reglab/housing_qa huggingface dataset:
NM Stat § 59A-23-2 (2021)
2021 New Mexico Statutes|Chapter 59A - Insurance Code|Article 23 - Group and Blanket Health Insurance Contracts|Section 59A-23-2 - Blanket health insurance.

A. Blanket health insurance is declared to be that form of health insurance covering special groups of not fewer than ten persons as enumerated in one of the following paragraphs: (1) under a policy or contract issued to a common carrier, which shall be deemed the policyholder, covering a group defined as all persons who may become passengers on the common carrier; (2) under a policy or contract issued to an employer that shall be deemed the policyholder, covering a group of employees defined by reference to exceptional hazards incident to employment; (3) under a policy or contract issued to a college, school or other institution of learning or to the head or principal thereof, who or which shall be deemed the policyholder, covering students and teachers; (4) under a policy or contract issued in the name of a volunteer fire department or first aid or other such volunteer group, which shall be deemed the policyholder, covering all of the members of the department or group; or (5) under a policy or contract issued to any other substantially similar group that, in the discretion of the superintendent, may be subject to the issuance of a blanket health policy or contract. B. An individual application shall not be required from a person covered under a blanket sickness or accident policy or contract. C. All benefits under any blanket sickness and accident policy shall be payable to the person insured or the person's agent, or to the person's designated beneficiary or beneficiaries, or to the person's estate, except that if the person insured is a minor, such benefits may be made payable to the minor's parent, guardian or other person actually supporting the minor. D. A blanket sickness or accident policy or contract issued to a college, school or other institution of learning or to the head or principal thereof shall not be identified or sold as a student health plan. History: Laws 1984, ch. 127, § 461; 2017, ch. 130, § 15. ANNOTATIONSCross references. — For existing forms and filings, see notes following 59A-5-21 NMSA 1978. The 2017 amendment, effective July 1, 2017, prohibited certain blanket sickness or accident policies from being sold as student health plans; in Subsection A, in the introductory language, after "groups of not", deleted "less" and added "fewer", after "ten", deleted "(10)", and after "the following paragraphs", deleted "(1) to (5) inclusive"; and added Subsection D.
NM Stat § 59A-23-3.1 (2021)
2021 New Mexico Statutes|Chapter 59A - Insurance Code|Article 23 - Group and Blanket Health Insurance Contracts|Section 59A-23-3.1 - Group insurance reports required.

A. At least quarterly, upon request by the employer, each insurer who has delivered or issued for delivery a policy of group insurance covering twenty-six or more employees, all or a portion of the premiums for which is paid by the employer of the insureds, shall submit to the employer a financial summary report by coverage of expenses incurred by or on behalf of the employees of that employer since the last report. The report shall include the number and amount of monthly paid claims, monthly covered lives and an accounting of reserves and retention costs. B. Upon request by the employer, each insurer shall provide to the employer claims information that provides sufficient detail, subject to state and federal privacy laws, to enable the employer to obtain and compare group health insurance rates from multiple insurers or establish a plan of self-insurance. C. The report and claims information required by this section shall be provided within thirty days from the date of request. History: 1978 Comp., § 59A-23-3.1, enacted by Laws 1985, ch. 167, § 1; 1987, ch. 281, § 2; 1993, ch. 164, § 1; 2007, ch. 53, § 1. ANNOTATIONSThe 2007 amendment, effective June 15, 2007, required insurers to provide claims experience information to employers to permit the employer to obtain and compare group health care rates and coverage from other carriers. The 1993 amendment, effective June 18, 1993, substituted "twenty-six" for "fifty" in the first sentence, inserted "and amount" in the second sentence, and deleted former Subsection B, relating to submission to the employer of premium and claim data 180 days after expiration of a policy covering more than 24 but less than 50 employees for which all or a portion of the premium is paid by the employer.
NM Stat § 59A-23-5 (2021)
2021 New Mexico Statutes|Chapter 59A - Insurance Code|Article 23 - Group and Blanket Health Insurance Contracts|Section 59A-23-5 - Extended disability benefit.

Any group health insurance policy may provide for payment not exceeding one thousand dollars ($1,000) as an extended disability benefit upon the insured's death from any cause, which benefit shall not be construed as life insurance. History: Laws 1984, ch. 127, § 464.
NM Stat § 59A-23-6.1 (2021)
2021 New Mexico Statutes|Chapter 59A - Insurance Code|Article 23 - Group and Blanket Health Insurance Contracts|Section 59A-23-6.1 - Coverage of alpha-fetoprotein IV screening test.

A blanket or group health policy, health care plan or certificate of health insurance that is delivered, issued for delivery or renewed in the state shall provide coverage for an alpha-fetoprotein IV screening test for pregnant women, generally between sixteen and twenty weeks of pregnancy, to screen for certain genetic abnormalities in the fetus. History: Laws 2004, ch. 122, § 5. ANNOTATIONSEffective dates. — Laws 2004, ch. 122, § 13 made Laws 2004, ch. 122, § 5 effective July 1, 2004.
NM Stat § 59A-23-6.2 (2021)
2021 New Mexico Statutes|Chapter 59A - Insurance Code|Article 23 - Group and Blanket Health Insurance Contracts|Section 59A-23-6.2 - Prior authorization for gynecological or obstetrical ultrasounds prohibited.

A. A blanket or group health insurance policy or contract that is delivered, issued for delivery or renewed in this state and that provides coverage for gynecological or obstetrical ultrasounds shall not require prior authorization for gynecological or obstetrical ultrasounds. B. Nothing in this section shall be construed to require payment for a gynecological or obstetrical ultrasound that is not: (1) medically necessary; or (2) a covered benefit. C. As used in this section, "prior authorization" means advance approval that is required by blanket or group health insurance policy or contract as a condition precedent to payment for medical care or related benefits rendered to a covered person, including prospective or utilization review conducted prior to the provision of covered medical care or related benefits. History: Laws 2019, ch. 182, § 4. ANNOTATIONSEmergency clauses. — Laws 2019, ch. 182, § 7 contained an emergency clause and was approved April 3, 2019.
NM Stat § 59A-23-7 (2021)
2021 New Mexico Statutes|Chapter 59A - Insurance Code|Article 23 - Group and Blanket Health Insurance Contracts|Section 59A-23-7 - Blanket or group health policy or certificate; provisions relating to individuals who are eligible for medical benefits under the medicaid program.

A. Each blanket or group health policy or certificate of insurance that is delivered, issued for delivery or renewed in this state shall include provisions that require benefits paid on behalf of a child or other insured person under the policy or certificate to be paid to the human services department when: (1) the human services department has paid or is paying benefits on behalf of the child or other insured person under the state's medicaid program pursuant to Title XIX of the federal Social Security Act, 42 U.S.C. 1396, et seq.; (2) payment for the services in question has been made by the human services department to the medicaid provider; and (3) the insurer is notified that the insured individual receives benefits under the medicaid program and that benefits must be paid directly to the human services department. B. The notice required under Paragraph (3) of Subsection A of this section may be accomplished through an attachment to the claim by the human services department for insurance benefits when the claim is first submitted by the human services department to the insurer. C. Notwithstanding any other provisions of law, checks in payment for claims pursuant to any blanket or group health insurance policy or certificate for health care services provided to persons who are also eligible for benefits under the medicaid program and provided by medical providers qualified to participate under the policy or certificate shall be made payable to the provider. The insurer may be notified that the insured individual is eligible for medicaid benefits through an attachment to the claim by the provider for insurance benefits when the claim is first submitted by the provider to the insurer. D. No blanket or group health insurance policy or certificate delivered, issued for delivery or renewed in this state on or after the effective date of this section shall contain any provision denying or limiting insurance benefits because services are rendered to an insured who is eligible for or who has received medical assistance under the medicaid program of this state. E. To the extent that payment for covered expenses has been made pursuant to the state medicaid program for health care items or services furnished to an individual, in any case where the insurer has a legal liability to make payments, the state is considered to have acquired the rights of the individual to payment by an insurer for those health care items or services. History: 1978 Comp., § 59A-23-7, enacted by Laws 1989, ch. 183, § 3; 1994, ch. 64, § 4. ANNOTATIONSCompiler's notes. — The phrase "effective date of this section" means June 16, 1989, the effective date of Laws 1989, ch. 183. The 1994 amendment, effective July 1, 1994, added Subsection E.
NM Stat § 59A-23-7.3 (2021)
2021 New Mexico Statutes|Chapter 59A - Insurance Code|Article 23 - Group and Blanket Health Insurance Contracts|Section 59A-23-7.3 - Maximum age of dependent.

Each blanket or group health policy or certificate of insurance delivered, issued for delivery or renewed in New Mexico on or after July 1, 2003 that provides coverage for an insured's dependent shall not terminate coverage of an unmarried dependent by reason of the dependent's age before the dependent's twenty-sixth birthday, regardless of whether the dependent is enrolled in an educational institution. History: Laws 2003, ch. 391, § 3; 2021, ch. 108, § 24. ANNOTATIONSThe 2021 amendment, effective July 1, 2021, after "before the dependent's", changed "twenty-fifth" to "twenty-sixth".
NM Stat § 59A-23-7.4 (2021)
2021 New Mexico Statutes|Chapter 59A - Insurance Code|Article 23 - Group and Blanket Health Insurance Contracts|Section 59A-23-7.4 - Coverage of circumcision for newborn males.

A blanket or group health insurance policy, health care plan or certificate of health insurance that is delivered, issued for delivery or renewed in the state shall provide coverage for circumcision for newborn males. History: Laws 2004, ch. 122, § 6. ANNOTATIONSEffective dates. — Laws 2004, ch. 122, § 13 made Laws 2004, ch. 122, § 6 effective July 1, 2004.
NM Stat § 59A-23-7.5 (2021)
2021 New Mexico Statutes|Chapter 59A - Insurance Code|Article 23 - Group and Blanket Health Insurance Contracts|Section 59A-23-7.5 - Coverage of part-time employees.

An insurer that provides group health insurance pursuant to Chapter 59A, Article 23 NMSA 1978 shall make available, upon an employer's request prior to issuance, delivery or renewal, coverage for regular part-time employees who work or are expected to work an average of at least twenty hours per week over a six-month period. Nothing in this section shall be construed to require an employer to offer or provide coverage for regular part-time employees. History: Laws 2005, ch. 42, § 2. ANNOTATIONSEffective dates. — Laws 2005, ch. 42, § 5 made Laws 2005, ch. 42, § 2 effective July 1, 2005.
NM Stat § 59A-23-7.6 (2021)
2021 New Mexico Statutes|Chapter 59A - Insurance Code|Article 23 - Group and Blanket Health Insurance Contracts|Section 59A-23-7.6 - Coverage of colorectal cancer screening.

A. A blanket or group health policy, health care plan or certificate of health insurance that is delivered, issued for delivery or renewed in this state shall provide coverage for colorectal screening for determining the presence of precancerous or cancerous conditions and other health problems. The coverage shall make available colorectal cancer screening, as determined by the health care provider in accordance with the evidence-based recommendations established by the United States preventive services task force. B. Coverage for colorectal screening may be subject to deductibles and coinsurance consistent with those imposed on other benefits under the same policy, plan or certificate. C. The provisions of this section shall not apply to short-term travel, accident-only or limited or specified-disease policies. History: Laws 2007, ch. 17, § 2. ANNOTATIONSEffective dates. — Laws 2007, ch. 17, contained no effective date provision, but, pursuant to N.M. Const., art. IV, § 23, was effective June 15, 2007, 90 days after the adjournment of the legislature.
NM Stat § 59A-23-7.7 (2021)
2021 New Mexico Statutes|Chapter 59A - Insurance Code|Article 23 - Group and Blanket Health Insurance Contracts|Section 59A-23-7.7 - General anesthesia and hospitalization for dental surgery.

A. A blanket or group health insurance policy, health care plan or certificate of health insurance that is delivered, issued for delivery or renewed in this state shall provide coverage for hospitalization and general anesthesia provided in a hospital or ambulatory surgical center for dental surgery for the following: (1) insureds exhibiting physical, intellectual or medically compromising conditions for which dental treatment under local anesthesia, with or without additional adjunctive techniques and modalities, cannot be expected to provide a successful result and for which dental treatment under general anesthesia can be expected to produce superior results; (2) insureds for whom local anesthesia is ineffective because of acute infection, anatomic variation or allergy; (3) insured children or adolescents who are extremely uncooperative, fearful, anxious or uncommunicative with dental needs of such magnitude that treatment should not be postponed or deferred and for whom lack of treatment can be expected to result in dental or oral pain or infection, loss of teeth or other increased oral or dental morbidity; (4) insureds with extensive oral-facial or dental trauma for which treatment under local anesthesia would be ineffective or compromised; or (5) other procedures for which hospitalization or general anesthesia in a hospital or ambulatory surgical center is medically necessary. B. The provisions of this section do not apply to short-term travel, accident-only or limited or specified disease policies. C. Coverage for dental surgery may be subject to copayments, deductibles and coinsurance subject to network and prior authorization requirements consistent with those imposed on other benefits under the same policy, plan or certificate. History: Laws 2007, ch. 218, § 3. ANNOTATIONSEffective dates. — Laws 2007, ch. 218, § 6 made Laws 2007, ch. 218, § 3 effective July 1, 2007.
NM Stat § 59A-23-7.8 (2021)
2021 New Mexico Statutes|Chapter 59A - Insurance Code|Article 23 - Group and Blanket Health Insurance Contracts|Section 59A-23-7.8 - Hearing aid coverage for children required.

A. A blanket or group health insurance policy, health care plan or certificate of health insurance that is delivered, issued for delivery or renewed in this state shall provide coverage for a hearing aid and any related service for the full cost of one hearing aid per hearing-impaired ear up to two thousand two hundred dollars ($2,200) every thirty-six months for hearing aids for insured children under eighteen years of age or under twenty-one years of age if still attending high school. The insured may choose a higher priced hearing aid and may pay the difference in cost above the two-thousand-two-hundred-dollar ($2,200) limit as provided in this subsection without financial or contractual penalty to the insured or to the provider of the hearing aid. B. An insurer that delivers, issues for delivery or renews in this state a blanket or group health insurance policy, health care plan or certificate of health insurance may make available to the policyholder the option of purchasing additional hearing aid coverage that exceeds the services described in this section. C. Hearing aid coverage offered shall include fitting and dispensing services, including providing ear molds as necessary to maintain optimal fit, provided by an audiologist, a hearing aid dispenser or a physician, licensed in New Mexico. D. The provisions of this section do not apply to short-term travel, accident-only or limited or specified disease policies. E. Coverage for hearing aids may be subject to deductibles and coinsurance consistent with those imposed on other benefits under the same policy, plan or certificate. F. For the purposes of this section, "hearing aid" means durable medical equipment that is of a design and circuitry to optimize audibility and listening skills in the environment commonly experienced by children. History: Laws 2007, ch. 356, § 3. ANNOTATIONSEffective dates. — Laws 2007, ch. 356, § 6 made Laws 2007, ch. 356, § 3 effective July 1, 2007.
NM Stat § 59A-23-7.10 (2021)
2021 New Mexico Statutes|Chapter 59A - Insurance Code|Article 23 - Group and Blanket Health Insurance Contracts|Section 59A-23-7.10 - Coverage for orally administered anticancer medications; limits on patient costs.

A. A blanket or group health insurance policy or contract that is delivered, issued for delivery or renewed in this state and that provides coverage for cancer treatment shall provide coverage for a prescribed, orally administered anticancer medication that is used to kill or slow the growth of cancerous cells on a basis no less favorable than intravenously administered or injected cancer medications that are covered as medical benefits by the plan. B. An insurer shall not increase patient cost-sharing for anticancer medications in order to achieve compliance with the provisions of this section. C. Coverage of orally administered anticancer medication shall not be subject to any prior authorization, dollar limit, copayment, deductible or coinsurance provision that does not apply to intravenously administered or injected anticancer medication used to kill or slow the growth of cancerous cells. D. As used in this section, "insurer" or "blanket or group health insurance plan": (1) means: (a) a health insurer; (b) a nonprofit health service provider; (c) a health maintenance organization; (d) a managed care organization; or (e) a provider service organization; and (2) does not include blanket or large group policies intended to supplement major medical group-type coverages such as medicare supplement, long-term care, disability income, specified disease, accident-only, hospital indemnity or other limited-benefit health insurance policies. History: Laws 2011, ch. 55, § 3. ANNOTATIONSEffective dates. — Laws 2011, ch. 55, § 7 made Laws 2011, ch. 55, § 3 effective June 17, 2011. Applicability. — Laws 2011, ch. 55, § 6 provided that the provisions of this act apply to insurance policies that provide coverage for cancer treatment and that are delivered, issued for delivery, amended, renewed or continued in this state on or after January 1, 2012.
NM Stat § 59A-23-7.11 (2021)
2021 New Mexico Statutes|Chapter 59A - Insurance Code|Article 23 - Group and Blanket Health Insurance Contracts|Section 59A-23-7.11 - Coverage of prescription eye drop refills.

A. A blanket or group health insurance policy or contract that is delivered, issued for delivery or renewed in this state and that provides coverage for prescription eye drops shall not deny coverage for a renewal of prescription eye drops when: (1) the renewal is requested by the insured at least twenty-three days for a thirty-day supply of eye drops, forty-five days for a sixty-day supply of eye drops or sixty-eight days for a ninety-day supply of eye drops from the later of the date that the original prescription was dispensed to the insured or the date that the last renewal of the prescription was dispensed to the insured; and (2) the prescriber indicates on the original prescription that additional quantities are needed and that the renewal requested by the insured does not exceed the number of additional quantities needed. B. As used in this section, "prescriber" means a person who is authorized pursuant to the New Mexico Drug, Device and Cosmetic Act [Chapter 26, Article 1 NMSA 1978] to prescribe prescription eye drops. History: Laws 2012, ch. 27, § 3. ANNOTATIONSEffective dates. — Laws 2012, ch. 27, § 7 provided that Laws 2012, ch. 27, § 3 was effective January 1, 2013. Applicability. — Laws 2012, ch. 27, § 6 provided that the provisions of Laws 2012, ch. 27, §§ 1 to 5 apply to insurance policies that provide coverage for prescription eye drops and that are delivered, issued for delivery, amended, renewed or continued in this state on or after January 1, 2013.
NM Stat § 59A-23-7.15 (2021)
2021 New Mexico Statutes|Chapter 59A - Insurance Code|Article 23 - Group and Blanket Health Insurance Contracts|Section 59A-23-7.15 - Coverage exclusion. (Contingent repeal. See note.)

Coverage of vasectomy and male condoms pursuant to Section 5 [59A-23-7.14 NMSA 1978] of this 2019 act is excluded for high-deductible individual or group health insurance policies, health care plans or certificates of insurance with health savings accounts delivered or issued for delivery in this state until an insured's deductible has been met.History: Laws 2019, ch. 263, § 6.ANNOTATIONSContingent repeal. — Laws 2019, ch. 263, § 11 provided that upon certification by the superintendent of insurance to the director of the legislative council service and the New Mexico compilation commission that federal law permits coverage of vasectomies and male condoms under high-deductible health benefits plans with health savings accounts, 59A-23-7.15 NMSA 1978 is repealed.Effective dates. — Laws 2019, ch. 263 contained no effective date provision, but, pursuant to N.M. Const., art. IV, § 23, was effective June 14, 2019, 90 days after the adjournment of the legislature.