Read the full stored bill text
- 83rd Session (2025)
Senate Bill No. 292–Senator Lange
CHAPTER..........
AN ACT relating to insurance; requiring certain insurers to allow
certain persons who are less than 65 years of age to purchase
a Medicare supplemental policy that the insurer makes
available for purchase to n ew insureds who are 65 years of
age or older; imposing certain restrictions on the limitations,
terms and conditions such an insurer may impose and the
premiums such an insurer may charge for such policies to
persons who are less than 65 years of age; requ iring such an
insurer to establish certain open enrollment periods for the
purchase of a Medicare supplemental policy; prohibiting an
insurer from imposing an exclusion of certain benefits with
respect to a Medicare supplemental policy issued during an
open enrollment period; and providing other matters properly
relating thereto.
Legislative Counsel’s Digest:
Existing federal law establishes the Medicare program, which is a public health
insurance program for persons 65 years of age or older and specified persons with
disabilities or end-stage renal disease who are less than 65 years of age. (42 U.S.C.
§§ 1395 et seq.) Existing federal law defines the term “Medicare supplemental
policy” to mean a policy offered by a private insurer that is primarily designe d to
pay expenses not reimbursed under Medicare because of certain limitations under
Medicare. Existing federal law requires the issuance of a Medicare supplemental
policy under certain circumstances but does not require a private insurer to sell or
issue a Medicare supplemental policy to a person who is less than 65 years of age
and enrolled in Medicare on the basis of a disability or end -stage renal disease. (42
U.S.C. § 1395ss)
Section 4 of this bill requires an insurer that offers a Medicare supplement al
policy in this State, including an insurer that provides coverage to state and local
government employees, to allow a person who is less than 65 years of age and
enrolled in Medicare on the basis of a disability or end -stage renal disease to
purchase any Medicare supplemental policy that the insurer offers to new insureds
in this State who are 65 years of age or older. Section 4 imposes certain limitations
on the premium rate that such an insurer may charge such persons for a Medicare
supplemental policy and prohibits insurers from imposing additional limitations,
terms or conditions on such persons with respect to the policy that the insurer
would not impose on persons who are 65 years of age or older.
Existing law requires an insurer offering a Medicare supplemental policy to
annually offer an open enrollment period for persons currently covered by a
Medicare supplemental policy, during which the insurer is prohibited from taking
certain actions with respect to the issuance or effectiveness of, or price charged for,
a policy offered to a person during the open enrollment period. (NRS 687B.352)
Section 4 requires an insurer to establish a similar open enrollment period which
allows an eligible person who is less than 65 years of age to purchase a Medicare
supplemental policy during a 6 -month period commencing on the first day of the
first month during which the person enrolled in coverage under Part B of Medicare,
which provides coverage for certain medica lly necessary services provided outside
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of a hospital. During that open enrollment period, section 4 prohibits an insurer
from taking certain actions with respect to the issuance or effectiveness of a policy
offered to the person. Section 4 also prohibits an insurer from imposing an
exclusion of benefits under a Medicare supplemental policy during that open
enrollment period based on a preexisting condition. Section 6 of this bill adds a
similar prohibition with regard to the open enrollment period establis hed under
existing law which will apply to both persons who are 65 years of age or older and
persons who are less than 65 years of age and suffering from a disability or end -
stage renal disease. Section 10 of this bill requires an insurer to establish a si milar
open enrollment period, which commences on October 1, 2025, and remains open
through April 1, 2026, for persons who are: (1) less than 65 years of age; (2)
suffering from a disability or end -stage renal disease; and (3) enrolled in coverage
under Par t B of Medicare as of October 1, 2025, on the basis of the disability or
end-stage renal disease.
Sections 7-9 of this bill establish the applicability of section 4 to: (1) a hospital
or medical services corporation; and (2) state and local governments th at offer
insurance to employees. Section 3 of this bill defines the term “Medicare
supplemental policy” to have the same meaning as is ascribed to it in federal
regulations, and section 2 of this bill establishes the applicability of that definition.
Sections 5 and 6 of this bill make conforming changes to remove duplicative
language from other existing provisions.
EXPLANATION – Matter in bolded italics is new; matter between brackets [omitted material] is material to be omitted.
THE PEOPLE OF THE STATE OF NEVADA, REPRESENTED IN
SENATE AND ASSEMBLY, DO ENACT AS FOLLOWS:
Section 1. Chapter 687B of NRS is hereby amended by adding
thereto the provisions set forth as sections 2, 3 and 4 of this act.
Sec. 2. As used in this chapter, unless the context otherwise
requires, the words and terms defined in NRS 687B.015 and
section 3 of this act have the meanings ascribed to them in those
sections.
Sec. 3. “Medicare supplemental policy” has the meaning
ascribed to it in 42 C.F.R. § 403.205.
Sec. 4. 1. An insurer that offers any Medicare
supplemental policy for delivery in this State shall allow a person
who is less than 65 years of age and eligible for and enrolled in
Medicare on the basis of a disability or end -stage renal disease to
purchase any Medicare supplemental policy that the insurer offers
to new insureds in this State who are 65 years of age or older.
2. An insurer shall not impose any limitation, term or
condition relating to coverage, benefits, protections, policies or
procedures with respect to a Medicare supplemental policy issued
to a person who is less than 65 years of age pursuant to subsection
1 if the limitation, term or condition is not imposed with respect to
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a Medicare supplemental policy offered by the insurer to a person
who is 65 years of age or older.
3. An insurer shall not charge a person described in
subsection 1:
(a) For a Standardized Benefit Plan A, Plan B or Plan D
Medicare supplemental policy, a premium rate that exceeds the
premium rate that the insurer would charge a person who is
exactly 65 years of age for the same Medicare supplemental policy.
(b) For a standardized benefit plan not described in paragraph
(a), a premium rate that exceeds 200 percent of the premium rate
that the insurer would charge a person who is exactly 65 years of
age for the same Medicare supplemental policy.
4. An insurer shall offer to a person who is less than 65 years
of age and eligible to purchase a Medicare supplemental policy
pursuant to subsection 1 an open enrollment pe riod commencing
on the first day of the first month that the person enrolled in
coverage pursuant to Medicare Part B, 42 U.S.C. §§ 1395j et seq.,
and remaining open for at least 6 months thereafter, during which
the person may purchase any Medicare supplem ental policy made
available by the insurer to new insureds in this State.
5. During the open enrollment period offered pursuant to
subsection 4, an insurer shall not:
(a) Deny or condition the issuance or effectiveness of a
Medicare supplemental policy based on the health status, claims
experience, receipt of health care or medical condition of a person
described in subsection 4; or
(b) Impose an exclusion of benefits provided under the
Medicare supplemental policy based on a preexisting medical
condition of a person described in subsection 4.
6. As used in this section, “standardized benefit plan”:
(a) Means a Medicare supplemental policy with a particular
package of benefits as required by federal law; and
(b) Includes, without limitation, any Medi care supplemental
policy designated as Standardized Benefit Plan A to N, inclusive,
any high deductible version of any such plan and any other
standardized package of benefits for Medicare supplemental
policies that may be established by federal law.
Sec. 5. NRS 687B.015 is hereby amended to read as follows:
687B.015 [As used in this chapter, unless the context otherwise
requires, “binder”] “Binder” means an oral or written contract for
temporary insurance which is used when a policy is not immediately
issued to evidence that the coverage attaches at a specified time and
continues until the policy is issued or the risk is declined.
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Sec. 6. NRS 687B.352 is hereby amended to read as follows:
687B.352 1. An insurer that issues a Medicare supplemental
policy shall offer to a person currently insured under any such
policy an annual open enrollment period commencing with the first
day of the birthday month of the person and remaining open for at
least 60 days thereafter, during which the person may purchase any
Medicare supplemental policy made available by the insurer in this
State that includes the same or lesser benefits. Innovative benefits,
as described in 42 U.S.C. § 1395ss(p)(4)(B), must not be considered
when determining whether a Medicare supplemental policy includes
the same benefits as or lesser benefits than another such policy.
2. During the open enrollment period offered pursuant to
subsection 1, an insurer shall not [deny] :
(a) Deny or condition the issuance or effectiveness, or
discriminate in the price of coverage, of a Medicare supplemental
policy based on the health status, claims experience, receipt of
health care or medical condition of a person described in subsection
1 [.] ; or
(b) Impose an exclusion of benefits provided under the
Medicare supplemental policy based on a preexisting medical
condition of a person described in subsection 1.
3. At least 30 days before the beginning of the open enrollment
period offered pursuant to subsection 1 but not more than 60 days
before the beginning of that period, an insurer that issues a Medicare
supplemental policy shall notify each person to whom the open
enrollment period applies of:
(a) The dates on which the open enrollment period begins and
ends and the rights of the person established by the provisions of
this section; and
(b) Any modification to the benefits provided by the policy
under which the person is currently insured or adjustment to the
premiums charged for that policy.
4. An insurer or other person or entity shall not vary the
commission associated with the purchase of Medicare supplemental
policies during the open enrollment period offered pursuant to
subsection 1, pay differential commissions associ ated with the
purchase of Medicare supplemental policies during that open
enrollment period or otherwise treat Medicare supplemental policies
purchased during that open enrollment period differently for the
purposes of commission for any reason, including, without
limitation:
(a) Because the Medicare supplemental policy was purchased
during the open enrollment period offered pursuant to subsection 1;
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(b) Because the Medicare supplemental policy is classified as
guaranteed issue under 42 U.S.C. § 1395ss or any other applicable
federal or state law or regulations; or
(c) Because of the health status, claims experience, receipt of
health care or medical condition of the insured.
5. An insurer or other person or entity must treat the purchase
of a Medicare supplemental policy during the open enrollment
period offered pursuant to subsection 1 in the same manner as the
renewal of a Medicare supplemental policy for all purposes relating
to the payment of a commission.
[6. As used in this section, “Medicare supplemental policy” has
the meaning ascribed to it in 42 C.F.R. § 403.205 and additionally
includes policies offered by public entities that otherwise meet the
requirements of that section.]
Sec. 7. NRS 695B.320 is hereby amended to read as follows:
695B.320 1. Nonprofit hospital and medical or dental service
corporations are subject to the provisions of this chapter, and to the
provisions of chapters 679A and 679B of NRS, subsections 2, 4, 17,
18 and 30 of NRS 680B.010, NRS 680B.025 to 680B.060,
inclusive, chapter 681B of NRS, NRS 686A.010 to 686A.315,
inclusive, 686B.010 to 686B.175, inclusive, 687B.010 to
687B.040, inclusive, 687B.070 to 687B.140, inclusive, 687B.150,
687B.160, 687B.180, 687B.200 to 687B.255, inclusiv e, 687B.270,
687B.310 to 687B.380, inclusive, and section 4 of this act,
687B.410, 687B.420, 687B.430, 687B.500 and chapters 692B,
692C, 693A and 696B of NRS, to the extent applicable and not in
conflict with the express provisions of this chapter.
2. For the purposes of this section and the provisions set forth
in subsection 1, a nonprofit hospital and medical or dental service
corporation is included in the meaning of the term “insurer.”
Sec. 8. NRS 287.010 is hereby amended to read as follows:
287.010 1. The governing body of any county, school
district, municipal corporation, political subdivision, public
corporation or other local governmental agency of the State of
Nevada may:
(a) Adopt and carry into effect a sys tem of group life, accident
or health insurance, or any combination thereof, for the benefit of its
officers and employees, and the dependents of officers and
employees who elect to accept the insurance and who, where
necessary, have authorized the governi ng body to make deductions
from their compensation for the payment of premiums on the
insurance.
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(b) Purchase group policies of life, accident or health insurance,
or any combination thereof, for the benefit of such officers and
employees, and the depende nts of such officers and employees, as
have authorized the purchase, from insurance companies authorized
to transact the business of such insurance in the State of Nevada,
and, where necessary, deduct from the compensation of officers and
employees the pre miums upon insurance and pay the deductions
upon the premiums.
(c) Provide group life, accident or health coverage through a
self-insurance reserve fund and, where necessary, deduct
contributions to the maintenance of the fund from the compensation
of officers and employees and pay the deductions into the fund. The
money accumulated for this purpose through deductions from the
compensation of officers and employees and contributions of the
governing body must be maintained as an internal service fund as
defined by NRS 354.543. The money must be deposited in a state or
national bank or credit union authorized to transact business in the
State of Nevada. Any independent administrator of a fund created
under this section is subject to the licensing requirement s of chapter
683A of NRS, and must be a resident of this State. Any contract
with an independent administrator must be approved by the
Commissioner of Insurance as to the reasonableness of
administrative charges in relation to contributions collected and
benefits provided. The provisions of NRS 439.581 to 439.597,
inclusive, 686A.135, 687B.352, 687B.408, 687B.692, 687B.723,
687B.725, 687B.805, 689B.030 to 689B.0317, inclusive, paragraphs
(b) and (c) of subsection 1 of NRS 689B.0319, subsections 2, 4, 6
and 7 of NRS 689B.0319, 689B.033 to 689B.0369, inclusive,
689B.0375 to 689B.050, inclusive, 689B.0675, 689B.265, 689B.287
and 689B.500 and section 4 of this act apply to coverage provided
pursuant to this paragraph, except that the provisions of NRS
689B.0378, 689B.03785 and 689B.500 only apply to coverage for
active officers and employees of the governing body, or the
dependents of such officers and employees.
(d) Defray part or all of the cost of maintenance of a self -
insurance fund or of the premiums upon i nsurance. The money for
contributions must be budgeted for in accordance with the laws
governing the county, school district, municipal corporation,
political subdivision, public corporation or other local governmental
agency of the State of Nevada.
2. If a school district offers group insurance to its officers and
employees pursuant to this section, members of the board of trustees
of the school district must not be excluded from participating in the
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group insurance. If the amount of the deductions from compensation
required to pay for the group insurance exceeds the compensation to
which a trustee is entitled, the difference must be paid by the trustee.
3. In any county in which a legal services organization exists,
the governing body of the county, or of any school district,
municipal corporation, political subdivision, public corporation or
other local governmental agency of the State of Nevada in the
county, may enter into a contract with the legal services
organization pursuant to which the officers and employees of the
legal services organization, and the dependents of those officers and
employees, are eligible for any life, accident or health insurance
provided pursuant to this section to the officers and employees, and
the dependents of the office rs and employees, of the county, school
district, municipal corporation, political subdivision, public
corporation or other local governmental agency.
4. If a contract is entered into pursuant to subsection 3, the
officers and employees of the legal services organization:
(a) Shall be deemed, solely for the purposes of this section, to be
officers and employees of the county, school district, municipal
corporation, political subdivision, public corporation or other local
governmental agency with which the legal services organization has
contracted; and
(b) Must be required by the contract to pay the premiums or
contributions for all insurance which they elect to accept or of which
they authorize the purchase.
5. A contract that is entered into pursuant to subsection 3:
(a) Must be submitted to the Commissioner of Insurance for
approval not less than 30 days before the date on which the contract
is to become effective.
(b) Does not become effective unless approved by the
Commissioner.
(c) Shall be dee med to be approved if not disapproved by the
Commissioner within 30 days after its submission.
6. As used in this section, “legal services organization” means
an organization that operates a program for legal aid and receives
money pursuant to NRS 19.031.
Sec. 9. NRS 287.04335 is hereby amended to read as follows:
287.04335 If the Board provides health insurance through a
plan of self -insurance, it shall comply with the provisions of NRS
439.581 to 439.597, inclusive, 68 6A.135, 687B.352, 687B.409,
687B.692, 687B.723, 687B.725, 687B.805, 689B.0353, 689B.255,
695C.1723, 695G.150, 695G.155, 695G.160, 695G.162,
695G.1635, 695G.164, 695G.1645, 695G.1665, 695G.167,
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695G.1675, 695G.170 to 695G.1712, inclusive, 695G.1714 to
695G.174, inclusive, 695G.176, 695G.177, 695G.200 to 695G.230,
inclusive, 695G.241 to 695G.310, inclusive, 695G.405 and
695G.415, and section 4 of this act, in the same manner as an
insurer that is licensed pursuant to title 57 of NRS is required to
comply with those provisions.
Sec. 10. 1. In addition to the open enrollment period
described in subsection 4 of section 4 of this act, an insurer that
offers any Medicare supplemental policy for delivery in this State as
of October 1, 2025, shall offer to a person who is less than 65 years
of age and is eligible for and enrolled in coverage pursuant to
Medicare Part B, 42 U.S.C. §§ 1395j et seq., on October 1, 2025, on
the basis of a disability or end -stage renal disease, an open
enrollment period commencing on October 1, 2025, and remaining
open through April 1, 2026.
2. During the open enrollment period offered pursuant t o
subsection 1, an insurer shall not:
(a) Deny or condition the issuance or effectiveness of a
Medicare supplemental policy based on the health status, claims
experience, receipt of health care or medical condition of a person
described in subsection 1; or
(b) Impose an exclusion of benefits provided under the Medicare
supplemental policy based on a preexisting medical condition of a
person described in subsection 1.
3. As used in this section:
(a) “Insurer” has the meaning ascribed to it in NRS 679A. 100
and additionally includes:
(1) A governing body of any county, school district,
municipal corporation, political subdivision, public corporation or
other local governmental agency of the State of Nevada that
provides Medicare supplemental policies th rough a self -insurance
reserve fund pursuant to NRS 287.010; and
(2) The Public Employees’ Benefits Program.
(b) “Medicare supplemental policy” has the meaning ascribed to
it in 42 C.F.R. § 403.205.
Sec. 11. The provisions of NRS 354.599 do not apply to any
additional expenses of a local government that are related to the
provisions of this act.
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