689C.325 - Coverage offered through network plan not required to be offered to eligible employee who does not reside or work in established geographic service area or if carrier lacks capacity to deli
689C.325 Coverage offered through network plan not required to be offered to eligible employee who does not reside or work in established geographic service area or if carrier lacks capacity to deliver adequate service to additional employers and employees. A carrier that offers coverage through a network plan is not required to offer coverage to or accept any applications for coverage from the eligible employees of a small employer pursuant to NRS 689C.310 and 689C.320 if:
1. The eligible employees do not reside or work in the established geographic service area of the network plan.
2. For a small employer whose eligible employees reside or work in the established geographic service area of the network plan, the carrier demonstrates to the satisfaction of the Commissioner that the carrier does not have the capacity to deliver adequate service to additional small employers and eligible employees because of the existing obligations of the carrier. If a carrier is authorized by the Commissioner not to offer coverage pursuant to this subsection, the carrier shall not thereafter offer coverage to additional small employers and eligible employees within that established geographic service area until the carrier demonstrates to the satisfaction of the Commissioner that it has regained the capacity to deliver adequate service to additional small employers and eligible employees within that service area.
(Added to NRS by 1997, 2921)