Transcript Slide 1

State of Nevada
Division of Industrial Relations
2011 Legislative Changes
W
orkers’
Compensation Section
Legal Disclaimer
• While every effort has been made to be
comprehensive, this overview is not guaranteed to
be all inclusive
• Those interested are strongly encouraged to read
the bills in their entirety at:
www.leg.state.nv.us
Select 2011 session>Bill Information
• If you need legal interpretation, please see your
attorney
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Reminder
NRS 616C.425 Date of determination of
amount of compensation and benefits. Except
as otherwise provided by a specific statute:
1. ... compensation and benefits [are] ...
determined as of the date of the accident or injury ...
2. ... subsequent injury or disability that primarily
arises from a previous accident or injury,... the date of
the previous accident or injury must be used to
determine the amount of compensation and benefits
to which the claimant is entitled.
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2011 Legislature Changes for
Workers’ Compensation
AB 74
SB 58
AB 98
SB 63
AB 141
SB 164
SB 21
SB 213
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Bills “Areas of Interest”
• Personnel Matters
• SB 21 – Catastrophic Injury and Life Care Plans
• Other Regulatory Matters
TPA Regulation
Employee Leasing Companies
• Fines/Penalties
 SB 63 UECA Reimbursement & Other
amounts owed
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Legend of Bill Text
• Bold italics = new language
• [therefore] = deleted language
• Plain text = existing language
• ( ) = explanatory language for training
purposes
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Personnel Matters
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Personnel Matters
AB 98 – WC Coverage for
Volunteer Health Practitioners
Sec. 29. 1. A volunteer health practitioner who dies or
is injured (or who incurs an occupational disease) as a
result of providing health or veterinary services
pursuant to sections 2 to 30, inclusive, of this act is
deemed to be an employee as defined in section 31.5
of this act for the purposes of receiving benefits for
the death or injury pursuant to chapters 616A to 616D
(and 617), inclusive, of NRS if:
(a) The practitioner is not otherwise eligible for such
benefits for the injury or death under the laws of this
or another state; and
(b) The practitioner or, in the case of death, the
practitioner’s personal representative, files a claim for
compensation under chapters 616A to 616D (or 617),
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inclusive, of NRS.
Personnel Matters
AB 98 – WC Coverage for
Volunteer Health Practitioners
Sec. 29. cont’d
3. ... To promote uniformity in the application of
sections 2 to 30, inclusive, of this act with other
states that enact similar legislation, the Division of
Industrial Relations shall consult with, and consider
the practices for filing, processing and paying claims
by, agencies having similar authority in other states.
4. As used in this section, “injury” means a physical
injury or mental injury, as described in NRS 616C.180,
or a disease for which an employee of this State who
is injured or contracts the disease in the course of the
employee’s employment would be entitled to benefits
under chapters 616A to 617, inclusive, of NRS.
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Personnel Matters
AB 98 – WC Coverage for
Volunteer Health Practitioners
Sec. 31.5. Volunteer health practitioners have deemed wages of $100 per
month
Sec. 32.5. NRS 616A.105 (and Sec. 33 – NRS 617.070) is hereby amended
to read as follows: 616A.105 “Employee” and “worker” are used
interchangeably in chapters 616A to 616D, inclusive, of NRS and mean
every person in the service of an employer under any appointment or
contract of hire or apprenticeship, express or implied, oral or written,
whether lawfully or unlawfully employed, and include, but not exclusively:
...
5. Volunteer health practitioners, as defined in section 19 of
this act, who are providing health or veterinary services pursuant
to sections 2 to 30, inclusive, of this act and are entitled to the
benefits of chapters 616A to 616D, inclusive, of NRS pursuant to
the provisions of section 29 of this act.
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Personnel Matters
AB 141– Heart and Lung Disease
& Physical Exams
Existing law establishes diseases of the lung and
heart as occupational diseases of full-time
firefighters, police officers and volunteer
firefighters. (NRS 617.455, 617.457)
Sec. 1. Employees covered under NRS 617.455
(lung disease) must submit to a thorough lung
function test upon employment
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Personnel Matters
AB 141– Heart and Lung Disease
& Physical Exams
Sec. 1 cont’d (lung disease): upon beginning
coverage, and once every 2 years until age 40 or
older
After age 40, annual exams required
Volunteer Firefighters – Exam Requirements:
• Upon employment
• Upon beginning coverage
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Personnel Matters
AB 141– Heart and Lung Disease
& Physical Exams
Volunteer Firefighters – Exam Requirements, (lung
disease) cont’d:
• X-rays once every three years
• After 50 yrs or older, exam & X-ray once every
two years
NRS 617.457 – heart disease:
Volunteer firefighter, when on continuously active
status, must submit to physical exam
• Upon employment
• Upon beginning coverage
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Personnel Matters
AB 141– Heart and Lung Disease
& Physical Exams
NRS 617.457 – heart disease (physical exam):
• Once every 3 years after the beginning of
coverage physical
• After 50 or older, once every two years
Employer must mail volunteer FF notice of
date/time and place of physical exam 10 days prior
and obtain a USPS certificate of mailing
Effective: October 1, 2011
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Personnel Matters
SB 58 – Employer Fraud
Section 1 of this bill adds a new section to NRS 616D
An employer commits fraud who knowingly makes a
false statement or representation or knowingly
conceals a material fact regarding the eligibility of a
person claiming workers’ compensation benefits
without limitation, information relating to:
•The identity of the person or
•The classification of the person as an
independent contractor
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Personnel Matters
SB 58 – Employer Fraud
An employer who commits fraud or any person who
conspires to commit fraud shall be punished as
follows:
• If the amount of benefit or payment was less
than $250; it’s a misdemeanor offense
• If the amount of benefit or payment was $250
or more, it’s a category D felony as provided in
NRS 193.130
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Personnel Matters
SB 58 – Employer Fraud
Sec. 3. amends NRS 616D.220 to specify that
misrepresenting the classification or duties of an
employee means “as they relate to the amount
of payroll upon which premium is based.”
Effective: October 1, 2011
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SB 21 - Catastrophic Injury
& Life Care Plans
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SB 21 – Catastrophic Injury
& Life Care Plans
NRS 616A.077 – Expands Definition of “Catastrophic Injury”
8. A coma or vegetative state;
9. The loss or significant impairment of function of one
or more vital internal organs or organ systems;
10. The mangling, crushing or amputation of a major
portion of an extremity;
11. An injury which the insurer and the injured
employee agree should be administered as a claim
for a catastrophic injury;
12. An injury determined to be a catastrophic injury
pursuant to section 1.4 of this act; or
13. Any other category of injury deemed to be catastrophic as
determined by the Administrator
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SB 21 – Catastrophic Injury
& Life Care Plans
NRS 616A.080 – Changes definition of vocational
rehabilitation counselor:
• Master’s degree in rehabilitation counseling
• Has been certified as a rehab counselor by the
Commission on Rehabilitation Counselor
Certification
Or
• Has been certified as an insurance
rehabilitation specialist by the
Certification of Disability Management
Specialists Commission
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SB 21 – Catastrophic Injury
& Life Care Plans
Sec. 1.4. New Provisions of NRS 616C:
1. An injured employee may submit to an
insurer a written request for a determination
that his or her injury should be administered
as a claim for a catastrophic injury.
2. If an employee submits a written request to
an insurer pursuant to subsection 1, the
insurer shall issue a written determination
concerning the request not later than 30 days
after receipt of the request.
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SB 21 – Catastrophic Injury
& Life Care Plans
Sec. 1.5. New Provisions of NRS 616C:
An insurer that did not originally accept a claim
as a claim for a catastrophic injury shall
designate the claim as a claim for a
catastrophic injury if at any time after the claim
is accepted the injury satisfies the
requirements for a catastrophic injury.
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SB 21 – Catastrophic Injury
& Life Care Plans
Sec. 1.6 NRS 616C.700:
(b) Within [90] 120 days after the date [of acceptance
of the claim,] on which the treating physician
determines that the condition of the injured
employee has stabilized and that the injured
employee requires a life care plan, develop a life
care plan in consultation with the adjuster, nurse and
vocational rehabilitation counselor assigned to the
claim pursuant to paragraph [(a).] (a); and
(c) Pay benefits and provide the proper medical
services to the injured employee during the
entire period of the development and
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implementation of the life care plan.
SB 21 – Catastrophic Injury
& Life Care Plans
NRS 616C.700(3) ...
3. In developing a life care plan for an injured
employee, the insurer, in consultation with the
adjuster, nurse and vocational rehabilitation
Counselor assigned to the claim pursuant to
paragraph (a) of subsection 1, shall assess
the following:
(a) The number of home or hospital visits
determined to be necessary or appropriate by
the registered nurse and vocational
rehabilitation counselor;
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SB 21 – Catastrophic Injury
& Life Care Plans
NRS 616C.700(3) ...
(b) The life expectancy of the injured
employee;
(c) The medical needs of the injured employee,
including, without limitation:
(1) Surgery;
(2) Prescription medication;
(3) Physical therapy; and
(4) Maintenance therapy
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SB 21 – Catastrophic Injury
& Life Care Plans
NRS 616C.700(3) ...
(d) The effect, if any, of any preexisting
medical condition; and
(e) The potential of the injured employee for
rehabilitation, taking into account:
(1) The injured employee’s medical
condition, age, educational level, work
experience and motivation; and
(2) Any other relevant factors.
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SB 21 – Catastrophic Injury
& Life Care Plans
NRS 616C.700(4)
4. A life care plan developed pursuant to
paragraph (b) of subsection 1 must
include, without limitation, a schedule for
the adjuster, nurse and vocational
rehabilitation counselor assigned to the
claim pursuant to paragraph (a) of
subsection 1 to meet or communicate
with the injured employee, if practicable,
and the treating physician to determine
the need for, without limitation:
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SB 21 – Catastrophic Injury
& Life Care Plans
NRS 616C.700(4) cont.
(a) Special medical attention or treatment;
(b) Psychological counseling or testing; and
(c) Any medical device, including, without
limitation:
(1) A wheelchair;
(2) A prosthesis; and
(3) A specially equipped or designed
motor vehicle.
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SB 21 – Catastrophic Injury
& Life Care Plans
NRS 616C.700(5)
5. A life care plan developed pursuant to
paragraph (b) of subsection 1 must
include a plan of action for treatment or
vocational rehabilitation of the injured
employee or consideration of the possible
permanent total disability of the injured
employee.
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SB 21 – Catastrophic Injury
& Life Care Plans
NRS 616C.700(6)
6. In addition to any claim determination affecting the
rights of an injured employee under his or her claim, or
responses to requests on behalf of the injured employee
for specific action or information on the claim or any other
contact that may occur, an insurer shall (a) Schedule a
personal meeting concerning the status of the claim to
take place at least once per calendar month between the
adjuster assigned to the claim pursuant to paragraph of
subsection 1 and the injured employee or a family
member or designated representative of the injured
employee;
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SB 21 – Catastrophic Injury
& Life Care Plans
NRS 616C.700(6) cont.
or
(b) If a personal meeting described in paragraph
(a) is not practicable, provide a written report
concerning the status of the claim and soliciting
requests and information at least once per
calendar month to the injured employee or a
family member or designated representative of
the injured employee. The report must be mailed
to the injured employee or a family member or
designated representative of the injured
employee by first-class mail.
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SB 21 – Catastrophic Injury
& Life Care Plans
NRS 616C.700(7)
7. Except as otherwise provided in this subsection,
a life care plan developed pursuant to paragraph
(b) of subsection 1 must be based on the
condition of the injured employee at the time the
life care plan is established. If there is a
substantial or significant change in the condition
or prognosis of the injured employee, the insurer
shall amend the life care plan to reflect the
change in the condition or prognosis of the
injured employee.
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SB 21 – Catastrophic Injury
& Life Care Plans
Sec. 1.7. NRS 616C.720 is hereby amended to read
as follows: 616C.720 [1.] An adjuster who administers
a claim for a catastrophic injury must
1. Have at least 4 years of experience in adjusting
workers’ compensation claims for lost time; or
2. Have at least 2 years of experience in
adjusting workers’ compensation claims for lost
time and work under the direct supervision of
an adjuster who has at least 4 years of
experience in adjusting such claims.
Effective: May 30, 2011
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Other Regulatory Matters:
•TPA Regulation
•Employee Leasing Companies
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Other Regulatory Matters
SB 164 – TPA Regulation
Section 16.5
NRS 616A.400 The Administrator shall:…
5. Determine whether an insurer or third-party
administrator has provided adequate facilities in this
State to administer claims and for the retention of a file
on each claim.
7. Conduct such investigations and examinations of
insurers or third-party administrators as the
Administrator deems reasonable to determine whether
any person has violated the provisions ...
Effective: June 17, 2011 for purpose of adopting
regulations and January 1, 2012 for all other purposes
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Other Regulatory Matters
AB 74
Employee Leasing Companies
Section 128. 616B.691(1). [For the purposes of
chapters 612 and 616A to 617, inclusive, of NRS,
an] An employee leasing company which
complies with the provisions of NRS 616B.670 to
616B.697, inclusive, shall be deemed to be the
employer of the employees it leases to a client
company. The provisions of this subsection
apply only for the purposes of chapters 612
and 616A to 617, inclusive, of NRS.
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Other Regulatory Matters
AB 74
Employee Leasing Companies
Section 128. NRS 616B.691(2)
2. [If an employee leasing company complies with the
provisions of subsection 3, the] An employee leasing company
shall be deemed to be [the] an employer of its leased
employees for the purposes of offering, sponsoring and
maintaining any benefit plans . [, including, without limitation,
for the purposes of the Employee Retirement Income Security
Act of 1974, 29 U.S.C. §§1001 et seq.] The provisions of
this subsection do not affect the employer-employee
relationship that exists between a leased employee
and a client company.
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Other Regulatory Matters
AB 74 Employee Leasing Companies
Section 128. NRS 616B.691(3)
3. An employee leasing company shall not offer , sponsor or
maintain for its leased employees any self-funded
[industrial] insurance program. An employee leasing
company shall not act as a self-insured employer or be a
member of an association of self-insured public or private
employers pursuant to chapters 616A to 616D, inclusive, or
chapter 617 of NRS [.] or title 57 of NRS (Insurance)
Effective: June 17, 2011 for the purpose of adopting
regulations and other administrative tasks to carry out
the act; October 1, 2011 for all other purposes
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Other Regulatory Matters
SB 213 – Employee Leasing Companies
Section 1. NRS 616B.679 (5) is hereby amended to read
As follows: ... An employee leasing company that has not had
sufficient operating history to have an audited financial statement
based upon at least 12 months of operating history must present
financial statements reviewed by a certified public accountant
covering its entire operating history. [Each]The financial
[statement] statements must [:] be prepared not more than
13 months before the submission of an application and
must:
(a) Indicate that the applicant has [maintained] positive working
capital, as defined by generally accepted accounting principles,
[throughout] for the period covered by the financial
[statement;] statements; or
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Other Regulatory Matters
SB 213 – Employee Leasing Companies
NRS 616B.679(5) ...
(b) Be accompanied by a bond, irrevocable letter of credit or
securities with a minimum market value equaling the maximum
deficiency in working capital for the period covered by the
financial statements plus $100,000. The bond, irrevocable
letter of credit or securities must be held by a depository
institution designated by the Administrator to secure payment
by the applicant of all taxes, wages, benefits or other
entitlements payable by the applicant.
Effective October 1, 2011
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Fines/Penalties
Uninsured Employers Claim
Account Reimbursement
& Other Amounts Owed
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Fines/Penalties
SB 63 – UECA and other amounts owed
Chapters 616C and 617 of the NRS add new sections to read
as follows:
1. Except as otherwise provided in this subsection, if
an employer fails to pay to the Division any amount
due pursuant to NRS 616C.220 (or NRS 617.401 in
the case of occupational disease) the Division may,
after the date on which the debt became due, file
with the office of the clerk of a court of competent
jurisdiction an application for the entry of summary
judgment against the employer for the amount due.
The Division may not enforce a judgment against an
employer if an appeal requested by the employer
pursuant to NRS 616C.220 (or NRS 617.401) is
pending.
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Fines/Penalties
SB 63 – UECA and other amounts owed
Chapters 616C and 617 of the NRS add new sections to read
as follows:
2. If the Division intends to file an application for the
entry of summary judgment, the Division shall, not
less than 15 days before the date on which the
application is filed, notify the employer of the
Division’s intention to file the application. The
notification must be sent by certified mail to the
last known address of the employer and must
include the name of the employee for whom the
claim was paid, the amount sought to be recovered
and the date on which the application will be filed
with the court.
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Fines/Penalties
SB 63 – UECA and other amounts owed
Chapters 616C and 617 of the NRS add new sections
to read as follows:
3. An application for the entry of summary judgment
must:
(a) Be accompanied by a certificate which specifies:
(1) The amount owed by the employer, including any
attorney’s fees, interest and administrative costs
due;
(2) The name and address of the employer; and
(3) That the Division has complied with the applicable
provisions of law relating to the determination of
the amount required to be paid; and
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Fines/Penalties
SB 63 – UECA and other amounts owed
(b) Include:
(1) A request that judgment be entered against the
employer for the amount specified in the
certificate; and
(2) Evidence that the employer was notified of the
application for the entry of summary judgment in
accordance with subsection 2.
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Fines/Penalties
SB 63 – UECA and other amounts owed
Chapters 616C and 617 of the NRS add new sections to read as
follows:
4. The court clerk, upon the filing of an application for
the entry of summary judgment which complies with
the requirements set forth in this section, shall
forthwith enter a judgment against the employer in the
amount of the debt, plus any attorney’s fees, interest
and administrative costs, as set forth in the certificate.
The Division shall serve a copy of the judgment,
together with a copy of the application and the
certificate, upon the employer against whom the
judgment is entered, either by personal service or by
mailing a copy to the last known address of the employer.
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Fines/Penalties
SB 63 – UECA and other amounts owed
Chapters 616C and 617 of the NRS add new sections
to read as follows:
5. An abstract of the judgment entered
pursuant to subsection 4, or a copy thereof,
may be recorded in the office of the county
recorder of any county.
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Fines/Penalties
SB 63 – UECA and other amounts owed
6. From the time of its recordation, the
judgment constitutes a lien upon all real and
personal property situated in the county that is
owned by the employer, or which the employer
may afterward acquire, until the lien expires.
The lien has the force, effect and priority of a
judgment lien and continues for 6 years after
the date of the judgment so entered by the
court clerk unless sooner released or otherwise
discharged.
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Fines/Penalties
SB 63 – UECA and other amounts owed
Chapters 616C and 617 of the NRS add new sections
to read as follows:
7. Within 6 years after the date of the recording of the
judgment or within 6 years after the date of the last
extension of the lien pursuant to this subsection,
the lien may be extended by recording an affidavit
of renewal in the office of the county recorder.
From the date of recording, the lien is extended for
6 years to all real and personal property situated in
the county that is owned by the employer or
acquired by the employer afterwards, unless the
lien is sooner released or otherwise discharged.
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Fines/Penalties
SB 63 – UECA and other amounts owed
Sec. 2. & 6. NRS 616C.220 and 617.401,
respectively, are amended to read as follows:
... 14. [In addition to any other liabilities provided
for in this section, the Administrator may impose an
administrative fine of not more than $10,000 against
an employer if the employer fails to provide
mandatory coverage required by the provisions of
Chapters 616A to 616D, (617) inclusive, of NRS.
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Fines/Penalties
SB 63 – UECA and other amounts owed
Sec. 2. & 6. NRS 616C.220 and 617.401,
respectively, are amended to read as follows:
15.] If the Division has not obtained a civil judgment
or an entry of summary judgment pursuant to
section 1 of this act And the Division assigns a debt
that arises under this section to the State Controller for
collection pursuant to NRS 353C.195, the State Controller
may bring an action in his or her own name in a court of
competent, jurisdiction to recover any amount that the
Division is authorized to recover pursuant to this section.
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Fines/Penalties
SB 63 – UECA and other amounts owed
Sec. 3. NRS 616D.200 is hereby amended to read
as follows:
... 4. In addition to any other penalty imposed pursuant to
paragraph (b) or (c) of subsection 3, the court shall order the
employer to: ... (b) Reimburse the Uninsured Employers’
Claim Account for all payments made from the account on
the employer’s behalf, including any benefits, administrative
costs or attorney’s fees paid from the account, that have not
otherwise been recovered pursuant to NRS 616C.220 [.] or
617.401, or included in a civil judgment or a summary
judgment entered pursuant to section 1 or 5 of this
act.
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Fines/Penalties
SB 63 – UECA and other amounts owed
Amendment to NRS 616D.210...
2. [The] Any person who: (a) Is the legal or beneficial owner of
25 percent or more of a business which terminates operations
while owing money to the Division for any unpaid administrative
fine imposed or benefit penalty ordered pursuant to NRS
616D.120, unpaid premium or interest charged pursuant to NRS
616D.200 or payments made from the Uninsured Employers’
Claim Account pursuant to NRS 616C.220 or 617.401, including
attorney’s fees, administrative costs, interest or penalties, and
becomes, or induces or procures another person to become, the
legal or beneficial owner of 25 percent or more of a new business
engaging in similar operations;
Or
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Fines/Penalties
SB 63 – UECA and other amounts owed
Amendment to NRS 616D.210 ...
(b) Knowingly aids or abets another person in carrying out
such conduct, is liable for the payment of any amount
owed to the Division and the reasonable costs incurred by
the Division to investigate and act upon such conduct.
3. [private carrier] An insurer shall not knowingly insure any
business which engages in the conduct described in
[subsection] : (a) Subsection 1 unless the premium and any
interest and penalties owed to the prior insurer have been paid
to that insurer [.3.] ; or
(b) Subsection 2 unless the amount due the Division
Pursuant to NRS 616C.220, 616D.120, 616D.200 or
617.401, including any attorney’s fees, administrative
costs, interest and penalties, has been paid to the Division.
Effective July 1, 2011
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Questions
Call or e-mail the Education Unit:
(702) 486-9102; [email protected]
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