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Nevada Revised Statutes

Chapter 695D

Nev. Rev. Stat. ch. 695D

Plans for Dental Care

695D.010Definitions 695D.012“Administrator” defined 695D.020“Commissioner” defined 695D.030“Dental care” defined 695D.040“Dentist” defined 695D.050“Member” defined 695D.060“Organization for dental care” defined 695D.070“Plan for dental care” defined 695D.080“Policy” defined 695D.090Applicability of title to organizations for dental care; applicability of chapter 695D.095Applicability of chapter and certain other provisions to organizations for dental care 695D.100Regulations 695D.102Summary of coverage: Contents of disclosure; approval by Commissioner; regulations 695D.104Summary of coverage: Copy required to be provided to group policyholder before issuance of policy; organization prohibited from offering plan unless disclosure approved by Commissioner 695D.110Certificate of authority: Required for establishing, operating, acting as administrator of, selling or offering to sell plan for dental care 695D.120Certificate of authority: Application 695D.130Certificate of authority: Issuance; fees 695D.140Certificate of authority: Notice of change of information; application for amendment; fee; approval 695D.150Certificate of authority: Expiration; renewal; fees 695D.153Capital account: Minimum amount; requirements 695D.157Hazardous financial condition: Regulations; determination; powers of Commissioner 695D.160Composition of board of directors for organization for dental care that is corporation 695D.170Bond or deposit: Required; amount; creation of Fund for Bonds of Organizations for Dental Care; judgment as lien; disposition upon dissolution, liquidation or other termination of organization 695D.180Requirements concerning bond 695D.190Certain persons in organization for dental care in fiduciary relationship to members; dentist subject to disciplinary action for breaches of fiduciary or contractual obligations 695D.200Policy: Review by prospective members at meeting; provision of copy to members; approval by Commissioner; form and contents; notice of change 695D.203Group plan issued to replace discontinued policy or coverage: Requirements; notice of reduction of benefits; statement of benefits; applicability to self-insured employer 695D.205Copayments and deductibles: Reasonableness; approval of Commissioner; regulations 695D.210Policy covering dependent of member required to include coverage for member’s newly born and adopted children and children placed with member for adoption to same extent as other dependents 695D.215Claims: Approval or denial; payment of claim and interest; request for additional information; award of costs and attorney’s fees; compliance with requirements; imposition of administrative fine or suspension or revocation of certificate of authority for failure to comply; report of compliance by organization 695D.2153Claims: Organization for dental care or administrator prohibited from denying claim for which prior authorization has been granted; exceptions 695D.2157Recovery of overpayments: Notice; procedures for challenging attempted recovery; limitation of period for recovery; exception 695D.216Required provision concerning coverage for services provided through telehealth to same extent as though provided in person or by other means; required provision concerning reimbursement for certain services provided through telehealth in same amount as though provided in person or by other means; prohibited acts 695D.2165Required provision concerning coverage for dental service provided by qualified dental hygienist in certain circumstances 695D.217Organization for dental care prohibited from denying coverage solely because claim involves act that constitutes domestic violence or applicant or insured was victim of domestic violence 695D.219Organization for dental care prohibited from denying coverage solely because applicant or member was intoxicated or under the influence of controlled substance; exceptions 695D.220Licensing of agents 695D.225Contracts between organization for dental care and dentist: Modification; submission of schedule of payments upon request; exceptions 695D.227Prohibitions related to setting of fees by plan or organization for dental care other than covered services to members 695D.230Advertising or materials used to enroll or solicit members: Approval of Commissioner; penalties 695D.240Limitation on use of charges or premiums for marketing and administrative expenses; regulations 695D.250Reserves: Maintenance; exception; held in fiduciary capacity; deposit; penalty for diversion or appropriation; regulations 695D.260Annual report; financial statement; quarterly statement; administrative penalty for failure to file timely report or statement; extension of time; payment of premium tax and filing fee 695D.270Examination by Commissioner 695D.280Rehabilitation, liquidation or conservation: Conduct 695D.290Trade practices and frauds: Applicability of provisions to organizations for dental care 695D.300Disciplinary action: Grounds; penalties 695D.310Disciplinary or other action: Notice; hearing; order