State Insurance Exchange Special Enrollment Period Extended
April 13, 2021
In response to the changes made to the premium tax credits by the American Rescue Plan Act, the state’s health insurance marketplace (Nevada Health Link) has extended its special open enrollment period (SEP) to August 15, 2021. This extension is occurring since premium tax credits have lowered premiums for a greater number of people; the state anticipates that the demand to enroll on the marketplace will rise.
While the creation of the SEP will affect individuals that will enroll on the marketplace, employers should be mindful of this extension in case there are employees who seek to drop coverage under their plans to take advantage of the SEP. Specifically, the permissible qualifying event for a revocation due to enrollment in a qualified plan will allow an employee to drop their employer’s plan mid-year if they intend to enroll in the marketplace. Unless future legislation or guidance indicates otherwise, applicable large employers are still required to offer full-time employees minimum value coverage satisfying one of the affordability safe harbors.
Nevada Health Link Press Release »
COVID-19 Insurance Update
July 21, 2020
On July 9, 2020, the Commissioner of Insurance adopted Emergency Regulation R054-20. The regulation prohibits health insurers regulated by the state from imposing cost sharing or medical management techniques to restrict access by an insured to screening, testing or a vaccine for COVID-19. Regulated health insurers must also provide to each insured and healthcare provider that participates in the network plan of the insurer with information concerning certain benefits and services related to COVID-19. Regulated health insurers must cover a prescription drug that is not included in the formulary of the insurer if: 1) no drug included in the formulary is available that would be effective to treat the condition; and 2) the unavailability of such drugs is due to a disruption in the supply of the drugs.
The regulation expires on the same date as the state of emergency, which began by declaration of the governor on March 12, 2020. Employers with health plans regulated by the state should be aware of this new regulation.
Emergency Regulation Extension Proposed
June 23, 2020
On June 15, 2020, the Department of Insurance proposed regulation to replace and extend emergency regulation promulgated on March 5, 2020. The emergency regulation was discussed in the March 17, 2020, edition of Compliance Corner. The proposed replacement will be effective until the date on which the emergency declared in the Declaration of Emergency for COVID-19 issued by Gov. Sisolak on March 12, 2020, expires.
Employers with plans regulated by the state should be aware of this development.
Proposed Regulation »
COVID-19 Insurance Updates
April 14, 2020
On March 30, 2020, the Division of Insurance issued guidance concerning the health insurance market in the state due to the COVID-19 outbreak. The statement asks health insurers in the state to:
- Be more flexible when it comes to premium payments during the outbreak. The division encourages insurers to provide additional 60-day grace periods, to waive late fees and penalties, work out payment plans and only cancel or nonrenew policies if all other efforts are exhausted.
- Make sure that consumers are aware of the available telehealth options, to pay out of network providers at the same rates as in network providers if the network cannot handle the increased load due to COVID-19, and to expand telehealth opportunities where possible.
- Eliminate or simplify pre-authorization standards.
- (Group plans) Permit employers to continue providing coverage to employees regardless of active work requirements in plan documents.
- (Pharmacies) Consider early or extra refills for chronic conditions of Nevadans who are most at risk during the pandemic, take necessary steps to prevent disruption in drug access, and provide allowances for out of network pharmacy refills if the network cannot handle the increased load or if supply chains are disrupted.
The guidance is primarily directed at insurers. However, employers should also be aware of these developments.
Statement Regarding Nevada Health Insurance Market Due to COVID-19 »
Special Enrollment Period for Exchange
March 31, 2020
On March 17, 2020, Nevada Health Link announced a special enrollment period (SEP) for individuals seeking health insurance on the Silver State Health Insurance Exchange. The SEP was initiated as a result of Gov. Sisolak’s March 12, 2020, Emergency Declaration due to the COVID-19 outbreak. The SEP runs from March 17, 2020, through April 15, 2020, and is available to anyone who has not previously enrolled in a plan on the exchange in 2020. It does not provide an opportunity to change plans on the exchange.
Employers with employees located in Nevada should be aware of this option in the event that they terminate or furlough employees who may lose their health coverage and need to enroll in a plan on the exchange.
Nevada Health Link SEP Announcement and Links »
Insurance Updates Regarding COVID-19
March 17, 2020
On March 5, 2020, the Nevada Department of Business and Industry’s Division of Insurance and Gov. Sisolak adopted an emergency regulation that prohibits insurance policies regulated by the state from imposing an out-of-pocket cost for a provider office, urgent care center, or emergency room visit when the purpose of the visit is testing for COVID-19. Additionally, the regulation prohibits insurers from charging Nevadans for the COVID-19 test itself or an immunization as one becomes available and further requires coverage for off-formulary prescription drugs if a formulary drug is not available for treatment. Lastly, the regulation requires health insurers to provide information on available benefits, options for medical advice and treatment through telehealth, and preventative measures related to COVID-19.
This emergency regulation does not apply to self-insured plans. Fully-insured employers with policies regulated in Nevada should be aware of these developments.
Press Release and copy of Emergency Regulation »
Consumer Alert »
DOI Guidance for Consumers »
Paid Leave Law
December 10, 2019
On October 4, 2019, Labor Commissioner Chambers issued Advisory Opinion 2019-02 concerning that state’s new paid leave law (SB 312), effective January 1, 2020. SB 312 requires Nevada employers with 50 or more employees in the state to provide employees with at least 0.01923 hours of paid leave for each hour worked in a benefit year, and employees can use that leave for any reason. The advisory opinion seeks to provide guidance on the new law.
The opinion points out that SB 312 does not apply to employers during the first two years of operation or to employers who already have leave policies that exceed the 0.01923 hours paid leave per hour of work. Temporary, seasonal, or on-call employees (those employees called out to work on an hourly or daily basis based upon employer need) do not count towards the 50 employee threshold. Employers can “frontload” an employee’s total accrual on the first day of the benefit year, but employers are not required to pay out any unused leave upon the employee’s termination.
Employers with Nevada employees should consult this advisory opinion for these and other clarifications of SB 312 while updating their leave policies.
Advisory Opinion 2019-02 »
State Law Amended to Provide Certain ACA Protections
October 29, 2019
On May 15, 2019, Gov. Sisolak signed Assembly Bill 170 into law. The bill requires insurers to offer health benefit plans to Nevada residents regardless of their health status, and provides a mechanism for the state to oversee insurers in the state and to help residents obtain such health benefit plans. The state passed this law in order to make sure that residents of the state with pre-existing conditions would not lose coverage in the event that the Affordable Care Act is struck down in the courts.
Nevada is one of several states that are passing state-level solutions in the event the ACA is struck down in the courts, in order to make sure that their residents are covered. Employers should keep an eye on these efforts in their own states, and be prepared to make any adjustments in the way they provide health coverage to their employees in light of any state-level changes.
Nevada Assembly Bill 170 »
New Paid Sick Leave Law Enacted, Effective in 2020
July 23, 2019
On June 13, 2019, Gov. Sisolak signed SB 312 into law. The law creates new paid leave requirements for certain employers. Specifically, Nevada employers with 50 or more employees in the state will be required to provide employees with at least 0.01923 hours of paid leave for each hour worked in a benefit year, and employees can use that leave for any reason.
Under the related formula, an employee who works 40 hours per week during the year will earn approximately 40 hours of paid leave for that year. Importantly, the law does not apply to temporary, seasonal, or on-call employees, and includes exemptions for employers in their first two years of operation and employers that, pursuant to a contract, policy, or collective bargaining agreement, provide employees with paid leave or PTO benefits that meet the law’s minimum requirements.
As for benefits, employers may limit the use of paid leave to 40 hours within a benefit year, and employers can front-load paid leave (credit the total amount of paid leave at the beginning of the year) or require leave to be accrued during the course of the year. If accrual is used, employers must allow employees to carry over accrued, unused paid leave to the following year (employers can limit the carryover to 40 hours, though). If front-loading is used, employers are not required to allow such a carryover.
According to the law, employers cannot deny an employee the right to use accrued paid leave for any reason, require an employee to provide an explanation for using the paid leave, or instruct an employee to find a replacement as a condition to using paid leave. Employees, though, must provide advance notice, where possible, of the intent to take leave.
Employers will have to post a notice (which will eventually be available from the Nevada Labor Commissioner) explaining employees’ and employers’ rights and obligations under the law. Employers will also be required to maintain a record of accrual and use of paid leave for each employee for a one-year period, and must provide employees an accounting of their paid leave accrual and use each payday (through a paystub or other method).
Employers will want to work closely with payroll providers in developing appropriate tracking, recording and accrual policies and procedures. The Labor Commissioner is charged with enforcement of the law and may impose administrative penalties of up to $5,000 per violation. (Violations can include failure to provide the leave or notice or to maintain mandated records.)
The new law is effective January 1, 2020, which gives employers little time to come into compliance. The Nevada Labor Commissioner will publish regulations in the future which will hopefully provide additional clarifications and guidance. Employers will want to work with payroll providers and with outside counsel in developing appropriate leave policies, considering the new law in Nevada.
SB 312 »
Mandated Leave and Accommodations for Victims of Domestic Violence
August 08, 2017
On March 8, 2017, Gov. Sandoval signed SB 361 into law (an act related to domestic violence), which effectively amends Chapters 608 and 613 of the Nevada Revised Statutes. This act generally requires Nevada employers to provide leave and reasonable accommodations for employees who are victims of domestic violence or whose family members are domestic violence victims. It also imposes recordkeeping requirements and prohibits certain discriminatory actions against these employees.
An employee who has been employed for at least 90 days may take up to a maximum of 160 hours of leave within 12 months immediately following the domestic violence occurrence. The leave hours may be paid or unpaid and can be used consecutively or intermittently. Domestic violence leave must be deducted from any applicable FMLA leave if the leave is used for a purpose that is also permitted under FMLA and the employee is otherwise eligible for FMLA. An employee may use leave hours for diagnosis, care or treatment of a health condition, or to receive counseling or assistance related to an act of domestic violence committed against the employee or family/household member of the employee.
Additionally, an employer must provide reasonable accommodations for these applicable employees. Examples of reasonable accommodations include work reassignments or transfers, modified schedules, a new work telephone number or any other accommodation necessary to ensure the safety of the employee and of the workplace, as long as it doesn’t create undue hardship. However, an employer may require the employee to provide documentation to substantiate any requests for accommodation.
An employer must maintain a record of the hours of leave taken under the law for each employee for a two-year period following the entry of the record, and must make those records available for inspection by the Labor Commissioner. The Nevada Labor Commissioner has posted an online bulletin describing the rights and benefits under the law. Employers are required to post the bulletin in a conspicuous location in each workplace maintained by the employer.
The Act related to domestic violence leave becomes effective Jan. 1, 2018. Thus, employers located in Nevada should review existing leave policies and make any pertinent changes to ensure compliance.
SB 361 »
Domestic Violence Victims Bulletin »