695D.203 - Group plan issued to replace discontinued policy or coverage: Requirements; notice of reduction of benefits; statement of benefits; applicability to self-insured employer.
695D.203 Group plan issued to replace discontinued policy or coverage: Requirements; notice of reduction of benefits; statement of benefits; applicability to self-insured employer.
1. A group plan for dental care issued by an organization for dental care to replace any discontinued policy or coverage for dental care must:
(a) Provide coverage for all persons who were covered under the previous policy or coverage on the date it was discontinued; and
(b) Except as otherwise provided in subsection 2, provide benefits which are at least as extensive as the benefits provided by the previous policy or coverage, except that benefits may be reduced or excluded to the extent that such a reduction or exclusion was permissible under the terms of the previous policy or coverage,
Ê if that plan is issued within 60 days after the date on which the previous policy or coverage was discontinued.
2. If an employer obtains a replacement plan pursuant to subsection 1 to cover the employees of the employer, any benefits provided by the previous policy or coverage may be reduced if notice of the reduction is given to the employees pursuant to NRS 608.1577.
3. Any organization for dental care which issues a replacement plan pursuant to subsection 1 may submit a written request to the insurer which provided the previous policy or coverage for a statement of benefits which were provided under that policy or coverage. Upon receiving such a request, the insurer shall give a written statement to the organization indicating what benefits were provided and what exclusions or reductions were in effect under the previous policy or coverage.
4. The provisions of this section apply to a self-insured employer who provides benefits to the employees of the self-insured employer for dental care and replaces those benefits with a group plan for dental care.
(Added to NRS by 1987, 851)