Public Option Statute
June 22, 2021
On June 9, 2021, Gov. Sisolak signed SB420 into law, introducing a public health insurance option that will be available through the state exchange for individuals, small businesses and employees of small businesses. The law allows insurers to bid for the opportunity to offer the coverage (and requires insurers that provide coverage to the state’s Medicaid population to bid). State officials would select in-network providers for the public option plan and mandate that the plan charge 5% less in monthly premiums than the average plan on the state insurance marketplace and 15% less four years after it is first offered. The public option plan will also have to undergo an actuarial study and the state would need a waiver from the federal government.
Plans offered under this law will not be available until 2026, to give regulators time to come up with additional regulations to fill in details concerning the option and to research the viability and affordability of the plan.
Small businesses in the state should be aware of this development.
Paid Vaccination Law
June 22, 2021
On June 9, 2021, Gov. Sisolak signed SB 209 into law, requiring private employers to provide leave to their employees so that they can receive a COVID-19 vaccine. Under the law, private employers with 50 or more employees must provide employees with two consecutive hours of paid leave to receive a single-dose vaccine and two consecutive hours of paid leave for each dose of a two-dose vaccine.
Employers must post a poster currently under development by the state’s labor commissioner in the workplace to inform employees of their rights under this new law. Employees are required to provide notice of their intent to obtain the vaccine in order to take the paid leave. The law does not exempt seasonal or temporary workers, but it does exempt employers who provide vaccinations on site during regular business hours.
The law also amends current paid leave laws by providing that leave to employees for any reason, including taking leave for medical reasons such as treating physical or mental illness. Discussion of the state’s paid leave laws can be found in a July 23, 2019, Compliance Corner article and a December 10, 2019, Compliance Corner article.
Qualifying employers should be aware of this law.
SB 209 »
Paid Leave Law for Family Care
June 22, 2021
On May 29, 2021, Gov. Sisolak passed AB 190 into law, requiring employers who provide paid or unpaid sick leave to allow employees to use that leave to take care of an immediate family member who has an illness, injury, medical appointment or other authorized medical need. Immediate family members include children, foster children, spouses, domestic partners, siblings, parents, mothers-in-law, fathers-in-law, grandchildren, grandparents or stepparents of an employee, as well as persons for whom employees are legal guardians.
Employees can take this leave under the same conditions and to the same extent as the leave taken for themselves, although employers may limit the amount of sick leave that an employee may use for this purpose to an amount which is equal to but not less than the amount of sick leave that the employee accrues during a six-month period. Employers must post a poster currently under development by the state’s labor commissioner in the workplace to inform employees of their rights under this new law.
Employers in the state should be aware of this new law.
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 »