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Network Adequacy

Plan Year 2020 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 2020 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 2020


Individual Health Plans 

June 3rd Network Plan applications due
June 17th DOI sends first objection letter
July 1st Carrier responses due in SERFF
July 15th DOI sends second objection letter
July 29th Carrier responses due in SERFF
August 12th DOI sends third objection letter

August 26th Carrier responses due in SERFF
September 1st DOI makes final determinations

Small Employer Group Health Plans

July 15th Network Plan applications due
July 29th DOI sends first objection letter
August 12th Carrier responses due in SERFF
August 26th DOI sends second objection letter
September 9th Carrier responses due in SERFF
September 23rd DOI sends third objection letter
October 7th Carrier responses due in SERFF
October 13th DOI makes final determinations

Helpful Links and Templates

2020 NV Network Adequacy Filing Guidance

Autism Provider Template
SSHIX Final PY2020 Annual Letter to Issuers
CMS PY2020 Annual Letter to Issuers
CMS Final 2019 Annual Letter to Issuers
CMS Final 2018 Annual Letter to Issuers
2020 Notice of Benefit and Payment Parameters
NV Essential Care Provider (ECP) List for 2020
Network Adequacy Regulation T005-18
NAC Adequacy of Network Plans Section

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.