Nev. Rev. Stat. § 686C.010 Short title.
This chapter may be cited as the Nevada Life and Health Insurance Guaranty Association Act.
NEVADA LIFE AND HEALTH INSURANCE GUARANTY ASSOCIATION
Nev. Rev. Stat. 686C
in effectNev. Rev. Stat. § 686C.020 Purpose of chapter.
The purpose of this chapter is to protect, within certain limits, the persons specified in subsections 1 and 2 of NRS 686C.030 against failure in the performance of contractual obligations under life insurance, health insurance and annuity policies or contracts specified in subsection 4 of NRS 686C.030 because of the impairment or insolvency of a member insurer issuing such policies or contracts.
Nev. Rev. Stat. § 686C.030 Scope of chapter: Coverage provided.
1. This chapter provides coverage for the life insurance, health insurance and annuity policies or contracts described in subsection 4 to persons who are:
(a) Owners of, enrollees in or certificate holders under such policies or contracts, other than structured settlement annuities, and who:
(1) Are residents of this state; or
(2) Are not residents, but only if:
(I) The member insurer that issued the policies or contracts is domiciled in this state;
(II) The states in which the persons reside have associations similar to the Association created by this chapter; and
(III) The persons are not eligible for coverage by an association in another state because the member insurer was not authorized in the other state at the time specified in that states law governing guaranty associations; and
(b) Regardless of where they reside, beneficiaries, assignees or payees of the persons covered under paragraph (a), including, without limitation, providers of health care rendering services covered under policies or certificates of health insurance, except for nonresident certificate holders under group policies or contracts.
2. For structured settlement annuities, except as otherwise provided in subsection 3, this chapter provides coverage to a payee under the annuity, or beneficiary of a payee if the payee is deceased, if the payee or beneficiary:
(a) Is a resident of this state, regardless of the residence of the owner of the annuity; or
(b) Is not a resident of this state, but:
(1) The owner of the annuity is a resident of this state, or the issuer of the annuity is domiciled in this state and the state in which the owner resides has an association similar to the Association created by this chapter; and
(2) Neither the payee or beneficiary nor the owner of the annuity is eligible for coverage by the association of the state in which the payee, beneficiary or owner resides.
3. This chapter does not provide coverage for a payee or beneficiary of a structured settlement annuity if the owner of the annuity is a resident of this state and the payee or beneficiary is afforded any coverage by the association of another state. In determining the application of the provisions of this chapter to a situation where a person could be covered by the association of more than one state, this chapter must be construed in conjunction with the laws of other states to result in coverage by only one association.
4. This chapter provides coverage to the persons described in subsections 1 and 2 for policies or contracts of direct, nongroup life insurance, health insurance and annuities, for certificates under direct group policies and contracts, and for supplemental contracts to any of these, in each case issued by member insurers, except as limited by this chapter.
Nev. Rev. Stat. § 686C.035 Scope of chapter: Coverage not provided.
1. This chapter does not provide coverage for:
(a) A portion of a policy or contract not guaranteed by the member insurer, or under which the risk is borne by the owner of the policy or contract.
(b) A policy or contract of reinsurance unless assumption certificates have been issued pursuant to that policy or contract.
(c) A portion of a policy or contract, other than a portion of a policy or contract of health insurance or that provides benefits for long-term care, including, without limitation, a rider that provides such benefits, to the extent that the rate of interest on which it is based, or the interest rate, crediting rate or similar factor determined by the use of an index or other external reference stated in the policy or contract employed in calculating returns or changes in value:
(1) Averaged over the period of 4 years before the date on which the association becomes obligated with respect to the policy or contract, exceeds the rate of interest determined by subtracting 2 percentage points from Moodys Corporate Bond Yield Average averaged for the same period, or for the period between the date of issuance of the policy or contract and the date the association became obligated, whichever period is less; and
(2) On or after the date on which the association becomes obligated with respect to the policy or contract, exceeds the rate of interest determined by subtracting 3 percentage points from Moodys Corporate Bond Yield Average as most recently available.
(d) A portion of a policy or contract issued to a plan or program of an employer, association or other person to provide life, health or annuity benefits to its employees, members or other persons to the extent that the plan or program is self-funded or uninsured, including, but not limited to, benefits payable by an employer, association or other person under:
(1) A multiple employer welfare arrangement described in 29 U.S.C. § 1002(40);
(2) A minimum-premium group insurance plan;
(3) A stop-loss group insurance plan; or
(4) A contract for administrative services only.
(e) A portion of a policy or contract to the extent that it provides for dividends, credits for experience, voting rights or the payment of any fee or allowance to any person, including the owner of a policy or contract, for services or administration connected with the policy or contract.
(f) A policy or contract issued in this state by a member insurer at a time when the member insurer was not authorized to issue the policy or contract in this state.
(g) A portion of a policy or contract to the extent that the assessments required by NRS 686C.230 with respect to the policy or contract are preempted by federal law.
(h) An obligation that does not arise under the express written terms of the policy or contract issued by the member insurer, including:
(1) Claims based on marketing materials;
(2) Claims based on side letters or other documents that were issued by the member insurer without satisfying applicable requirements for filing or approval of policy or contract forms;
(3) Misrepresentations of or regarding policy or contract benefits;
(4) Extra-contractual claims; or
(5) A claim for penalties or consequential or incidental damages.
(i) A contractual agreement that establishes the member insurers obligation to provide a guarantee based on accounting at book value for participants in a defined-contribution benefit plan by reference to a portfolio of assets owned by the benefit plan or its trustee, which in each case is not an affiliate of the member insurer.
(j) A portion of a policy or contract to the extent that it provides for interest or other changes in value which are determined by the use of an index or other external reference stated in the policy or contract, but which have not been credited to the policy or contract, or as to which the rights of the owner of the policy or contract are subject to forfeiture, determined on the date the member insurer becomes an impaired or insolvent insurer, whichever occurs first. If the interest or changes in value of a policy or contract are credited less frequently than annually, for the purpose of determining the values that have been credited and are not subject to forfeiture, the interest or change in value determined by using procedures stated in the policy or contract must be credited as if the contractual date for crediting interest or changing values was the date of the impairment or insolvency of the insured member, whichever occurs first and is not subject to forfeiture.
(k) An unallocated annuity contract other than an annuity owned by a governmental retirement plan established under section 401, 403(b) or 457 of the Internal Revenue Code, 26 U.S.C. §§ 401, 403(b) and 457, respectively, or the trustees of such a plan.
(l) A policy or contract providing any hospital, medical, prescription drug or other health care benefits pursuant to 42 U.S.C. §§ 1395w-21 et seq. and 1395w-101 et seq. or 42 U.S.C. §§ 1396 et seq., and any regulations adopted pursuant thereto.
2. As used in this section, Moodys Corporate Bond Yield Average means the monthly average for corporate bonds published by Moodys Investors Service, Inc., or any successor average.
Nev. Rev. Stat. § 686C.038 Applicability of chapter to riders for long-term care.
For the purposes of this chapter, benefits provided pursuant to a rider for long-term care to a life insurance policy or annuity contract shall be deemed the same type of benefits provided in the life insurance policy or annuity contract to which the rider applies.
Nev. Rev. Stat. § 686C.040 Definitions.
As used in this chapter, unless the context otherwise requires, the words and terms defined in NRS 686C.045 to 686C.127, inclusive, have the meanings ascribed to them in those sections.
Nev. Rev. Stat. § 686C.045 Account defined.
Account means one of the accounts maintained pursuant to NRS 686C.130.
Nev. Rev. Stat. § 686C.048 Annuity defined.
Annuity includes an agreement for allocated funding, a structured settlement annuity and an immediate or deferred annuity.
Nev. Rev. Stat. § 686C.050 Association defined.
Association means the Nevada Life and Health Insurance Guaranty Association.
Nev. Rev. Stat. § 686C.055 Authorized assessment defined.
Authorized assessment or authorized as used in the context of assessments means or describes an assessment authorized by a resolution of the Board of Directors of the Association to be imposed immediately or later on member insurers in a specified amount.
Nev. Rev. Stat. § 686C.061 Benefit plan defined.
Benefit plan means a benefit plan for a specific employee, union or association of natural persons.
Nev. Rev. Stat. § 686C.065 Called assessment defined.
Called assessment or called as used in the context of assessments means or describes an authorized assessment required by a notice mailed by the Association to member insurers to be paid within the time set forth in the notice.
Nev. Rev. Stat. § 686C.070 Contractual obligation defined.
Contractual obligation means any obligation under a policy or contract or a certificate under a group policy or contract, or portion thereof, for which coverage is provided under NRS 686C.030.
Nev. Rev. Stat. § 686C.080 Covered policy or contract defined.
Covered policy or contract means any policy or contract included within the scope of this chapter, as expressed in NRS 686C.030 and 686C.035.
Nev. Rev. Stat. § 686C.084 Extra-contractual claim defined.
Extra-contractual claim includes a claim relating to bad faith in the payment of claims and a claim for punitive or exemplary damages or for costs and attorneys fees.
Nev. Rev. Stat. § 686C.087 Health maintenance organization defined.
Health maintenance organization has the meaning ascribed to it in NRS 695C.030.
Nev. Rev. Stat. § 686C.090 Impaired insurer defined.
Impaired insurer means a member insurer which is not an insolvent insurer and is placed under an order of rehabilitation or conservation by a court of competent jurisdiction.
Nev. Rev. Stat. § 686C.095 Insolvent insurer defined.
Insolvent insurer means a member insurer which is ordered to liquidate by a court of competent jurisdiction after a finding of insolvency.
Nev. Rev. Stat. § 686C.100 Member insurer defined.
Member insurer means an insurer which is licensed or holds a certificate of authority to transact in this state any kind of insurance for which coverage is provided in this chapter or a health maintenance organization which holds a certificate of authority to operate in this State. The term includes an insurer or health maintenance organization whose license or certificate of authority in this state has been suspended, revoked, not renewed or voluntarily withdrawn. The term does not include:
1. A fraternal benefit society;
2. A mandatory state pooling plan;
3. A mutual assessment company or other person that operates on the basis of assessments;
4. An insurance exchange;
5. An organization that is authorized only to issue charitable gift annuities under NRS 688A.281 to 688A.285 , inclusive;
6. A reinsurance program operated by the State Government; or
7. An organization similar to any of those listed in subsections 1 to 6, inclusive.
Nev. Rev. Stat. § 686C.104 Owner defined.
Owner of a policy or contract means the person who is identified as the legal owner under the terms of the policy or contract or who is otherwise vested with legal title to the policy or contract through a valid assignment completed in accordance with the terms of the policy or contract and properly recorded as the owner on the books of the issuer.
Nev. Rev. Stat. § 686C.108 Person defined.
Person includes a government, governmental agency or political subdivision of a government.
Nev. Rev. Stat. § 686C.110 Premiums defined.
Premiums means amounts received in any calendar year on covered policies or contracts less premiums, considerations and deposits returned thereon, and less dividends and credits for experience thereon. The term does not include:
1. Any amounts received for policies or contracts or for the portions of policies or contracts for which coverage is not provided under NRS 686C.030 except that the assessable premium is not reduced on account of paragraph (c) of subsection 1 of NRS 686C.035 relating to limitations on interest and subsection 2 or paragraph (b) of subsection 1 of NRS 686C.210 relating to limitations with respect to any one life.
2. Premiums for an unallocated annuity contract, except those issued in accordance with the provisions of a governmental retirement plan, established under section 401, 403(b) or 457 of the Internal Revenue Code, 26 U.S.C. §§ 401, 403(b) and 457, respectively, or the trustees of such a plan.
3. Premiums that exceed $5,000,000 for several nongroup policies of life insurance owned by one owner, regardless of:
(a) Whether the owner is a natural person, firm, corporation or other person;
(b) Whether any person insured under the policies is an officer, manager, employee or other person; or
(c) The number of policies or contracts held by the owner.
Nev. Rev. Stat. § 686C.115 Principal place of business defined.
1. Principal place of business of an organization means the single state in which the natural persons who establish policy for the direction, control and coordination of the operations of the organization as a whole primarily perform that function, determined by the Association in its reasonable judgment by considering:
(a) The state in which the primary executive and administrative headquarters of the organization is located;
(b) The state in which the principal office of the chief executive officer of the organization is located;
(c) The state in which the board of directors, or similar governing authority, of the organization conducts the majority of its meetings;
(d) The state in which the executive or managerial committee of the board of directors, or similar governing authority, of the organization conducts the majority of its meetings; and
(e) The state from which the management of the overall operations of the organization is directed.
2. Principal place of business of the sponsor of a benefit plan means the principal place of business of the association, committee, joint board of trustees or similar group of representatives of the parties who establish or maintain the plan or, if that cannot be ascertained, of the employer or the employee organization that has the largest investment in the plan, except that in either case if more than half of the participants of the plan are employed in one state, it means that state. In the case of a benefit plan sponsored by affiliated companies comprising a consolidated corporation, it means the state in which the holding company or controlling affiliate has its principal place of business as determined by using the factors set forth in subsection 1.
Nev. Rev. Stat. § 686C.120 Resident defined.
Resident means any person to whom a contractual obligation is owed and who resides in this state on the date of entry of a court order that determines a member insurer to be impaired or insolvent. A person may be a resident of but one state, which in the case of a person other than a natural person is its principal place of business. A citizen of the United States who is a resident of a foreign country or of a territory or insular possession subject to the jurisdiction of the United States which does not have an association similar to the Association created by this chapter shall be deemed to be a resident of the state of domicile of the member insurer that issued the policy or contract.
Nev. Rev. Stat. § 686C.123 State defined.
State means a state of the United States, the District of Columbia, Puerto Rico, the United States Virgin Islands or any territory or insular possession subject to the jurisdiction of the United States.
Nev. Rev. Stat. § 686C.124 Structured settlement annuity defined.
Structured settlement annuity means an annuity purchased to fund periodic payments to a plaintiff or other claimant in payment for or with respect to personal injury suffered by the plaintiff or other claimant.
Nev. Rev. Stat. § 686C.125 Supplemental contract defined.
Supplemental contract means a written agreement for the distribution of proceeds from a life or health insurance policy or contract or an annuity.
Nev. Rev. Stat. § 686C.127 Unallocated annuity contract defined.
Unallocated annuity contract means an annuity contract or group annuity certificate which is not issued to and owned by a natural person except to the extent such an annuity contract or group annuity certificate is guaranteed to a natural person by an insurer under such contract or certificate.
Nev. Rev. Stat. § 686C.128 Document describing general purposes and current limitations of chapter: Preparation; distribution and revision; disclaimer; related duties by member insurer.
1. The Association shall prepare, and submit to the Commissioner for approval, a summary document describing the general purposes and current limitations of this chapter. After the expiration of 60 days after the approval of the summary document by the Commissioner, a member insurer may not deliver a policy or contract to the policy or contract owner, certificate holder or enrollee unless the summary document is delivered to the policy or contract owner, certificate holder or enrollee at the time of delivery of the policy or contract. The document must also be available upon request by the policy or contract owner, certificate holder or enrollee. The distribution, delivery, contents or interpretation of this document does not guarantee that the policy or contract or the policy or contract owner, certificate holder or enrollee is covered in the event of the impairment or insolvency of a member insurer. The descriptive document must be revised by the Association as amendments to this chapter may require. Failure to receive this document does not give the policy or contract owner, certificate holder or enrollee any greater rights than those stated in this chapter.
2. The document prepared pursuant to subsection 1 must contain a clear and conspicuous disclaimer on its face. The Commissioner shall establish the form and content of the disclaimer. The disclaimer must:
(a) State the name and address of the Association and of the Division;
(b) Prominently warn the policy or contract owner, certificate holder or enrollee that the Association may not cover the policy or contract or, if coverage is available, it will be subject to substantial limitations and exclusions and conditioned on continued residence in this State;
(c) State the types of policies and contracts for which guaranty funds will provide coverage;
(d) State that the member insurer and its agents are prohibited by law from using the existence of the Association for the purpose of sales, solicitation or inducement to purchase any form of insurance or coverage offered by a health maintenance organization;
(e) State that the policy or contract owner, certificate holder or enrollee should not rely on coverage under the Association when selecting an insurer;
(f) Explain the rights and procedures for filing a complaint to allege a violation of any provision of this chapter; and
(g) Provide other information as directed by the Commissioner, including sources of information about the financial condition of insurers, if the information is not proprietary and is subject to disclosure under the law of the state in which the member insurer is domiciled.
3. A member insurer shall retain evidence of compliance with subsection 1 while the policy or contract for which the notice is given remains in effect.
Nev. Rev. Stat. § 686C.130 Creation of Association; membership; operation; accounts; supervision by Commissioner.
1. There is hereby created a nonprofit legal entity to be known as the Nevada Life and Health Insurance Guaranty Association. All member insurers shall be and remain members of the Association as a condition of their authority to transact insurance or operate a health maintenance organization, as applicable, in this state. The Association shall perform its functions under the plan of operation established and approved pursuant to NRS 686C.290 and shall exercise its powers through a Board of Directors established pursuant to NRS 686C.140 .
2. For purposes of administration and assessment, the Association shall maintain two accounts:
(a) The Health Account; and
(b) The Life and Annuity Account, which consists of:
(1) The Subaccount for Life Insurance; and
(2) The Subaccount for Annuities, including annuities owned by a governmental retirement plan, or its trustees, established under section 401, 403(b) or 457 of the Internal Revenue Code, 26 U.S.C. §§ 401, 403(b) and 457.
3. The Association is under the immediate supervision of the Commissioner and is subject to the applicable provisions of the Nevada Insurance Code. Meetings or records of the Association may be opened to the public by majority vote of the Board of Directors.
Nev. Rev. Stat. § 686C.140 Board of Directors: Members; vacancies; initial selection; reimbursement of expenses.
1. The Board of Directors of the Association consists of not less than 7 nor more than 11 members, serving terms as established in the plan of operation.
2. The members of the Board who represent member insurers must be selected by member insurers subject to the approval of the Commissioner. If practicable, one of the members of the Board must be an officer of a domestic member insurer.
3. Two public representatives must be appointed to the Board by the Commissioner. A public representative may not be an officer, director or employee of a member insurer, engaged in the business of insurance or a health maintenance organization.
4. Vacancies on the Board must be filled for the remaining period of the term by majority vote of the members of the Board, subject to the approval of the Commissioner, for members who represent member insurers, and by the Commissioner for public representatives.
5. To select the initial Board of Directors, and initially organize the Association, the Commissioner shall give notice to all member insurers of the time and place of the organizational meeting. In determining voting rights at the organizational meeting, each member insurer is entitled to one vote in person or by proxy. If the Board of Directors is not selected within 60 days after notice of the organizational meeting, the Commissioner may appoint the initial members to represent member insurers in addition to the public representatives.
6. In approving selections or in appointing members to the Board, the Commissioner shall consider, among other things, whether all member insurers are fairly represented.
7. Members of the Board may be reimbursed from the assets of the Association for expenses incurred by them as members of the Board of Directors, but members of the Board may not otherwise be compensated by the Association for their services.
Nev. Rev. Stat. § 686C.150 Powers regarding impaired insurers.
If a member insurer is an impaired insurer, the Association may, subject to any conditions it may impose which do not impair the contractual obligations of the impaired insurer and which are approved by the Commissioner:
1. Guarantee, assume, reissue or reinsure, or cause to be guaranteed, assumed, reissued or reinsured, any or all of the covered policies or contracts of the impaired insurer.
2. Provide such money, pledges, loans, notes, guarantees or other means as are proper to effectuate subsection 1, and assure payment of the contractual obligations of the impaired insurer pending action under subsection 1.
Nev. Rev. Stat. § 686C.152 Duties regarding insolvent insurers.
If a member insurer is an insolvent insurer, the Association shall:
1. Guarantee, assume, reissue or reinsure, or cause to be guaranteed, assumed, reissued or reinsured, the policies or contracts of the insolvent insurer; or
2. Ensure payment of the contractual obligations of the insolvent insurer and:
(a) Provide such money, pledges, loans, notes, guarantees or other means as are reasonably necessary to discharge its duties; or
(b) Provide benefits and coverages in accordance with NRS 686C.153 and 686C.154 .
Nev. Rev. Stat. § 686C.153 Provision of substitute benefits and coverage with respect to covered policies or contracts.
1. When proceeding pursuant to paragraph (b) of subsection 2 of NRS 686C.152 , the Association shall:
(a) With respect to covered policies or contracts, ensure payment of benefits that would have been payable under the policies or contracts of the insolvent insurer, for claims incurred with respect to:
(1) A group policy or contract, not later than the earlier of the next renewal date under the policy or contract or 45 days, but in no event less than 30 days, after the date when the Association becomes obligated with respect to that policy or contract.
(2) A nongroup policy, contract or annuity, not later than the earlier of the next renewal date, if any, under the policy, contract or annuity or 1 year, but in no event less than 30 days, after the date when the Association becomes obligated with respect to that policy, contract or annuity.
(b) Make diligent efforts to provide all known insureds, policy or contract owners or enrollees with respect to group policies or contracts, or annuitants with respect to annuities, 30 days notice of termination of the benefits provided pursuant to paragraph (a).
(c) With respect to nongroup life insurance, health insurance or annuity policies or contracts, make available substitute coverage on an individual basis, in accordance with the provisions of subsection 2, to each known insured or annuitant, or owner if other than the insured, enrollee or annuitant, and to each natural person formerly insured, formerly an enrollee or formerly an annuitant, under a group policy or contract who is not eligible for replacement group coverage, if the insured, enrollee or annuitant had a right under law or the terminated policy, contract or annuity to convert coverage to individual coverage or to continue an individual policy, contract or annuity in force until a specified age or for a specified period, during which the member insurer had no right unilaterally to make changes in any provision of the policy, contract or annuity or had a right only to make changes in premium by class.
2. In providing the substitute coverage required under paragraph (c) of subsection 1, the Association may offer to reissue the terminated coverage or to issue an alternative policy or contract at actuarially justified rates without requiring evidence of insurability or a waiting period or exclusion that would not have applied under the terminated policy or contract and may reinsure any alternative or reinsured policy or contract.
Nev. Rev. Stat. § 686C.154 Alternative policies or contracts: Adoption; approval; contents; premium; coverage.
1. Alternative policies or contracts adopted by the Association are subject to the approval of the Commissioner. The Association may adopt alternative policies or contracts of various types for future issuance without regard to any particular impairment or insolvency.
2. An alternative policy or contract must contain at least the minimum statutory provisions required in this state and provide benefits that are not unreasonable in relation to the premium charged. The Association shall set the premium in accordance with a table of rates which it shall adopt. The premium must reflect the amount of insurance to be provided and the age and class of risk of each insured or enrollee, but must not reflect any changes in the health of the insured or enrollee after the original policy or contract was last underwritten.
3. An alternative policy or contract issued by the Association must provide coverage of a type similar to that of the policy or contract issued by the impaired or insolvent insurer, as determined by the Association.
4. If the Association elects to reissue terminated coverage at a rate of premium different from that charged under the terminated policy or contract, the premium must be set by the Association at an actuarially justified amount in accordance with the amount of insurance provided and the age and class of risk, subject to approval by the Commissioner pursuant to subsection 1.
Nev. Rev. Stat. § 686C.155 Ensuring of payment or credit of guaranteed minimum interest rate.
When proceeding pursuant to paragraph (b) of subsection 2 of NRS 686C.152 with respect to any policy or contract carrying guaranteed minimum interest rates, the Association shall ensure the payment or crediting of a rate of interest consistent with paragraph (c) of subsection 1 of NRS 686C.035.
Nev. Rev. Stat. § 686C.156 Issuance of substitute coverage for policy or contract that uses external reference for calculating returns or changes in value.
In carrying out its duties in connection with guaranteeing, assuming, reissuing or reinsuring a policy or contract under NRS 686C.150 and 686C.152, the Association may issue substitute coverage for a policy or contract that provides an interest rate, crediting rate or similar factor determined by use of an index or other external reference stated in the policy or contract employed in calculating returns or changes in value by issuing an alternative policy or contract if:
1. In lieu of the index or other external reference stated in the original policy or contract, the alternative policy or contract provides for a fixed interest rate, payment of dividends guaranteed as to minimum amount, or a different method of calculating interest or changes in value;
2. There is no requirement for evidence of insurability, waiting period or other exclusion that would not have applied under the replaced policy or contract; and
3. The alternative policy or contract is substantially similar to the replaced policy or contract in all other material terms.
Nev. Rev. Stat. § 686C.158 Payment of premiums; liability for unearned premiums.
Premiums due for coverage after entry of an order of liquidation of an insolvent insurer belong to and are payable at the direction of the Association, and the Association is liable for unearned premiums due to owners of policies or contracts arising after the entry of such an order.
Nev. Rev. Stat. § 686C.160 Imposition of restraints on insurers.
In carrying out its responsibilities under NRS 686C.152, the Association may, subject to approval by a court of this state:
1. Impose permanent liens on policies and contracts in connection with any guarantee, assumption or reinsurance if the Association finds that the amounts which can be assessed under this chapter are less than the amounts needed to ensure full and prompt performance of the Associations duties or that the economic or financial conditions as they affect member insurers are sufficiently adverse that the imposition of such permanent liens is in the public interest.
2. Impose temporary moratoriums or liens on payments of cash values and policy loans or any right to withdraw money held in conjunction with policies or contracts, in addition to any contractual provisions for deferral of paying cash value or lending against the policy or contract. In addition, in the event of a temporary moratorium or charge imposed by the court in the insolvent or impaired insurers state which has jurisdiction over the conservation, rehabilitation or liquidation of the insurer on such payment or lending, or on any other right to withdraw money held in conjunction with policies or contracts, the Association may defer such payment, lending or withdrawal for the period of the moratorium or charge, except for claims covered by the Association to be paid in accordance with a procedure for cases of hardship established by the liquidator or rehabilitator and approved by the court.
Nev. Rev. Stat. § 686C.170 Liability for guaranty provided by laws of another state or jurisdiction.
The Association is not liable under NRS 686C.152 where a guaranty is provided to residents of this state by the laws of the domiciliary state or jurisdiction of the impaired or insolvent insurer other than this state.
Nev. Rev. Stat. § 686C.175 Receipt and disposition of deposit held pursuant to law or required by Commissioner for benefit of creditors.
A deposit in this state, held pursuant to law or required by the Commissioner for the benefit of creditors, including, without limitation, policy or contract owners, certificate holders and enrollees, not turned over to the domiciliary receiver upon the entry of a final order of liquidation or order approving a plan of rehabilitation of a member insurer domiciled in this state or a reciprocal state pursuant to NRS 696B.290 or 696B.300 must be promptly paid to the Association. The Association is entitled to retain a portion of an amount so paid to it that is equal to the percentage determined by dividing the aggregate amount of claims by policy or contract owners, certificate holders and enrollees that are related to that insolvency for which the Association has provided statutory benefits by the aggregate amount of all claims by policy or contract owners, certificate holders and enrollees in this state related to that insolvency, and shall remit the remainder to the domiciliary receiver. The amount so remitted is a distribution of the assets of the member insurer for the purposes of chapter 696B of NRS.
Nev. Rev. Stat. § 686C.180 Provision of assistance to Commissioner.
The Association may render assistance and advice to the Commissioner upon request by the Commissioner, concerning rehabilitation, payment of claims, continuation of coverage or the performance of other contractual obligations of an impaired or insolvent insurer.
Nev. Rev. Stat. § 686C.190 Legal standing.
The Association has standing:
1. To appear or intervene before a court or agency in this state which has jurisdiction over an impaired or insolvent insurer concerning which the Association is or may become obligated under this chapter or over any person or property against whom or which the Association may have rights through subrogation or otherwise. Its standing extends to all matters germane to the powers and duties of the Association, including proposals for reinsuring, reissuing, modifying or guaranteeing the policies or contracts of the impaired or insolvent insurer and the determination of the policies or contracts and contractual obligations.
2. To appear or intervene before a court or agency in another state which has jurisdiction over an impaired or insolvent insurer for which the Association is or may become obligated, or over any person or property against whom or which the Association may have rights through subrogation or otherwise.
Nev. Rev. Stat. § 686C.200 Subrogation.
1. A person receiving benefits under this chapter shall be deemed to have assigned his or her rights under, and any causes of action against any person for losses arising under, resulting from or otherwise relating to, the covered policy or contract to the Association to the extent of the benefits received because of this chapter, whether the benefits are payments of or on account of contractual obligations, continuation of coverage or provision of substitute or alternative coverages. The Association may require an assignment to it of those rights and causes of action by any payee, policy or contract owner, certificate holder, enrollee, beneficiary, insured or annuitant as a condition precedent to the receipt of any rights or benefits conferred by this chapter upon that person.
2. The rights of the Association to subrogation under this subsection have the same priority against the assets of the impaired or insolvent insurer as that possessed by the person entitled to receive benefits under this chapter.
3. In addition to the rights provided under subsections 1 and 2, the Association has all rights of subrogation at common law and any other equitable or legal remedy which would have been available to the impaired or insolvent insurer or the owner, beneficiary or payee of a policy or contract, a certificate holder or an enrollee with respect to the policy or contract, including, in the case of a structured settlement annuity, any rights of the owner, beneficiary or payee of the annuity, to the extent of benefits received under this chapter, against a person originally or by succession responsible for the losses arising from the personal injury relating to the annuity or payment for it, except any such person responsible solely by reason of serving as an assignee under section 130 of the Internal Revenue Code, 26 U.S.C. § 130.
4. If the provisions of subsections 1, 2 and 3 are invalid or ineffective with respect to any person or any claim for any reason, the amount payable to the Association with respect to the related covered obligations is reduced by the amount realized by any other person with respect to the person or claim which is attributable to the policies or contracts or portions thereof covered by the Association.
5. If the Association has provided benefits with respect to a covered obligation and a person recovers amounts as to which the Association has rights under subsections 1 to 4, inclusive, the person shall pay to the Association the portion of the recovery attributable to the policies or contracts or portions thereof covered by the Association.
Nev. Rev. Stat. § 686C.210 Limitations on obligations.
1. The benefits that the Association may become obligated to cover may not exceed the lesser of:
(a) The contractual obligations for which the member insurer is liable or would have been liable if it were not an impaired or insolvent insurer;
(b) With respect to one life, regardless of the number of policies or contracts:
(1) Three hundred thousand dollars in death benefits from life insurance, but not more than $100,000 in net cash for surrender and withdrawal for life insurance; or
(2) Two hundred fifty thousand dollars in the present value of benefits from annuities, including net cash for surrender and withdrawal;
(c) With respect to health insurance for any one life:
(1) One hundred thousand dollars for coverages other than disability income insurance, health benefit plans or long-term care insurance, including any net cash for surrender or withdrawal;
(2) Three hundred thousand dollars for disability income insurance or long-term care insurance; or
(3) Five hundred thousand dollars for health benefit plans;
(d) With respect to each payee of a structured settlement annuity, or beneficiary or beneficiaries of the payee if deceased, $250,000 in present value of benefits from the annuity in the aggregate, including any net cash for surrender or withdrawal; or
(e) With respect to each participant in a governmental retirement plan covered by an unallocated annuity contract which is owned by a governmental retirement plan established under section 401, 403(b) or 457 of the Internal Revenue Code, 26 U.S.C. §§ 401, 403(b) and 457, respectively, or the trustees of such a plan, and which is approved by the Commissioner, an aggregate of $250,000 in present-value annuity benefits, including the value of net cash for surrender and net cash for withdrawal, regardless of the number of contracts.
2. In no event is the Association obligated to cover more than:
(a) With respect to any one life or person under paragraphs (b) to (e), inclusive, of subsection 1:
(1) An aggregate of $300,000 in benefits, excluding benefits for health benefit plans; or
(2) An aggregate of $500,000 in benefits, including benefits for health benefit plans.
(b) With respect to one owner of several nongroup policies of life insurance, whether the owner is a natural person or an organization and whether the persons insured are officers, managers, employees or other persons, more than $5,000,000 in benefits, regardless of the number of policies and contracts held by the owner.
3. The limitations set forth in this section are limitations on the benefits for which the Association is obligated before taking into account its rights to subrogation or assignment or the extent to which those benefits could be provided out of the assets of the impaired or insolvent insurer attributable to covered policies or contracts. The cost of the Associations obligations under this chapter may be met by the use of assets attributable to covered policies or contracts, or reimbursed to the Association pursuant to its rights to subrogation or assignment.
4. In performing its obligation to provide coverage under NRS 686C.150 and 686C.152 , the Association need not guarantee, assume, reinsure, reissue or perform, or cause to be guaranteed, assumed, reinsured, reissued or performed, the contractual obligations of the impaired or insolvent insurer under a covered policy or contract which do not materially affect the economic value or economic benefits of the covered policy or contract.
5. As used in this section, health benefit plan has the meaning ascribed to it in NRS 687B.470 .
Nev. Rev. Stat. § 686C.220 General powers.
The Association may:
1. Enter into such contracts as are necessary or proper to carry out the provisions and purposes of this chapter.
2. Sue or be sued, including the taking of any legal action necessary or proper for recovery of any unpaid assessments under NRS 686C.230 or to settle claims or potential claims against it.
3. Borrow money to effect the purposes of this chapter. Any notes or other evidence of indebtedness of the Association not in default are legal investments for domestic insurers and may be carried as admitted assets.
4. Employ or retain such persons as are necessary or appropriate to handle the financial transactions of the Association, and to perform such other functions as become necessary or proper under this chapter.
5. Take such legal action as may be necessary or appropriate to avoid or recover payment of improper claims.
6. Exercise, for the purposes of this chapter and to the extent approved by the Commissioner, the powers of a domestic life or health insurer or health maintenance organization, but in no case may the Association issue insurance policies or annuities other than those issued to perform its contractual obligations under this chapter.
7. Join an organization of one or more other state associations having similar purposes, to further the purposes and administer the powers and duties of the Association.
8. Organize itself as a corporation or in other legal form permitted by the laws of this state.
9. Request information from a person seeking coverage from the Association to aid the Association in determining its obligations under this chapter with respect to the person, and the person shall promptly comply with the request.
10. Except where otherwise provided by law, in accordance with the terms and conditions of the applicable policy or contract, file for actuarially justified rate or premium increases for any policy for which the Association provides coverage under the provisions of this chapter.
11. Take other necessary or appropriate action to perform its duties and discharge its obligations under this chapter or to exercise its power under this chapter.
Nev. Rev. Stat. § 686C.221 Determination of means to provide benefits; limitation on entitlement to benefits.
1. The Board of Directors of the Association may exercise reasonable business judgment to determine the means by which the Association is to provide the benefits of this chapter in an economical and efficient manner.
2. Where the Association has arranged or offered to provide the benefits of this chapter to a covered person under a plan or arrangement that satisfies the obligations of the Association under this chapter, the covered person is not entitled to benefits from the Association in addition to or other than those provided under the plan or arrangement.
Nev. Rev. Stat. § 686C.222 Requests for information from member insurers.
The Association may request information from member insurers to aid in the exercise of its powers under this chapter, and each member shall promptly comply with such a request.
Nev. Rev. Stat. § 686C.223 Election to succeed to rights and obligations of member insurer; transfer of obligations to another insurer.
1. As used in this section, coverage date means the date on which the Association becomes liable for the obligations of a member insurer.
2. At any time after the coverage date, the Association may elect to succeed to the rights and obligations of the member insurer which accrue on or after the coverage date and relate to policies or contracts covered, in whole or in part, by the Association under any one or more agreements for indemnity reinsurance entered into by the member insurer as ceding insurer and selected by the Association. However, the Association may not exercise its right of election with respect to an agreement for reinsurance if the receiver, rehabilitator or liquidator of the member insurer has previously expressly disaffirmed the agreement. The election must be effected by a notice to the receiver, rehabilitator or liquidator and the affected reinsurers. If the Association makes such an election:
(a) The Association is responsible for all unpaid premiums due under each agreement for periods both before and after the coverage date, and for the performance of all other obligations to be performed after the coverage date, in each case which relates to a policy or contract covered in whole or in part by the Association. The Association may charge a policy or contract covered in part by it, through reasonable methods of allocation, for the costs of reinsurance in excess of the obligations of the Association.
(b) The Association is entitled to any amount payable by the reinsurer under each agreement with respect to losses or events that occur in periods after the coverage date and relate to policies or contracts covered in whole or in part by the Association, but upon receipt of any such amount, the Association is obligated to pay, to the beneficiary under the policy or contract on account of which the amount was paid, that portion of the amount received by the Association that exceeds the benefits paid by the Association on account of the policy or contract less the retention by the impaired or insolvent insurer applicable to the loss or event.
(c) The Association and each reinsurer shall, within 30 days after the election, calculate the net balance due to or from the Association under each agreement as of the date of the election, giving full credit for all items paid by the member insurer or its receiver, rehabilitator or liquidator, or the reinsurer, between the coverage date and the date of the election. The Association or the reinsurer shall pay the net balance within 5 days after the completion of the calculation. If a receiver, rehabilitator or liquidator has received any amount due the Association pursuant to paragraph (b), the recipient shall remit the amount to the Association as promptly as practicable.
(d) The reinsurer may not terminate an agreement for reinsurance insofar as it relates to policies or contracts covered by the Association in whole or in part, or set off any unpaid premium due for a period before the coverage date against the amount due the Association, if the Association, within 60 days after the election, pays the premiums due for periods both before and after the coverage date which relate to such policies or contracts.
3. If the Association transfers its obligation to another insurer, and the Association and the other insurer so agree, the other insurer succeeds to the rights and obligations of the Association under subsection 2 effective as of the agreed date, whether or not the Association has made the election described in subsection 2, except that:
(a) An agreement for indemnity reinsurance automatically terminates as to new reinsurance unless the reinsurer and the other insurer agree to the contrary;
(b) The obligation of the Association to the beneficiary under paragraph (b) of subsection 2 ceases on the date of the transfer to the other insurer; and
(c) This subsection does not apply if the Association has previously expressly determined in writing that it will not exercise its right of election under subsection 2.
4. The provisions of this section supersede an affected agreement for reinsurance which provides for or requires payment of proceeds of reinsurance, on account of a loss or event that occurs after the coverage date, to the receiver, rehabilitator or liquidator of the insolvent insurer. The receiver, rehabilitator or liquidator remains entitled to any amounts payable by the reinsurer under the agreement with respect to losses or events that occur before the coverage date, subject to any applicable setoff.
5. Except as otherwise expressly provided, this section does not alter or modify the terms or conditions of any agreement of the insolvent insurer for reinsurance, abrogate or limit any right of a reinsurer to rescind an agreement for reinsurance, or give an owner or beneficiary of a policy or contract an independent cause of action against a reinsurer under an agreement for indemnity reinsurance that is not otherwise set forth in the agreement.
Nev. Rev. Stat. § 686C.224 Assumption of reinsurance contracts: Authority; duties and responsibilities of ceding member insurers and Association.
1. At any time within 180 days after the date of an order of liquidation, the Association may elect to succeed to the rights and obligations of the ceding member insurer that relate to policies or contracts covered, in whole or in part, by the Association, in each case under any one or more reinsurance contracts entered into by the insolvent insurer and its reinsurers and selected by the Association. Any such assumption must be effective on the date of the order of liquidation. The election must be carried out by the Association sending written notice, return receipt requested, to the affected reinsurers.
2. To facilitate the earliest practicable decision about whether to assume any of the contracts of reinsurance, and to protect the financial position of the estate, the receiver and each reinsurer of the ceding member insurer shall make available upon request to the Association as soon as possible after commencement of formal delinquency proceedings:
(a) Copies of in-force contracts of reinsurance and all related files and records relevant to the determination of whether such contracts should be assumed; and
(b) Notices of any defaults under the reinsurance contracts or any known event or condition which with the passage of time could become a default under the reinsurance contracts.
3. The following apply to reinsurance contracts assumed by the Association:
(a) The Association is responsible for all unpaid premiums due pursuant to the reinsurance contracts for periods both before and after the date of the order of liquidation, and is responsible for the performance of all other obligations to be performed after the date of the order of liquidation, in each case which relates to policies or contracts covered, in whole or in part, by the Association. The Association may charge policies or contracts covered in part by the Association, through reasonable allocation methods, the costs for reinsurance in excess of the obligations of the Association and shall provide notice and an accounting of these changes to the liquidator.
(b) The Association may be entitled to any amounts payable by the reinsurer pursuant to the reinsurance contracts with respect to losses or events that occur in periods after the date of the order of liquidation and which relate to policies or contracts covered, in whole or in part, by the Association, provided that, upon receipt of any such amounts, the Association is obligated to pay to the beneficiary, under the policy or contract on account of which the amounts were paid, a portion of the amount equal to the lesser of:
(1) The amount received by the Association; or
(2) The excess of the amount received by the Association over the amount equal to the benefits paid by the Association on account of the policy or contract, less the retention of the member insurer applicable to the loss or event.
(c) Within 30 days after the Associations election, the Association and each reinsurer under the contracts assumed by the Association shall calculate the net balance due to or from the Association pursuant to each reinsurance contract on the election date with respect to policies or contracts covered, in whole or in part, by the Association, which calculation must give full credit to all items paid by either the member insurer or its receiver or the reinsurer before the election date. The reinsurer shall pay the receiver any amounts due for losses or events before the date of the order of liquidation, subject to any set-off for premiums unpaid for periods before the date, and the Association or reinsurer shall pay any remaining balance due to the other, in each case within 5 days after the completion of the aforementioned calculation. Any disputes over the amounts due to either the Association or the reinsurer must be resolved by arbitration pursuant to the terms of the affected reinsurance contracts or, if the contracts contain no arbitration clause, as otherwise prescribed by law. If the receiver has received any amounts due to the Association under paragraph (d), the receiver shall remit the same to the Association as promptly as practicable.
(d) If the Association or receiver, on the Associations behalf, within 60 days after the election date, pays the unpaid premiums due for periods both before and after the election date that relate to policies or contracts covered, in whole or in part, by the Association, the reinsurer is not entitled to terminate the reinsurance contracts for failure to pay premiums insofar as the reinsurance contracts relate to policies or contracts covered, in whole or in part, by the Association, and is not entitled to set off any unpaid amounts due pursuant to the other contracts, or unpaid amounts due from parties other than the Association, against amounts due to the Association.
Nev. Rev. Stat. § 686C.225 Termination of obligations: Replacement of coverage under policy or contract.
The Associations obligations with respect to coverage under any policy or contract of the impaired or insolvent insurer or under any reissued or alternative policy or contract ceases on the date the policy or contract is replaced by another similar policy or contract by the policy or contract owner, certificate holder or enrollee or the Association.
Nev. Rev. Stat. § 686C.226 Termination of obligations: Failure to pay premiums.
Failure to pay premiums within 31 days after the date required pursuant to the terms of any guaranteed, assumed, alternative or reissued policy or contract or substitute coverage terminates the Associations obligations under the policy, contract or coverage, except with respect to any claims incurred or any net cash surrender value which may be due in accordance with the provisions of this chapter.
Nev. Rev. Stat. § 686C.230 Imposition; classes.
1. To provide the money necessary to carry out the powers and duties of the Association, the Board of Directors shall assess the member insurers, separately for each account, at such times and for such amounts as the Board finds necessary. An assessment is due upon at least 30 days written notice to the member insurer and accrues interest after it is due at the rate provided in NRS 99.040 .
2. There are two classes of assessments, as follows:
(a) Assessments in Class A must be authorized and called for the purpose of meeting administrative and legal costs and other expenses. An assessment in Class A need not be related to a particular impaired or insolvent insurer.
(b) Assessments in Class B must be authorized and called to the extent necessary to carry out the powers and duties of the Association under NRS 686C.150 to 686C.220 , inclusive, with regard to an impaired or insolvent insurer.
Nev. Rev. Stat. § 686C.240 Computation; necessity; notification.
1. The Board of Directors of the Association shall determine the amount of each assessment in Class A and may, but need not, prorate it. If an assessment is prorated, the Board may provide that any surplus be credited against future assessments in Class B. An assessment which is not prorated must not exceed $500 for each member insurer for any 1 calendar year.
2. The Board may determine the amount of each assessment in Class B for long-term care insurance written by an impaired or insolvent insurer according to a methodology included in the plan of operation established and approved pursuant to NRS 686C.290 . The methodology must provide for the imposition of:
(a) One-half of the assessment on member insurers that primarily provide accident and health insurance; and
(b) One-half of the assessment on member insurers that primarily provide life insurance and annuities.
3. Except as otherwise provided in subsection 5, the Board may allocate any assessment in Class B among the accounts and among the subaccounts of the Life and Annuity Account according to a formula based on the premiums or reserves of the impaired or insolvent insurer or any other standard which the Board, in its sole discretion, considers fair and reasonable under the circumstances.
4. Except as otherwise provided in subsection 5, assessments in Class B against member insurers for each account and subaccount must be in the proportion that the premiums received on business in this State by each assessed member insurer on policies or contracts covered by each account or subaccount for the 3 most recent calendar years for which information is available preceding the year in which the insurer became impaired or insolvent bears to premiums received on business in this State for those calendar years by all assessed member insurers.
5. The Board shall allocate to:
(a) The Life and Annuity Account the percentage of an assessment in Class B for long-term care insurance written by an impaired or insolvent insurer that is equal to the quotient of:
(1) The difference between 0.5 and the percentage of the Health Account that was contributed by member insurers that primarily provide life insurance and annuities; and
(2) The difference between the percentage of the Life and Annuity Account that was contributed by member insurers that primarily provide life insurance and annuities and the percentage of the Health Account that was contributed by such member insurers.
(b) The Health Account the remainder of an assessment in Class B for long-term care insurance written by an impaired or insolvent insurer that is not allocated to the Life and Annuity Account pursuant to paragraph (a).
6. Assessments for money to meet the requirements of the Association with respect to an impaired or insolvent insurer must not be authorized or called until necessary to carry out the purposes of this chapter. Classification of assessments under subsection 2 of NRS 686C.230 and computation of assessments under this section must be made with a reasonable degree of accuracy, recognizing that exact determinations may not always be possible. The Association shall notify each member insurer of its anticipated prorated share of an assessment authorized but not yet called within 180 days after it is authorized.
7. For the purposes of this section, a member insurer shall be deemed to:
(a) Primarily provide life insurance and annuities if the sum of the accessible in-state life insurance premiums and annuity premiums of the member insurer is equal to or greater than the accessible in-state health insurance premiums of the member insurer. For the purposes of this paragraph, health insurance premiums:
(1) Include, without limitation, premiums for health maintenance organization coverage; and
(2) Do not include premiums for disability income and long-term care insurance.
(b) Primarily provide health insurance if the member insurer is not a member insurer described in paragraph (a).
Nev. Rev. Stat. § 686C.250 Abatement or deferment; maximum amount; effect of insufficiency; allocation of funds among claims.
1. The Association may abate or defer, in whole or in part, the assessment of a member insurer if, in the opinion of the Board of Directors, payment of the assessment would endanger the ability of the member insurer to fulfill its contractual obligations. If an assessment against a member insurer is abated or deferred in whole or in part, the amount by which that assessment is abated or deferred may be assessed against the other member insurers in a manner consistent with the basis for assessments set forth in this section. As soon as the conditions that caused a deferral have been removed or rectified, the member insurer shall pay all assessments that were deferred pursuant to a plan of repayment approved by the Association.
2. Except as otherwise provided in subsection 3, the total of all assessments authorized by the Association with respect to a member insurer for:
(a) The Life and Annuity Account and each of its subaccounts; and
(b) The Health Account,
Ê respectively must not in any 1 calendar year exceed 2 percent of the member insurers average annual premiums received in this state on the policies and contracts covered by the subaccount or account during the 3 calendar years preceding the year in which the member insurer became impaired or insolvent.
3. If two or more assessments are authorized in 1 calendar year with respect to member insurers that became impaired or insolvent in different calendar years, the average annual premiums received for the purposes of the limitation provided in subsection 2 are equal and limited to the higher of the 3-year annual premiums for the applicable account or subaccount as calculated pursuant to this section.
4. If the maximum assessment, together with the other assets of the Association in an account, does not provide in any 1 year in either account an amount sufficient to carry out the responsibilities of the Association, the necessary additional money must be assessed as soon thereafter as permitted by this chapter.
5. If the maximum assessment for a subaccount of the Life and Annuity Account in any 1 year does not provide an amount sufficient to carry out the responsibilities of the Association, then pursuant to subsection 4 of NRS 686C.240 , the Board shall assess the other subaccount for the necessary additional amount, subject to the maximum stated in subsection 2.
6. The Board may provide in the plan of operation a method of allocating funds among claims, whether relating to one or more impaired or insolvent insurers, when the maximum assessment is insufficient to cover anticipated claims.
Nev. Rev. Stat. § 686C.260 Refund to member insurers.
The Board of Directors may, by an equitable method as established in the plan of operation, refund to member insurers, in proportion to the contribution of each member insurer to that account, the amount by which the assets of the account exceed the amount the Board finds is necessary to carry out during the coming year the obligations of the Association with regard to that account, including assets accruing from assignment, subrogation, net realized gains and income from investments. A reasonable amount may be retained in any account to provide funds for the continuing expenses of the Association and for future claims.
Nev. Rev. Stat. § 686C.270 Rates and dividends may reflect assessments.
It is proper for any member insurer, in determining its rates of premium and dividends to owners of policies or contracts as to any kind of insurance or coverage offered by a health maintenance organization within the scope of this chapter, to consider the amount reasonably necessary to meet its obligations for assessment under this chapter.
Nev. Rev. Stat. § 686C.280 Issuance, effect and use of certificate of contribution; offset against liability for premium tax; recoupment of assessments; payment and deposit of refund.
1. The Association shall issue to each member insurer paying an assessment under this chapter, other than an assessment in Class A, a certificate of contribution, in a form prescribed by the Commissioner, for the amount of the assessment so paid. All outstanding certificates are of equal dignity and priority without reference to amounts or dates of issue. A member insurer may show a certificate of contribution as an asset in its financial statement in such form, for such amount, if any, and for such period as the Commissioner may approve.
2. A member insurer may offset against its liability for premium tax to this state, accrued with respect to business transacted in a calendar year, an amount equal to 20 percent of the amount certified pursuant to subsection 1 in each of the 5 calendar years following the year in which the assessment was paid. If a member insurer ceases to transact business, it may offset all uncredited assessments against its liability for premium tax for the year in which it so ceases.
3. A member insurer that is exempt from its liability for premium tax described in subsection 2 may recoup its assessments under this chapter by imposing a surcharge on its premiums in an amount approved by the Commissioner. The Commissioner shall approve such a surcharge upon determining that the amount of the surcharge is reasonably calculated to recoup the assessments over a reasonable period of time. Any amount recouped under this subsection shall not be deemed to constitute a premium for any purpose relating to this Code.
4. If a member insurer recoups a larger amount through a surcharge imposed pursuant to subsection 3 than it paid in assessments over a period of time prescribed in the plan of operation established and approved pursuant to NRS 686C.290 , the member insurer shall remit the excess amount to the Association. The Association shall apply such excess amounts to reduce future assessments in the appropriate account in accordance with the plan of operation.
5. Any sum acquired by refund from the Association pursuant to NRS 686C.260 which previously had been written off by the contributing member insurer and offset against premium taxes as provided in subsection 2 must be paid to the Department of Taxation and deposited by it with the State Treasurer for credit to the State General Fund. The Association shall notify the Commissioner and the Department of Taxation of each refund made.
Nev. Rev. Stat. § 686C.285 Protest by member insurer: Procedure.
1. A member insurer that wishes to protest all or part of an assessment shall pay the full amount of the assessment when due, as set forth in the notice from the Association. The payment may be used to meet obligations of the Association during the pendency of the assessment and any subsequent appeal. Payment must be accompanied by a statement in writing that the payment is made under protest and setting forth briefly the grounds for the protest.
2. Within 60 days after the payment of an assessment under protest, the Association shall notify the member insurer in writing of the determination of the Association with respect to the protest, unless the Association notifies the member insurer that additional time is required to resolve the issues raised by the protest.
3. Within 30 days after a final decision is made, the Association shall notify the protesting member insurer in writing of the final decision. Within 60 days after receipt of that notice, the protesting member insurer may appeal the decision to the Commissioner.
4. As an alternative to making a final decision with respect to a protest concerning the basis of assessment, the Association may refer the protest to the Commissioner for a final decision, with or without a recommendation from the Association.
5. If a protest or appeal is upheld, the amount paid in error or excess must be returned to the member insurer. Interest must be paid on the refund at the rate actually earned by the Association.
Nev. Rev. Stat. § 686C.290 Plan of operation: Submission; amendments; approval by Commissioner; compliance; contents; delegation of duties or powers.
1. The Association shall submit to the Commissioner a plan of operation and any amendments thereto necessary or suitable to ensure the fair, reasonable and equitable administration of the Association. The plan of operation and any amendments thereto become effective upon approval in writing by the Commissioner, or 30 days after submission if the Commissioner has not disapproved them. All member insurers shall comply with the plan of operation.
2. If at any time the Association fails to submit suitable amendments to the plan, the Commissioner shall adopt, after notice and hearing, such reasonable regulations as are necessary or advisable to effectuate the provisions of this chapter. The regulations continue in force until modified by the Commissioner or superseded by a plan submitted by the Association and approved by the Commissioner.
3. In addition to satisfying the other requirements of this chapter, the plan of operation must:
(a) Establish procedures for handling the assets of the Association.
(b) Establish the amount and method of reimbursing members of the Board of Directors under NRS 686C.140 .
(c) Establish regular places and times for meetings of the Board.
(d) Establish procedures for records to be kept of all financial transactions of the Association, its agents and the Board.
(e) Establish the procedures whereby selections for the Board will be made and submitted to the Commissioner.
(f) Establish the methodology required by subsection 2 of NRS 686C.240 and any additional procedures for assessments under NRS 686C.230 to 686C.270 , inclusive.
(g) Establish the period of time over which a member insurer must determine whether the member insurer has recouped an excess amount pursuant to subsection 4 of NRS 686C.280 , the manner in which the member insurer must remit any excess amount to the Association and the manner in which the Association must apply any such excess amount to reduce future assessments.
(h) Contain additional provisions necessary or proper for the execution of the powers and duties of the Association.
4. The plan of operation may provide that any or all powers and duties of the Association, except those under subsection 3 of NRS 686C.220 and NRS 686C.230 to 686C.285 , inclusive, are delegated to a corporation, Association or other organization which performs or will perform functions similar to those of this Association, or its equivalent, in two or more states. Such an organization must be reimbursed for any payments made on behalf of the Association and paid for its performance of any function of the Association. A delegation under this subsection takes effect only with the approval of the Board of Directors and the Commissioner, and may be made only to an organization that extends protection not substantially less favorable and effective than that provided by this chapter.
Nev. Rev. Stat. § 686C.300 Additional powers and duties of Commissioner; suspension or revocation of certificate of authority or levy of forfeiture; appeals to Commissioner; judicial review; notification of effect of chapter.
1. In addition to the duties and powers otherwise provided in this chapter, the Commissioner:
(a) Shall, upon request of the Board of Directors, provide the Association with a statement of the premiums in this and any other appropriate states for each member insurer.
(b) Shall, when an impairment is declared and the amount of the impairment is determined, serve a demand upon the impaired insurer to make good the impairment within a reasonable time. Notice to the insurer is notice to its stockholders, if any. The failure of the insurer to comply with such demand promptly does not excuse the Association from the performance of its powers and duties under this chapter.
(c) Must, in any liquidation or rehabilitation involving a domestic member insurer, be appointed as the liquidator or rehabilitator.
2. The Commissioner may suspend or revoke, after notice and hearing, the certificate of authority to transact insurance or operate a health maintenance organization in this state, as applicable, of any member insurer which fails to pay an assessment when due or fails to comply with the plan of operation. As an alternative, the Commissioner may levy a forfeiture on any member insurer which fails to pay an assessment when due. The forfeiture may not exceed 5 percent of the unpaid assessment per month, but no forfeiture may be less than $100 per month.
3. A final action of the Board of Directors or the Association may be appealed to the Commissioner by any member insurer if the appeal is taken within 60 days after the insurer receives notice of the final action. A final action or order of the Commissioner is subject to judicial review in a court of competent jurisdiction pursuant to the procedure provided in chapter 233B of NRS for contested cases.
4. The liquidator, rehabilitator or conservator of any impaired insurer may notify all interested persons of the effect of this chapter.
Nev. Rev. Stat. § 686C.303 Action by Commissioner upon failure to act by Association.
If the Association fails to act within a reasonable time with respect to an insolvent insurer, as provided in NRS 686C.150 to 686C.155, inclusive, the Commissioner may exercise the powers and perform the duties of the Association under this chapter with respect to the insolvent insurer.
Nev. Rev. Stat. § 686C.306 Notice to other insurance commissioners of certain actions by Commissioner; reports by Commissioner of certain information to Board of Directors.
1. The Commissioner shall notify the commissioners of insurance of all the other states within 30 days after the Commissioner takes any of the following actions against a member insurer:
(a) Revokes a member insurers license;
(b) Suspends a member insurers license; or
(c) Makes any formal order that a member insurer is to restrict its premium writing, obtain additional contributions to surplus, withdraw from the state, reinsure all or any part of its business, or increase capital, surplus, or any other account for the security of the owners of its policies or contracts or its creditors.
2. The Commissioner shall report to the Board of Directors when the Commissioner has taken any of the actions set forth in subsection 1, or has received a report from any other commissioner indicating that any such action has been taken in another state. The report to the Board must contain all significant details of the action taken or the report received from another commissioner.
3. The Commissioner shall report to the Board of Directors when the Commissioner has reasonable cause to believe from an examination of a member insurer, whether completed or in process, that the insurer may be impaired or insolvent.
4. The Commissioner shall furnish to the Board the ratios of the Insurance Regulatory Information System developed by the National Association of Insurance Commissioners and listings of companies not included in those ratios, and the Board may use the information contained therein in carrying out its duties and responsibilities under this chapter. Such reports and the information contained therein must be kept confidential by the Board until such time as made public by the Commissioner or other lawful authority.
Nev. Rev. Stat. § 686C.310 Provision of information and advice by Board of Directors relating to financial condition of insurers.
1. The Board of Directors may, upon majority vote, notify the Commissioner of any information indicating any member insurer may be impaired or insolvent.
2. The Board may, upon majority vote, make reports and recommendations to the Commissioner upon any matter germane to the solvency, liquidation, rehabilitation or conservation of any member insurer or germane to the solvency of any person seeking admission to transact insurance or operate a health maintenance organization in this state. These reports and recommendations are not open to public inspection.
3. The Commissioner may seek the advice and recommendations of the Board concerning any matter affecting the duties and responsibilities of the Commissioner regarding the financial condition of member insurers and of persons seeking admission to transact insurance or operate a health maintenance organization in this state.
4. The Board may, upon majority vote, make recommendations to the Commissioner for the detection and prevention of the insolvency of member insurers.
Nev. Rev. Stat. § 686C.330 Impaired or insolvent insurers: Liability for unpaid assessments of insureds; maintenance and disclosure of records of Association; status of Association as creditor; distribution of ownership by court.
1. This chapter does not reduce the liability for unpaid assessments of the insureds of an impaired insurer operating under a plan with liability for assessments.
2. Records must be kept of all meetings of the Board of Directors to discuss the activities of the Association in carrying out its powers and duties under NRS 686C.150 to 686C.220 , inclusive. The records of the Association with respect to an impaired or insolvent insurer may not be disclosed before the termination of a proceeding for liquidation, rehabilitation or conservation involving the impaired or insolvent insurer or the termination of the impairment or insolvency of the insurer, except upon the order of a court of competent jurisdiction. This subsection does not limit the duty of the Association to render a report of its activities under NRS 686C.350 .
3. For the purpose of carrying out its obligations under this chapter, the Association shall be deemed to be a creditor of the impaired or insolvent insurer to the extent of assets attributable to covered policies reduced by any amounts to which the Association is entitled as subrogee pursuant to NRS 686C.200 . Assets of the impaired or insolvent insurer attributable to covered policies or contracts must be used to continue all covered policies and contracts and pay all contractual obligations of the impaired or insolvent insurer as required by this chapter. Assets attributable to covered policies or contracts, as used in this subsection, are that proportion of the assets which the reserves that should have been established for covered policies or contracts bear to the reserves that should have been established for all policies or contracts written by the impaired or insolvent insurer.
4. As a creditor of the impaired or insolvent insurer under subsection 3 and consistent with NRS 696B.415 , the Association and other similar associations are entitled to receive a disbursement out of the marshaled assets, from time to time as the assets become available to reimburse it, as a credit against contractual obligations under this chapter. If the liquidator has not, within 120 days after a final determination of insolvency of a member insurer by the court in the insolvent or impaired insurers state which has jurisdiction over the conservation, rehabilitation or liquidation of the member insurer, made an application to the court for the approval of a proposal to disburse assets out of marshaled assets to guaranty associations having obligations because of the insolvency, the Association is entitled to make application to the court for approval of its own proposal to disburse those assets.
5. Before the termination of any proceeding for liquidation, rehabilitation or conservation, the court may take into consideration the contributions of the respective parties, including the Association, the shareholders, policy or contract owners, certificate holders and enrollees of the impaired or insolvent insurer, and any other party with a bona fide interest, in making an equitable distribution of the ownership of the impaired or insolvent insurer. In making such a determination, consideration must be given to the welfare of the policy or contract owners, certificate holders and enrollees of the continuing or successor insurer. No distribution to stockholders, if any, of an impaired or insolvent insurer may be made until the total amount of valid claims of the Association, with interest thereon, for money expended in exercising its powers and performing its duties under NRS 686C.150 to 686C.155 , inclusive, with respect to that insurer have been fully recovered by the Association.
Nev. Rev. Stat. § 686C.333 Recovery of distributions made before petition for liquidation or rehabilitation of insurer.
1. If an order for liquidation or rehabilitation of a member insurer domiciled in this state has been entered, the receiver appointed under such order is entitled to recover on behalf of the member insurer, from any affiliate that controlled it, the amount of distributions, other than stock dividends paid by the member insurer on its capital stock, made at any time during the 5 years preceding the petition for liquidation or rehabilitation, subject to the limitations of subsections 2, 3 and 4.
2. No distribution is recoverable if the member insurer shows that when paid the distribution was lawful and reasonable, and that the member insurer did not know and could not reasonably have known that the distribution might adversely affect the ability of the member insurer to fulfill its contractual obligations.
3. Any person who was an affiliate that controlled the member insurer at the time the distributions were paid is liable up to the amount of distributions the person received. Any person who was an affiliate that controlled the member insurer at the time the distributions were declared, is liable up to the amount of distributions the person would have received if they had been paid immediately. If two or more persons are liable with respect to the same distributions, they are jointly and severally liable.
4. The maximum amount recoverable pursuant to this subsection is the amount needed in excess of all other available assets of the impaired or insolvent insurer to pay the contractual obligations of the impaired or insolvent insurer.
5. If any person liable under subsection 3 is insolvent, all its affiliates that controlled it at the time the dividend was paid are jointly and severally liable for any resulting deficiency in the amount recovered from the insolvent affiliate.
Nev. Rev. Stat. § 686C.340 Impaired or insolvent insurers: Stay of proceedings; reopening of default judgments.
All proceedings in which the impaired or insolvent insurer is a party in any court in this state must be stayed for 60 days from the date an order of liquidation, rehabilitation or conservation is final to permit proper legal action by the Association on any matters germane to its powers or duties. If a judgment has been entered under any decision, order, verdict or finding based on default, the Association may apply to have the judgment set aside by the same court that entered the judgment and is entitled to defend against the suit on the merits.
Nev. Rev. Stat. § 686C.350 Examination and regulation of Association by Commissioner; annual financial report.
The Association is subject to examination and regulation by the Commissioner. The Board of Directors shall submit to the Commissioner, not later than 120 days after the end of its fiscal year, a financial report in a form approved by the Commissioner and a report of its activities during the preceding fiscal year. Upon the request of a member insurer, the Association shall provide the insurer with a copy of the report.
Nev. Rev. Stat. § 686C.360 Exemption of Association from payment of fees and taxes; exceptions.
The Association is exempt from payment of all fees and all taxes levied by this state or any of its political subdivisions, except taxes on property and the commerce tax imposed pursuant to chapter 363C of NRS.
Nev. Rev. Stat. § 686C.370 Immunity from liability.
There is no liability on the part of and no cause of action of any nature arises against any member insurer or its agents or employees, the Association or its agents or employees, members of the Board or the Commissioner or the representatives of the Commissioner for any act or omission by them in the performance of their powers and duties under this chapter. This immunity extends to participation in any organization of other state associations whose purposes are similar, and to any such organization and its agents or employees.
Nev. Rev. Stat. § 686C.380 Actions arising under chapter: Venue; appeal bond not required of Association.
Venue in an action against the Association arising under this chapter lies in Washoe County. No appeal bond may be required of the Association in an appeal that relates to a cause of action arising under this chapter.
Nev. Rev. Stat. § 686C.390 Unlawful advertisement using existence of Association for sale, solicitation or inducement to purchase; exception.
It is unlawful for a member insurer, agent or affiliate of a member insurer, or other person to make, publish, circulate or place before the public, or cause any other person to do so, in any publication, notice, circular, letter or poster, or over any radio or television station, any advertisement or statement, written or oral, which uses the existence of the Association for the sale, solicitation or inducement to purchase any form of insurance or coverage offered by a health maintenance organization that is covered by the Association. This section does not apply to the Association or any other person that does not sell or solicit insurance or coverage offered by a health maintenance organization.
Nev. Rev. Stat. § 686C.2241 Assumption of reinsurance contracts: Suspension of rights and obligations for period after order of liquidation.
1. During the period after the date of an order of liquidation until the election date, or, if the election date does not occur, until 180 days after the date of the order of liquidation:
(a) Neither the Association nor the reinsurer shall have any rights or obligations under reinsurance contracts that the Association has the right to assume under NRS 686C.224 , whether for periods before or after the date of the order of liquidation.
(b) The reinsurer, the receiver and the Association shall, to the extent practicable, provide each other data and records as reasonably requested.
2. Once the Association has elected to assume a reinsurance contract, the parties rights and obligations are governed by the provisions of NRS 686C.224 .
Nev. Rev. Stat. § 686C.2243 Assumption of reinsurance contracts: Contracts not assumed by Association.
If the Association does not elect to assume a reinsurance contract by the election date under NRS 686C.224, the Association has no rights or obligations, in each case for periods both before and after the date of the order of liquidation, with respect to the reinsurance contract.
Nev. Rev. Stat. § 686C.2245 Assumption of reinsurance contracts: Transfer of contracts by Association.
When policies or contracts, or covered obligations with respect thereto, are transferred to an assuming insurer, reinsurance on the policies or contracts may also be transferred by the Association, in the case of policies or contracts assumed under NRS 686C.224, subject to the following:
1. Unless the reinsurer and the assuming insurer agree otherwise, the reinsurance contract transferred must not cover any new policies or contracts in addition to those transferred.
2. The obligations described in NRS 686C.224 no longer apply with respect to matters arising after the effective date of the transfer.
3. Notice must be given in writing, return receipt requested, by the transferring party to the affected reinsurer not less than 30 days before the effective date of the transfer.
Nev. Rev. Stat. § 686C.2247 Assumption of reinsurance contracts: Applicability of other provisions.
The provisions of NRS 686C.224 to 686C.2249, inclusive, supersede the provisions of any state law or of any affected reinsurance contract that provides for or requires any payment of reinsurance proceeds, on account of losses or events that occur in periods after the date of an order of liquidation, to the receiver of the insolvent insurer or any other person. The receiver shall remain entitled to any amounts payable by the reinsurer pursuant to the reinsurance contracts with respect to losses or events that occur in periods before the date of the order of liquidation, subject to applicable set-off provisions.
Nev. Rev. Stat. § 686C.2249 Assumption of reinsurance contracts: Terms and conditions of contract not affected; exceptions.
1. Except as otherwise provided in NRS 686C.130 to 686C.226 , inclusive, nothing in NRS 686C.224 to 686C.2249 , inclusive, shall alter or modify the terms and conditions of any reinsurance contract.
2. Nothing in this section shall:
(a) Abrogate or limit any rights of any reinsurer to claim that it is entitled to rescind a reinsurance contract;
(b) Give a policy or contract owner, certificate holder, enrollee or beneficiary an independent cause of action against a reinsurer that is not otherwise set forth in the reinsurance contract;
(c) Limit or affect the Associations rights as a creditor of the estate against the assets of the estate; or
(d) Apply to reinsurance agreements covering property or casualty risks.
Source: NV Statutes (Official Site)URL: https://www.leg.state.nv.us/nrs/NRS-686C.htmlFetched: 10/4/2026