USA Statutes : nevada
Title : Title 57 - INSURANCE
Chapter : CHAPTER 695A - FRATERNAL BENEFIT SOCIETIES
As used in this chapter, unless the
context otherwise requires, the words and terms defined in NRS 695A.003
to 695A.044 , inclusive, have the meanings ascribed to
them in those sections.
(Added to NRS by 1991, 221; A 1995, 2432)
“Benefit contract” means
an agreement for the provision of any contractual benefit authorized by
NRS 695A.180 .
(Added to NRS by 1991, 221)
“Benefit member” means a
member of a society who is an adult and who is designated by the laws or
rules of the society to be a benefit member under a benefit contract.
(Added to NRS by 1991, 221)
“Certificate” means the
document issued as written evidence of the benefit contract.
(Added to NRS by 1991, 221)
“Fraternal
benefit society” means any incorporated society, order or supreme lodge,
without capital stock, including one exempted under the provisions of
paragraph (b) of subsection 1 of NRS 695A.570 whether incorporated or not, which:
1. Is conducted solely for the benefit of its members and their
beneficiaries and not for profit;
2. Operates on a lodge system with ritualistic form of work;
3. Has a representative form of government; and
4. Provides benefits in accordance with this chapter.
(Added to NRS by 1971, 1835; A 1991, 222)
“Insurer” includes every person
engaged as principal and as indemnitor, surety or contractor in the
business of entering into contracts of insurance.
(Added to NRS by 1991, 221)
“Laws” means the articles of
incorporation, charter, constitution and bylaws of the society.
(Added to NRS by 1991, 221)
“Lodge” means a subordinate unit of
a society, and includes a camp, court, council, branch or any similar
entity by whatever name designated.
(Added to NRS by 1991, 221)
“Lodge system” means the
system under which a society is operating if:
1. The society has a supreme governing body and subordinate lodges
into which members are elected, initiated or admitted in accordance with
its laws, ritual and rules; and
2. The subordinate lodges are required by the laws of the society
to hold regular meetings at least once in each month.
(Added to NRS by 1971, 1835; A 1991, 223)
“Medicaid” means a program
established in any state pursuant to Title XIX of the Social Security Act
(42 U.S.C. §§ 1396 et seq.) to provide assistance for part or all of the
cost of medical care rendered on behalf of indigent persons.
(Added to NRS by 1995, 2431)
“Order for
medical coverage” means an order of a court or administrative tribunal to
provide coverage under a certificate for health benefits to a child
pursuant to the provisions of 42 U.S.C. § 1396g-1.
(Added to NRS by 1995, 2431)
“Premiums” means premiums,
rates, dues or other required contributions by whatever name known, which
are payable under the certificate.
(Added to NRS by 1971, 1835; A 1991, 223)
“Representative form of government” means that form of government which
a society has when:
1. It has a supreme governing body which is:
(a) An assembly composed of delegates elected either directly by
the members of the society or at intermediate assemblies or conventions
of members or their representatives, and such other delegates as
prescribed in the laws of the society; or
(b) A board composed of persons elected by the members of the
society, either directly or by their representatives in intermediate
assemblies, and such other persons as prescribed in the laws of the
society.
2. If its supreme governing body is an assembly:
(a) The elected delegates constitute a majority in number, have a
majority of the votes and have not less than the number of votes
necessary to amend the laws of the society;
(b) The election of delegates is done in person or by mail, as
prescribed in the laws of the society;
(c) The assembly is elected and meets not less than once every 4
years;
(d) A board of directors is elected by the assembly to conduct the
business of the society in the interim between meetings of the assembly;
and
(e) Vacancies on the board of directors are filled in the manner
prescribed in the laws of the society.
3. If its supreme governing body is a board:
(a) The persons elected to the board constitute a majority in
number, have a majority of the votes and have not less than the number of
votes necessary to amend the laws of the society;
(b) The election of the members of the board is done in person or
by mail, as prescribed in the laws of the society;
(c) The term of any member of the board does not exceed 4 years;
(d) The board meets not less than quarterly to conduct the business
of the society;
(e) Vacancies on the board are filled in the manner prescribed in
the laws of the society; and
(f) A person filling the unexpired term of an elected member of the
board is considered to be an elected member.
4. The officers of the society are elected either by the supreme
governing body or by the board of directors.
5. Only benefit members are eligible for election to the supreme
governing body, the board of directors or any intermediate assembly.
6. Each member who is entitled to vote has only one vote, and
votes are not cast by proxy.
(Added to NRS by 1971, 1836; A 1991, 223)
“Rules” includes all rules,
regulations and resolutions adopted by the supreme governing body or
board of directors of a society and which generally apply to the members
of the society.
(Added to NRS by 1991, 221)
“Society” means a fraternal
benefit society.
(Added to NRS by 1991, 221)
Ten or more citizens of the United States, a majority of
whom are citizens of this state, who desire to form a fraternal benefit
society, may make, sign and acknowledge before some person competent to
take acknowledgment of deeds, articles of incorporation, in which must be
stated:
1. The proposed corporate name of the society, which must not so
closely resemble the name of any society or insurer as to be misleading
or confusing;
2. The purposes for which it is being formed, which must not
include more liberal powers than are granted by this chapter;
3. The mode in which its corporate powers are to be exercised; and
4. The names and residences of the incorporators and the names,
residences and official titles of all the officers, trustees, directors
or other persons who are to have and exercise the general control of the
management of the affairs and money of the society for the first year or
until the ensuing election at which all officers must be elected by the
supreme governing body, which election must be held not later than 1 year
after the date of the issuance of the permanent certificate of authority.
(Added to NRS by 1971, 1836; A 1991, 224)
1. Duly certified copies of the laws and rules of the society,
copies of all proposed forms of certificates, applications therefor,
circulars to be issued by the society and a bond conditioned upon the
return to applicants of the advanced payments if the organization is not
completed within 1 year must be filed with the Commissioner, who may
require such further information as he deems necessary. The bond with
sureties approved by the Commissioner must be in such amount, not less
than $300,000 nor more than $1,500,000, as required by the Commissioner.
All documents filed must be in the English language. If the purposes of
the society conform to the requirements of this chapter and all
applicable provisions of the law of this state have been complied with,
the Commissioner shall so certify, retain and file the articles of
incorporation and furnish the incorporators a preliminary certificate of
authority for the society to solicit members as provided in this chapter.
2. No preliminary certificate of authority granted under the
provisions of this section is valid after 1 year from its date or after
such further period, not exceeding 1 year, as may be authorized by the
Commissioner upon cause shown, unless 500 applicants have been secured
and the organization has been completed as provided in this chapter. The
articles of incorporation and all proceedings thereunder are void 1 year
after the date of the preliminary certificate of authority, or at the
expiration of the extended period, unless the society has completed its
organization and received a certificate of authority to do business.
(Added to NRS by 1971, 1837; A 1991, 225)
1. Upon receipt of a preliminary certificate of authority from the
Commissioner, the society:
(a) May solicit members for the purpose of completing its
organization;
(b) Shall collect from each applicant the amount of not less than
one regular monthly premium in accordance with its table of rates; and
(c) Shall issue to each applicant a receipt for the amount
collected.
2. A society shall not incur any liability other than for the
return of an advance premium, or issue any certificate, or pay, allow, or
offer or promise to pay or allow, any death or disability benefit to any
person until:
(a) Actual bona fide applications for benefits have been secured
aggregating at least $500,000 on not less than 500 applicants, and all
required evidence of insurability has been furnished to and approved by
the society;
(b) Not less than 10 subordinate lodges have been established into
which the 500 applicants have been admitted;
(c) There has been submitted to the Commissioner, under oath of the
president or secretary, or corresponding officer of the society, a list
of the applicants, giving their names and addresses, the date each was
admitted, the name and number of the subordinate lodge of which each
applicant is a member, the amount of benefits to be granted and the
premiums therefor; and
(d) It has been shown to the Commissioner, by sworn statement of
the treasurer or corresponding officer of the society, that at least 500
applicants have each paid in cash at least one regular monthly premium as
provided in this chapter, which premiums in the aggregate must amount to
at least $150,000.
3. The advance premiums provided for in subsection 2 must be held
in trust during the period of organization and if the society has not
qualified for a permanent certificate of authority within 1 year, as
provided in this chapter, the premiums must be returned to the applicants.
(Added to NRS by 1971, 1837; A 1991, 225)
1. The Commissioner may make such examination and require such
further information as he deems advisable. Upon presentation of
satisfactory evidence that the society has complied with all applicable
provisions of law, he shall issue to the society a certificate of
authority indicating that the society may transact business pursuant to
the provisions of this chapter.
2. The certificate of authority is prima facie evidence of the
existence of the society on the date of the certificate.
3. The Commissioner shall cause a record of the certificate of
authority to be made. A certified copy of the record may be given in
evidence with like effect as the original certificate of authority.
4. For the issuance or renewal of a certificate of authority, a
society must pay to the Commissioner:
(a) A fee of $250 if the number of outstanding benefit contracts
within Nevada of the society is 600 or less;
(b) A fee of $500 if the number of outstanding benefit contracts
within Nevada of the society is more than 600 but less than 1,200; and
(c) A fee of $2,450 if the number of outstanding benefit contracts
within Nevada of the society is 1,200 or more.
Ê Each such certificate or renewal expires on March 1 following its
issuance.
5. If a society properly applies for the renewal of its
certificate of authority but does not receive approval of its application
by March 1, it may continue to transact business pursuant to this chapter
unless it receives notice that the application for renewal is
specifically denied.
6. A certified copy or duplicate of a certificate of authority is
prima facie evidence that the society may lawfully transact business in
this state pursuant to the provisions of this chapter during the period
stated on the license.
(Added to NRS by 1971, 1838; A 1991, 226, 1633; 1993, 2304)
A society
shall operate for the benefit of its members and their beneficiaries by
providing benefits as specified in NRS 695A.180 and may:
1. Operate for any lawful social, intellectual, educational,
charitable, benevolent, moral, fraternal, patriotic or religious purpose.
2. Carry out its purposes directly or through subsidiary
corporations or affiliated organizations.
3. Create, maintain and operate, or establish organizations to
operate, nonprofit institutions to further the society’s purposes. Such
institutions may charge a reasonable amount for their services.
4. Organize and operate lodges for children under the minimum age
for adult membership. Membership and initiation in local lodges must not
be required of children, and they must not have a voice or vote in the
management of the society.
5. Adopt laws and rules for the government of the society, the
admission of its members and the management of its affairs.
6. Amend its laws and rules.
7. Exercise any other power which is necessary and incidental to
carrying into effect the objects and purposes of the society and which is
not inconsistent with the provisions of this chapter.
(Added to NRS by 1971, 1838; A 1991, 227)
1. A society shall not charge a provider of health care a fee to
include the name of the provider on a list of providers of health care
given by the society to its insureds.
2. A society shall not contract with a provider of health care to
provide health care to an insured unless the society uses the form
prescribed by the Commissioner pursuant to NRS 629.095 to obtain any information related to the
credentials of the provider of health care.
3. A contract between a society and a provider of health care may
be modified:
(a) At any time pursuant to a written agreement executed by both
parties.
(b) Except as otherwise provided in this paragraph, by the society
upon giving to the provider 30 days’ written notice of the modification.
If the provider fails to object in writing to the modification within the
30-day period, the modification becomes effective at the end of that
period. If the provider objects in writing to the modification within the
30-day period, the modification must not become effective unless agreed
to by both parties as described in paragraph (a).
4. If a society contracts with a provider of health care to
provide health care to an insured, the society shall:
(a) If requested by the provider of health care at the time the
contract is made, submit to the provider of health care the schedule of
payments applicable to the provider of health care; or
(b) If requested by the provider of health care at any other time,
submit to the provider of health care the schedule of payments specified
in paragraph (a) within 7 days after receiving the request.
5. As used in this section, “provider of health care” means a
provider of health care who is licensed pursuant to chapter 630 , 631 , 632 or 633 of NRS.
(Added to NRS by 1999, 1649 ; A 2001, 2732 ; 2003, 3362 )
No unincorporated or voluntary association may transact business in this
state as a fraternal benefit society.
(Added to NRS by 1971, 1839; A 1991, 227)
1. The principal office of any domestic society must be located in
this state.
2. The meetings of its supreme governing body may be held in any
state, district, province or territory in which the society has at least
five subordinate lodges, and all business transacted at those meetings is
as valid in all respects as if the meetings were held in this state.
3. The minutes of the proceedings of the supreme governing body
and the board of directors must be written in the English language.
4. A society may provide in its laws for an official publication
in which any notice, report or statement which is required by law to be
given to a member, including a notice of election, may be published. Such
a report, notice or statement must be printed conspicuously in the
publication.
5. If the records of a society indicate that two or more benefit
members have the same mailing address, an official publication mailed to
one member shall be deemed to be mailed to all members at the same
address unless a member requests a separate copy.
6. A society may provide in its laws or rules a procedure by which
a benefit member may pursue a grievance or complaint against the society,
its supreme governing body, officers, directors or other members.
(Added to NRS by 1971, 1839; A 1991, 227)
1. A domestic society that wishes to consolidate or merge with any
other society must file with the Commissioner:
(a) A certified copy of the written contract containing in full the
terms and conditions of the consolidation or merger;
(b) A sworn statement by the president and secretary or
corresponding officers of each society showing the financial condition
thereof on a date fixed by the Commissioner, but not earlier than
December 31, next preceding the date of the contract;
(c) The certification of such officers, duly verified by their
respective oaths, that the consolidation or merger has been approved by a
two-thirds vote of the supreme governing body of each society at a
regular or special meeting of such bodies or, if permitted by the laws of
the society, by mail; and
(d) Evidence that at least 60 days before the action of the supreme
governing body of each society, the text of the contract was furnished to
all members of each society either by mail or by publication in full in
the official publication of each society.
2. If the Commissioner finds that the contract containing in full
the terms and conditions of the consolidation or merger is in conformity
with the provisions of this section, that the financial statements are
correct and that the consolidation or merger is just and equitable to the
members of each society, he shall approve the contract and issue a
certification of that fact.
3. The contract becomes effective upon approval by the
Commissioner unless any society which is a party to the contract is
incorporated under the laws of any other state or territory, in which
case the consolidation or merger does not become effective unless:
(a) It is approved as provided by the laws of the other state or
territory and a certificate of such approval has been filed with the
Commissioner of this state; or
(b) If the laws of the other state or territory do not provide for
such approval, it is approved by the officer responsible for supervising
the business of insurance in the other state or territory and a
certificate of such approval has been filed with the Commissioner of this
state.
4. Upon the consolidation or merger becoming effective as provided
in this chapter, all the rights, franchises and interests of the
consolidated or merged societies in and to every species of property,
real, personal or mixed, and things in action belonging thereto are
vested in the society resulting from or remaining after the consolidation
or merger without any other instrument, except that conveyances of real
property may be evidenced by proper deeds. The title to any real property
or interest therein, vested under the laws of this state in any of the
societies consolidated or merged, does not revert and is not in any way
impaired by the consolidation or merger but vests absolutely in the
society resulting from or remaining after the consolidation or merger.
5. The affidavit of any officer of the society or of anyone
authorized by it to mail any notice or document, stating that the notice
or document has been duly addressed and mailed, is prima facie evidence
that the notice or document has been furnished the addressees.
(Added to NRS by 1971, 1839; A 1991, 228)
Any domestic fraternal benefit society may be converted to
and licensed as a mutual life insurer by compliance with all the
applicable requirements of chapter 693A of
NRS if a plan of conversion is:
1. Prepared by the board of directors of the society in writing
setting forth in full the terms and conditions of the conversion;
2. Approved by the affirmative vote of two-thirds of all members
of the supreme governing body of the society at a regular or special
meeting; and
3. Approved by the Commissioner, who may give such approval if he
finds that the proposed change is in conformity with the laws of this
state and not prejudicial to the certificate holders of the society.
(Added to NRS by 1971, 1840; A 1991, 229; A 1991, 229)
1. Subject to the limitations set forth in subsections 2, 3 and 4,
a society shall specify in its laws or rules for each class of membership:
(a) The standards of eligibility and the process for admission to
membership in that class; and
(b) The rights and privileges of membership in that class, provided
that only benefit members may have the right to vote on the management of
the business of the society relating to insurance.
2. If benefits are provided on the lives of children, the minimum
age for membership as an adult must be not less than 15 and not greater
than 21 years of age.
3. A society may also admit social members, who have no voice or
vote in the management of its affairs relating to insurance.
4. Membership rights in the society must not be assignable.
(Added to NRS by 1971, 1841; A 1973, 1582; 1991, 229)
1. A society shall not, when considering eligibility for coverage
or making payments under a certificate for health benefits, consider the
availability of, or eligibility of a person for, medical assistance under
Medicaid.
2. To the extent that payment has been made by Medicaid for health
care, a society:
(a) Shall treat Medicaid as having a valid and enforceable
assignment of an insured’s benefits regardless of any exclusion of
Medicaid or the absence of a written assignment; and
(b) May, as otherwise allowed by its certificate for health
benefits, evidence of coverage or contract and applicable law or
regulation concerning subrogation, seek to enforce any reimbursement
rights of a recipient of Medicaid against any other liable party if:
(1) It is so authorized pursuant to a contract with Medicaid
for managed care; or
(2) It has reimbursed Medicaid in full for the health care
provided by Medicaid to its insured.
3. If a state agency is assigned any rights of a person who is:
(a) Eligible for medical assistance under Medicaid; and
(b) Covered by a certificate for health benefits,
Ê the society that issued the health policy shall not impose any
requirements upon the state agency except requirements it imposes upon
the agents or assignees of other persons covered by the certificate.
(Added to NRS by 1995, 2431)
1. To the extent reasonably applicable, a fraternal benefit
society shall comply with the provisions of NRS 689B.340 to 689B.590 , inclusive, and chapter 689C of NRS relating to the portability and
availability of health insurance offered by the society to its members.
If there is a conflict between the provisions of this chapter and the
provisions of NRS 689B.340 to
689B.590 , inclusive, and chapter 689C
of NRS, the provisions of NRS 689B.340
to 689B.590 , inclusive, and chapter 689C of NRS control.
2. For the purposes of subsection 1, unless the context requires
that a provision apply only to a group health plan or a carrier that
provides coverage under a group health plan, any reference in those
sections to “group health plan” or “carrier” must be replaced by
“fraternal benefit society.”
(Added to NRS by 1997, 2954; A 2001, 1923 )
A society shall
not deny the enrollment of a child pursuant to an order for medical
coverage under a certificate for health benefits pursuant to which a
parent of the child is insured, on the ground that the child:
1. Was born out of wedlock;
2. Has not been claimed as a dependent on the parent’s federal
income tax return; or
3. Does not reside with the parent or within the society’s
geographic area of service.
(Added to NRS by 1995, 2431)
If a child has coverage
under a certificate for health benefits pursuant to which a noncustodial
parent of the child is insured, the society issuing that certificate
shall:
1. Provide to the custodial parent such information as necessary
for the child to obtain any benefits under that coverage.
2. Allow the custodial parent or, with the approval of the
custodial parent, a provider of health care to submit claims for covered
services without the approval of the noncustodial parent.
3. Make payments on claims submitted pursuant to subsection 2
directly to the custodial parent, the provider of health care or an
agency of this or another state responsible for the administration of
Medicaid.
(Added to NRS by 1995, 2432)
If a parent is required
by an order for medical coverage to provide coverage under a certificate
for health benefits for a child and the parent is eligible for coverage
of members of his family under a certificate for health benefits, the
society that issued the certificate:
1. Shall, if the child is otherwise eligible for that coverage,
allow the parent to enroll the child in that coverage without regard to
any restrictions upon periods for enrollment.
2. Shall, if:
(a) The child is otherwise eligible for that coverage; and
(b) The parent is enrolled in that coverage but fails to apply for
enrollment of the child,
Ê enroll the child in that coverage upon application by the other parent
of the child, or by an agency of this or another state responsible for
the administration of Medicaid or a state program for the enforcement of
child support established pursuant to 42 U.S.C. §§ 651 et seq., without
regard to any restrictions upon periods for enrollment.
3. Shall not terminate the enrollment of the child in that
coverage or otherwise eliminate that coverage of the child unless the
society has written proof that:
(a) The order for medical coverage is no longer in effect; or
(b) The child is or will be enrolled in comparable coverage through
another insurer on or before the effective date of the termination of
enrollment or elimination of coverage.
(Added to NRS by 1995, 2432)
1. If a person:
(a) Adopts a dependent child; or
(b) Assumes and retains a legal obligation for the total or partial
support of a dependent child in anticipation of adopting the child,
Ê while the person is eligible for group coverage under a certificate for
health benefits, the society issuing that certificate shall not restrict
the coverage, in accordance with NRS 689B.340 to 689B.590 , inclusive, and chapter 689C of NRS relating to the portability and
availability of health insurance, of the child solely because of a
preexisting condition the child has at the time he would otherwise become
eligible for coverage pursuant to that policy.
2. For the purposes of this section, “child” means a person who is
under 18 years of age at the time of his adoption or the assumption of a
legal obligation for his support in anticipation of his adoption.
(Added to NRS by 1995, 2432; A 1997, 2954)
1. A domestic society may amend its laws in accordance with the
provisions thereof by action of its supreme governing body at any regular
or special meeting thereof or, if its laws so provide, by referendum.
Such a referendum may be held in accordance with the provisions of its
laws by the vote of the voting members of the society, by the vote of
delegates or representatives of voting members or by the vote of local
lodges. A society may provide for voting by mail. No amendment submitted
for adoption by referendum may be adopted unless, within 6 months after
the date of submission thereof, a majority of all of the voting members
of the society have signified their consent to the amendment by one of
the methods specified in this section.
2. No amendment to the laws of any domestic society becomes
effective unless approved by the Commissioner, who shall approve the
amendment if he finds that it has been duly adopted and is not
inconsistent with any requirement of the laws of this state or with the
character, objects and purposes of the society. Unless the Commissioner
disapproves an amendment within 60 days after it is filed, such amendment
shall be deemed approved. The approval or disapproval of the Commissioner
must be in writing and mailed to the secretary or corresponding officer
of the society at its principal office. If the Commissioner disapproves
an amendment, the reasons therefor must be stated in the written notice.
3. Within 90 days after their approval by the commissioner, all
the amendments, or a synopsis thereof, must be furnished to all members
of the society either by mail or by publication in full in the official
publication of the society. The affidavit of any officer of the society
or of anyone authorized by it to mail any amendments or synopsis thereof,
stating facts which show that the amendments or synopsis thereof have
been duly addressed and mailed, is prima facie evidence that the
amendments or synopsis thereof have been furnished the addressee.
4. Every foreign or alien society authorized to do business in
this state shall file with the Commissioner a duly certified copy of all
amendments of, or additions to, its laws within 90 days after their
enactment.
5. Printed copies of the laws as amended, certified by the
secretary or corresponding officer of the society, are prima facie
evidence of the legal adoption thereof.
(Added to NRS by 1971, 1841; A 1991, 230)
1. A society authorized to do business in this state may provide
the following contractual benefits in any form:
(a) Death benefits;
(b) Endowment benefits;
(c) Annuity benefits;
(d) Temporary or permanent disability benefits;
(e) Hospital, medical or nursing benefits;
(f) Monument or tombstone benefits to the memory of deceased
members; and
(g) Any other benefits which life insurance companies are
authorized to pay which are not inconsistent with the provisions of this
chapter.
2. A society shall specify in its laws or rules those persons who
may be issued, or covered by, the contractual benefits set forth in
subsection 1, consistent with the purpose of providing benefits to
members and their dependents. A society may provide benefits on the lives
of children under the minimum age for adult membership upon the
application of an adult.
(Added to NRS by 1971, 1842; A 1991, 231)
1. Except as otherwise provided in this section, a benefit
contract which provides coverage for prescription drugs must not limit or
exclude coverage for a drug if the drug:
(a) Had previously been approved for coverage by the society for a
medical condition of an insured and the insured’s provider of health care
determines, after conducting a reasonable investigation, that none of the
drugs which are otherwise currently approved for coverage are medically
appropriate for the insured; and
(b) Is appropriately prescribed and considered safe and effective
for treating the medical condition of the insured.
2. The provisions of subsection 1 do not:
(a) Apply to coverage for any drug that is prescribed for a use
that is different from the use for which that drug has been approved for
marketing by the Food and Drug Administration;
(b) Prohibit:
(1) The society from charging a deductible, copayment or
coinsurance for the provision of benefits for prescription drugs to the
insured or from establishing, by contract, limitations on the maximum
coverage for prescription drugs;
(2) A provider of health care from prescribing another drug
covered by the benefit contract that is medically appropriate for the
insured; or
(3) The substitution of another drug pursuant to NRS
639.23286 or 639.2583 to 639.2597 , inclusive; or
(c) Require any coverage for a drug after the term of the benefit
contract.
3. Any provision of a benefit contract subject to the provisions
of this chapter that is delivered, issued for delivery or renewed on or
after October 1, 2001, which is in conflict with this section is void.
(Added to NRS by 2001, 861 ; A 2003, 2299 )
1. Except as otherwise provided in subsection 2, a society shall
approve or deny a claim relating to a certificate of health insurance
within 30 days after the society receives the claim. If the claim is
approved, the society shall pay the claim within 30 days after it is
approved. If the approved claim is not paid within that period, the
society shall pay interest on the claim at the rate of interest
established pursuant to NRS 99.040
unless a different rate of interest is established pursuant to an express
written contract between the society and the provider of health care. The
interest must be calculated from 30 days after the date on which the
claim is approved until the claim is paid.
2. If the society requires additional information to determine
whether to approve or deny the claim, it shall notify the claimant of its
request for the additional information within 20 days after it receives
the claim. The society shall notify the provider of health care of all
the specific reasons for the delay in approving or denying the claim. The
society shall approve or deny the claim within 30 days after receiving
the additional information. If the claim is approved, the society shall
pay the claim within 30 days after it receives the additional
information. If the approved claim is not paid within that period, the
society shall pay interest on the claim in the manner prescribed in
subsection 1.
3. A society shall not request a claimant to resubmit information
that the claimant has already provided to the society, unless the society
provides a legitimate reason for the request and the purpose of the
request is not to delay the payment of the claim, harass the claimant or
discourage the filing of claims.
4. A society shall not pay only part of a claim that has been
approved and is fully payable.
5. A court shall award costs and reasonable attorney’s fees to the
prevailing party in an action brought pursuant to this section.
(Added to NRS by 1991, 1330; A 1999, 1649 )
A society shall not deny
a claim, refuse to issue a benefit contract or cancel a benefit contract
solely because the claim involves an act that constitutes domestic
violence pursuant to NRS 33.018 , or
because the person applying for or covered by the benefit contract was
the victim of such an act of domestic violence, regardless of whether the
insured or applicant contributed to any loss or injury.
(Added to NRS by 1997, 1096)
[Effective July 1, 2006.]
1. Except as otherwise provided in subsection 2, a society that
provides health benefits shall not:
(a) Deny a claim under a benefit contract solely because the claim
involves an injury sustained by an insured as a consequence of being
intoxicated or under the influence of a controlled substance.
(b) Cancel a benefit contract solely because an insured has made a
claim involving an injury sustained by the insured as a consequence of
being intoxicated or under the influence of a controlled substance.
(c) Refuse to issue a benefit contract to an eligible applicant
solely because the applicant has made a claim involving an injury
sustained by the applicant as a consequence of being intoxicated or under
the influence of a controlled substance.
2. The provisions of this section do not prohibit a society from
enforcing a provision included in a benefit contract to:
(a) Deny a claim which involves an injury to which a contributing
cause was the insured’s commission of or attempt to commit a felony;
(b) Cancel a benefit contract solely because of such a claim; or
(c) Refuse to issue a benefit contract to an eligible applicant
solely because of such a claim.
(Added to NRS by 2005, 2345 , effective July 1, 2006)
1. A society may grant paid-up nonforfeiture benefits, cash
surrender values, certificate loans and such other options as its laws
may permit.
2. In the case of certificates for which reserves are computed on
the Commissioners 1980 Standard Ordinary Mortality Table or such other
table of mortality as may be specified by the society and approved by the
Commissioner, every paid-up nonforfeiture benefit and the amount of any
cash surrender value, loan or other option granted must not be less than
the corresponding amount ascertained in accordance with the provisions of
the laws of this state applicable to life insurance companies issuing
policies containing like insurance benefits based upon those tables.
(Added to NRS by 1971, 1843; A 1985, 1185; 1991, 231)
1. The owner of a benefit contract has the right at all times to
change any beneficiary in accordance with the laws or rules of the
society, unless the owner waives that right by requesting in writing that
his designation of a beneficiary be irrevocable. Every society by its
laws or rules may limit the scope of a designation of a beneficiary and
shall provide that a revocable beneficiary does not have or obtain any
vested interest in the proceeds of any certificate until the certificate
has become due and payable in conformity with the provisions of the
benefit contract.
2. A society may provide for the payment of funeral benefits to
the extent of such portion of any payment under a certificate as might
reasonably appear to be due to any person equitably entitled thereto by
reason of having incurred expense occasioned by the burial of a member,
but the portion so paid must not exceed $1,000.
3. If, at the death of any person insured under a benefit
contract, there is no lawful beneficiary to whom the insurance benefits
are payable, the amount of such benefits, except to the extent that
funeral benefits may be paid as provided in subsection 2, are payable:
(a) To the estate of the deceased insured; or
(b) To the owner of the certificate if he is not the person insured
under the benefit contract.
(Added to NRS by 1971, 1844; A 1991, 232)
No money or other benefit, charity, relief or aid to be
paid, provided or rendered by any society is liable to attachment,
garnishment or other process, or to be seized, taken, appropriated or
applied by any legal or equitable process or operation of law to pay any
debt or liability of a benefit member or beneficiary, or any other person
who may have a right thereunder, either before or after payment by the
society.
(Added to NRS by 1971, 1844; A 1991, 233)
1. Every society authorized to do business in this state shall
issue to each owner of a benefit contract a certificate specifying the
amount of benefits provided thereby. The certificate, together with any
riders or endorsements attached thereto, the laws of the society, the
application for membership, the application for insurance and the
declaration of insurability, if any, signed by the applicant, and all
amendments to each thereof, constitute the agreement, as of the date of
issuance, between the society and the member, and the certificate must so
state. A copy of the application for insurance and the declaration of
insurability, if any, must be endorsed upon or attached to the
certificate.
2. All statements on an application for insurance are
representations and not warranties. Any waiver of this provision is void.
3. Except with regard to contracts providing benefits payable in
variable amounts, any changes, additions or amendments to the laws of the
society duly made or enacted after the issuance of the certificate bind
the owner and the beneficiaries, and govern and control the benefit
contract as though the changes, additions or amendments were in force at
the time of the application for insurance, except that no change,
addition or amendment may destroy or diminish benefits which the society
contracted to give the owner as of the date of issuance.
4. Any person upon whose life a benefit contract is issued before
he attains the age of majority is bound by the terms of the application
and certificate and by all the laws and rules of the society as though
the age of majority had been attained at the time of application.
5. Copies of any of the documents mentioned in this section,
certified by the secretary or corresponding officer of the society, must
be received in evidence of the terms and conditions thereof.
6. Except with regard to contracts providing benefits payable in
variable amounts, a society shall provide in its laws that if its
reserves as to all or any class of certificates become impaired, its
supreme governing body or board of directors may require each owner of
such certificates to pay to the society the amount of his equitable
proportion of such deficiency as ascertained by its board, and that if
the payment is not made, the owner may elect to:
(a) Let it stand as an indebtedness against the certificate and
draw interest at a rate not to exceed that specified for loans made
pursuant to the certificates; or
(b) In lieu of, or in combination with paragraph (a), accept a
proportionate reduction in benefits under the certificate.
Ê The society may specify the manner of the election and which
alternative is to be presumed if no election is made by the owner.
(Added to NRS by 1971, 1844; A 1991, 233)
A society may, subject to
regulation by the Commissioner, offer a policy of health insurance that
has a high deductible and is in compliance with 26 U.S.C. § 223 for the
purposes of establishing a health savings account.
(Added to NRS by 2005, 2158 )
1. No certificate may be delivered or issued for delivery in this
state unless a copy of the form of the certificate has been filed with
and approved by the Commissioner in conformity with the requirements of
NRS 687B.120 .
2. The certificate must contain:
(a) A provision stating the amount of premiums which are payable
under the certificate;
(b) A provision setting forth the society’s laws or rules which, if
violated, will result in the termination or reduction of benefits payable
under the certificate;
(c) If the laws of the society provide for the expulsion or
suspension of a member, a provision that any member who is expelled or
suspended, except for nonpayment of a premium or, during the period of
contestability, for material misrepresentation in the application for
membership or insurance, may maintain the certificate in force by
continuing payment of the required premium; and
(d) All standard contractual provisions which are required by the
provisions of chapters 687B , 688A , 688B , 689 , 689A and 689B of NRS to be included in similar policies issued
by life or health insurers in this state, and which are not inconsistent
with the provisions of this chapter.
3. The certificate may contain:
(a) A provision that the member is entitled to a grace period of 1
month in which the payment of any premium after the first may be made.
(b) For a benefit contract issued on the life of a person under the
society’s minimum age for membership as an adult, a provision governing
the transfer of ownership to the insured at an age specified in the
certificate. A society may require approval of an application for
membership in order to make the transfer, and may provide for the
regulation, government and control of such a certificate and all rights,
obligations and liabilities incident to the certificate, including rights
of ownership before the transfer.
(c) The terms and conditions governing the assignability of the
benefit contract.
(Added to NRS by 1971, 1845; A 1991, 234)
1. A society that offers or issues a benefit contract which
provides coverage for prescription drugs shall include with any
certificate for such a contract provided to a benefit member, notice of
whether a formulary is used and, if so, of the opportunity to secure
information regarding the formulary from the society pursuant to
subsection 2. The notice required by this subsection must:
(a) Be in a language that is easily understood and in a format that
is easy to understand;
(b) Include an explanation of what a formulary is; and
(c) If a formulary is used, include:
(1) An explanation of:
(I) How often the contents of the formulary are
reviewed; and
(II) The procedure and criteria for determining which
prescription drugs are included in and excluded from the formulary; and
(2) The telephone number of the society for making a request
for information regarding the formulary pursuant to subsection 2.
2. If a society offers or issues a benefit contract which provides
coverage for prescription drugs and a formulary is used, the society
shall:
(a) Provide to any insured or participating provider of health
care, upon request:
(1) Information regarding whether a specific drug is
included in the formulary.
(2) Access to the most current list of prescription drugs in
the formulary, organized by major therapeutic category, with an
indication of whether any listed drugs are preferred over other listed
drugs. If more than one formulary is maintained, the society shall notify
the requester that a choice of formulary lists is available.
(b) Notify each person who requests information regarding the
formulary, that the inclusion of a drug in the formulary does not
guarantee that a provider of health care will prescribe that drug for a
particular medical condition.
(Added to NRS by 2001, 860 )
The laws of
the society may provide that no subordinate body or any of its
subordinate officers or members may waive any of the provisions of the
laws of the society. Such a provision is binding on the society and every
member and beneficiary of a member.
(Added to NRS by 1971, 1849; A 1991, 237)
1. Except as otherwise provided in subsection 3, a domestic
society may, by a reinsurance agreement, cede any individual risk or
risks in whole or in part to an insurer, other than another fraternal
benefit society, authorized to provide reinsurance in this state, or if
not so authorized, one which is approved in writing by the Commissioner,
but no such society may reinsure substantially all of its insurance in
force without the written permission of the Commissioner.
2. A society may take credit for the reserves on such ceded risks
to the extent reinsured, but no credit may be allowed as an admitted
asset or as a deduction from liability to a ceding society for
reinsurance made, ceded, renewed or otherwise becoming effective after
July 1, 1963, unless the reinsurance is payable by the assuming insurer
on the basis of the liability of the ceding society under the benefit
contract or contracts reinsured without diminution because of the
insolvency of the ceding society.
3. A society may reinsure the risks of another society in a
consolidation or merger which is approved by the Commissioner pursuant to
NRS 695A.130 .
(Added to NRS by 1971, 1849; A 1987, 649; 1991, 237)
1. A foreign or alien society shall not transact business in this
state without a license issued by the Commissioner.
2. A foreign or alien society may be licensed to transact business
in this state upon a showing that its assets are invested in accordance
with the provisions of this chapter and upon filing with the Commissioner:
(a) A duly certified copy of its laws, certified by its secretary
or corresponding officer;
(b) A power of attorney to the Commissioner as prescribed in NRS
695A.400 ;
(c) A statement of its business under oath of its president and
secretary or corresponding officers in a form prescribed by the
Commissioner, duly verified by an examination made by the supervising
insurance officer of its home state or other state, territory, province
or country, satisfactory to the Commissioner of this state;
(d) Certification from the proper officer of its home state,
territory, province or country that the society is legally incorporated
and licensed to transact business therein;
(e) Copies of its certificate forms; and
(f) Such other information as the Commissioner may deem necessary.
3. Any foreign or alien society desiring admission to this state
must comply substantially with the requirements and limitations of this
chapter applicable to domestic societies.
(Added to NRS by 1971, 1849; A 1991, 237)
1. When the Commissioner upon investigation finds that a domestic
society:
(a) Has exceeded its powers;
(b) Has failed to comply with any provision of this chapter;
(c) Is not fulfilling its contracts in good faith;
(d) Has a membership of less than 400 after an existence of 1 year
or more; or
(e) Is conducting business fraudulently or in a manner hazardous to
its members, creditors, the public or the business,
Ê he shall notify the society of his findings, state in writing the
reasons for his dissatisfaction, and issue a written order requiring the
society to make the necessary corrections. If the Commissioner finds that
the society has failed to comply with the order within 30 days after
receiving it, he shall notify the society of his finding of noncompliance
and require the society to show cause on a date named why it should not
be enjoined from carrying on any business until the violation complained
of has been corrected, or why an action in quo warranto should not be
commenced against the society.
2. If on that date the society does not present good and
sufficient reasons why it should not be so enjoined or why such action
should not be commenced, the Commissioner may present the facts relating
thereto to the Attorney General, who shall, if he deems the circumstances
warrant, commence an action to enjoin the society from transacting
business or an action in quo warranto.
3. The court shall thereupon notify the officers of the society of
a hearing. If, after a full hearing, it appears that the society should
be so enjoined or liquidated or a receiver appointed, the court shall
enter the necessary order.
4. A society that is so enjoined shall not do business until:
(a) The Commissioner finds that the violation complained of has
been corrected;
(b) The costs of the action have been paid by the society, if the
court finds that the society was in default as charged;
(c) The court has dissolved its injunction; and
(d) The Commissioner has reinstated the certificate of authority.
5. If the court orders the society liquidated, it must be enjoined
from carrying on any further business, whereupon the receiver of the
society shall proceed at once to take possession of the books, papers,
money and other assets of the society and, under the direction of the
court, proceed forthwith to close the affairs of the society and to
distribute its funds to those entitled thereto.
6. No action under this section may be recognized in any court of
this state unless brought by the Attorney General upon request of the
Commissioner. Whenever a receiver is to be appointed for a domestic
society, the court shall appoint the Commissioner as the receiver.
7. The provisions of this section relating to hearing by the
Commissioner, action by the Attorney General at the request of the
Commissioner, hearing by the court, injunction and receivership apply to
a society which voluntarily determines to discontinue business.
(Added to NRS by 1971, 1850; A 1991, 238)
1. When the Commissioner upon investigation finds that a foreign
or alien society transacting or applying to transact business in this
state:
(a) Has exceeded its powers;
(b) Has failed to comply with any provision of this chapter;
(c) Is not fulfilling its contracts in good faith; or
(d) Is conducting its business fraudulently or in a manner
hazardous to its members or creditors or the public,
Ê he shall notify the society of his findings, state in writing the
reasons for his dissatisfaction and issue a written order requiring the
society to make the necessary corrections. If the Commissioner finds that
the society has failed to comply with the order within 30 days after
receiving it, he shall notify the society of his finding of noncompliance
and require the society to show cause on a date named why its license
should not be suspended, revoked or refused.
2. If on that date the society does not present good and
sufficient reason why its authority to do business in this state should
not be suspended, revoked or refused, the Commissioner may suspend or
refuse the license of the society to do business in this state until
satisfactory evidence is furnished to him that the suspension or refusal
should be withdrawn, or he may revoke the authority of the society to do
business in this state.
3. Nothing contained in this section prevents a society from
continuing in good faith all contracts made in this state during the time
the society was legally authorized to transact business in this state.
(Added to NRS by 1971, 1851; A 1991, 239)
1. Every insurance agent of a society must be licensed pursuant to
chapter 683A of NRS and any regulations
adopted by the Commissioner which apply to health and life insurance
agents.
2. No written or other examination is required of a person who
held a license as an insurance agent on July 1, 1977, for renewals of his
license.
3. No examination or license is required of:
(a) Any regular salaried officer or employee of a licensed society
who devotes substantially all of his services to activities other than
the solicitation of fraternal insurance contracts from the public, and
who does not receive for the solicitation of such contracts any
commission or other compensation directly dependent upon the amount of
business obtained; or
(b) Any member of the society who does not write insurance
contracts, and whose solicitation or negotiation is incidental to
securing new members for his society, and whose only remuneration
consists of prizes in the form of merchandise or payments of a nominal
amount of money.
(Added to NRS by 1971, 1851; A 1977, 693; 1991, 239)
1. Every society authorized to do business in this state shall
appoint in writing the Commissioner and each successor in office to be
its true and lawful attorney upon whom all lawful process in any action
or proceeding against it must be served, and shall agree in the writing
that any lawful process against it which is served on the Commissioner is
of the same legal force and validity as if served upon the society, and
that the authority continues in force so long as any liability remains
outstanding in this state. A copy of the appointment, certified by the
Commissioner, constitutes sufficient evidence of the appointment and must
be admitted in evidence with the same validity as the original.
2. Service must be made only upon the Commissioner, or if absent,
upon the person in charge of his office. It must be made in duplicate and
constitutes sufficient service upon the society. When legal process
against a society is served upon the Commissioner, he shall forthwith
forward one of the duplicate copies by registered mail, prepaid, directed
to the secretary or corresponding officer.
3. No such service may require a society to file its answer,
pleading or defense in less than 30 days from the date of mailing the
copy of the service to a society.
4. Legal process must not be served upon a society except in the
manner provided in this section.
5. At the time of serving any process upon the Commissioner, the
plaintiff or complainant in the action shall pay to the Commissioner a
fee of $5.
6. For the purposes of this section, “process” includes only the
summons or the initial documents served in an action. The Commissioner is
not required to serve any documents after the initial service of process.
(Added to NRS by 1971, 1854; A 1971, 1956; 1985, 612; 1991, 240)
No application or
petition for injunction against any domestic, foreign or alien society,
or any of its lodges, may be recognized in any court of this state unless
made by the Attorney General upon request of the Commissioner.
(Added to NRS by 1971, 1855; A 1991, 240)
All decisions and findings of the Commissioner made under the
provisions of this chapter are subject to review by proper proceedings in
any court of competent jurisdiction in this state.
(Added to NRS by 1971, 1855; A 1991, 241)
1. All assets must be held, invested and disbursed for the use and
benefit of the society and no member or beneficiary may have or acquire
individual rights therein or become entitled to any apportionment or the
surrender of any part thereof, except as provided in the benefit contract.
2. A society may create, maintain, invest, disburse and apply any
special fund necessary to carry out any purpose permitted by the laws of
the society.
3. A society may, pursuant to a resolution of its supreme
governing body and subject to the provisions of NRS 688A.390 , establish and operate one or more separate
accounts and issue contracts providing benefits payable in variable
amounts. For the purposes of NRS 688A.390 , a society shall be deemed to be a domestic
life insurer.
(Added to NRS by 1971, 1855; A 1991, 241)
1. A society shall invest its money only in such investments as
are authorized by the laws of this state for the investment of assets of
life insurers and subject to the limitations thereon.
2. Any foreign or alien society permitted or seeking to do
business in this state which invests its money in accordance with the
laws of the state, district, territory, country or province in which it
is incorporated shall be deemed to meet the requirements of this section
for the investment of money.
(Added to NRS by 1971, 1855; A 1991, 241)
1. Every society transacting business in this state shall
annually, on or before the first day of March, unless for cause shown the
time has been extended by the Commissioner, file with the Commissioner a
true statement of its financial condition, transactions and affairs for
the preceding calendar year and pay a filing fee of $25. The statement
must be in such general form and context as approved by the National
Association of Insurance Commissioners for fraternal benefit societies
and as supplemented by additional information required by the
Commissioner. The statement must include separately from the society’s
admitted assets all real or personal property owned, held or leased by
the society for the purposes of its nonprofit institutions operated
pursuant to NRS 695A.090 .
2. A synopsis of its annual statement providing an explanation of
the facts concerning the condition of the society thereby disclosed must
be printed and mailed to each benefit member of the society not later
than June 1 of each year, or, in lieu thereof, the synopsis may be
published in the society’s official publication established pursuant to
NRS 695A.120 .
3. As a part of the annual statement required by subsection 1,
each society shall, on or before the first day of March, file with the
Commissioner a valuation of its certificates in force on the preceding
December 31. The Commissioner may, in his discretion for cause shown,
extend the time for filing the valuation for not more than 2 calendar
months. The valuation must be done pursuant to NRS 695A.490 . The valuation and supporting data must be
certified by a qualified actuary or, at the expense of the society,
verified by the actuary of the department of insurance of the state in
which the society is domiciled.
(Added to NRS by 1971, 1856; A 1987, 466; 1991, 241)
If
a society fails to file the annual statement in the form and within the
time provided by NRS 695A.450 , it
shall pay to the Commissioner $100 for each day that the statement
remains unfiled or deficient, and, upon notice by the Commissioner to
that effect, its authority to do business in this state ceases until the
statement is properly filed.
(Added to NRS by 1971, 1857; A 1991, 242)
1. The officers and members of the supreme governing body or any
subordinate body of a society are not personally liable for payment of
any benefits provided by the society.
2. A person may be indemnified and reimbursed by a society for
expenses reasonably incurred by, and liabilities imposed upon, him in
connection with or arising out of any action, suit or proceeding, whether
civil, criminal, administrative or investigative, or threat thereof, in
which the person may be involved because he is or was a director,
officer, employee or agent of the society or of any firm, corporation or
organization which he served in any capacity at the request of the
society.
3. A person may not be so indemnified or reimbursed as to any
matter in an action, suit or proceeding, or threat thereof, in which he
is finally adjudged to be guilty of a breach of a duty as a director,
officer, employee or agent of the society, or which is made the subject
of a compromise settlement, unless:
(a) He acted in good faith for a purpose he reasonably believed to
be in the best interests of the society; and
(b) If a criminal action, he had no reasonable cause to believe
that his conduct was unlawful.
4. The determination of whether the conduct of a person meets the
standard required for indemnification and reimbursement may only be made
by:
(a) The supreme governing body or board of directors by a majority
vote of a quorum consisting of persons who were not parties to the
action, suit or proceeding; or
(b) A court of competent jurisdiction.
5. The termination of any action, suit or proceeding by judgment,
order, settlement or conviction, or upon a plea of nolo contendere, does
not create a conclusive presumption that the person does not meet the
standard of conduct required for indemnification and reimbursement.
6. The right of indemnification and reimbursement does not exclude
other rights to which the person may be entitled as a matter of law, and
inures to the benefit of his heirs, executors and administrators.
7. A society may purchase and maintain insurance on behalf of any
person who is or was a director, officer, employee or agent of the
society, or who is serving or has served at the request of the society as
a director, officer, employee or agent of any other firm, corporation or
organization, against any liability asserted against and incurred by him
in that capacity or arising out of his status as such, whether or not the
society may indemnify the person against liability pursuant to this
section.
8. A director, officer, employee, member or volunteer of a society
who serves without compensation is not liable, and no cause of action may
be brought for damages resulting from his exercise of judgment or
discretion in carrying out his duties or responsibilities on behalf of
the society, unless the act or omission involved willful or wanton
misconduct.
(Added to NRS by 1991, 221)
1. The minimum standards of valuation for certificates issued
before July 1, 1964, are those provided by the law applicable immediately
before July 1, 1963, but not lower than the standards used in the
calculating of rates for those certificates.
2. Except as otherwise provided in subsection 4, the minimum
standard of valuation for certificates issued on or after July 1, 1964,
but before January 1, 1993, is 3.5 percent interest and the following:
(a) For certificates of life insurance, American Men Ultimate Table
of Mortality, with Bowerman’s or Davis’ Extension thereof or with the
consent of the Commissioner, the Commissioners 1941 Standard Ordinary
Mortality Table, the Commissioners 1941 Standard Industrial Mortality
Table or the Commissioners 1958 Standard Ordinary Mortality Table, using
the actual age of the insured for male risks and an age not more than 3
years younger than the actual age of the insured for female risks.
(b) For annuity and pure endowment certificates, excluding any
disability and accidental death benefits in those certificates, the 1937
Standard Annuity Mortality Table or the Annuity Mortality Table for 1949,
Ultimate, or any modification of either of these tables approved by the
Commissioner.
(c) For total and permanent disability benefits in or supplementary
to life insurance certificates, Hunter’s Disability Table, or the Class
III Disability Table (1926) modified to conform to the contractual
waiting period, or the tables of Period 2 disablement rates and the 1930
to 1950 termination rates of the 1952 Disability Study of the Society of
Actuaries with due regard to the type of benefit. Any such table must,
for active lives, be combined with a mortality table permitted for
calculating the reserves for life insurance certificates.
(d) For accidental death benefits in or supplementary to life
insurance certificates, the Inter-Company Double Indemnity Mortality
Table or the 1959 Accidental Death Benefits Table. Either table must be
combined with a mortality table permitted for calculating the reserves
for life insurance certificates.
(e) For noncancellable accident and health benefits, the Class III
Disability Table (1926) with conference modifications or, with the
consent of the Commissioner, tables based upon the society’s own
experience.
3. Except as otherwise provided in subsection 4, the minimum
standard of valuation for certificates issued on or after January 1,
1993, is:
(a) For certificates of life insurance, the Commissioners 1980
Standard Ordinary Mortality Table or any more recent table made
applicable to life insurance companies; and
(b) For annuity and pure endowment certificates, total and
permanent disability benefits, accidental death benefits and
noncancellable accident and health benefits, such tables as are
authorized for use by life insurance companies in this state.
4. A society may value its certificates in accordance with the
valuation standards used for policies containing comparable benefits
which are issued in this state by life insurance companies.
5. The Commissioner may:
(a) Accept other standards for valuation if he finds that the
reserves produced thereby will not be less in the aggregate than reserves
computed in accordance with the minimum valuation standard prescribed in
this section.
(b) Vary the standards of mortality applicable to all benefit
contracts on substandard lives or other extra-hazardous lives by any
society authorized to do business in this state.
6. Any society, with the consent of the commissioner of insurance
of the state of domicile of the society and under such conditions, if
any, as he may impose, may establish and maintain reserves on its
certificates in excess of the reserves required thereunder, but the
contractual rights of any benefit member are not affected thereby.
(Added to NRS by 1971, 1858; A 1985, 1186; 1991, 242)
The Commissioner, or any person he may appoint, may examine any
domestic, foreign or alien society which is transacting business or
applying for admission to transact business in this state in the same
manner as authorized for the examination of domestic, foreign or alien
insurers. For the purposes of this section, the provisions of NRS
679B.230 to 679B.300 , inclusive, are applicable to societies.
(Added to NRS by 1971, 1859; A 1991, 244)
A society authorized to do business in this
state and its agents are subject to the provisions of chapter 686A of NRS relating to trade practices and frauds,
except that nothing in that chapter applies to or affects:
1. The right of a society to determine its eligibility
requirements for membership; or
2. The offering of benefits exclusively to members or persons
eligible for membership in the society by a subsidiary corporation or
affiliated organization of the society.
(Added to NRS by 1971, 1860; A 1991, 245)
Every
society organized or licensed under this chapter is hereby declared to be
a charitable and benevolent institution, and is exempt from every state,
county, district, municipal and school tax other than taxes on real
property and office equipment.
(Added to NRS by 1971, 1861; A 1991, 245)
Societies
are not exempt from the provisions of NRS 679B.700 . If a society is an admitted health insurer,
as that term is defined in NRS 449.450 ,
it is not exempt from the fees imposed pursuant to NRS 449.465 .
(Added to NRS by 1985, 1071)
Except as otherwise provided in this chapter or by specific statute,
societies are governed by this chapter and are exempt from all other
provisions of the insurance laws of this state.
(Added to NRS by 1971, 1861; A 1991, 246)
1. Nothing contained in this chapter shall be construed to affect
or apply to:
(a) Grand or subordinate lodges of societies, orders or
associations now doing business in this state which provide benefits
exclusively through local or subordinate lodges;
(b) Orders, societies or associations which admit to membership
only persons engaged in one or more crafts or hazardous occupations, in
the same or similar lines of business, insuring only their own members
and their families and the ladies’ societies or ladies’ auxiliaries to
such orders, societies or associations;
(c) Domestic societies which limit their membership to employees of
a particular city or town, designated firm, business house or corporation
which provide for a death benefit of not more than $400 or disability
benefits of not more than $350 to any person in any 1 year, or both; or
(d) Domestic societies or associations of a purely religious,
charitable or benevolent description, which provide for a death benefit
of not more than $400 or for disability benefits of not more than $350 to
any one person in any 1 year, or both.
2. Any society or association described in paragraphs (c) or (d)
of subsection 1 which provides for death or disability benefits for which
benefit certificates are issued, and any such society or association
included in paragraph (d) of subsection 1 which has more than 1,000
members, shall not be exempted from the provisions of this chapter but
shall comply with all requirements thereof.
3. No society which, by the provisions of this section, is exempt
from the requirements of this chapter, except any society described in
paragraph (b) of subsection 1, shall give or allow, or promise to give or
allow, to any person any compensation for procuring new members.
4. Every society which provides for benefits in case of death or
disability resulting solely from accident and which does not obligate
itself to pay natural death or sick benefits shall have all of the
privileges and be subject to all the applicable provisions and
regulations of this chapter, except that the provisions thereof relating
to medical examination, valuations of benefit certificates and
incontestability shall not apply to such society.
5. The Commissioner may require from any society or association,
by examination or otherwise, such information as will enable him to
determine whether such society or association is exempt from the
provisions of this chapter.
6. Societies, exempted under the provisions of this section, shall
also be exempt from all other provisions of the insurance laws of this
state.
(Added to NRS by 1971, 1861)
1. Any person who makes a false or fraudulent statement in or
relating to an application for membership or for the purpose of obtaining
money from or a benefit in any society is guilty of a gross misdemeanor.
2. Any person who solicits membership for, or in any manner
assists in procuring membership in, any society not licensed to do
business in this State is subject to an administrative fine, imposed by
the Commissioner, of not less than $25 nor more than $500 for each
violation. In addition if the person is an insurance agent of the
society, the Commissioner may suspend, revoke, limit or refuse to
continue his license in the manner provided in NRS 683A.451 and 683A.461 .
3. Any person convicted of a willful violation of, or neglect or
refusal to comply with, any provision of this chapter for which a penalty
is not otherwise prescribed shall be punished by a fine of not more than
$1,000 for each violation, and not more than $10,000 for all related
violations.
(Added to NRS by 1971, 1862; A 1977, 695; 1979, 1493; 2001, 2248
)
