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§ 59A-23E-10 NMSA 1978

Group health plan; group health insurance; use of affiliation period by health maintenance organizations as alternative to preexisting condition exclusion

Known as the Health Insurance Portability Act

The act spans §§ 59–59 (20 sections).

Laws 1997, ch. 243, § 10; 1998, ch. 41, § 14.

A. A health maintenance organization that offers health insurance coverage in connection with a group health plan and does not impose any preexisting condition exclusion allowed pursuant to Section 59A-23E-3 NMSA 1978 with respect to any particular coverage option may impose an affiliation period for the coverage option if that period:

(1) is applied uniformly without regard to any health status related factors; and

(2) does not exceed two months, or three months in the case of a late enrollee.

B. During an affiliation period, a health maintenance organization is not required to provide health care services or benefits to a participant or beneficiary, and it shall not charge a premium to a participant or beneficiary for any coverage.

C. An affiliation period begins to run on the enrollment date and shall run concurrently with any waiting period under the plan.

D. A health maintenance organization described in Subsection A of this section may use alternative methods different from those described in that subsection to address adverse selection as approved by the superintendent.

Official source: NMOneSource (New Mexico Compilation Commission). Reproduced from public-domain New Mexico statutes; confirm against the official source for the current text. Not legal advice.