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