{"data":{"id":"us-nv/nrs-689b.0285","jurisdiction":"us-nv","citation":"NRS 689B.0285","heading":"System for resolving complaints of insureds: Establishment; approval; requirements; examination; exception.","body":"1. Except as otherwise provided in subsection 4, each insurer that issues a policy of group health insurance in this State shall establish a system for resolving any complaints of an insured concerning health care services covered under the policy. The system must be approved by the Commissioner.\n2. A system for resolving complaints established pursuant to subsection 1 must include an initial investigation, a review of the complaint by a review board and a procedure for appealing a determination regarding the complaint. The majority of the members on a review board must be insureds who receive health care services pursuant to a policy of group health insurance issued by the insurer.\n3. The Commissioner may examine the system for resolving complaints established pursuant to subsection 1 at such times as the Commissioner deems necessary or appropriate.\n4. Each insurer that issues a policy of group health insurance in this State that provides, delivers, arranges for, pays for or reimburses any cost of health care services through managed care shall provide a system for resolving any complaints of an insured concerning the health care services that complies with the provisions of NRS 695G.200 to 695G.310, inclusive.","path":["TITLE 57 — INSURANCE","CHAPTER 689B - GROUP AND BLANKET HEALTH INSURANCE","GROUP POLICIES","General Provisions"],"source_url":"https://www.leg.state.nv.us/NRS/NRS-689B.html#NRS689BSec0285","current_through":"2025 session (NRS as revised 2026-08-25)","vintage":"","retrieved_at":"2026-09-03T05:51:46Z","sha256":"ea5de6163bdfe0b657ce503546bab80264135465c136bf49677c98d09e1d9db8","source_id":"us-nv","stale":true,"prev":"us-nv/nrs-689b.0283","next":"us-nv/nrs-689b.029"},"notice":"GroundRules: Original legal text. Not legal advice."}