NRS: CHAPTER 686B - RATES AND ESSENTIAL INSURANCE

[Rev. 6/29/2024 4:58:42 PM--2023]

CHAPTER 686B - RATES AND ESSENTIAL INSURANCE

RATES AND SERVICE ORGANIZATIONS

General Provisions

NRS 686B.010 Construction and purposes.

NRS 686B.045 Waiver for state innovation of applicable provisions of Patient Protection and Affordable Care Act; implementation of state plan.

NRS 686B.050 Standards.

NRS 686B.060 Determination of whether rates comply with standards.

NRS 686B.070 Filing of rates, forms of related policies and supplementary information and any changes and amendments thereof with Commissioner.

NRS 686B.080 Filing and supporting information open to public inspection; copies; exceptions.

NRS 686B.090 Rates and supplementary information: Established based on factors or through modified use of rate service organization in certain circumstances.

NRS 686B.100 Filing of supporting data.

NRS 686B.110 Approval or disapproval of rate proposals for kind or line of insurance other than health plans: Procedure; regulations.

NRS 686B.112 Approval or disapproval of rate filing for health plan: Procedure; regulations; assessment of costs.

NRS 686B.115 Hearing on rates open to public; cost for transcripts; public testimony.

NRS 686B.117 Intervention in hearing on rates.

NRS 686B.119 Notice to policyholders by insurer of material change in premiums based upon change in zip code of policyholder by United States Postal Service; regulations.

NRS 686B.125 Limitation on rates for coverage for dental care; exception; annual report of losses and premiums collected required; examination by Commissioner to ascertain compliance. [Effective through December 31, 2025.]

NRS 686B.125 Limitation on rates for coverage for dental care; annual report of losses and premiums collected required; calculation of average ratio of losses to premiums and identification of excessive rate; examination by Commissioner to ascertain compliance; consequences of failure to comply with limitation on rates; exceptions. [Effective January 1, 2026.]

NRS 686B.130 Licensing of rate service organization and advisory organization: Required to provide services relating to rates of certain insurance; services of rate service organization and advisory organization required to be offered to any insurer.

NRS 686B.140 Licensing of rate service organization and advisory organization: Application; issuance, expiration and renewal of license. [Effective until the date of the repeal of 42 U.S.C. § 666, the federal law requiring each state to establish procedures for withholding, suspending and restricting the professional, occupational and recreational licenses for child support arrearages and for noncompliance with certain processes relating to paternity or child support proceedings.]

NRS 686B.140 Licensing of rate service organization and advisory organization: Application; issuance, expiration and renewal of license. [Effective on the date of the repeal of 42 U.S.C. § 666, the federal law requiring each state to establish procedures for withholding, suspending and restricting the professional, occupational and recreational licenses for child support arrearages and for noncompliance with certain processes relating to paternity or child support proceedings.]

NRS 686B.143 Payment of child support: Statement by applicant for license; grounds for denial of license; duty of Commissioner. [Effective until the date of the repeal of 42 U.S.C. § 666, the federal law requiring each state to establish procedures for withholding, suspending and restricting the professional, occupational and recreational licenses for child support arrearages and for noncompliance with certain processes relating to paternity or child support proceedings.]

NRS 686B.147 Suspension of license for failure to pay child support or comply with certain subpoenas or warrants; reinstatement of license. [Effective until the date of the repeal of 42 U.S.C. § 666, the federal law requiring each state to establish procedures for withholding, suspending and restricting the professional, occupational and recreational licenses for child support arrearages and for noncompliance with certain processes relating to paternity or child support proceedings.]

NRS 686B.150 Binding agreements by insurers relating to rates and rules.

NRS 686B.160 Rules providing statistical plans for use by insurers in recording and reporting of experience; authorized designation of rate service organization to assist Commissioner in gathering and compiling experience for availability to public.

NRS 686B.170 Examination of service organizations by Commissioner.

NRS 686B.175 Commissioner authorized to assess insurers for state contribution for federally reinsured losses.

Advisory Organization for Industrial Insurance

NRS 686B.1751 Definitions.

NRS 686B.1752 “Advisory Organization” defined.

NRS 686B.1753 “Basic premium rate” defined.

NRS 686B.1754 “Classification of risks” defined.

NRS 686B.1755 “Expenses” defined.

NRS 686B.1757 “Industrial insurance” defined.

NRS 686B.1759 “Insurer” defined.

NRS 686B.17595 “Large-deductible agreement” defined.

NRS 686B.176 “Plan for rating experience” defined.

NRS 686B.17605 “Prospective loss cost” defined.

NRS 686B.1761 “Rate” defined.

NRS 686B.1762 “Willful” defined.

NRS 686B.1763 Applicability of provisions; Commissioner required to administer provisions.

NRS 686B.1764 Designation as statistical agent; duties.

NRS 686B.17645 Duty to file with Commissioner formula to assess insurers for certain costs; approval of formula.

NRS 686B.1765 Powers.

NRS 686B.1767 Prohibited acts by advisory organization.

NRS 686B.1769 Uniform Plan for Rating Experience: Requirements; use.

NRS 686B.177 Rating information to be filed with Commissioner; approval of rates.

NRS 686B.1771 Insurer not required to issue policy of industrial insurance to any particular employer; plan for apportionment among insurers of persons entitled to insurance who have not been accepted by an insurer; approval of rates for plan by Commissioner; regulations.

NRS 686B.1772 Insurers required to adhere to Uniform System of Classifications of Risks and Uniform Plan for Rating Experience; filing with and approval by Commissioner of subclassifications for Uniform System of Classification.

NRS 686B.1773 Insurers required to record and report certain information and adhere to manual of rules and Uniform Plan for Rating Experience.

NRS 686B.1774 Commissioner required to determine whether interaction among insurers and employers for buying and selling industrial insurance is competitive.

NRS 686B.1775 Filing of rates, supplementary rate information and supporting data by insurer with Commissioner; findings of Commissioner.

NRS 686B.1777 Circumstances under which Commissioner authorized to require supporting information regarding rates and required to hold hearing related to disapproval of rates.

NRS 686B.1779 Disapproval of rates: Authority of Commissioner; required grounds.

NRS 686B.178 Disapproval of rates: Commissioner required to issue written order stating reasons for disapproval and date by which insurer must discontinue use of rate.

NRS 686B.1781 Payment of dividends: Prohibition against discrimination among policyholders; submission of plan for payments and other requirements related to industrial insurance.

NRS 686B.1782 Agreements to lessen competition among insurers prohibited; insurers prohibited from agreeing to rates established in manner that conflicts with provisions.

NRS 686B.1783 Maintenance of records by insurer, advisory organization or plan for apportioned risks; examination of records by Commissioner.

NRS 686B.1784 Examination of insurer, advisory organization or plan for apportioned risks by Commissioner; exception; cost of examination.

NRS 686B.1785 Request for reconsideration of rates by Advisory Organization or insurer; appeal.

NRS 686B.1786 Large-deductible agreements: Applicability.

NRS 686B.17863 Large-deductible agreements: Full collateralization required; size of obligations limited.

NRS 686B.17867 Large-deductible agreements: Insurer in hazardous financial condition prohibited from issuing or renewing policy containing large-deductible agreement; exception.

NRS 686B.1787 Insurer or advisory organization authorized to request hearing before Commissioner related to order made or action taken by Commissioner without hearing.

NRS 686B.1789 Provisions governing hearing.

NRS 686B.179 Revocation or suspension of license.

NRS 686B.1793 Penalties.

NRS 686B.1797 Insurer prohibited from withholding or giving false or misleading information to Commissioner or Advisory Organization.

NRS 686B.1799 Limitation on liability of insurer or rating organization acting within scope of employment.

ESSENTIAL INSURANCE

General Provisions

NRS 686B.180 Unavailability of essential coverage; plans for providing coverage; regulations.

NRS 686B.185 Immunity of Commissioner and association.

NRS 686B.200 Voluntary plan for sharing risks: Submission to and approval by Commissioner.

Associations

NRS 686B.210 Nevada Essential Insurance Association: Establishment; membership; plan of operation; regulations.

NRS 686B.220 Nevada Essential Insurance Association: Membership and reimbursement of Board of Directors; submission to and approval or adoption of plan of operation by Commissioner.

NRS 686B.230 Nevada Essential Insurance Association: General powers.

NRS 686B.240 Nevada Essential Insurance Association: Powers of Commissioner and Association.

NRS 686B.250 Nevada Essential Insurance Association: Immunity from liability.

NRS 686B.260 Conversion into domestic stock insurer: “Insured” defined.

NRS 686B.270 Conversion into domestic stock insurer: Applicability of certain provisions governing nonprofit cooperative corporations.

NRS 686B.280 Conversion into domestic stock insurer: Filing and contents of notice of intent to qualify.

NRS 686B.290 Conversion into domestic stock insurer: Notice to insurers and insureds; hearing.

NRS 686B.300 Conversion into domestic stock insurer: Determination of percentage of stock for each insured.

NRS 686B.310 Conversion into domestic stock insurer: Capitalization.

NRS 686B.320 Conversion into domestic stock insurer: Issuance of certificate of authority.

NRS 686B.330 Conversion into domestic mutual insurer or domestic reciprocal insurer: “Insured” defined.

NRS 686B.340 Conversion into domestic mutual insurer or domestic reciprocal insurer: Exemption from applicability of NRS 81.130 and 81.510.

NRS 686B.350 Conversion into domestic mutual insurer or domestic reciprocal insurer: Filing and contents of notice of intent to qualify.

NRS 686B.360 Conversion into domestic mutual insurer or domestic reciprocal insurer: Notice to insurers and insured; hearing; compliance with certain provisions for qualification.

NRS 686B.370 Conversion into domestic mutual insurer or domestic reciprocal insurer: Issuance of certificate of authority.

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RATES AND SERVICE ORGANIZATIONS

General Provisions

NRS 686B.010 Construction and purposes.

1. The Legislature intends that NRS 686B.010 to 686B.1799, inclusive, be liberally construed to achieve the purposes stated in subsection 2, which constitute an aid and guide to interpretation but not an independent source of power.

2. The purposes of NRS 686B.010 to 686B.1799, inclusive, are to:

(a) Protect policyholders and the public against the adverse effects of excessive, inadequate or unfairly discriminatory rates;

(b) Encourage, as the most effective way to produce rates that conform to the standards of paragraph (a), independent action by and reasonable price competition among insurers;

(d) Authorize cooperative action among insurers in the rate-making process, and to regulate such cooperation in order to prevent practices that tend to bring about monopoly or to lessen or destroy competition;

(e) Encourage the most efficient and economic marketing practices; and

(f) Regulate the business of insurance in a manner that will preclude application of federal antitrust laws.

(Added to NRS by 1971, 1698; A 1985, 1067; 2017, 2344; 2019, 1434)

NRS 686B.020 Definitions. As used in NRS 686B.010 to 686B.1799, inclusive, unless the context otherwise requires:

1. “Advisory organization,” except as limited by NRS 686B.1752, means any person or organization which is controlled by or composed of two or more insurers and which engages in activities related to rate making. For the purposes of this subsection, two or more insurers with common ownership or operating in this State under common ownership constitute a single insurer. An advisory organization does not include:

(a) A joint underwriting association;

(b) An actuarial or legal consultant; or

2. “Market segment” means any line or kind of insurance or, if it is described in general terms, any subdivision thereof or any class of risks or combination of classes.

3. “Rate service organization” means any person, other than an employee of an insurer, who assists insurers in rate making or filing by:

(a) Collecting, compiling and furnishing loss or expense statistics;

(b) Recommending, making or filing rates or supplementary rate information; or

4. “Supplementary rate information” includes any manual or plan of rates, statistical plan, classification, rating schedule, minimum premium, policy fee, rating rule, rule of underwriting relating to rates and any other information prescribed by regulation of the Commissioner.

(Added to NRS by 1971, 1698; A 1985, 1067; 1991, 2117; 1995, 2055; 2003, 3351; 2017, 2345; 2019, 1434)

NRS 686B.030 Applicability.

1. Except as otherwise provided in subsection 2 and NRS 686B.125, the provisions of NRS 686B.010 to 686B.1799, inclusive, apply to all kinds and lines of direct insurance written on risks or operations in this State by any insurer authorized to do business in this State, except:

(a) Ocean marine insurance;

(b) Contracts issued by fraternal benefit societies;

(d) Variable and fixed annuities;

(e) Credit accident and health insurance;

(f) Property insurance for business and commercial risks;

(g) Casualty insurance for business and commercial risks other than insurance covering the liability of a practitioner licensed pursuant to chapters 630 to 640, inclusive, of NRS or who holds a license or limited license issued pursuant to chapter 653 of NRS;

(h) Surety insurance;

(i) Health insurance offered through a group health plan maintained by a large employer; and

(j) Credit involuntary unemployment insurance.

2. The exclusions set forth in paragraphs (f) and (g) of subsection 1 extend only to issues related to the determination or approval of premium rates.

(Added to NRS by 1971, 1699; A 1971, 1943; 1985, 1067; 1993, 2397; 1995, 2056; 2003, 3304; 2011, 3368; 2013, 3604; 2017, 2345; 2019, 1434, 2740; 2023, 1710)

NRS 686B.040 Exemptions.

1. Except as otherwise provided in subsection 2, the Commissioner may by rule exempt any person or class of persons or any market segment from any or all of the provisions of NRS 686B.010 to 686B.1799, inclusive, if and to the extent that the Commissioner finds their application unnecessary to achieve the purposes of those sections.

2. The Commissioner may not, by rule or otherwise, exempt an insurer from the provisions of NRS 686B.010 to 686B.1799, inclusive, with regard to insurance covering the liability of a practitioner licensed pursuant to chapter 630, 631, 632 or 633 of NRS for a breach of the practitioner’s professional duty toward a patient.

(Added to NRS by 1971, 1699; A 1985, 1068; 2003, 919, 3352; 2017, 2346; 2019, 1435)

NRS 686B.045 Waiver for state innovation of applicable provisions of Patient Protection and Affordable Care Act; implementation of state plan.

1. The Commissioner may apply to the Secretary of Health and Human Services pursuant to 42 U.S.C. § 18052 for a waiver for state innovation of applicable provisions of the Patient Protection and Affordable Care Act, Public Law 111-148, with respect to health insurance coverage in this State for a plan year beginning on or after January 1, 2020.

2. The Commissioner may implement a state plan that meets the waiver requirements in a manner consistent with state and federal law and as approved by the Secretary of Health and Human Services.

(Added to NRS by 2019, 1433)

NRS 686B.050 Standards.

1. Rates must not be excessive, inadequate or unfairly discriminatory, nor may an insurer charge any rate which if continued will have or tend to have the effect of destroying competition or creating a monopoly.

2. The Commissioner may disapprove rates if there is not a reasonable degree of price competition at the consumer level with respect to the class of business to which they apply. In determining whether a reasonable degree of price competition exists, the Commissioner shall consider all relevant tests, including:

(a) The number of insurers actively engaged in the class of business and their shares of the market;

(b) The existence of differentials in rates in that class of business;

(c) Whether long-run profitability for insurers generally of the class of business is unreasonably high in relation to its riskiness;

(d) Consumers’ knowledge in regard to the market in question; and

(e) Whether price competition is a result of the market or is artificial.

Ê If competition does not exist, rates are excessive if they are likely to produce a long-run profit that is unreasonably high in relation to the riskiness of the class of business, or if expenses are unreasonably high in relation to the services rendered.

3. Rates are inadequate if they are clearly insufficient, together with the income from investments attributable to them, to sustain projected losses and expenses in the class of business to which they apply.

4. One rate is unfairly discriminatory in relation to another in the same class if it clearly fails to reflect equitably the differences in expected losses and expenses. Rates are not unfairly discriminatory because different premiums result for policyholders with similar exposure to loss but different expense factors, or similar expense factors but different exposure to loss, so long as the rates reflect the differences with reasonable accuracy. Rates are not unfairly discriminatory if they are averaged broadly among persons insured under a group, franchise or blanket policy.

(Added to NRS by 1971, 1699; A 1987, 1533)

NRS 686B.060 Determination of whether rates comply with standards. In determining whether rates comply with the standards under NRS 686B.050, the following criteria shall be applied:

1. Due consideration shall be given to past and prospective loss and expense experience within and outside of this state, to catastrophe hazards and contingencies, to trends within and outside of this state, to loadings for leveling premium rates over time or for dividends or savings to be allowed or returned by insurers to their policyholders, members or subscribers, and to all other relevant factors, including the judgment of technical personnel.

2. Risks may be classified in any reasonable way for the establishment of rates and minimum premiums, except that classifications may not be based on race, color, creed, national origin, sexual orientation or gender identity or expression. Rates thus produced may be modified for individual risks in accordance with rating plans or schedules which establish reasonable standards for measuring probable variations in hazards, expenses, or both.

3. The expense provisions included in the rates to be used by an insurer may reflect the operating methods of the insurer and, so far as it is credible, its own expense experience.

4. The rates may contain an allowance permitting a profit that is not unreasonable in relation to the riskiness of the class of business.

(Added to NRS by 1971, 1700; A 2017, 1079)

NRS 686B.070 Filing of rates, forms of related policies and supplementary information and any changes and amendments thereof with Commissioner.

1. Every authorized insurer and every rate service organization licensed under NRS 686B.140 which has been designated by any insurer for the filing of rates under subsection 2 of NRS 686B.090 shall file with the Commissioner all:

(a) Rates and proposed increases thereto;

(b) Forms of policies to which the rates apply;

(d) Changes and amendments thereof,

Ê made by it for use in this state.

2. A filing made pursuant to this section must include a proposed effective date and must be filed not less than 30 days before that proposed effective date, except that a filing for a proposed increase or decrease in a rate may include a request that the Commissioner authorize an effective date that is earlier than the proposed effective date.

3. If an insurer makes a filing for a proposed increase in a rate for insurance covering the liability of a practitioner licensed pursuant to chapter 630, 631, 632 or 633 of NRS for a breach of the practitioner’s professional duty toward a patient, the insurer shall not include in the filing any component that is directly or indirectly related to the following:

(a) Capital losses, diminished cash flow from any dividends, interest or other investment returns, or any other financial loss that is materially outside of the claims experience of the professional liability insurance industry, as determined by the Commissioner.

(b) Losses that are the result of any criminal or fraudulent activities of a director, officer or employee of the insurer.

Ê If the Commissioner determines that a filing includes any such component, the Commissioner shall, pursuant to NRS 686B.110, disapprove the proposed increase, in whole or in part, to the extent that the proposed increase relies upon such a component.

4. If an insurer makes a filing for a proposed increase in a rate for a health benefit plan, as that term is defined in NRS 687B.470, the filing must include a unified rate review template, a written description justifying the rate increase and any rate filing documentation.

5. As used in this section, “rate filing documentation,” “unified rate review template” and “written description justifying the rate increase” have the meanings ascribed in 45 C.F.R. § 154.215.

(Added to NRS by 1971, 1700; A 1981, 698; 1987, 1533; 1989, 2176; 2003, 919, 3352; 2013, 257, 3605)

NRS 686B.080 Filing and supporting information open to public inspection; copies; exceptions.

1. Except as otherwise provided in subsections 2 to 5, inclusive, each filing and any supporting information filed under NRS 686B.010 to 686B.1799, inclusive, must, as soon as filed, be open to public inspection at any reasonable time. Copies may be obtained by any person on request and upon payment of a reasonable charge therefor.

2. All rates for health benefit plans available for purchase by individuals and small employers are considered proprietary and constitute trade secrets, and are not subject to disclosure by the Commissioner to persons outside the Division except as agreed to by the carrier or as ordered by a court of competent jurisdiction.

3. The provisions of subsection 2 expire annually on the date 30 days before open enrollment.

4. Except in cases of violations of NRS 689A.010 to 689A.740, inclusive, or 689C.015 to 689C.355, inclusive, the unified rate review template and rate filing documentation used by carriers servicing the individual and small employer markets are considered proprietary and constitute a trade secret, and are not subject to disclosure by the Commissioner to persons outside the Division except as agreed to by the carrier or as ordered by a court of competent jurisdiction.

5. An insurer providing blanket health insurance in accordance with the provisions of chapter 689B of NRS shall make all information concerning rates available to the Commissioner upon request. Such information is considered proprietary and constitutes a trade secret and is not subject to disclosure by the Commissioner to persons outside the Division except as agreed by the insurer or as ordered by a court of competent jurisdiction.

6. For the purposes of this section:

(a) “Open enrollment” has the meaning ascribed to it in 45 C.F.R. § 147.104(b)(1)(ii).

(b) “Rate filing documentation” and “unified rate review template” have the meanings ascribed to them in 45 C.F.R. § 154.215.

(Added to NRS by 1971, 1700; A 1985, 1068; 2013, 3605; 2015, 3471; 2019, 1435)

NRS 686B.090 Rates and supplementary information: Established based on factors or through modified use of rate service organization in certain circumstances.

1. An insurer shall establish rates and supplementary rate information for any market segment based on the factors in NRS 686B.060. If an insurer has insufficient creditable loss experience, it may use rates and supplementary rate information prepared by a rate service organization, with modification for its own expense and loss experience.

2. An insurer may discharge its obligation under subsection 1 of NRS 686B.070 by giving notice to the Commissioner that it uses rates and supplementary rate information prepared by a designated rate service organization, with such information about modifications thereof as are necessary fully to inform the Commissioner. The insurer’s rates and supplementary rate information shall be deemed those filed from time to time by the rate service organization, including any amendments thereto as filed, subject to the modifications filed by the insurer.

(Added to NRS by 1971, 1701; A 1987, 1534; 2003, 920, 3353)

NRS 686B.100 Filing of supporting data.

1. By rule, the Commissioner may require the filing of supporting data as to any or all kinds or lines of insurance or subdivisions thereof or classes of risks or combinations thereof as the Commissioner deems necessary for the proper functioning of the process for monitoring and regulating rates. The supporting data must include:

(a) The experience and judgment of the filer, and, to the extent it wishes or the Commissioner requires, of other insurers or rate service organizations;

(b) Its interpretation of any statistical data relied upon;

(d) Any other relevant matters required by the Commissioner.

2. Whenever a filing of a proposed increase in a rate is not accompanied by such information as the Commissioner has required under subsection 1, the Commissioner may so inform the insurer and the filing shall be deemed to be made when the information is furnished.

(Added to NRS by 1971, 1701; A 1985, 1068; 1987, 1534; 1989, 601, 2176)

NRS 686B.110 Approval or disapproval of rate proposals for kind or line of insurance other than health plans: Procedure; regulations.

1. Except as otherwise provided in NRS 686B.112, the Commissioner shall consider each proposed increase or decrease in the rate of any kind or line of insurance or subdivision thereof filed with the Commissioner pursuant to subsection 1 of NRS 686B.070. If the Commissioner finds that a proposed increase will result in a rate which is not in compliance with NRS 686B.050 or subsection 3 of NRS 686B.070, the Commissioner shall disapprove the proposal. The Commissioner shall approve or disapprove each proposal no later than 30 days after it is determined by the Commissioner to be complete pursuant to subsection 6. If the Commissioner fails to approve or disapprove the proposal within that period, the proposal shall be deemed approved.

2. If the Commissioner disapproves a proposed increase or decrease in any rate pursuant to subsection 1, the Commissioner shall send a written notice of disapproval to the insurer or the rate service organization that filed the proposal. The notice must set forth the reasons the proposal is not in compliance with NRS 686B.050 or subsection 3 of NRS 686B.070 and must be sent to the insurer or the rate service organization not more than 30 days after the Commissioner determines that the proposal is complete pursuant to subsection 6.

3. Upon receipt of a written notice of disapproval from the Commissioner pursuant to subsection 2 or 6, the insurer or rate service organization may request that the Commissioner reconsider the proposed increase or decrease. The request for reconsideration must be received by the Commissioner not more than 30 days after the insurer or rate service organization receives the written notice of disapproval from the Commissioner, except that if the insurer or rate service organization requests, in writing, an extension of 30 additional days in which to request a reconsideration, the Commissioner shall grant the extension. A request for reconsideration submitted pursuant to this subsection may include, without limitation, any documents or other information for review by the Commissioner in reconsidering the proposal. The Commissioner shall approve or disapprove the proposal upon reconsideration not later than 30 days after receipt of the request for reconsideration and shall notify the insurer or rate service organization of his or her approval or disapproval.

4. Whenever an insurer has no legally effective rates as a result of the Commissioner’s disapproval of rates or other act, the Commissioner shall on request specify interim rates for the insurer that are high enough to protect the interests of all parties and may order that a specified portion of the premiums be placed in an escrow account approved by the Commissioner. When new rates become legally effective, the Commissioner shall order the escrowed funds or any overcharge in the interim rates to be distributed appropriately, except that refunds to policyholders that are de minimis must not be required.

5. If the Commissioner disapproves a proposed rate pursuant to subsection 1 or subsection 6 or upon reconsideration pursuant to subsection 3 and an insurer requests a hearing to determine the validity of the action of the Commissioner, the insurer has the burden of showing compliance with the applicable standards for rates established in NRS 686B.010 to 686B.1799, inclusive. Any such hearing must be held:

(a) Within 30 days after the request for a hearing has been submitted to the Commissioner; or

(b) Within a period agreed upon by the insurer and the Commissioner.

Ê If the hearing is not held within the period specified in paragraph (a) or (b), or if the Commissioner fails to issue an order concerning the proposed rate for which the hearing is held within 45 days after the hearing, the proposed rate shall be deemed approved.

6. The Commissioner shall by regulation specify the documents or any other information which must be included in a proposal to increase or decrease a rate submitted to the Commissioner pursuant to subsection 1. Each such proposal shall be deemed complete upon its filing with the Commissioner, unless the Commissioner, within 15 business days after the proposal is filed with the Commissioner, determines that the proposal is incomplete because the proposal does not comply with the regulations adopted by the Commissioner pursuant to this subsection. The Commissioner shall notify the insurer or rate service organization if the Commissioner determines that the proposal is incomplete. The notice must be sent within 15 business days after the proposal is filed with the Commissioner and must set forth the documents or other information that is required to complete the proposal. The Commissioner may disapprove the proposal if the insurer or rate service organization fails to provide the documents or other information to the Commissioner within 30 days after the insurer or rate service organization receives the notice that the proposal is incomplete. If the Commissioner disapproves the proposal pursuant to this subsection, the Commissioner shall notify the insurer or rate service organization of that fact in writing.

(Added to NRS by 1971, 1702; A 1987, 1535; 1989, 2177; 1991, 1630; 1995, 1415, 1746; 1997, 548; 2003, 920, 3353; 2013, 257; 2017, 2346; 2019, 1436)

NRS 686B.112 Approval or disapproval of rate filing for health plan: Procedure; regulations; assessment of costs.

1. The Commissioner shall perform an actuarial review of and consider each rate filing of a health plan issued pursuant to the provisions of chapter 689A, 689B, 689C, 695B, 695C, 695D or 695F of NRS, including, without limitation, long-term care and Medicare supplement plans, filed with the Commissioner pursuant to subsection 1 of NRS 686B.070. If the Commissioner finds that a proposed rate which is contained in a rate filing will result in a rate which is not in compliance with NRS 686B.050 or subsection 3 of NRS 686B.070, the Commissioner shall disapprove the rate filing. The Commissioner shall approve or disapprove each rate filing not later than 60 days after the rate filing is determined by the Commissioner to be complete pursuant to subsection 4. If the Commissioner fails to approve or disapprove the rate filing within that period, the rate filing shall be deemed approved.

2. Whenever an insurer has no legally effective rates as a result of the Commissioner’s disapproval of rates or other act, the Commissioner shall on request specify interim rates for the insurer that are high enough to protect the interests of all parties and may order that a specified portion of the premiums be placed in an escrow account approved by the Commissioner. When new rates become legally effective, the Commissioner shall order the escrowed funds or any overcharge in the interim rates to be distributed appropriately, except that refunds to policyholders that are de minimis must not be required.

3. If the Commissioner disapproves a rate filing pursuant to subsection 1, and an insurer requests a hearing to determine the validity of the action of the Commissioner, the insurer has the burden of showing compliance with the applicable standards for rates established in NRS 686B.010 to 686B.1799, inclusive. Any such hearing must be held:

(a) Within 30 days after the request for a hearing has been submitted to the Commissioner; or

(b) Within a period agreed upon by the insurer and the Commissioner.

Ê If the hearing is not held within the period specified in paragraph (a) or (b), or if the Commissioner fails to issue an order concerning the rate filing for which the hearing is held within 45 days after the hearing, the rate filing shall be deemed approved.

4. The Commissioner shall by regulation specify the documents or any other information which must be included in a rate filing submitted to the Commissioner pursuant to subsection 1. Each such rate filing shall be deemed complete upon its filing with the Commissioner, unless the Commissioner, within 15 business days after the rate filing is filed with the Commissioner, determines that the rate filing is incomplete because the rate filing does not comply with the regulations adopted by the Commissioner pursuant to this subsection.

5. The Commissioner may assess against an insurer the actual cost for the external actuarial review of a rate filing submitted pursuant to subsection 1.

(Added to NRS by 2017, 2343; A 2019, 1437, 1704)

NRS 686B.115 Hearing on rates open to public; cost for transcripts; public testimony.

1. Any hearing held by the Commissioner to determine whether rates comply with the provisions of NRS 686B.010 to 686B.1799, inclusive, must be open to members of the public.

2. All costs for transcripts prepared pursuant to such a hearing must be paid by the insurer requesting the hearing.

3. At any hearing which is held by the Commissioner to determine whether rates comply with the provisions of NRS 686B.010 to 686B.1799, inclusive, and which involves rates for insurance covering the liability of a practitioner licensed pursuant to chapter 630, 631, 632 or 633 of NRS for a breach of the practitioner’s professional duty toward a patient, if a person is not otherwise authorized pursuant to this title to become a party to the hearing by intervention, the person is entitled to provide testimony at the hearing if, not later than 2 days before the date set for the hearing, the person files with the Commissioner a written statement which states:

(a) The name and title of the person;

(b) The interest of the person in the hearing; and

4. If a person provides testimony at a hearing in accordance with subsection 3:

(a) The Commissioner may, if the Commissioner finds it necessary to preserve order, prevent inordinate delay or protect the rights of the parties at the hearing, place reasonable limitations on the duration of the testimony and prohibit the person from providing testimony that is not relevant to the issues raised at the hearing.

(b) The Commissioner shall consider all relevant testimony provided by the person at the hearing in determining whether the rates comply with the provisions of NRS 686B.010 to 686B.1799, inclusive.

(Added to NRS by 1987, 1532; A 1995, 1623; 2003, 921; 2017, 2347; 2019, 1438)

NRS 686B.117 Intervention in hearing on rates. If a filing made with the Commissioner pursuant to paragraph (a) of subsection 1 of NRS 686B.070 pertains to insurance covering the liability of a practitioner licensed pursuant to chapter 630, 631, 632 or 633 of NRS for a breach of the practitioner’s professional duty toward a patient, any interested person, and any association of persons or organization whose members may be affected, may intervene as a matter of right in any hearing or other proceeding conducted to determine whether the applicable rate or proposed increase thereto:

1. Complies with the standards set forth in NRS 686B.050 and subsection 3 of NRS 686B.070.

2. Should be approved or disapproved.

(Added to NRS by 2003, 3351; A 2013, 259)

NRS 686B.119 Notice to policyholders by insurer of material change in premiums based upon change in zip code of policyholder by United States Postal Service; regulations. Each insurer shall notify its policyholders, in a manner which the Commissioner shall prescribe by regulation, if the policyholders’ premiums for insurance will be materially increased or decreased because the zip code assigned to the address of the policyholder is changed by the United States Postal Service.

(Added to NRS by 1991, 2117)

1. Except as otherwise provided in this section, no insurer, organization or person licensed pursuant to this title may sell or offer to sell any contract providing coverage for dental care at a rate which is excessive for the benefits offered to the insured or member. For the purpose of this section, a ratio of losses to premiums collected which is less than 75 percent is presumed to show an excessive rate.

2. The provisions of subsection 1 do not apply to a contract providing coverage for dental care that is sold to a small employer pursuant to the provisions of chapter 689C of NRS. As used in this subsection, “small employer” has the meaning ascribed to it in NRS 689C.095.

3. Each year, every insurer, organization or person licensed pursuant to this title who provides coverage for dental care in this State shall, in accordance with requirements established by regulation of the Commissioner, file with the Commissioner a report of the losses and premiums collected for that insurer, organization or person, as applicable, for the calendar year.

4. For the purposes of subsection 3, the values of losses and premiums collected must be determined at the end of each calendar year for the entire calendar year.

5. The Commissioner may, pursuant to NRS 679B.240, examine the accounts, records, documents and transactions of any insurer, organization or person licensed pursuant to this title who sells or offers to sell any contract providing coverage for dental care in this State to ascertain compliance with the provisions of this section.

(Added to NRS by 1983, 2028; A 2013, 3606; 2023, 850)

2. Each year, every insurer, organization or person licensed pursuant to this title who provides coverage for dental care in this State shall, in accordance with requirements established by regulation of the Commissioner, file with the Commissioner a report of the losses and premiums collected for that insurer, organization or person, as applicable, for the calendar year.

3. For the purposes of subsection 2, the values of losses and premiums collected must be determined at the end of each calendar year for the entire calendar year.

4. The Commissioner shall, based on the reports filed pursuant to subsection 2:

(a) Calculate the aggregate average ratio of losses to premiums collected for each such insurer, organization and other person licensed pursuant to this title for the immediately preceding 3-year period or for the entire period during which the insurer, organization or other person has provided coverage for dental care in this State, whichever time period is shorter, for each market segment in which the insurer, organization or person operates; and

(b) Identify each such insurer, organization and other person licensed pursuant to this title whose aggregate average ratio of losses to premiums collected for a market segment is presumed to show an excessive rate pursuant to subsection 1.

5. On or before June 1 of each year, the Commissioner shall publish on an internet website maintained by the Division:

(a) A list of each insurer, organization or person licensed pursuant to this title who provided coverage for dental care in this State during the immediately preceding calendar year; and

(b) For each such insurer, organization or person licensed pursuant to this title, the aggregate average ratio of losses to premiums collected for the immediately preceding 3-year period or for the entire period during which the insurer, organization or person has provided coverage for dental care in this State, whichever time period is shorter, for each market segment in which the insurer, organization or person operates.

6. The Commissioner may, pursuant to NRS 679B.240, examine the accounts, records, documents and transactions of any insurer, organization or person licensed pursuant to this title who sells or offers to sell any contract providing coverage for dental care in this State to ascertain compliance with the provisions of this section.

7. If the Commissioner determines, after conducting an examination pursuant to subsection 6, that an insurer, organization or person licensed pursuant to this title has failed to comply with the provisions of subsection 1:

(a) The insurer, organization or person, as applicable, must submit to the Commissioner an adjusted rate filing in accordance with NRS 686B.070 not later than 60 days after the date of the determination, regardless of whether the insurer, organization or person is requesting a change in rates. If the Commissioner determines, based on the information calculated pursuant to paragraph (a) of subsection 4, that the previously approved rates are excessive, the Commissioner may require the insurer, organization or person to file a decreased rate that would bring the insurer, organization or person into compliance with provisions of subsection 1.

(b) The Commissioner may order the insurer, organization or person to submit a plan to compensate any insureds or members who:

(1) Are residents of this State; and

(2) Were affected by the excessive rates during any year under examination pursuant to subsection 6.

8. The provisions of subsections 1 and 7 and paragraph (b) of subsection 4 do not apply to a contract providing coverage for dental care that is sold to a small employer pursuant to the provisions of chapter 689C of NRS. As used in this subsection, “small employer” has the meaning ascribed to it in NRS 689C.095.

(Added to NRS by 1983, 2028; A 2013, 3606; 2023, 850, 851, effective January 1, 2026)

1. A rate service organization and an advisory organization shall not provide any service relating to the rates of any insurance subject to NRS 686B.010 to 686B.1799, inclusive, and an insurer shall not utilize the services of an organization for such purposes unless the organization has obtained a license pursuant to NRS 686B.140.

2. A rate service organization and an advisory organization shall not refuse to supply any services for which it is licensed in this state to any insurer authorized to do business in this state and offering to pay the fair and usual compensation for the services.

(Added to NRS by 1971, 1702; A 1985, 1069; 1995, 2056; 2019, 1439)

1. A rate service organization or an advisory organization applying for a license as required by NRS 686B.130 must include with its application:

(a) A copy of its constitution, charter, articles of organization, agreement, association or incorporation, and a copy of its bylaws, plan of operation and any other rules or regulations governing the conduct of its business;

(b) A list of its membership and subscribers;

(c) The name and address of one or more residents of this State upon whom notices, process affecting it or orders of the Commissioner may be served;

(d) A statement showing its technical qualifications for acting in the capacity for which it seeks a license;

(e) If the applicant is a natural person who wishes to obtain a license as a rate service organization, the statement required pursuant to NRS 686B.143;

(f) Any other relevant information and documents that the Commissioner may require; and

(g) All applicable fees.

2. If the applicant is a natural person, the application must include the social security number of the applicant.

3. Every organization which has applied for a license pursuant to subsection 1 shall thereafter promptly notify the Commissioner of every material change in the facts or in the documents on which its application was based.

4. If the Commissioner finds that the applicant and the natural persons through whom it acts are competent, trustworthy and technically qualified to provide the services proposed, and that all requirements of law are met, the Commissioner shall issue a license specifying the authorized activity of the applicant. The Commissioner shall not issue a license if the proposed activity would tend to create a monopoly or to lessen or destroy competition in prices.

5. A license issued pursuant to this section continues in effect until the licensee leaves the State or until the license is suspended, revoked or otherwise terminated. A license may be renewed upon:

(a) If the licensee is a natural person who has been issued a license as a rate service organization, submission of the statement required pursuant to NRS 686B.143 and payment of all applicable fees for renewal to the Commissioner on or before the last day on which the license is renewable; or

(b) If the licensee is an advisory organization or a rate service organization that is not a natural person, payment of all applicable fees for renewal to the Commissioner on or before the last day on which the license is renewable.

6. A license which is not renewed annually expires on March 1. The Commissioner may accept a request for renewal received by the Commissioner within 30 days after the expiration of the license if the request is accompanied by:

(a) If the licensee is a natural person who has been issued a license as a rate service organization, the statement required pursuant to NRS 686B.143 and a fee for renewal of 150 percent of all applicable fees otherwise required, except for any fee required pursuant to NRS 680C.110; or

(b) If the licensee is a rate service organization that is not a natural person or is an advisory organization, a fee for renewal of 150 percent of all applicable fees otherwise required, except for any fee required pursuant to NRS 680C.110.

7. Any amendment to a document filed pursuant to paragraph (a) of subsection 1 must be filed at least 30 days before it becomes effective. Failure to comply with this subsection is a ground for revocation of the license granted pursuant to subsection 4.

(Added to NRS by 1971, 1702; A 1987, 463; 1995, 2056; 1997, 2197, 2210; 2009, 1784)

1. A rate service organization or an advisory organization applying for a license as required by NRS 686B.130 must include with its application:

(b) A list of its membership and subscribers;

(c) The name and address of one or more residents of this state upon whom notices, process affecting it or orders of the Commissioner may be served;

(d) A statement showing its technical qualifications for acting in the capacity for which it seeks a license;

(e) Any other relevant information and documents that the Commissioner may require; and

(f) All applicable fees.

2. Every organization which has applied for a license pursuant to subsection 1 shall thereafter promptly notify the Commissioner of every material change in the facts or in the documents on which its application was based.

3. If the Commissioner finds that the applicant and the natural persons through whom it acts are competent, trustworthy and technically qualified to provide the services proposed, and that all requirements of law are met, the Commissioner shall issue a license specifying the authorized activity of the applicant. The Commissioner shall not issue a license if the proposed activity would tend to create a monopoly or to lessen or destroy competition in prices.

4. A license issued pursuant to this section continues in effect until the licensee leaves the state or until the license is suspended, revoked or otherwise terminated. A license may be renewed by payment of all applicable fees for renewal to the Commissioner on or before the last day on which it is renewable.

5. A license which is not renewed annually expires on March 1. The Commissioner may accept a request for renewal received by the Commissioner within 30 days after the expiration of the license if the request is accompanied by a fee for renewal of 150 percent of all applicable fees otherwise required, except for any fee required pursuant to NRS 680C.110.

6. Any amendment to a document filed pursuant to paragraph (a) of subsection 1 must be filed at least 30 days before it becomes effective. Failure to comply with this subsection is a ground for revocation of the license granted pursuant to subsection 3.

(Added to NRS by 1971, 1702; A 1987, 463; 1995, 2056; 1997, 2197, 2210; 2009, 1784, effective on the date of the repeal of 42 U.S.C. § 666, the federal law requiring each state to establish procedures for withholding, suspending and restricting the professional, occupational and recreational licenses for child support arrearages and for noncompliance with certain processes relating to paternity or child support proceedings)

1. A natural person who applies for the issuance or renewal of a license as a rate service organization shall submit to the Commissioner the statement prescribed by the Division of Welfare and Supportive Services of the Department of Health and Human Services pursuant to NRS 425.520. The statement must be completed and signed by the applicant.

2. The Commissioner shall include the statement required pursuant to subsection 1 in:

(a) The application or any other forms that must be submitted for the issuance or renewal of the license; or

(b) A separate form prescribed by the Commissioner.

3. A license as a rate service organization may not be issued or renewed by the Commissioner if the applicant is a natural person who:

(a) Fails to submit the statement required pursuant to subsection 1; or

(b) Indicates on the statement submitted pursuant to subsection 1 that the applicant is subject to a court order for the support of a child and is not in compliance with the order or a plan approved by the district attorney or other public agency enforcing the order for the repayment of the amount owed pursuant to the order.

4. If an applicant indicates on the statement submitted pursuant to subsection 1 that the applicant is subject to a court order for the support of a child and is not in compliance with the order or a plan approved by the district attorney or other public agency enforcing the order for the repayment of the amount owed pursuant to the order, the Commissioner shall advise the applicant to contact the district attorney or other public agency enforcing the order to determine the actions that the applicant may take to satisfy the arrearage.

(Added to NRS by 1997, 2196)

1. If the Commissioner receives a copy of a court order issued pursuant to NRS 425.540 that provides for the suspension of all professional, occupational and recreational licenses, certificates and permits issued to a person who is the holder of a license as a rate service organization, the Commissioner shall deem the license issued to that person to be suspended at the end of the 30th day after the date on which the court order was issued unless the Commissioner receives a letter issued to the holder of the license by the district attorney or other public agency pursuant to NRS 425.550 stating that the holder of the license has complied with the subpoena or warrant or has satisfied the arrearage pursuant to NRS 425.560.

2. The Commissioner shall reinstate a license as a rate service organization that has been suspended by a district court pursuant to NRS 425.540 if the Commissioner receives a letter issued by the district attorney or other public agency pursuant to NRS 425.550 to the person whose license was suspended stating that the person whose license was suspended has complied with the subpoena or warrant or has satisfied the arrearage pursuant to NRS 425.560.

(Added to NRS by 1997, 2196)

NRS 686B.150 Binding agreements by insurers relating to rates and rules. No insurer shall assume any obligation to any person other than a policyholder or other companies under common control to use or adhere to certain rates or rules, and no other person shall impose any penalty or other adverse consequence for failure of an insurer to adhere to certain rates or rules.

(Added to NRS by 1971, 1703)

1. The Commissioner may promulgate or approve reasonable rules providing statistical plans for use thereafter by all insurers in the recording and reporting of loss and expense experience, in order that the experience of insurers may be made available to the Commissioner.

2. The Commissioner may designate one or more rate service organizations to assist the Commissioner in gathering such experience and making compilations thereof, which must be made available to the public.

(Added to NRS by 1971, 1703; A 1987, 1535)

NRS 686B.170 Examination of service organizations by Commissioner.

1. Whenever the Commissioner deems it necessary in order to inform himself or herself about any matter related to the enforcement of the insurance laws, the Commissioner may examine the affairs and condition of any rate service organization under subsection 1 of NRS 686B.130. So far as reasonably necessary for an examination pursuant to this subsection, the Commissioner may examine the accounts, records, documents or evidences of transactions, so far as they relate to the examinee, of any officer, manager, general agent, employee, person who has executive authority over or is in charge of any segment of the examinee’s affairs, person controlling or having a contract under which the person has the right to control the examinee whether exclusively or with others, person who is under the control of the examinee, or any person who is under the control of a person who controls or has a right to control the examinee whether exclusively or with others. On demand every examinee under this subsection shall make available to the Commissioner for examination any of its own accounts, records, documents or evidences of transactions and any of those of the persons listed in this subsection.

2. The Commissioner shall examine every licensed rate service organization at intervals to be established by rule.

3. In lieu of all or part of an examination conducted pursuant to subsections 1 and 2, or in addition to it, the Commissioner may order an independent audit by certified public accountants or actuarial evaluation by actuaries approved by the Commissioner of any person subject to the examination requirement. Any accountant or actuary selected is subject to rules respecting conflicts of interest promulgated by the Commissioner. Any audit or evaluation conducted pursuant to this subsection is subject to subsections 6 to 15, inclusive, so far as appropriate.

4. In lieu of all or part of an examination conducted pursuant to this section, the Commissioner may accept the report of an audit already made by certified public accountants or actuarial evaluation by actuaries approved by the Commissioner, or the report of an examination made by the insurance department of another state.

5. An examination may cover comprehensively all aspects of the examinee’s affairs and condition. The Commissioner shall determine the exact nature and scope of each examination, and in doing so shall take into account all relevant factors, including but not limited to the length of time the examinee has been operating, the length of time the examinee has been licensed in this state, the nature of the services provided, the nature of the accounting records available and the nature of examinations performed elsewhere.

6. For each examination conducted pursuant to this section, the Commissioner shall issue an order stating the scope of the examination and designating the examiner in charge. Upon demand a copy of the order must be exhibited to the examinee.

7. Any examiner authorized by the Commissioner shall, so far as necessary to the purposes of the examination, have access at all reasonable hours to the premises and to any books, records, files, securities, documents or property of the examinee and to those of persons listed in subsection 1 so far as they relate to the affairs of the examinee.

8. The officer, employees and agents of the examinee and of persons listed in subsection 1 shall comply with every reasonable request of the examiners for assistance in any matter relating to the examination. A person shall not obstruct or interfere with the examination in any way other than by legal process.

9. If the Commissioner finds the accounts or records to be inadequate for proper examination of the condition and affairs of the examinee or improperly kept or posted, the Commissioner may employ experts to rewrite, post or balance them at the expense of the examinee.

10. The examiner in charge of an examination shall make a proposed report of the examination which must include such information and analysis as is ordered in subsection 6, together with the examiner’s recommendations. Preparation of the proposed report may include conferences with the examinee or the representatives of the examinee at the option of the examiner in charge. The proposed report is confidential until filed in accordance with subsection 11.

11. The Commissioner shall serve a copy of the proposed report upon the examinee. Within 20 days after service, the examinee may serve upon the Commissioner a written demand for a hearing on the contents of the report. If a hearing is demanded, the Commissioner shall give notice and hold a hearing pursuant to NRS 679B.310 to 679B.370, inclusive, except that on demand by the examinee the hearing must be private. Within 60 days after the hearing or if no hearing is demanded then within 60 days after the last day on which the examinee might have demanded a hearing, the Commissioner shall adopt the report with any necessary modifications and file it for public inspection, or the Commissioner shall order a new examination.

12. The Commissioner shall forward a copy of the examination report to the examinee immediately upon adoption, except that if the proposed report is adopted without change, the Commissioner need only so notify the examinee.

13. The examinee shall forthwith furnish copies of the adopted report to each member of its board of directors or other governing board.

14. The Commissioner may furnish, without cost or at a price to be determined by the Commissioner, a copy of the adopted report to the insurance commissioner of each state in the United States and of each foreign jurisdiction in which the examinee is licensed and to any other interested person in this state or elsewhere.

15. In any proceeding by or against the examinee or any officer or agent thereof the examination report as adopted by the Commissioner is admissible as evidence of the facts stated therein. In any proceeding by or against the examinee, the facts asserted in any report properly admitted in evidence are presumed to be true in the absence of contrary evidence.

16. The reasonable costs of an examination conducted pursuant to this section must be paid by the examinee except as otherwise provided in subsection 19. These costs include the salary and expenses of each examiner and any other expenses which are directly apportioned to the examination.

17. The amount payable pursuant to subsection 16 is due 10 days after the examinee has been served a detailed account of the costs.

18. The Commissioner may require any examinee, before or from time to time during an examination to deposit with the State Treasurer such deposits as the Commissioner deems necessary to pay the costs of the examination. Any deposit and any payment made pursuant to subsections 16 and 17 must be deposited in the Fund for Insurance Administration and Enforcement.

19. On the examinee’s request or on the motion of the Commissioner, the Commissioner may pay all or part of the costs of an examination whenever the Commissioner finds that, because of the frequency of examinations or other factors, imposition of the costs would place an unreasonable burden on the examinee. The Commissioner shall include in his or her annual report information about any instance in which the Commissioner applied this subsection.

20. Deposits and payments made pursuant to subsections 16 to 19, inclusive, shall not be deemed to be a tax or license fee within the meaning of any statute. If any other state charges a per diem fee for examination of examinees domiciled in this state, any examinee domiciled in that other state shall pay the same fee when examined by the Commissioner of Insurance of this state.

(Added to NRS by 1971, 1704; A 1977, 811; 1991, 1820)

NRS 686B.175 Commissioner authorized to assess insurers for state contribution for federally reinsured losses.

1. The Commissioner is authorized to assess each insurance company authorized to do business in this state an aggregate amount sufficient to provide a fund to reimburse the Secretary of Housing and Urban Development in the manner set forth in section 1223(a)(1) of the National Housing Act as amended by section 1103 of the Urban Property Protection and Reinsurance Act of 1968, P.L. 90-448, 82 Stat. 476. The assessment shall be on those lines reinsured during the current year in this state by the Secretary of Housing and Urban Development pursuant to such act. The assessment shall be in the proportion that the premiums earned during the preceding calendar year by each such company in this state bear to the aggregate premiums earned on those lines in this state by all insurers. The fund may be provided in whole or in part from appropriations by the Legislature.

2. Rates used by an insurer shall not be deemed excessive because they contain an amount reasonably calculated to recoup assessments made under this section.

(Added to NRS by 1971, 1707)

Advisory Organization for Industrial Insurance

NRS 686B.1751 Definitions. As used in NRS 686B.1751 to 686B.1799, inclusive, unless the context otherwise requires, the words and terms defined in NRS 686B.1752 to 686B.1762, inclusive, have the meanings ascribed to them in those sections.

(Added to NRS by 1995, 2049; A 1999, 2220, 3381; 2001, 2256; 2017, 2348)

NRS 686B.1752 “Advisory Organization” defined. “Advisory Organization,” when preceded by the definite article, means the organization designated by the Commissioner pursuant to NRS 686B.1764.

(Added to NRS by 1995, 2049)

NRS 686B.1753 “Basic premium rate” defined. “Basic premium rate” means the portion of a rate attributable to the cost of losses per unit of exposure and includes the expense of adjusting those losses.

(Added to NRS by 1995, 2049)

NRS 686B.1754 “Classification of risks” defined. “Classification of risks” or “classification” means the system or arrangement used to recognize differences of exposure to hazards among employers with different occupations, industries or operations.

(Added to NRS by 1995, 2049)

NRS 686B.1755 “Expenses” defined. “Expenses” means the portion of a rate attributable to the costs for the acquisition of employers to insure, supervision of employees and agents, collection of accounts, general expenses, taxes, licenses and fees.

(Added to NRS by 1995, 2049)

NRS 686B.1757 “Industrial insurance” defined. “Industrial insurance” means insurance which provides the compensation required by chapters 616A to 617, inclusive, of NRS and employer’s liability insurance provided in connection with that insurance.

(Added to NRS by 1995, 2049)

NRS 686B.1759 “Insurer” defined. “Insurer” means any private carrier authorized to provide industrial insurance in this state.

(Added to NRS by 1995, 2049; A 1997, 1450; 1999, 444, 1833)

NRS 686B.17595 “Large-deductible agreement” defined. “Large-deductible agreement” means any combination of one or more policies, endorsements, contracts or security arrangements, which provide for the policyholder to bear the risk of loss of a specified amount of $25,000 or more per claim or occurrence covered under a policy of industrial insurance and which may be subject to an aggregate limit of the policyholder’s reimbursement obligations.

(Added to NRS by 2017, 2342)

NRS 686B.176 “Plan for rating experience” defined. “Plan for rating experience” means a procedure used to predict the future losses of an individual policyholder by measuring the past losses of the individual policyholder against the losses of other policyholders in the same classification to determine any prospective credit, debit or unitary modifications of premiums for the individual policyholder.

(Added to NRS by 1995, 2049)

NRS 686B.17605 “Prospective loss cost” defined. “Prospective loss cost” means the portion of a rate that is based on historical aggregate losses and loss adjustment expenses which are adjusted to their ultimate value and projected to a future point in time. Except as otherwise provided in this section, the term does not include provisions for expenses or profit.

(Added to NRS by 1999, 2219)

NRS 686B.1761 “Rate” defined. “Rate” means the cost of insurance based on a unit of exposure to liability before any adjustments are made for an individual employer’s losses, or expenses, or a combination of both. The term does not include minimum premiums charged by an insurer.

(Added to NRS by 1995, 2049)

NRS 686B.1762 “Willful” defined. “Willful” or “willfully” in relation to an act or omission which constitutes a violation of this chapter means with actual knowledge or belief that the act or omission constitutes a violation and with specific intent to commit the violation.

(Added to NRS by 1995, 2049)

NRS 686B.1763 Applicability of provisions; Commissioner required to administer provisions.

1. NRS 686B.1751 to 686B.1799, inclusive, apply to insurers providing industrial insurance and to the Advisory Organization designated by the Commissioner. The Commissioner shall administer the provisions of these sections.

2. These provisions apply to all industrial insurance issued in this state except reinsurance.

(Added to NRS by 1995, 2049; A 2017, 2348)

NRS 686B.1764 Designation as statistical agent; duties. The Commissioner shall designate one licensed advisory organization to act as the Commissioner’s statistical agent and to assist the Commissioner in compiling relevant statistical information. The designation must be made pursuant to reasonable competitive bidding procedures established by the Commissioner. The Advisory Organization shall:

1. Provide reliable statistics for industrial insurance.

2. Collect and tabulate information and statistics in a Uniform Statistical Plan, to be approved and used by the Commissioner.

3. Formulate a manual of rules reasonably related to the recording and reporting of data according to the Uniform Statistical Plan, Uniform Plan for Rating Experience and the Uniform System of Classification, and present the proposed manual to the Commissioner for approval.

(Added to NRS by 1995, 2050)

NRS 686B.17645 Duty to file with Commissioner formula to assess insurers for certain costs; approval of formula.

1. The Advisory Organization shall, at least 60 days before imposing an assessment pursuant to this section, file with the Commissioner a formula for an assessment on all insurers, which results in an equitable distribution among all insurers, of:

(a) The costs of paying the expenses of the members of the appeals panel for industrial insurance pursuant to the provisions of NRS 616B.770; and

(b) Any costs incurred by the Advisory Organization to administer the appeals panel for industrial insurance pursuant to the provisions of NRS 616B.760 to 616B.790, inclusive.

2. The formula for the assessment filed pursuant to subsection 1 shall be deemed approved unless it is disapproved by the Commissioner within 60 days after it is filed.

(Added to NRS by 1999, 3381; A 2001, 2256)

NRS 686B.1765 Powers. The Advisory Organization may:

1. Develop statistical plans including definitions for the classification of risks.

2. Collect statistical data from its members and subscribers or any other reliable source.

3. Prepare and distribute data on prospective loss costs.

4. Prepare and distribute manuals of rules and schedules for rating which do not permit calculating the final rates without using information other than the information in the manual.

5. Distribute any information filed with the Commissioner which is open to public inspection.

6. Conduct research and collect statistics to discover, identify and classify information on the causes and prevention of losses.

7. Prepare and file forms and endorsements for policies and consult with its members, subscribers and any other knowledgeable persons on their use.

8. Collect, compile and distribute information on the past and current premiums charged by individual insurers if the information is available for public inspection.

9. Conduct research and collect information to determine what effect changes in benefits to injured employees pursuant to chapters 616A to 617, inclusive, of NRS will have on prospective loss costs.

10. Prepare and distribute rules and rating values for the Uniform Plan for Rating Experience.

11. Calculate and provide to the insurer the modification of premiums based on the individual employer’s losses.

12. Assist an individual insurer to develop rates, supplementary rate information or other supporting information if authorized to do so by the insurer.

(Added to NRS by 1995, 2050; A 1997, 1450, 1451; 1999, 444, 2220, 2224; 2001, 154)

NRS 686B.1767 Prohibited acts by advisory organization. An advisory organization shall not:

1. Compile or distribute recommendations concerning rates which include expenses, other than expenses to adjust losses or profit; or

2. File rates, supplementary rate information or supporting information on behalf of an insurer.

(Added to NRS by 1995, 2050; A 1997, 1451, 1452; 1999, 444, 2224)

NRS 686B.1769 Uniform Plan for Rating Experience: Requirements; use.

1. The Uniform Plan for Rating Experience must:

(a) Contain reasonable standards for eligibility in the Plan;

(b) Provide adequate incentives for employers to prevent losses; and

2. The Plan must be the exclusive basis for adjusting future premiums by evaluating an individual employer’s characteristics which tend to produce losses, but an insurer may file a rating plan that provides for an adjustment of premiums retrospectively based on an individual employer’s past experience of losses.

(Added to NRS by 1995, 2051)

NRS 686B.177 Rating information to be filed with Commissioner; approval of rates. The Advisory Organization shall file with the Commissioner a copy of every prospective loss cost, every manual of rating rules, every rating schedule and every change, amendment or modification to them which is proposed for use in this state at least 60 days before they are distributed to the Organization’s members, subscribers or other persons. The rates shall be deemed to be approved unless they are disapproved by the Commissioner within 60 days after they are filed.

(Added to NRS by 1995, 2051; A 1997, 1452; 1999, 444, 2221, 2224; 2001, 154; 2017, 1042)

1. No insurer is required to issue to any particular employer a policy for industrial insurance.

2. The Commissioner shall approve a plan submitted by the Advisory Organization for equitable apportionment among insurers of those persons who in good faith are entitled to insurance but who have not been accepted by an insurer. Every insurer shall participate in the plan. The Commissioner shall adopt regulations to carry out the plan.

3. The Advisory Organization shall submit to the Commissioner the rates, supplementary rate information and forms for policies for the plan at least 60 days before they become effective. The rates submitted to the Commissioner must:

(a) Reflect the experience of the persons insured pursuant to the plan to the extent that those rates are actuarially appropriate.

(b) Be actuarially determined to ensure that the plan is self-sustaining.

4. The Commissioner shall disapprove any rates for the plan which do not meet the standards of NRS 686B.050. The rates shall be deemed to be approved unless they are disapproved by the Commissioner within 60 days after they are filed pursuant to the procedures in NRS 686B.1775.

(Added to NRS by 1995, 2051; A 1997, 973; 1999, 428)

1. Every insurer shall adhere to the Uniform System of Classifications of Risks and Uniform Plan for Rating Experience filed with the Commissioner by the Advisory Organization.

2. Any insurer may develop a subclassification or subclassifications for the Uniform System of Classification. Any subclassification must be filed with the Commissioner 60 days before it becomes effective. The Commissioner shall disapprove the subclassification if the insurer fails to show the data to be produced by it will be consistent with the Uniform Statistical Plan and System of Classification filed by the Advisory Organization with the Commissioner.

(Added to NRS by 1995, 2051)

NRS 686B.1773 Insurers required to record and report certain information and adhere to manual of rules and Uniform Plan for Rating Experience.

1. Every insurer shall:

(a) Record and report its experience and losses for policies of industrial insurance to the Advisory Organization in a form consistent with the Uniform Statistical Plan approved by the Commissioner; and

(b) Adhere to the manual of rules and Uniform Plan for Rating Experience when providing or reporting its business for industrial insurance.

2. No insurer may agree with another insurer or the Advisory Organization to adhere to a manual of rules which is not reasonably related to the recording or reporting of data according to the Uniform Statistical Plan or Uniform System of Classifications filed by the Advisory Organization.

(Added to NRS by 1995, 2051)

NRS 686B.1774 Commissioner required to determine whether interaction among insurers and employers for buying and selling industrial insurance is competitive.

1. The Commissioner shall determine whether the interaction among insurers and employers for the buying and selling of industrial insurance is competitive. Competition among these insurers is presumed to exist unless the Commissioner specifically finds, after a hearing and review of the structure, performance and conduct of the insurers, that there is no reasonable degree of competition among them and that the interaction is not competitive. Any finding by the Commissioner that there is no competition among the insurers and that the interaction is not competitive, expires 1 year after the date it is issued.

2. To determine whether competition exists among insurers, the Commissioner shall review existing information available to the Commissioner or participate in the development of new sources of such information. The Commissioner may conduct his or her own studies, cooperate with knowledgeable officers in other states, hire outside consultants or conduct studies in any other appropriate manner.

(Added to NRS by 1995, 2052; A 1997, 1456; 1999, 2224)

NRS 686B.1775 Filing of rates, supplementary rate information and supporting data by insurer with Commissioner; findings of Commissioner.

1. Each insurer shall file with the Commissioner all the rates, supplementary rate information, supporting data, and changes and amendments thereof, except any information filed by the Advisory Organization, which the insurer intends to use in this state. An insurer may adopt by reference any supplementary rate information or supporting data that has been previously filed by that insurer and approved by the Commissioner. The filing must indicate the date the rates will become effective. An insurer may file its rates pursuant to this subsection by filing:

(a) Final rates; or

(b) A multiplier and, if used by an insurer, a premium charged to each policy of industrial insurance regardless of the size of the policy which, when applied to the prospective loss costs filed by the Advisory Organization pursuant to NRS 686B.177, will result in final rates.

2. Each insurer shall file the rates, supplementary rate information and supporting data pursuant to subsection 1:

(a) Except as otherwise provided in subsection 4, if the interaction among insurers and employers is presumed or found to be competitive, not later than 15 days before the date the rates become effective.

(b) If the Commissioner has issued a finding that the interaction is not competitive, not later than 60 days before the rates become effective.

3. If the information supplied by an insurer pursuant to subsection 1 is insufficient, the Commissioner shall notify the insurer and require the insurer to provide additional information. The filing must not be deemed complete or available for use by the insurer and review by the Commissioner must not commence until all the information requested by the Commissioner is received by the Commissioner. If the requested information is not received by the Commissioner within 60 days after its request, the filing may be disapproved without further review.

4. If, after notice to the insurer and a hearing, the Commissioner finds that an insurer’s rates require supervision because of the insurer’s financial condition or because of rating practices which are unfairly discriminatory, the Commissioner shall order the insurer to file its rates, supplementary rate information, supporting data and any other information required by the Commissioner, at least 60 days before they become effective.

5. For any filing made by an insurer pursuant to this section, the Commissioner may authorize an earlier effective date for the rates upon a written request from the insurer.

6. Except as otherwise provided in subsection 1, every rate filed by an insurer must be filed in the form and manner prescribed by the Commissioner.

7. As used in this section, “supporting data” means:

(a) The experience and judgment of the insurer and of other insurers or of the Advisory Organization, if relied upon by the insurer;

(b) The interpretation of any statistical data relied upon by the insurer;

(d) Any other relevant matters required by the Commissioner.

(Added to NRS by 1995, 2052; A 1997, 1453; 1999, 444, 2221, 2224; 2001, 154)

NRS 686B.1777 Circumstances under which Commissioner authorized to require supporting information regarding rates and required to hold hearing related to disapproval of rates.

1. If the Commissioner finds that:

(a) The interaction among insurers is not competitive;

(b) The rates filed by insurers whose interaction is competitive are inadequate or unfairly discriminatory; or

Ê the Commissioner may require the insurers to file information supporting their existing rates. Before the Commissioner may disapprove those rates, the Commissioner shall notify the insurers and hold a hearing on the rates and the supplementary rate information.

2. The Commissioner may disapprove any rate without a hearing. Any insurer whose rates are disapproved in this manner may request in writing and within 30 days after the disapproval that the Commissioner conduct a hearing on the matter.

(Added to NRS by 1995, 2053; A 1997, 1454; 1999, 444, 2222, 2224; 2001, 154)

NRS 686B.1779 Disapproval of rates: Authority of Commissioner; required grounds.

1. The Commissioner may disapprove a rate filed by an insurer at any time.

2. The Commissioner shall disapprove a rate if:

(a) An insurer has failed to meet the requirements for filing a rate pursuant to this chapter or the regulations of the Commissioner;

(b) The rate is inadequate or unfairly discriminatory and the interaction among insurers and employers is competitive; or

(c) A rate is inadequate, excessive or unfairly discriminatory and the Commissioner has found and issued an order that the interaction among the insurers and employers is not competitive.

(Added to NRS by 1995, 2053; A 1997, 1455; 1999, 444, 2223, 2224; 2001, 154)

NRS 686B.178 Disapproval of rates: Commissioner required to issue written order stating reasons for disapproval and date by which insurer must discontinue use of rate. If the Commissioner disapproves a rate, the Commissioner shall issue a written order stating the reasons for the disapproval and stating the date when the rate must no longer be used for policies which are issued or renewed. The date established by the Commissioner must be within a reasonable period after the written order is issued. The Commissioner shall issue the order within 30 days after the hearing. The Commissioner may require that the premiums be adjusted after the date of the order for those policies in effect on the date of the order.

(Added to NRS by 1995, 2053)

NRS 686B.1781 Payment of dividends: Prohibition against discrimination among policyholders; submission of plan for payments and other requirements related to industrial insurance.

1. An insurer shall not unfairly discriminate among its policyholders in paying a dividend, savings, unearned premium deposits or an equivalent abatement of premiums allowed or returned by an insurer for a policy of industrial insurance.

2. A plan for the payment of dividends for industrial insurance must be filed before there is a dividend payment. The plan shall be deemed approved unless the Commissioner disapproves the plan within 30 days after it is filed and received by the Commissioner. An insurer shall not condition the payment of a dividend upon the renewal of a policy or contract by the policyholder, member or subscriber.

3. An insurer paying savings, unearned premium deposits or an equivalent abatement for premiums allowed or returned for a policy of industrial insurance must receive prior approval.

(Added to NRS by 1995, 2053; A 2003, 3305)

NRS 686B.1782 Agreements to lessen competition among insurers prohibited; insurers prohibited from agreeing to rates established in manner that conflicts with provisions.

1. No insurer or advisory organization may make any agreement with any person, insurer or advisory organization to restrain trade unreasonably or to lessen substantially the competition between insurers.

2. No insurer may agree to use any rate, rating plan or rating rules, other than the uniform plan for rating experience, except as necessary to comply with the provisions of this chapter concerning the activity of the Advisory Organization and insurers relating to the Uniform Statistical Plan, the Uniform Plan for Rating Experience and the Uniform System of Classifications of Risks and the development of subclassifications.

3. The fact that two or more insurers, whether or not they subscribe to the Advisory Organization, use consistently or intermittently the same rates, rating plans, rating schedules, rating rules, classifications for rates, rules for underwriting, surveys, inspections or similar materials does not require a finding by the Commissioner that an agreement to restrain trade or lessen competition exists.

4. Two or more insurers which are commonly owned or operated in this state with common management or control may act or agree to act among themselves as if they were a single insurer for any activities authorized by NRS 686B.1751 to 686B.1799, inclusive.

(Added to NRS by 1995, 2053)

NRS 686B.1783 Maintenance of records by insurer, advisory organization or plan for apportioned risks; examination of records by Commissioner. Every insurer, advisory organization and plan for apportioned risks shall maintain records of the kind reasonably adapted to its method of operation and reflecting its experience or the experience of its members and the data or other information collected or used by it. The Commissioner may examine those records at any reasonable time to determine whether the activities of the insurer, advisory organization or plan for apportioned risks comply with the provisions of this chapter and chapters 616A to 617, inclusive, of NRS. These records must be maintained in an office in this state or must be made available to the Commissioner for examination or inspection at any time after reasonable notice to the insurer, advisory organization or plan for apportioned risks.

(Added to NRS by 1995, 2054)

NRS 686B.1784 Examination of insurer, advisory organization or plan for apportioned risks by Commissioner; exception; cost of examination.

1. The Commissioner may examine any insurer, advisory organization or plan for apportioned risks whenever the Commissioner determines that such an examination is necessary.

2. The reasonable cost of an examination must be paid by the insurer or other person examined upon presentation by the Commissioner of an accounting of those costs pursuant to NRS 679B.290.

3. In lieu of an examination, the Commissioner may accept the report of an examination made by the agency of another state that regulates insurance.

(Added to NRS by 1995, 2054; A 1999, 2223)

NRS 686B.1785 Request for reconsideration of rates by Advisory Organization or insurer; appeal. Any person aggrieved by any decision, action or omission of the Advisory Organization or an insurer regarding rates or other information filed with the Commissioner may request in writing that the Organization or insurer reconsider the decision, action or omission. Except as otherwise provided in NRS 616B.772, 616B.775 and 616B.787, if the request for reconsideration is rejected or is not acted upon within 30 days by the Organization or insurer, the person requesting reconsideration may, within 30 days thereafter, appeal from the decision, action or omission to the Commissioner by filing a written complaint and request for a hearing specifying the grounds relied upon.

(Added to NRS by 1995, 2054; A 1999, 3381; 2001, 2256)

NRS 686B.1786 Large-deductible agreements: Applicability. This section and NRS 686B.17863 and 686B.17867 apply to any policy of industrial insurance which:

1. Is issued by an insurer which:

(a) Has a rating of less than “A-” from A.M. Best Company, Inc., or a substantially equivalent rating from another rating agency, as determined by the Commissioner; and

(b) Has less than $200,000,000 in surplus, with surplus calculated as the difference between the insurer’s net admitted assets and the insurer’s total liabilities;

2. Contains a large-deductible agreement;

3. Is not issued to a federal, state or local governmental entity; and

4. Is issued for delivery or renewed on or after January 1, 2018.

(Added to NRS by 2017, 2343)

NRS 686B.17863 Large-deductible agreements: Full collateralization required; size of obligations limited. An insurer shall:

1. Require full collateralization of the outstanding obligations owed under a large-deductible agreement using one of the following methods:

(a) A surety bond issued by a surety insurer authorized to transact such insurance in this State, and whose financial strength and size ratings from A.M. Best Company, Inc., are not less than “A” and “V,” respectively, or are substantially equivalent ratings from another rating agency, as determined by the Commissioner;

(b) An irrevocable letter of credit issued by a financial institution with an office physically located within this State, and the deposits of which are federally insured; or

(c) Cash or securities held in trust by a third party or the insurer and subject to a trust agreement for the express purpose of securing the policyholder’s obligation under a large-deductible agreement, provided that if the assets are held by the insurer, those assets may not be commingled with the insurer’s other assets; and

2. Limit the size of the policyholder’s obligations under a large-deductible agreement to 20 percent of the total net worth of the policyholder at the inception of the policy and again at each renewal, as determined by an audited financial statement as of the most recent fiscal year-end for which such a statement is available, with the total net worth of the policyholder calculated as the difference between the total assets and the total liabilities of the policyholder.

(Added to NRS by 2017, 2344)

NRS 686B.17867 Large-deductible agreements: Insurer in hazardous financial condition prohibited from issuing or renewing policy containing large-deductible agreement; exception. Except when otherwise specifically approved by the Commissioner in writing or by electronic communication, any insurer determined to be in a hazardous financial condition pursuant to NRS 680A.205, or the equivalent provisions of law in any other state as determined by the Commissioner, is prohibited from issuing or renewing a policy that includes a large-deductible agreement.

(Added to NRS by 2017, 2344)

NRS 686B.1787 Insurer or advisory organization authorized to request hearing before Commissioner related to order made or action taken by Commissioner without hearing. Any insurer or advisory organization, to which is directed any order made or action taken by the Commissioner without a hearing, may request a hearing before the Commissioner.

(Added to NRS by 1995, 2054)

NRS 686B.1789 Provisions governing hearing. A hearing required by any of the provisions of NRS 686B.1751 to 686B.1799, inclusive, is governed by NRS 679B.310 to 679B.370, inclusive, except that any limits of time imposed by NRS 686B.1751 to 686B.1799, inclusive, control.

(Added to NRS by 1995, 2054; A 2017, 2348)

NRS 686B.179 Revocation or suspension of license. The Commissioner may, after notice and hearing, revoke or suspend the license of an advisory organization for failure to comply with the provisions of this chapter.

(Added to NRS by 1995, 2055)

NRS 686B.1793 Penalties.

1. An insurer or other person who violates any provision of NRS 686B.1751 to 686B.1799, inclusive, shall, upon the order of the Commissioner, pay an administrative fine not to exceed $1,000 for each violation and not to exceed $10,000 for each willful violation. These administrative fines are in addition to any other penalty provided by law. Any insurer using a rate before it has been filed with the Commissioner as required by NRS 686B.1775, shall be deemed to have committed a separate violation for each day the insurer failed to file the rate.

2. The Commissioner may suspend or revoke the license of any advisory organization or insurer who fails to comply with an order within the time specified by the Commissioner or any extension of that time made by the Commissioner. Any suspension of a license is effective for the time stated by the Commissioner in his or her order or until the order is modified, rescinded or reversed.

3. The Commissioner, by written order, may impose a penalty or suspend a license pursuant to this section only after written notice to the insurer, organization or plan for apportioned risks and a hearing.

(Added to NRS by 1995, 2055; A 1999, 2223; 2017, 2348)

NRS 686B.1797 Insurer prohibited from withholding or giving false or misleading information to Commissioner or Advisory Organization. An insurer or other person shall not willfully withhold information from, or knowingly give false or misleading information to, the Commissioner or to the Advisory Organization, which will affect the rates, classifications of risks or Uniform Statistical Plan for industrial insurance.

(Added to NRS by 1995, 2055)

NRS 686B.1799 Limitation on liability of insurer or rating organization acting within scope of employment. No insurer or rating organization or member thereof in its capacity as a member or officer or employee of the licensed rating organization when acting within the scope of his or her employment is liable for injury or death or other damage proximately caused by a failure to inspect, or the manner or extent of inspection of, an employer’s locations, plants or operations for classification, control of losses or rating, or by that person’s comment or failure to comment on the subject matter or object of the inspection.

(Added to NRS by 1995, 2055)

ESSENTIAL INSURANCE

General Provisions

NRS 686B.180 Unavailability of essential coverage; plans for providing coverage; regulations.

1. If the Commissioner finds after a hearing that in any part of this state any essential insurance coverage is not readily available in the voluntary market, and that the public interest requires such availability, the Commissioner may by regulation promulgate plans to provide such insurance coverages for any risks in this state which are equitably entitled to but otherwise unable to obtain such coverage, or may call upon insurers to prepare plans for approval by the Commissioner. Such plans may also include any kind of reinsurance that is unavailable and that would facilitate making essential insurance coverage available where it would otherwise not be available.

2. The plan promulgated or prepared under subsection 1 must:

(a) Give consideration to the need for adequate and readily accessible coverage, alternative methods of improving the market affected, the preferences of the insurers and agents, the inherent limitations of the insurance mechanism, the need for reasonable underwriting standards, and the requirement of reasonable loss-prevention measures;

(b) Establish procedures that will create minimum interference with the voluntary market;

(d) Establish procedures for applicants and participants to have grievances reviewed by an impartial body.

3. Each plan must require participation by all insurers doing any business in this state of the kinds covered by the specific plan and all agents licensed to represent such insurers in this state for the specified kinds of business, except that the Commissioner may exclude kinds of insurance, classes of insurers or classes of persons for administrative convenience or because it is not equitable or practicable to require them to participate in the plan.

4. The plan may provide for optional participation by insurers not required to participate under subsection 3.

5. Each plan must provide for the method of underwriting and classifying risks, making and filing rates, adjusting and processing claims and any other insurance or investment function that is necessary for the purpose of providing essential insurance coverage.

6. In providing for the recoupment of deficits which may be incurred in the plan, an option must be offered to an insured each policy year to pay a capital stabilization charge which must not exceed 100 percent of the premium charged to the insured in that year. The Commissioner shall determine the amount of the charge from appropriate factors of loss experience and risk associated with the plan and the insured. An insured who pays the stabilization charge must not be required to pay any assessment to recoup a deficit in the plan incurred in any policy year for which the charge is paid. The plan must provide for the return to the insured of so much of the insured’s payment as remains after all actual or potential liabilities under the policy have been discharged.

7. The plan must specify the basis of participation and assessment of insurers as necessary and must provide for the participation of agents and the conditions under which risks must be accepted.

8. Every participating insurer and agent shall provide to any person seeking coverages of kinds available in the plans the services prescribed in the plans, including full information on the requirements and procedures for obtaining coverage under the plans whenever the business is not placed in the voluntary market.

9. The plan must specify what commission rates must be paid for business placed in the plans.

10. If the Commissioner finds that the lack of cooperating insurers or agents in an area makes the functioning of the plan difficult, the Commissioner may order that the plan set up a branch service office or take other appropriate steps to insure that service is available.

(Added to NRS by 1971, 1706; A 1975, 402; 1977, 303; 1985, 1069)

NRS 686B.185 Immunity of Commissioner and association. There is no liability on the part of, and no cause of action of any nature arises against, the Commissioner or the representatives of the Commissioner or any essential insurance association, its agents or employees, under a plan established pursuant to the provisions of NRS 686B.180, for any good faith action taken by them in the performance of their powers and duties under such plan.

(Added to NRS by 1975, 403)

NRS 686B.200 Voluntary plan for sharing risks: Submission to and approval by Commissioner. Insurers doing business within this state are authorized to prepare voluntary plans providing any specified kind, line or class of insurance coverage or subdivision or combination thereof for all or any part of this state in which such insurance is not readily available in the voluntary market and in which the public interest requires the availability of such coverage. Such plans shall be submitted to the Commissioner and if approved by the Commissioner may be put into operation.

(Added to NRS by 1971, 1707)

Associations

NRS 686B.210 Nevada Essential Insurance Association: Establishment; membership; plan of operation; regulations.

1. If after a hearing the Commissioner determines that a voluntary or mandatory plan would, in the judgment of the Commissioner, fail for any reason to provide essential insurance coverage, the Commissioner may, by regulation, establish a nonprofit unincorporated legal entity to be known as the Nevada Essential Insurance Association. All insurers required to participate pursuant to subsection 3 of NRS 686B.180 shall become members of the Association as a condition of their authority to transact insurance in this state.

2. The Association shall perform its functions under a plan of operation established by regulations promulgated by the Commissioner pursuant to subsection 1 of NRS 686B.180.

(Added to NRS by 1975, 398)

NRS 686B.220 Nevada Essential Insurance Association: Membership and reimbursement of Board of Directors; submission to and approval or adoption of plan of operation by Commissioner.

1. The administrative powers of the Nevada Essential Insurance Association shall be vested in a Board of Directors consisting of not less than five nor more than nine members serving terms as established in the plan of organization. The members of the Board shall be appointed by the Commissioner with due consideration given to the composition of the membership of the Association and to the interests of the insureds who are provided essential insurance coverage by the Association.

2. Members of the Board may be reimbursed from the assets of the Association for expenses incurred by them as members of the Board of Directors and for reasonable and equitable compensation as may be prescribed by the terms of the plan of organization.

3. The Board of Directors of the Association shall submit to the Commissioner a plan of organization for the Association and make suitable or necessary amendments thereto to assure the fair, reasonable and equitable administration of the Association. The plan of operation shall become effective upon approval in writing by the Commissioner.

4. If the Association fails to submit a suitable plan of operation within a reasonable period of time, or if at any time thereafter the Association fails to submit suitable amendments to the plan, the Commissioner shall promulgate a plan as necessary or advisable to effectuate the provisions of this section.

(Added to NRS by 1975, 398)

NRS 686B.230 Nevada Essential Insurance Association: General powers.

1. The Nevada Essential Insurance Association has, for purposes of this section and to the extent approved by the Commissioner, the general powers and authority granted under the laws of this state to carriers licensed to transact the kinds of insurance defined in NRS 681A.020 to 681A.080, inclusive.

2. The Association may take any necessary action to make available necessary insurance, including but not limited to, the following:

(a) Assess participating insurers amounts necessary to pay the obligations of the Association, administration expenses, the cost of examinations and other expenses authorized by this chapter. The assessment of each member insurer for the kind or kinds of insurance designated in the plan must be in the proportion that the net direct written premiums of the member insurer for the preceding calendar year bear to the net direct written premiums of all member insurers for the preceding calendar year. A member insurer may not be assessed in any year an amount greater than 5 percent of his or her net direct written premiums for the preceding calendar year. Each member insurer must be allowed a premium tax credit at the rate of 20 percent per year for 5 successive years beginning on the first day of the calendar year after the calendar year in which the insurer pays the assessment pursuant to this subsection.

(b) Enter into such contracts as are necessary or proper to carry out the provisions and purposes of this section.

(c) Sue or be sued, including taking any legal action necessary to recover any assessments for, on behalf of or against participating carriers.

(d) Investigate claims brought against the fund and adjust, compromise, settle and pay covered claims to the extent of the Association’s obligation and deny all other claims. Process claims through its employees or through one or more member insurers or other persons designated as servicing facilities. Designation of a service facility is subject to the approval of the Commissioner, but such a designation may be declined by a member insurer.

(e) Classify risks as may be applicable and equitable.

(f) Establish appropriate rates, rate classifications and rating adjustments and file those rates with the Commissioner in accordance with this chapter.

(g) Administer any type of reinsurance program for or on behalf of the Association or any participating carriers.

(h) Pool risks among participating carriers.

(i) Issue and market, through agents, policies of insurance providing the coverage required by this section in its own name or on behalf of participating carriers.

(j) Administer separate pools, separate accounts or other plans as may be deemed appropriate for separate carriers or groups of carriers.

(k) Invest, reinvest and administer all funds and moneys held by the Association.

(l) Borrow funds needed by the Association to carry out the purposes of this section.

(m) Develop, effectuate and promulgate any loss-prevention programs aimed at the best interests of the Association and the insuring public.

(n) Operate and administer any combination of plans, pools, reinsurance arrangements or other mechanisms as deemed appropriate to best accomplish the fair and equitable operation of the Association for the purposes of making available essential insurance coverage.

3. In providing for the recoupment of a deficit of the Association, an option must be offered to an insured each policy year to pay a capital stabilization charge which must not exceed 100 percent of the premium charged to the insured in that year. The Board of Directors shall determine the amount of the charge from appropriate factors of loss experience and risk associated with the Association and the insured. An insured who pays the stabilization charge must not be required to pay any assessment to recoup a deficit of the Association incurred in any policy year for which the charge is paid. The Association’s plan of operation must provide for the return to the insured of so much of the insured’s payment as remains after all actual or potential liabilities under the policy have been discharged.

(Added to NRS by 1975, 398; A 1977, 305; 2003, 3305; 2021, 110)

NRS 686B.240 Nevada Essential Insurance Association: Powers of Commissioner and Association. The Commissioner and the Nevada Essential Insurance Association may:

1. Give consideration to the need for adequate and readily accessible coverage, to alternative methods of improving the market affected, to the preferences of the insurers and agents, to the inherent limitations of the insurance mechanism, to the need for reasonable underwriting standards and to the requirement of reasonable loss-prevention measures.

2. Establish procedures that will create minimum interference with the voluntary market.

3. Spread the burden imposed by the facility equitably and efficiently.

4. Establish procedures for applicants and participants to have grievances reviewed.

5. Take all reasonable and necessary steps to dissolve the Association at the earliest date when essential insurance becomes readily available in the private market. The dissolution of the Association, including its assets and liabilities, must be accomplished under the supervision of the Commissioner in an equitable and reasonable manner. The dissolution must, if determined to be appropriate by the Commissioner, provide for the repayment of any loans or other money provided or contributed by the State of Nevada for the formation or continuance of the Association.

(Added to NRS by 1975, 399; A 2003, 3306)

NRS 686B.250 Nevada Essential Insurance Association: Immunity from liability. There is no liability on the part of, and no cause of action of any nature arises against, the Nevada Essential Insurance Association or its agents or employees, members of the Board or the Commissioner or the representatives of the Commissioner for any good faith performance of their powers and duties under NRS 686B.210 to 686B.240, inclusive.

(Added to NRS by 1975, 400)

NRS 686B.260 Conversion into domestic stock insurer: “Insured” defined. As used in NRS 686B.270 to 686B.320, inclusive, unless the context otherwise requires, “insured” means any person who has maintained at least 1 year of coverage with an essential insurance association.

(Added to NRS by 1981, 1021)

NRS 686B.270 Conversion into domestic stock insurer: Applicability of certain provisions governing nonprofit cooperative corporations. The provisions of NRS 81.130 and 81.510 do not apply to the conversion of an essential insurance association to a domestic stock insurer as provided in NRS 686B.280 to 686B.320, inclusive.

(Added to NRS by 1981, 1023; A 1985, 1878; 1991, 1318)

NRS 686B.280 Conversion into domestic stock insurer: Filing and contents of notice of intent to qualify.

1. An essential insurance association shall, whenever requested to do so by the Commissioner, file a notice of intent to qualify as a domestic stock insurer. In the absence of a request by the Commissioner, an essential insurance association may file such a notice whenever it considers it appropriate.

2. The notice must be filed with the Commissioner at least 4 months before the date the association is to become a domestic stock insurer and must contain:

(a) An application prepared pursuant to chapter 680A of NRS for a certificate of authority to transact business in Nevada as a domestic stock insurer;

(b) A valuation of capital and surplus according to both market and amortized value based on the association’s annual financial statement for the previous year;

(d) The terms of any proposal offering money or its equivalent in lieu of issuing fractional shares.

(Added to NRS by 1981, 1021)

NRS 686B.290 Conversion into domestic stock insurer: Notice to insurers and insureds; hearing.

1. At the time the association files a notice of intent to qualify as a domestic stock insurer, it must give notice of its intent to all participating insurers and all insureds on a form approved by the Commissioner. The notice to each insured must state the total amount of stock to be issued and the amount of shares to which the insured is entitled.

2. Any participating insurer or insured may, within 30 days after the date of the notice, apply to the Division for a hearing concerning the association’s ability to qualify as a domestic insurer, the valuation of capital and surplus, or the proposed number and distribution of shares of stock.

(Added to NRS by 1981, 1022; A 1991, 1630; 1993, 1917; 2003, 3307)

NRS 686B.300 Conversion into domestic stock insurer: Determination of percentage of stock for each insured. The association shall determine the percentage of stock to which each insured is entitled as follows:

1. The amount of gain or loss from operations, including an equitable allocation of investment income attributable to operations, is calculated for each of the following groups:

(a) Insureds who have not paid a capital stabilization charge;

(b) Insureds who have paid this charge for a given policy year; and

2. For each calendar year the association has been in operation, the amount of gain or loss from operations, including an equitable allocation of investment income attributable to each group, is divided by the number of insured months in that group.

3. For each group in which an insured participated in any calendar year, the insured’s number of insured months in that group is multiplied by the amount of income per insured month attributable to that group, as determined in subsection 2.

4. For each insured, the results of the calculations performed under subsection 3 for each group in which the insured was a member during a particular calendar year are added.

5. For each insured, the total amount the insured paid in capital stabilization charges is computed.

6. For each insured, the sum of the results of the calculations performed under subsections 4 and 5 are divided by the total surplus of the association as shown in its financial statement for the year preceding its conversion to a domestic stock insurer, to obtain that insured’s percentage of ownership of the total stock to be distributed.

(Added to NRS by 1981, 1022)

NRS 686B.310 Conversion into domestic stock insurer: Capitalization. An association must comply with the provisions of NRS 680A.120 to qualify as a domestic stock insurer. Any paid-in capital in excess of the minimum amount required may be shown as surplus.

(Added to NRS by 1981, 1023)

NRS 686B.320 Conversion into domestic stock insurer: Issuance of certificate of authority. Upon determining that the Association has complied with NRS 686B.280 to 686B.310, inclusive, and all other requirements applicable to domestic stock insurers, the Commissioner may issue to the Association a certificate of authority to transact business as a domestic stock insurer.

(Added to NRS by 1981, 1023; A 2003, 3307)

NRS 686B.330 Conversion into domestic mutual insurer or domestic reciprocal insurer: “Insured” defined. As used in NRS 686B.330 to 686B.370, inclusive, unless the context otherwise requires, “insured” has the meaning ascribed to it in NRS 686B.260.

(Added to NRS by 2003, 3303)

NRS 686B.340 Conversion into domestic mutual insurer or domestic reciprocal insurer: Exemption from applicability of NRS 81.130 and 81.510. The provisions of NRS 81.130 and 81.510 do not apply to the conversion of an essential insurance association to a domestic mutual insurer or a domestic reciprocal insurer as provided in NRS 686B.330 to 686B.370, inclusive.

(Added to NRS by 2003, 3304)

NRS 686B.350 Conversion into domestic mutual insurer or domestic reciprocal insurer: Filing and contents of notice of intent to qualify.

1. An essential insurance association shall, if requested to do so by the Commissioner, file a notice of intent to qualify as a domestic mutual insurer or a domestic reciprocal insurer. In the absence of a request by the Commissioner, an essential insurance association may file such a notice at such time as the association determines appropriate.

2. The notice must be filed with the Commissioner at least 4 months before the date the association is to become a domestic mutual insurer or a domestic reciprocal insurer and must include:

(a) An application prepared pursuant to chapter 680A of NRS for a certificate of authority to transact business in Nevada as a domestic mutual insurer or a domestic reciprocal insurer;

(b) A valuation of the policyholder’s surplus according to both market and amortized value based on the association’s annual financial statement for the previous year; and

(Added to NRS by 2003, 3304)

NRS 686B.360 Conversion into domestic mutual insurer or domestic reciprocal insurer: Notice to insurers and insured; hearing; compliance with certain provisions for qualification.

1. At the time the association files a notice of intent to qualify as a domestic mutual insurer or domestic reciprocal insurer, it must give a notice of intent to all participating insurers and all insureds on a form approved by the Commissioner.

3. An association must comply with the provisions of:

(a) Chapter 692B of NRS, as applicable to mutual insurers, to qualify as a domestic mutual insurer; or

(b) Chapter 694B of NRS, as applicable to reciprocal insurers, to qualify as a domestic reciprocal insurer.

(Added to NRS by 2003, 3304)

NRS 686B.370 Conversion into domestic mutual insurer or domestic reciprocal insurer: Issuance of certificate of authority. Upon determining that an association has complied with NRS 686B.330 to 686B.370, inclusive, and all other requirements applicable to domestic mutual insurers, if the association is qualifying as a domestic mutual insurer, or to domestic reciprocal insurers, if the association is qualifying as a domestic reciprocal insurer, the Commissioner may issue to the association a certificate of authority to transact business as a domestic mutual insurer or a domestic reciprocal insurer.

(Added to NRS by 2003, 3304)