Nevada Healthcare Insurance laws & HR compliance analysis

Nevada Healthcare Insurance: What you need to know

There is no state law requiring employers to offer group healthcare insurance to their employees, but most employers do provide this benefit. However, if any healthcare insurance is offered, Nevada's insurance laws require policies to cover certain benefits (mandated benefits).
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States are not permitted to regulate self-insured benefit plans. Nevada's mandated benefits, continuation, and conversion provisions do not apply to health plans in which the employer pays all benefits without the proceeds of any insurance policy. An employer's health plan is self-insured if the risk of paying claims is on the employer and not on an insurance company. Self-insured plans may contract with third-party administrators (TPAs), including insurance companies, to process benefit claims. The TPA pays the claims and is then reimbursed by the employer. Many self-insured plans also buy “stop-loss” insurance to cover very large claims. The purchase of stop-loss insurance does not result in the loss of self-insured status and the exemption from state insurance law regulation.
Employers are required to notify employees of their intent to accept a group health or dental policy that covers their employees (Nev. Rev. Stat. Sec. 608.1577). Employers must notify employees and the insurer when they intend to terminate, reduce, or modify substantially any benefit under such policies, or to change insurers. Employers must also notify employees of their inability to pay a premium when due or their intention to stop paying premiums. These notices must be given at least 15 days before the (1) acceptance of, change in, or termination of benefits or insurers; or (2) when the next unpaid premium is ...

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