1. An insurer shall provide to each policyholder, or producer of insurance acting on behalf of a policyholder, on a form approved by the Commissioner, a summary of the coverage provided by each policy of group or blanket health insurance offered by the insurer. The summary must disclose any:
- (a) Significant exception, reduction or limitation that applies to the policy;
- (b) Restriction on payment for care in an emergency, including related definitions of emergency and medical necessity;
- (c) Right of the insurer to change the rate of premium and the factors, other than claims experienced, which affect changes in rate;
- (d) Provisions relating to renewability; and
- (e) Other information that the Commissioner finds necessary for full and fair disclosure of the provisions of the policy.
- 2. The language of the disclosure must be easily understood. The disclosure must state that it is only a summary of the policy and that the policy should be read to ascertain the governing contractual provisions.
- 3. The Commissioner shall not approve a proposed disclosure that does not satisfy the requirements of this section and of applicable regulations.
- 4. In addition to the disclosure, the insurer shall provide information about guaranteed availability of basic and standard plans for benefits to an eligible person.
- 5. The insurer shall provide the summary before the policy is issued.
(Added to NRS by 2001, 2219; A 2019, 300)