2018 ACA-Compliant Health Insurance Rate Filing Guidance 

Carriers will be required to complete and submit the 2018 Nevada Rate Filing Template (the Template) for all non-grandfathered individual and small group rate filings with effective dates of January 1, 2018 and later, regardless of whether the filing is for new products or for a change to rates for existing products, sold on or off the Exchange. The Template captures information related to enrollment, mapping of current plans to terminating plans, the development of the index rate, rating factors, risk adjustment transfer payments, experience data and quality measures.

The information reported in the Template is intended to be consistent with current State and Federal laws and other regulatory guidance. If any subsequent changes are made to State or Federal law and/or guidance that are in conflict with these instructions, the revised laws/guidance will supersede these instructions. In particular, unless otherwise notified due to a change in law, the Division expects that the rates filed for the 2018 benefit year will be in compliance with the Affordable Care Act (ACA).

The Template is an Excel based workbook designed to streamline the data collection process in order to meet the Division’s long-term goals for a more efficient rate review process.

2018 Nevada Rate Filing Template (Exel) 
2018 Nevada Rate Filing Instructions 
2018 Nevada Rate Filing Guidance
2018 Nevada Rate Filing Timeline   

May 18, 2017 Webinar Presentation on Rates, Form filing checklist, QHP and SADP Certification (View Here).

Filing Requirements

Life and Health filing requirements are outlined in the SERFF general instructions.

Additional Requirements include:

Procedure and Filing Guidance for Approval of Variable Text

Discretionary Group filings – All applicable requirements in the SERFF general instructions plus:

  1. Form LH 100 (Discretionary and Non-Employer Groups)
  2. Copy of Trust Agreement

Preferred Provider Organization in conjunction with health insurance – All requirements contained in the SERFF general instructions plus:

  1. List of providers used in connection with form(s)

Charitable Gift Annuities

Please send all Charitable Gift Annuity applications by email to Nanci Hoffman (nhoffman@doi.nv.gov).  Mailed applications will not be accepted after February 26, 2016.

To satisfy the requirements regarding Charitable Gift Annuities, please see NRS 688A.281 through NRS 688A.285 at Charitable Gift Annuities Statutes 

Rate Increases – All requirements contained in the SERFF general instructions plus:

  1. Clearly indicate in cover letter amount of increase applied for
  2. Actuarial memorandum describing policy
  3. Loss ratio history