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This page lists some of the action toward parity compliance undertaken by Nevada regulatory agencies since 2008.

Are we missing any actions taken by state regulatory agencies? Let us know at info@paritytrack.org.

Action in the Regulatory Arena

2015

Nevada’s Division of Insurance has a document (pdf | Get Adobe® Reader®) that shows the coverage provided in its Essential Health Benefits (EHB) Benchmark Plans for 2017. The document contains information on the coverage provided for mental health services, substance use disorder services, and autism services. Accompanying this is a PowerPoint (pdf | Get Adobe® Reader®) that explains that plans – except state employee plans – are no longer allowed to have a $36,000 annual maximum for applied behavior analysis. even though this is allowed in the section of the state insurance law about autism services. The 2016 Benchmark Plan (pdf | Get Adobe® Reader®) still allows this (found on page 5).

7/2015

Nevada’s Division of Insurance released a reference document (pdf | Get Adobe® Reader®) that lists what is required of individual plans, small employer fully-insured plans, and large employer fully-insured plans. The list includes:

  • Plans must cover autism services
  • Large employer fully-insured plans must comply with the Federal Parity Law
  • Individual plans and small employer fully-insured plans must cover mental health services
  • Individual plans and small employer fully-insured plans must cover substance use disorder services

Nevada Parity Law

There are multiple sections of the state insurance law that are relevant to parity:

The sections about coverage for mental health conditions and substance use disorders will be summarized in the “Behavioral Health” section below on this page and the sections about autism coverage will be summarized in the “Autism” section below on this page.

Behavioral Health

The sections (linked above) of the insurance law about parity for behavioral health coverage require individual plans and small employer fully-insured plans to cover the following mental health conditions:

  • Schizophrenia
  • Schizoaffective disorder
  • Bipolar disorder
  • Major depressive disorders
  • Panic disorder
  • Obsessive-compulsive disorder

Nothing specifies how plans must cover these conditions, just that they must cover these conditions.

The sections about substance use disorders require small employer fully-insured plans to cover substance use disorder services and requires insurers to offer individual plans that cover substance use disorder services, which individuals can accept or reject. This coverage included:

Autism

The sections of the state law about autism require large employer fully-insured plans, small employer fully-insured plans, and public employee plans to cover autism services. Individual plans must offer to cover these services, but individuals can choose to accept or reject this coverage. The coverage is for children through age 17 or through age 21, if they are enrolled in high school. When coverage is in place, plans must follow these requirements:

  • $36,000 annual maximum for applied behavior analysis
  • Financial requirements must be the same as those in place for other medical services
  • No annual limits for outpatient visits unless the child goes beyond the annual maximum
  • Defines autism treatment as habilitative or rehabilitative care, prescription care, psychiatric care, psychological care, behavior therapy, or therapeutic care (all of these are defined within the law)
  • Defines autism as autistic disorder, Asperger’s disorder, and pervasive developmental disorder not otherwise specified

Get Support

Nevada Insurance Division

Common Violations

In seeking care or services, be aware of the common ways parity rights can be violated.

Common Violations

Definition

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