689C.135 - Effect of provision in health benefit plan for restricted network on determination of rates. - Nevada Statutes

689C.135  Effect of provision in health benefit plan for restricted network on determination of rates.

      1.  For the purposes of determining rates charged for health benefit plans, a health benefit plan that contains a provision for a restricted network is not similar coverage to a health benefit plan that does not contain such a provision if the restriction of benefits results in material differences in cost of claims.

      2.  As used in this section, “provision for a restricted network” means any provision of a group health benefit plan that conditions the payment of benefits, in whole or in part, on the use of providers of health care who have entered into a contractual arrangement with the carrier to provide health care to persons covered by the plan.

      (Added to NRS by 1995, 980)