Nevada Revised Statutes 695C.240 – Information required to be available for inspection
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Every health maintenance organization shall have available for inspection the following information:
Terms Used In Nevada Revised Statutes 695C.240
- Enrollee: means a natural person who has been voluntarily enrolled in a health care plan. See Nevada Revised Statutes 695C.030
- Health maintenance organization: means any person which provides or arranges for provision of a health care service or services and is responsible for the availability and accessibility of such service or services to its enrollees, which services are paid for or on behalf of the enrollees on a periodic prepaid basis without regard to the dates health services are rendered and without regard to the extent of services actually furnished to the enrollees, except that supplementing the fixed prepayments by nominal additional payments for services in accordance with regulations adopted by the Commissioner shall not be deemed to render the arrangement not to be on a prepaid basis. See Nevada Revised Statutes 695C.030
1. A current statement of financial condition including a balance sheet and summary of receipts and disbursements;
2. A description of the organizational structure and operation of the health maintenance organization and a summary of any material changes since the issuance of the last report;
3. A description of services and information as to where and how to secure them; and
4. A clear and understandable description of the health maintenance organization’s method for resolving enrollee complaints.