Network Adequacy
Plan Year 2026 Network Plan Submission Instructions
Carriers must include a validated CMS ECP/Network Adequacy template in each SERFF Binder for every individual and small group market segment. The template must be uploaded to the "Templates" tab of the SERFF Binder for validation within the Plan Management module.
Beginning with Plan Year 2026, carriers submitting medical QHPs in Nevada must comply with the Federal network adequacy requirements stated in the 2023 Final Letter to Issuers.
For non-QHPs, Nevada requires that issuers comply with the Network Adequacy requirements under Nevada Revised Statutes (“NRS”) 687B.490 which are clarified by regulation in the Adequacy of Network Plans section of the Nevada Administrative Code (“NAC”) under 687B.750 to NAC 687B.784.
NOTE: the Binder Checklist, NV Network Adequacy Declaration Document, Supplemental Provider Template and, if necessary, the Year over Year Deficiency Response must be included within supporting documentation of the risk pool binders for all individual and small group network plans.
Important Network Adequacy Dates for Plan Year 2026
INDIVIDUAL HEALTH AND DENTAL PLANS
June 2nd- Network Plan applications due
August 29th- Division makes final determinations
SMALL EMPLOYER GROUP HEALTH AND DENTAL PLANS
July 14th- Network Plan applications due
September 29th- Division makes final determinations
Objections/Responses
The Division anticipates no more than a two-week turn around for review after a submission and, under normal circumstances, the carriers will have two weeks to respond to objections.
Helpful Links and Templates
2026 NV Network Adequacy Filing Guidance - Medical
2026 NV Network Adequacy Filing Guidance - Dental
SSHIX Final PY2026 Annual Letter to Issuers
CMS Published Guidance and Regulations
CMS Application Materials (includes Final Non-exhaustive HHS List of ECPs)
2026 Network Adequacy Declaration Document
Justification for Network Adequacy/Essential Community Provider (ECP) Objections
PY26 Binder Completion Checklist
YOY Deficiency Response Sample
Supplemental Provider Template