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Network Adequacy

Plan Year 2024 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 2024 Network Adequacy Declaration Document, the Autism Provider Template, the Network Adequacy Year Over Year Template, and the Network Adequacy Filing Checklist within the "Supporting Documentation" tab of each applicable Binder.  

Important Network Adequacy Dates for Plan Year 2024

May 31st- Network Plan applications due
June 11th - Division finishes completeness check
June 15th - Carrier responses due in SERFF
June 29th - Division sends first objection letter
July 13th - Carrier responses due in SERFF
July 27th - Division sends first objection letter
August 10th - Carrier responses due in SERFF
August 24th- Division sends second objection letter
September 6th - Carrier responses due in SERFF
August 31st - Division makes final determinations

Small Employer Group Health Plans

July 12th - Network Plan applications due
July 14th - Division finishes completeness check
July 18th - Carrier responses due in SERFF
July 31st - Division sends first objection letter
August 14th - Carrier responses due in SERFF
August 28th - Division sends second objection letter
September 11th - Carrier responses due in SERFF
September 18th - Division sends second objection letter
September 25th - Carrier responses due in SERFF
September 23rd - Division makes final determinations

Helpful Links and Templates

2024 NV Network Adequacy Filing Guidance
SSHIX Final PY2024 Annual Letter to Issuers
CMS Published Guidance and Regulations
Final Non-exhaustive HHS List of ECP's
Network Adequacy Regulation LCB File No. R067-19
NAC Adequacy of Network Plans Section  

For questions concerning Network Adequacy, please contact Maile Campbell in the Division's Product Compliance Section:  mcampbell@doi.nv.gov or (775) 687-0735.