695D.200 - Policy: Issuance; form and contents; notice of change. - Nevada Statutes

695D.200  Policy: Issuance; form and contents; notice of change.

      1.  An organization for dental care shall:

      (a) Hold a meeting for all prospective members to review fully the policy being offered and describe the coverage under the plan for dental care before any contract is executed between the parties.

      (b) Provide to each member a copy of the policy describing his or her coverage under the plan for dental care.

      2.  The Commissioner must approve every policy and amendment to it before they are distributed to the members or any other person. If the Commissioner does not disapprove the policy within 30 days after it is filed with the Commissioner, it shall be deemed to be approved. If the Commissioner disapproves a policy, the Commissioner shall notify the organization of the reasons for disapproval. The Commissioner shall grant a hearing on any disapproval of a policy or amendment within 15 days after the organization requests, in writing, a hearing on the matter.

      3.  A policy must contain a clear and complete statement of the contract between the parties or a summary of the contract which describes:

      (a) The dental care and other benefits to which the member is entitled;

      (b) Any limitations on the care to be provided, including any deductibles or copayments to be paid by a member;

      (c) Where information is available and how dental care may be obtained; and

      (d) The member’s obligations for payment under the plan for dental care.

      4.  The organization must give notice to the Commissioner and every member 30 days before any change is made in the member’s policy.

      (Added to NRS by 1983, 2025)