May 1, 2023 Bulletins SMALL BUSINESS HEALTH INSURANCE PREMIUM RELIEF INITIATIVE PREMIUM REDUCTION PERCENTAGE FOR COVERAGE ACTIVE July 1, 2023 UNTIL BULLETIN 2023-010: THIS BULLETIN is issued pursuant to NMSA 1978, Section 59A-23F-11, which established the Health Care Affordability Fund to “reduce premiums for small businesses and their employees.” This Bulletin sets forth program parameters, requirements for issuers, and the Office of Superintendent of Insurance’s (OSI’s) responsibilities under the Small Business Health Insurance Premium Relief Initiative established in […] Read More
April 20, 2023 Bulletins COVERAGE FOR RECONSTRUCTIVE SURGERY FOLLOWING MASTECTOMY BULLETIN 2023-008: This Bulletin replaces Bulletin No. 2000-008, which is hereby rescinded and withdrawn. This Bulletin is issued by the New Mexico Office of Superintendent of Insurance (OSI) to remind managed health care plans and health insurers offering major medical plans in New Mexico about the requirements of the Women’s Health and Cancer Rights Act of 1998 […] Read More
April 12, 2023 Bulletins PUBLIC ADJUSTER SURETY BOND BULLETIN 2023-007: Beginning on June 16, 2023, House Bill 229 requires only Public Adjusters to submit a Surety Bond to obtain and maintain licensure. In light of this statutory change, per Section 59A-13-5(B), NMSA 1978, the Superintendent releases any surety insurer from liability on any existing bond issued on behalf of an independent adjuster. Any bond filed […] Read More
April 12, 2023 Bulletins ADJUSTER LICENSING REQUIREMENTS BULLETIN 2023-006: THE FOLLOWING BULLETIN is issued pursuant to Sections 59A-2-8, 59A-11-10, and 59A-13-5, NMSA 1978, and Rules 13.1.2.1 through 13.1.2.10 NMAC. The Office of Superintendent of Insurance continues to receive inquiries related to the licensing of both resident and nonresident adjusters. These inquiries have revealed some discrepancies between the requirements set forth in Chapter 59A NMSA […] Read More
March 8, 2023 Bulletins MORATORIUM ON REVIEW AND APPROVAL OF EXCEPTED BENEFITS FILINGS BULLETIN 2023-005: The Legislature enacted the Short-Term Health Plan and Excepted Benefit Act, NMSA 1978 §§ 59A-23G-1 through 59A-23G-6, on June 14, 2019. The Act required the Superintendent to adopt and promulgate rules for excepted benefits plans as defined in the act. The Superintendent has been diligently adopting and promulgating rules for excepted benefits plans through 13.10.34 […] Read More
February 27, 2023 Bulletins MINIMIZING COVERAGE DISRUPTIONS AFTER THE FEDERAL MEDICAID CONTINUOUS COVERAGE REQUIREMENT EXPIRES DURING THE 2023 PLAN YEAR BULLETIN 2023-004: THIS BULLETIN is issued pursuant to NMSA 1978, Section 59A-23F-11, which established the Health Care Affordability Fund (HCAF) to “reduce health care premiums and cost sharing for New Mexico residents who purchase health care coverage on the New Mexico health insurance exchange” and 13.10.36.10 NMAC. MINIMIZING COVERAGE DISRUPTIONS AFTER THE FEDERAL MEDICAID CONTINUOUS COVERAGE REQUIREMENT […] Read More
February 3, 2023 Bulletins TIMELINESS AND COMPLETENESS OF CORRESPONDENCE RELATED TO MEMBER GRIEVANCES Bulletin 2023-002: This Bulletin is issued to improve the processes required by the Member Grievance Rule, 13.10.17 NMAC, and to remind insurers of their obligations under that Rule. Specifically, that insurers must timely provide complete documents and responses to the OSI Managed Health Care Bureau (MHCB). TIMELINESS AND COMPLETENESS OF CORRESPONDENCE RELATED TO MEMBER GRIEVANCES Read More
February 3, 2023 Bulletins REQUIREMENTS FOR MARCH 1st MEMBER GRIEVANCE COMPLIANCE FILING BULLETIN 2023-003: All major medical health insurers subject to the jurisdiction of the Office of Superintendent of Insurance shall file their annual member grievance compliance filing on March 1st of each year. This compliance filing requirement shall apply to all major medical insurers currently offering comprehensive major medical coverage with 250 or more insureds. Null filings are […] Read More
January 3, 2023 Bulletins PHARMACY BENEFIT MANAGER LICENSURE AND LICENSURE RENEWAL REQUIREMENTS FOR 2023 AND THEREAFTER BULLETIN 2023-001: This Bulletin applies to any Pharmacy Benefit Manager (PBM) seeking licensure or renewal of licensure in New Mexico pursuant to the Pharmacy Benefit Manager Act Section 59A-61-1 et seq. N.M.S.A. 1978. PBM licensure renewal and annual reports are due before March 1, 2023. PHARMACY BENEFIT MANAGER LICENSURE AND LICENSURE RENEWAL REQUIREMENTS FOR 2023 AND THEREAFTER Read More
December 28, 2022 Bulletins PROVIDER CREDENTIALING REPORTING BULLETIN 2022-024: Pursuant to 13.10.28.10(D) NMAC, “[e]ach health carrier shall submit a report to the superintendent regarding its credentialing process for the prior two-year period beginning December 31, 2018, and on December 31 for all even numbered years thereafter, or as otherwise directed by the superintendent.” The December 31st reporting deadline does not account for the time […] Read More
