Group underwriting, eligibility, contributory and noncontributory plans, COBRA and coordination of benefits are covered in the national Group Health Insurance guide. This guide covers Nevada's group health statute (NRS 689B): what counts as a group, required provisions, disabled dependents, continuation during disability leave and replacement of a group plan.

What counts as a group

• Group health insurance covers a group of two or more people formed for a purpose other than obtaining insurance (NRS 689B.020).
• A group life or group health policy may not be delivered to a group formed to buy insurance unless the Commissioner approves (NRS 689B.026). A single employer covering its employees, officers, directors or proprietors and their dependents is a standard eligible group (NAC 679B.036).

Required provisions

• Statements are representations. A statement can't be used to void coverage unless it's in a signed written instrument given to the insured or beneficiary (NRS 689B.030(1)).
• Summary of coverage: each employee or member receives a statement of the essential features of the coverage, one per family (NRS 689B.030(2)).
• Hospice care benefits must be included (NRS 689B.030(5)).

Dependents

• Disabled children: coverage continues past the limiting age while a child can't support themselves because of a physical handicap or intellectual disability and is dependent on the member. Proof is due within 31 days after the limiting age, then as required, but no more than once a year after two years (NRS 689B.035).
• Newborns and adopted children: covered from birth or placement, with premature births included (NRS 689B.033).

Continuation during total disability leave

A group policy must continue coverage for an employee on unpaid leave because of total disability. It continues until the earliest of: employment ending, the employee getting other coverage, the group policy ending, or 12 months of these benefits (NRS 689B.0345).

Replacing a group plan

If a group plan is discontinued and replaced within 60 days, the new policy must cover everyone covered under the old plan on the date it ended, with benefits at least as broad, subject to permitted reductions (NRS 689B.065).

Common exam traps

• Two or more people make a group in Nevada.
• Disability leave continuation: 12 months at most.
• Replacement within 60 days must pick up everyone covered under the old plan.
• Disabled child proof within 31 days after the limiting age.
• Statements can void coverage only if they're in a signed document given to the insured.