Bill > SB482

Introduced Session

Legislative Counsel's Digest: The McCarran-Ferguson Act reserves to the states the right to regulate the 1 business of insurance, except in certain situations where the United States Congress 2 explicitly regulates the business of insurance. (15 U.S.C. 1011-1015) In 2010, 3 the United States Congress enacted the Patient Protection and Affordable Care Act, 4 through which the United States Congress authorized two or more states to enter 5 into healthcare choice compacts under which the issuer of any qualified health plan 6 to which the compact applies would be required to: (1) be licensed in each state; or 7 (2) submit to the jurisdiction of each such state. (42 U.S.C. 18053(a)(1)(B)(ii)) 8 Existing law authorizes the Commissioner of Insurance to enter into such compacts 9 with the regulatory officers in other states to further the uniform treatment of 10 insurers throughout the United States. (NRS 679B.220) Section 2of this bill 11 authorizes the Commissioner to enter into such compacts to also ensure: (1) market 12 stability; or (2) essential insurance is available to Nevada residents. Section 1of 13 this bill authorizes the Commissioner to allow reciprocal licenses to be issued to 14 health carriers that are licensed to do business in Arizona, California, Idaho, 15 Oregon or Utah without the health carrier first being required to obtain a certificate 16 of authority to do business in Nevada. Section 1additionally authorizes the 17 Commissioner to adopt regulations to carry out this reciprocal licensure program, 18 including regulations authorizing the Commissioner to establish any fees the 19 Commissioner deems appropriate to carry out this program. Section 55of this bill 20 makes conforming changes by requiring certain certificates to be filed only at the 21 request of the Commissioner. 22 The Patient Protection and Affordable Care Act established a transitional 23 reinsurance program to help stabilize premiums in the individual market for the 24 2014, 2015 and 2016 benefit years. (42 U.S.C. 18061) This program expired on 25 December 31, 2016. Sections 5-44of this bill generally provide for the 26 establishment of the Nevada Reinsurance Program to replace the now defunct 27 federal transitional reinsurance program. Section 23of this bill establishes the 28 Nevada Reinsurance Program. Sections 24-29of this bill create the Board of 29 Directors of the Nevada Reinsurance Program and prescribe various procedures and 30 requirements of the Board. Section 30of this bill requires the Board to prepare, for 31 adoption by the Commissioner, a reinsurance plan of operation for the 32 administration of the Nevada Reinsurance Program. Section 31of this bill requires 33 this reinsurance plan of operation to establish certain procedures and requirements, 34 including procedures for determining: (1) the payment parameters made by the 35 Nevada Reinsurance Program that the Commissioner approves in sections 33-35of 36 this bill; and (2) any assessments to be charged or collected from eligible 37 contributors. Section 36of this bill provides the manner in which reinsurance 38 payments are calculated, and section 37of this bill provides the procedure for an 39 eligible health carrier to request reinsurance payments from the Nevada 40 Reinsurance Program. Section 39of this bill creates the Nevada Reinsurance 41 Program Account in the State General Fund and requires: (1) money received from 42 certain assessments and from certain federal and state funds to be deposited into the 43 Account; and (2) money deposited into the Account be expended for the operation 44 and administration of the Nevada Reinsurance Program and to make reinsurance 45 payments. Section 41of this bill requires the Board to submit to the Commissioner 46 and make available to the public a report summarizing the operations of the Nevada 47 Reinsurance Program for each benefit year. Section 42of this bill requires the 48 Board to: (1) hire and cooperate with an independent certified public accountant to 49 perform an audit for each benefit year of the Nevada Reinsurance Program; and (2) 50 submit this audit to the Commissioner and make it available to the public. Section 351 of this bill makes a conforming change. 52 Federal law authorizes a state to apply to the Secretary of Health and Human 53 Services for a waiver of various requirements of the Patient Protection and 54 Affordable Care Act with respect to health insurance coverage in the state for a 55 plan year. (42 U.S.C. 18502) Section 45of this bill incorporates this federal 56 language into state law by authorizing the Commissioner to apply for such a waiver 57 for a plan year beginning on January 1, 2020. Sections 46-54, 58and 59of this bill 58 make conforming changes. 59 Existing law requires any health benefit plan for individuals that is not 60 purchased on the Silver State Health Insurance Exchange to be: (1) made available 61 for purchase at any time during the calendar year; (2) subject to a waiting period of 62 not more than 90 days after the date on which the application was received; (3) 63 effective upon the first day of the month immediately after the month in which the 64 waiting period ends; and (4) not retroactive to the date on which the application for 65 coverage was received. (NRS 687B.480) Section 56of this bill removes these 66 requirements. 67 Federal law provides that, with respect to the premium rate charged by a health 68 insurance insurer for health insurance coverage offered in the individual or small 69 group market, the rate may vary with respect to a particular plan or coverage 70 involved only by: (1) age, except that such rate shall not vary by more than 3 to 1 71 for adults; and (2) tobacco use, except that such rate shall not vary by more than 1.5 72 to 1. (42 U.S.C. 300gg(a)(1)(A)) Existing law incorporates federal law by 73 authorizing such a premium rate to vary with respect to the particular plan or 74 coverage involved based on the following characteristics: (1) tobacco use, except 75 that the rate shall not vary by more than 1.5 to 1 for individuals who vary in 76 tobacco use; and (2) age, except that the rate must not vary by a ratio of more than 77 3 to 1 for certain individuals that is consistent with the uniform age rating curve 78 established in the Federal Act. (NRS 687B.500) Section 57of this bill removes 79 these requirements from existing law and instead allows variations in a premium 80 rate based on: (1) tobacco use; and (2) age consistent with the uniform age rating 81 curve established in the Federal Act. The federal requirements for tobacco use and 82 age still apply to section 57. 83 SENATE AND ASSEMBLY, DO ENACT AS FOLLOWS: Section 1. Chapter 679B of NRS is hereby amended by adding 1 thereto a new section to read as follows: 2 1. The Commissioner may allow reciprocal licenses to be 3 issued to health carriers licensed to do business in Arizona, 4 California, Idaho, Oregon and Utah to enable said health carriers 5 to do business in Nevada without completing a separate 6 application for a certificate of authority in Nevada, other than a 7 petition for recognition of their respective state s license with the 8 grant of a reciprocal Nevada license. 9 2. The Commissioner may adopt regulations to carry out the 10 provisions of subsection 1, including, without limitation, 11 regulations to establish any fees the Commissioner deems 12 appropriate to carry out the provisions of subsection 1. 13

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Chapter 251. (on 05/30/2019)

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