Administrative Manual.

     (Added to NAC by Com. to Admin. Pub. Employees’ Deferred Comp. Prog., eff. 9-13-91; A by R015-98, 5-29-98; R066-13, 12-23-2013)

      NAC 287.730  Appointment of subcommittee to review proposals for position of recordkeeper and make recommendations; general meeting of Committee regarding applicants; negotiation of changes to accepted proposals. (NRS 287.330)

     1.  The Chair shall, if he or she deems it appropriate, appoint a subcommittee to review the proposals from applicants for the position of recordkeeper and make recommendations to the full Committee.

     2.  The Chair shall call a general meeting of the Committee to:

     (a) Accept information from appropriate sources pertaining to any applicant.

     (b) Conduct interviews of the applicants.

     (c) Select one or more of the applicants for appointment as a recordkeeper.

     3.  Acceptance of an applicant’s proposal does not preclude the Committee from negotiating specific changes to the proposal which are in the best interests of the State of Nevada.

     (Added to NAC by Com. to Admin. Pub. Employees’ Deferred Comp. Prog., eff. 9-13-91; A by R015-98, 5-29-98; R066-13, 12-23-2013)

      NAC 287.735  Investment consultants: Selection and removal. (NRS 287.330)

     1.  The Committee will select such investment consultants as are necessary to provide services needed for the selection of recordkeepers and for the administration of the Program and the investment of the money of the participants.

     2.  Such an investment consultant serves at the pleasure of the Committee and may be removed from the position at any time by a majority vote of the Committee.

     (Added to NAC by Com. to Admin. Pub. Employees’ Deferred Comp. Prog., eff. 9-13-91; A by R015-98, 5-29-98; R066-13, 12-23-2013)

PROVISION OF HEALTH INSURANCE THROUGH PLAN OF SELF-INSURANCE

      NAC 287.750  System for resolving complaints of insureds: Requirements for approval and annual report. (NRS 679B.130)  If the Board of the Public Employees’ Benefits Program provides health insurance through a plan of self-insurance:

     1.  To obtain approval of a system for resolving complaints of insureds under the plan of self-insurance from the Commissioner of Insurance as required pursuant to NRS 287.04335 and 695G.200, the Board must submit to the Division of Insurance of the Department of Business and Industry:

     (a) The name and title of the employee responsible for the system for resolving complaints;

     (b) A description of the procedure used to notify an insured of the decision regarding his or her complaint; and

     (c) A copy of the explanation of rights and procedures that will be provided to insureds.

     2.  The Board shall submit its annual report regarding its system for resolving complaints to the Commissioner of Insurance as required pursuant to NRS 287.04335 and 695G.220 on or before February 1 of each year. The Board shall retain a copy of the annual report for 3 years or until the next examination of the system for resolving complaints is conducted by the Division pursuant to NRS 287.04335 and 695G.200, whichever is longer.

     3.  The Board is not required to include in the annual report information concerning an oral inquiry by an insured relating to a misunderstanding or miscommunication if the misunderstanding or miscommunication was resolved within 1 working day after the inquiry was made. If the misunderstanding or miscommunication was not resolved within 1 working day, the Board shall report the misunderstanding or miscommunication as a complaint in the annual report.

     (Added to NAC by Comm’r of Insurance by R008-02, eff. 5-23-2002)

TRUST FUND FOR FUTURE RETIREMENT BENEFITS OF LOCAL GOVERNMENTAL EMPLOYEES

      NAC 287.760  Definitions. (NRS 287.017)  As used in NAC 287.760 to 287.792, inclusive, unless the context otherwise requires, the words and terms defined in NAC 287.762 to 287.774, inclusive, have the meanings ascribed to them in those sections.

     (Added to NAC by Com. on Local Gov’t Finance by R089-08, eff. 9-18-2008)

      NAC 287.762  “Benefits plan” defined. (NRS 287.017)  “Benefits plan” has the meaning ascribed to it in NRS 287.017.

     (Added to NAC by Com. on Local Gov’t Finance by R089-08, eff. 9-18-2008)

      NAC 287.764  “Board of trustees” defined. (NRS 287.017)  “Board of trustees” means the persons appointed by a governing body to administer a trust fund established pursuant to NRS 287.017.

     (Added to NAC by Com. on Local Gov’t Finance by R089-08, eff. 9-18-2008)

      NAC 287.766  “Governing body” defined. (NRS 287.017)  “Governing body” means the governing body of a local government.

     (Added to NAC by Com. on Local Gov’t Finance by R089-08, eff. 9-18-2008)

      NAC 287.768  “Local government” defined. (NRS 287.017)  “Local government” has the meaning ascribed to it in NRS 287.017.

     (Added to NAC by Com. on Local Gov’t Finance by R089-08, eff. 9-18-2008)

      NAC 287.770  “Professional fund manager” defined. (NRS 287.017)  “Professional fund manager” means a person or entity that provides investment management services, including, without limitation, the implementation of investment strategies and the management of an investment portfolio.

     (Added to NAC by Com. on Local Gov’t Finance by R089-08, eff. 9-18-2008)

      NAC 287.772  “Retirement benefits” defined. (NRS 287.017)  “Retirement benefits” has the meaning ascribed to it in NRS 287.017.

     (Added to NAC by Com. on Local Gov’t Finance by R089-08, eff. 9-18-2008)

      NAC 287.774  “Trust fund” defined. (NRS 287.017)  “Trust fund” means a trust fund established pursuant to NRS 287.017.

     (Added to NAC by Com. on Local Gov’t Finance by R089-08, eff. 9-18-2008)

      NAC 287.776  Resolution to establish trust fund; periodic reports. (NRS 287.017)

     1.  A trust fund must be established by a resolution of the governing body, which must include specific statements regarding:

     (a) The purpose of the trust fund;

     (b) A statement that all contributions to the trust fund, including any interest and income earned on the money in the trust fund, are held in trust, are irrevocable and may be used only to:

          (1) Provide, for the benefit of retired employees of that local government and the spouses and dependents of those employees, retirement benefits in accordance with the benefits plan of that local government; and

          (2) Pay any reasonable administrative expenses incident to the provision of those benefits and the administration of the trust fund;

     (c) The sources of the money expected to be deposited in the trust fund;

     (d) The appointment by the governing body of a board of trustees, including, without limitation, the number of members of the board of trustees and their terms of office, as determined pursuant to NAC 287.778;

     (e) A statement that the powers, duties, rights and obligations of the board of trustees will conform to the requirements of NRS 287.017 and NAC 287.760 to 287.792, inclusive;

     (f) A statement that, except as otherwise provided in paragraph (h) of subsection 2 of NRS 287.017, no other money will be commingled with the money in the trust fund and that the trust fund will be maintained as a separate account; and

     (g) A statement that the money in the trust fund will not be used to finance debt of the local government and will not be available for loans to other funds of the local government.

     2.  A copy of the resolution adopted pursuant to subsection 1 must be filed with the Department of Taxation within 30 days after its adoption by the governing body. The Department of Taxation shall report at least annually to the Committee on Local Government Finance regarding the trust funds established during the reporting period.

     (Added to NAC by Com. on Local Gov’t Finance by R089-08, eff. 9-18-2008)

      NAC 287.778  Board of trustees: Appointment and terms of members. (NRS 287.017)

     1.  In appointing a board of trustees:

     (a) If the assets of the trust fund will only be deposited in the Retirement Benefits Investment Fund pursuant to subparagraph (1) of paragraph (g) of subsection 2 of NRS 287.017, the governing body shall appoint at least three but not more than five persons to the board of trustees, including:

          (1) One or more persons who each have a combination of education and experience in finance or economics that totals 5 years or more;

          (2) A public officer or employee of the local government who manages the fiscal affairs of the local government; and

          (3) A beneficiary of the benefits plan of the local government.

     (b) If the assets of the trust fund will be invested only in investments authorized for a local government pursuant to subparagraph (2) of paragraph (g) of subsection 2 of NRS 287.017, or in such investments and deposited in the Retirement Benefits Investment Fund pursuant to subparagraph (1) of paragraph (g) of subsection 2 of NRS 287.017, the governing body shall appoint at least three but not more than five persons to the board of trustees, including:

          (1) One or more persons who each have a combination of education and experience in finance or economics that totals 5 years or more;

          (2) A public officer or employee of the local government who manages the fiscal affairs of the local government; and

          (3) A beneficiary of the benefits plan of the local government who has a combination of education and experience in finance or economics that totals 5 years or more.

     (c) If the assets of the trust fund qualify to be invested pursuant to subsection 2 of NAC 287.790, the governing body shall appoint five persons to the board of trustees, including:

          (1) Two persons who have experience in the securities exchange market;

          (2) A public officer or employee of the local government who manages the fiscal affairs of the local government;

          (3) A person who is not an employee of the local government, who has a combination of education and experience in finance or economics that totals 7 years or more; and

          (4) A beneficiary of the benefits plan of the local government who has a combination of education and experience in finance or economics that totals 7 years or more.

     2.  A person may not be appointed to the board of trustees pursuant to this section if the person:

     (a) Has a substantial financial interest in the ownership or negotiation of the securities or other financial instruments in which the assets of the trust fund are invested.

     (b) Is a member of the governing body that established the trust fund.

     3.  A resolution adopted by two or more governing bodies to form a pooled trust pursuant to paragraph (h) of subsection 2 of NRS 287.017 may include a provision for appointment of a member of the board of trustees of a participating governing body as a member of the board of trustees of the pooled trust.

     4.  The term of a member of a board of trustees appointed pursuant to this section must be at least 2 years, but not more than 4 years.

     5.  The governing body may reappoint a member of the board of trustees, and may alter the composition of the board of trustees determined pursuant to subsection 1 if required pursuant to NAC 287.790.

     (Added to NAC by Com. on Local Gov’t Finance by R089-08, eff. 9-18-2008)

      NAC 287.780  Board of trustees: Selection and duties of chair and vice chair; meetings; quorum; voting. (NRS 287.017)

     1.  The members of a board of trustees shall select a chair and vice chair from the members of the board of trustees.

     2.  The chair of the board of trustees shall:

     (a) Preside at all meetings of the board of trustees; and

     (b) Perform the duties incident to the office and such other duties as may be prescribed by the board of trustees from time to time.

     3.  The vice chair shall:

     (a) Perform such duties as from time to time may be assigned to him or her by the chair or by the board of trustees; and

     (b) In the absence of the chair, or in the event of the chair’s inability or refusal to act, as determined by the majority of the board of trustees, perform the duties of the chair.

     4.  The board of trustees shall meet quarterly or at the call of the chair when business is presented. The governing body may remove a member of the board of trustees if the member fails to attend two consecutive meetings or any three meetings during a calendar year.

     5.  The board of trustees shall comply with the provisions of chapter 241 of NRS.

     6.  A majority of the members of the board of trustees constitutes a quorum for all purposes.

     7.  Any member of the board of trustees may request a roll call vote of record.

     (Added to NAC by Com. on Local Gov’t Finance by R089-08, eff. 9-18-2008)

      NAC 287.782  Board of trustees: Restrictions. (NRS 287.017)

     1.  The board of trustees may not negotiate or otherwise determine the retirement benefits provided to the beneficiaries of the trust fund.

     2.  A member of the board of trustees may not bind the board of trustees by word or action unless the board of trustees has, in its corporate capacity, designated such member as its agent for a specific purpose and for that purpose only.

     3.  The earnings of the trust fund shall not inure to the benefit of any member of the board of trustees except that a member of the board of trustees may be a beneficiary of the trust fund through participation in his or her employer’s benefits plan.

     4.  A member of the board of trustees shall not be interested, directly or indirectly, as principal, partner, agent or otherwise in any contract entered into or expenditure authorized by the board of trustees, or in the profits or results thereof.

     (Added to NAC by Com. on Local Gov’t Finance by R089-08, eff. 9-18-2008)

      NAC 287.784  Board of trustees: Compensation of members; staffing; provision for expenses. (NRS 287.017)

     1.  A governing body may provide for the payment to members of the board of trustees of:

     (a) Compensation of not more than $80 for each day or portion of a day that the member is actually engaged in the work of the board of trustees; and

     (b) The per diem allowance and travel expenses normally provided for officers and employees of the local government, if any, for each day or portion of a day that the member is actually engaged in the work of the board of trustees.

     2.  The governing body shall provide to the board of trustees the staff necessary to assist the board of trustees in carrying out its powers and duties, including, without limitation, staff to organize and provide notice of the meetings of the board of trustees, take the minutes of such meetings, receive and disseminate financial reports of the professional fund managers of the trust fund, if any, and prepare financial reports and budgets for the board of trustees.

     3.  The governing body shall provide for the necessary and reasonable expenses of the board of trustees, including, without limitation, the costs of the annual audit required pursuant to NAC 287.786.

     (Added to NAC by Com. on Local Gov’t Finance by R089-08, eff. 9-18-2008)

      NAC 287.786  Determination of annual contributions; annual budgeting and auditing. (NRS 287.017)

     1.  The governing body shall annually inform the board of trustees of the amount of the contributions that the governing body expects to make to the trust fund. In determining such a contribution, the governing body may:

     (a) Commission actuarial studies that estimate the liabilities of the benefits plan of the local government for the ensuing 5 fiscal years; or

     (b) Use an alternative method of calculation that is allowed by generally accepted accounting principles and which is performed or commissioned by the governing body.

Ê The results of any such studies or calculations must be completed before March 1 of each year in order that the amount of the contributions to the trust fund is determined before completion of the tentative budget of the board of trustees for submission to the governing body pursuant to subsection 2.

     2.  The board of trustees shall annually submit a tentative budget to the governing body for its consideration, approval and inclusion in the tentative and final budgets of the governing body. The tentative budget submitted by the board of trustees must incorporate the amount of contributions determined pursuant to subsection 1. The governing body may modify the tentative budget of the board of trustees at its discretion.

     3.  The board of trustees shall cause the trust fund to be audited annually. The books, records and accounts of the trust fund may be audited by the same person or entity that audits the books, records and accounts of the local government. The governing body shall incorporate the results of the audit into the annual audit report of the local government.

     (Added to NAC by Com. on Local Gov’t Finance by R089-08, eff. 9-18-2008)

      NAC 287.788  Contract with professional fund manager; investment plan. (NRS 287.017)  

     1.  The board of trustees may contract with a professional fund manager if the assets of the trust fund are invested:

     (a) In an investment which is authorized for a local government pursuant to subparagraph (2) of paragraph (g) of subsection 2 of NRS 287.017.

     (b) Pursuant to subsection 2 of NAC 287.790.

     2.  Unless all the assets of the trust fund will only be deposited in the Retirement Benefits Investment Fund pursuant to subparagraph (1) of paragraph (g) of subsection 2 of NRS 287.017, the board of trustees shall develop an investment plan for the trust fund in consultation with a professional fund manager, if the board has entered into a contract with such a person pursuant to subsection 1, or with any other investment management advisor retained by the board of trustees. The investment plan must be approved as to its conformity with this subsection by the Committee on Local Government Finance before the investment of any assets of the trust fund. The investment plan must:

     (a) Include formal investment policies consistent with the requirements of NRS 287.017 and NAC 287.760 to 287.792, inclusive, including, without limitation, policies governing acceptable risks, diversification requirements and the fundamental processes for regulating the investment of the assets of the trust fund.

     (b) Include processes governing the selection and monitoring of the staff and any professional fund manager or other investment management advisor assisting the board of trustees in the administration of the trust fund that are sufficient to ensure such staff, professional fund managers and other advisors have appropriate expertise and exhibit appropriate fiduciary behavior for such positions.

     (c) Include appropriate investment training for members of the board of trustees and staff to ensure that they are knowledgeable in the prevailing investment practices.

     (d) Include travel policies for participation in investment training for members of the board of trustees and staff that support the need for training and are defensible in the context of the interests of the public and the beneficiaries of the trust fund.

     (e) Include an organizational plan for the selection and retention of competent investment expertise among the staff and in professional fund managers and other advisors, and incorporate a competitive process for the selection of both staff and professional fund managers and advisors.

     (f) Provide for the development of and annual review by the board of trustees of the asset allocation strategy of the investment plan and the positioning of classes of assets in the investment portfolio of the trust fund in light of general market trends and valuations.

     (g) Provide, on at least an annual basis, for a formal evaluation of the role or potential role of passive or indexed investment strategies applicable to the investment portfolio of the trust fund, and of appropriate strategies to minimize the costs of the administration of the trust fund, including, without limitation, the costs of transactions, professional fund managers and other advisors and investment training.

     (h) Provide for a periodic review of investment-related practices, including, without limitation, services provided by brokers and unconventional investment strategies, in the context of fiduciary standards and the interests of economy.

     (i) Establish formal benchmarks for the performance of the portfolio and managed accounts that are specific to the assigned role of the manager of the portfolio or account.

     (j) Provide for the regular evaluation of the performance of the portfolio using consistent, documented and reliable disciplines, and establish clear criteria and procedures for selection and termination of investments by managers.

     (k) Provide for regular communications on investment results to the governing body in a clear and intelligible format.

     3.  Approval by the Committee on Local Government Finance of the investment plan required in subsection 2 does not create or establish any fiduciary responsibility between the Committee on Local Government Finance and the trust fund or its beneficiaries.

     (Added to NAC by Com. on Local Gov’t Finance by R089-08, eff. 9-18-2008)

      NAC 287.790  Deposit and investment of assets; maintenance as separate account; prohibited uses; reimbursement of administrative expenses. (NRS 287.017)

     1.  Except as otherwise provided in subsection 4, if the market value of the investment portfolio of a trust fund at the end of a fiscal year is $100,000,000 or less, the assets of the trust fund may only be:

     (a) Deposited in the Retirement Benefits Investment Fund pursuant to subparagraph (1) of paragraph (g) of subsection 2 of NRS 287.017; and

     (b) Invested in any investment which is authorized for a local government pursuant to subparagraph (2) of paragraph (g) of subsection 2 of NRS 287.017.

     2.  Except as otherwise provided in subsection 4, if the market value of the investment portfolio in a trust fund at the end of a fiscal year is more than $100,000,000, the assets of the trust fund may be:

     (a) Deposited in the Retirement Benefits Investment Fund pursuant to subparagraph (1) of paragraph (g) of subsection 2 of NRS 287.017;

     (b) Invested in any investment which is authorized for a local government pursuant to subparagraph (2) of paragraph (g) of subsection 2 of NRS 287.017; and

     (c) Invested in any stocks or other equity securities or bonds or other debt securities which meet the requirements of subparagraph (3) of paragraph (g) of subsection 2 of NRS 287.017.

     3.  If the market value of the investment portfolio of a trust fund that is invested pursuant to subsection 2 falls below $100,000,000 at the end of a fiscal year, the board of trustees:

     (a) Is not required to liquidate any investments described in paragraph (c) of subsection 2.

     (b) Shall invest the assets of the trust fund in the manner set forth in subsection 1 until the market value of the portfolio is more than $100,000,000.

     4.  The assets of a pooled trust authorized pursuant to paragraph (h) of subsection 2 of NRS 287.017 may only be deposited in the Retirement Benefits Investment Fund established pursuant to NRS 355.220.

     5.  All interest, earnings, dividends and distributions received from the investment of assets in the trust fund, minus the expenses charged for such investments, must be deposited into the trust fund.

     6.  Except as otherwise provided in paragraph (h) of subsection 2 of NRS 287.017, the trust fund must be maintained as a separate account, and no other money may be commingled with the money in the trust fund.

     7.  Money in the trust fund must not be used to finance the debt of the local government and must not be used for loans to other funds of the local government.

     8.  Reasonable charges may be assessed to the trust fund for reimbursement of the direct expenses incurred by the board of trustees in administering the trust fund.

     (Added to NAC by Com. on Local Gov’t Finance by R089-08, eff. 9-18-2008)

      NAC 287.792  Requests for transfers of money. (NRS 287.017)

     1.  Except as otherwise provided in subsection 2, the board of trustees shall, upon request of the governing body, transfer money from the trust fund to an account designated by the governing body not later than 10 business days after the first day of the month following receipt of the request by the board of trustees. A request by the governing body pursuant to this subsection must include, without limitation:

     (a) An explanation of the manner in which the proposed transfer will be used to fulfill the requirements of the benefits plan of the local government;

     (b) A copy of the budget of the local government for the current fiscal year, which demonstrates that expenditures for retirement benefits are authorized by the governing body pursuant to an agreement between the local government and its employees;

     (c) Minutes of the meeting of the governing body at which the transfer was proposed; and

     (d) The signature of the chairperson of the governing body.

     2.  If the request by the governing body does not meet the requirements of this section, the board of trustees may delay transfer of the money until the governing body has complied with the requirements.

     (Added to NAC by Com. on Local Gov’t Finance by R089-08, eff. 9-18-2008)