NRS 695D.157 – Hazardous financial condition: Regulations; determination; powers of Commissioner.

1. The Commissioner may adopt regulations to define when an organization for dental care is considered to be in a hazardous financial condition and to set forth the standards to be considered by the Commissioner in determining whether the continued operation of an organization for dental care transacting business in this State may be considered […]

NRS 695D.160 – Composition of board of directors for organization for dental care that is corporation.

If an organization for dental care is a corporation, its board of directors must include: 1. Dentists who have contracted with the organization to provide dental care to its members; and 2. Members of the plan for dental care, who must comprise at least one-third of the membership of the board by the end of […]

NRS 695D.170 – Bond 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.

1. Except as otherwise provided in this section, before a certificate of authority may be issued to an organization for dental care: (a) The officers responsible for operating the organization must file with the Commissioner a collective fidelity bond for $1,000,000; and (b) The organization must file with the Commissioner a surety bond in the […]

NRS 695D.180 – Requirements concerning bond.

An organization for dental care or its officers under this chapter shall file a bond with the Commissioner. The bond must comply with NRS 679B.175. (Added to NRS by 1983, 2024; A 2021, 2995)

NRS 695D.190 – Certain persons in organization for dental care in fiduciary relationship to members; dentist subject to disciplinary action for breaches of fiduciary or contractual obligations.

Any director, officer, partner or employee of an organization for dental care who receives, collects, disburses or invests money in connection with the activities of that organization is responsible for that money and has a fiduciary duty and relationship to the members of the organization. Any dentist who breaches this fiduciary duty or fails to […]

NRS 695D.200 – Policy: Review by prospective members at meeting; provision of copy to members; approval by Commissioner; 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 […]

NRS 695D.203 – Group plan issued to replace discontinued policy or coverage: Requirements; notice of reduction of benefits; statement of benefits; applicability to self-insured employer.

1. A group plan for dental care issued by an organization for dental care to replace any discontinued policy or coverage for dental care must: (a) Provide coverage for all persons who were covered under the previous policy or coverage on the date it was discontinued; and (b) Except as otherwise provided in subsection 2, […]

NRS 695D.205 – Copayments and deductibles: Reasonableness; approval of Commissioner; regulations.

1. Each copayment and deductible required to be paid by a member must be reasonable and reasonably related to the cost of the particular service. 2. Every organization for dental care shall submit to the Commissioner for approval any proposal for copayment or deductible before it is imposed on the members. The Commissioner shall approve […]

NRS 695D.210 – Policy 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.

1. Any policy which provides coverage for a dependent of a member must provide that benefits for children are payable for a member’s newly born child, adopted child or child placed with the member for the purpose of adoption to the same extent that the coverage applies to other dependents. 2. The policy may require […]

NRS 695D.215 – Claims: Approval or denial; request for additional information; payment; interest on unpaid claim.

1. Except as otherwise provided in subsection 2, an organization for dental care shall approve or deny a claim relating to a plan for dental care within 30 days after the organization for dental care receives the claim. If the claim is approved, the organization for dental care shall pay the claim within 30 days […]

NRS 695D.2153 – Claims: Organization for dental care or administrator prohibited from denying claim for which prior authorization has been granted; exceptions.

1. An organization for dental care or an administrator of a dental plan shall not refuse to pay a claim for dental care for which the organization for dental care or administrator, as applicable, has granted prior authorization unless: (a) A limitation on coverage provided under the applicable plan for dental care, including, without limitation, […]

NRS 695D.2157 – Recovery of overpayments: Notice; procedures for challenging attempted recovery; limitation of period for recovery; exception.

1. An organization for dental care or an administrator who recovers overpayments under a plan for dental care shall provide written notice to a dentist of any attempt to recover an overpayment, other than a duplicate payment. The notice must include, without limitation: (a) A description of the error that justifies the recovery; and (b) […]

NRS 695D.216 – Required provision concerning coverage for services provided through telehealth to same extent and in same amount as though provided in person or by other means; exception; prohibited acts. [Effective through the earlier of 1 year after the date on which the Governor terminates the emergency described in the Declaration of Emergency for COVID-19 issued on March 12, 2020, or June 29, 2023.] Required provision concerning coverage for services provided through telehealth to same extent as though provided in person or by other means; prohibited acts. [Effective on the earlier of 1 year after the date on which the Governor terminates the emergency described in the Declaration of Emergency for COVID-19 issued on March 12, 2020, or June 30, 2023.]

1. A plan for dental care must include coverage for services provided to a member through telehealth to the same extent and, except for services provided through audio-only interaction, in the same amount as though provided in person or by other means. 2. An organization for dental care shall not: (a) Require a member to […]

NRS 695D.217 – Organization 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.

An organization for dental care shall not deny a claim, refuse to issue a policy or cancel a policy solely because the claim involves an act that constitutes domestic violence pursuant to NRS 33.018, or because the person applying for or covered by the policy was the victim of such an act of domestic violence, […]

NRS 695D.219 – Organization for dental care prohibited from denying coverage solely because applicant or member was intoxicated or under the influence of controlled substance; exceptions.

1. Except as otherwise provided in subsection 2, an organization for dental care shall not: (a) Deny a claim under a plan for dental care solely because the claim involves an injury sustained by a member as a consequence of being intoxicated or under the influence of a controlled substance. (b) Cancel participation under a […]

NRS 695D.220 – Licensing of agents.

1. The provisions of chapter 683A of NRS apply to the licensing of agents for an organization for dental care. 2. As used in this section, “agent” means any person who is associated, directly or indirectly, with the organization and engages in soliciting or enrolling members. (Added to NRS by 1983, 2027)

NRS 695D.225 – Contracts between organization for dental care and dentist: Modification; submission of schedule of payments upon request; exceptions.

1. Except as otherwise provided in NRS 695D.227, a contract between an organization for dental care and a dentist may be modified: (a) At any time pursuant to a written agreement executed by both parties. (b) Except as otherwise provided in this paragraph, by the organization for dental care upon giving to the dentist 45 […]

NRS 695D.227 – Prohibitions related to setting of fees by plan or organization for dental care other than covered services to members.

1. No plan for dental care and no contract between an organization for dental care and a dentist may require, directly or indirectly, that the dentist provide dental care to a member at a fee set by or subject to the approval of the organization for dental care unless the dental care is a covered […]

NRS 695D.230 – Advertising or materials used to enroll or solicit members: Approval of Commissioner; penalties.

1. Every organization for dental care must submit any advertising, or other materials to be used to enroll or solicit members, to the Commissioner for approval by the Commissioner before they are used by the organization. 2. If the Commissioner does not disapprove the advertising or other materials within 30 days after they are filed […]

NRS 695D.240 – Limitation on use of charges or premiums for marketing and administrative expenses; regulations.

1. The organization for dental care shall use not more than 25 percent of its prepaid charges or premiums for marketing and administrative expenses, including all costs to solicit members or dentists. 2. The Commissioner may adopt regulations which define “marketing and administrative expenses” for the purposes of subsection 1. (Added to NRS by 1983, […]