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Network Adequacy

2018 Network Plan Submission Instructions

Carriers must include a validated CMS ECP/Network Adequacy template within the risk pool Binder, for each individual and small group market segment.  This validated template will be located within the "Templates" tab of the Binder within the SERFF Plan Management module.  Carriers must also submit a 2019 Network Adequacy Declaration Document, the Autism Provider Template, and the Network Adequacy Year Over Year Template within the "Supporting Documentation" tab of each applicable Binder.  

Important Network Adequacy Dates for Plan Year 2019


QHP Plans

June 8th Network Plan applications due
June 22nd DOI sends first objection letter
July 6th Carrier responses due in SERFF
July 20th DOI sends second objection letter
August 6th Carrier responses due in SERFF
August 17th DOI makes final determinations

NON-QHP Health Plans

 

July 13th Network Plan applications due
July 25th DOI sends first objection letter
August 6th Carrier responses due in SERFF
August 20th DOI sends second objection letter
September 3rd Carrier responses due in SERFF
September 17th DOI sends third objection letter
October 1st Carrier responses due in SERFF
October 11th DOI makes final determinations             

Helpful Links and Templates

Autism Provider Template
Final 2019 Annual Letter to Issuers
Final 2018 Annual Letter to Issuers
2019 Notice of Benefit and Payment Parameters
2019 Essential Community Providers/Network Adequacy Template
NV Essential Care Provider (ECP) List for 2019
Network Adequacy Regulation R002-18
NAC Adequacy of Network Plans Section
2019 Network Adequacy Guidance - PowerPoint
Network Adequacy Year Over Year Template

For questions concerning Network Adequacy, please contact Jeremey Gladstone in the Division's Life and Health Section:  jgladstone@doi.nv.gov or (775) 687-0729.