reglab/housing_qa huggingface dataset:
NM Stat § 59A-22-29 (2021)
2021 New Mexico Statutes|Chapter 59A - Insurance Code|Article 22 - Health Insurance Contracts|Section 59A-22-29 - Conforming to statute.

A. Other policy provisions. No policy provision which is not subject to Sections 424 through 446 [59A-22-3 to 59A-22-25 NMSA 1978], inclusive, of this article shall make a policy, or any portion thereof, less favorable in any respect to the insured or the beneficiary than the provisions thereof which are subject to this article. B. Policy conflicting with this article. A policy delivered or issued for delivery in this state in violation of this article shall be held valid but shall be construed as provided in this article. When any provision in a policy subject to this article is in conflict with any provision of this article, the rights, duties and obligations of the insurer, the insured and the beneficiary shall be governed by the provisions of this article. History: Laws 1984, ch. 127, § 450. ANNOTATIONSCross references. — For existing forms and filings, see notes following 59A-5-21 NMSA 1978.
NM Stat § 59A-22-30 (2021)
2021 New Mexico Statutes|Chapter 59A - Insurance Code|Article 22 - Health Insurance Contracts|Section 59A-22-30 - Age limit.

If any such policy contains a provision establishing, as an age limit or otherwise, a date after which coverage provided by the policy will not be effective, and if such date falls within a period for which premium is accepted by the insurer or if the insurer accepts a premium after such date, the coverage provided by the policy will continue in force subject to any right of cancellation until the end of the period for which premium has been accepted. In the event the age of the insured has been misstated and if, according to the correct age of the insured, the coverage provided by the policy would not have become effective, or would have ceased prior to the acceptance of such premium or premiums, then the liability of the insurer shall be limited to the refund, upon request, of all premiums paid for the period not covered by the policy. History: Laws 1984, ch. 127, § 451. ANNOTATIONSAm. Jur. 2d, A.L.R. and C.J.S. references. — Age requirement of disability policy as to proof of disability before reaching specified age as barring recovery where disability occurs before, but proof is made after, attainment of such age, 18 A.L.R.2d 1061. Clause in health and accident, or similar, policy reducing amount of, or terminating, periodic payments after insured reaches specified age, as applicable to disability incurred before such age was reached, 53 A.L.R.2d 552.
NM Stat § 59A-22-30.1 (2021)
2021 New Mexico Statutes|Chapter 59A - Insurance Code|Article 22 - Health Insurance Contracts|Section 59A-22-30.1 - Maximum age of dependent.

An individual or group health policy or certificate of insurance delivered, issued for delivery or renewed in New Mexico 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 2005, ch. 41, § 1; 2021, ch. 108, § 17. ANNOTATIONSCross references. — For age of dependents see 59A-22-2 and 59A-22-34.2 NMSA 1978. The 2021 amendment, effective July 1, 2021, after "before the dependent's", changed "twenty-fifth" to "twenty-sixth".
NM Stat § 59A-22-31 (2021)
2021 New Mexico Statutes|Chapter 59A - Insurance Code|Article 22 - Health Insurance Contracts|Section 59A-22-31 - Industrial health insurance.

A. The term "industrial health insurance" as used herein means sickness and accident insurance under individual policies for which the premium is payable weekly, and includes any such policy which covers sickness only or accident only. B. Any insurer authorized to write health insurance in this state shall have the power to issue industrial health policies. C. No policy of industrial health insurance may be delivered or issued for delivery in the state unless it has printed thereon the words "industrial policy." D. Each such policy shall be subject to the provisions of this article except that no such policy shall be required to contain any of the policy provisions set forth in Sections 424 through 446 [59A-22-3 to 59A-22-25 NMSA 1978], inclusive, of this article, other than the provisions relating to the presence of a preexisting disease or physical condition; provided, however, that no such policy shall contain any provision relative to notice or proof of loss, or the time for paying benefits, or the time within which suit may be brought upon the policy, which in the opinion of the superintendent is less favorable to the insured than would be permitted by such policy provisions; and provided further, that such policy may contain a provision that upon proper written request, a named beneficiary shall be designated in or by endorsement on the policy to receive the proceeds thereof on the death of the insured, and there shall be reserved to the insured the power to change the beneficiary at any time by written notice to the insurer at its home office, accompanied by the policy for endorsement of the change thereon by the insurer; the insurer shall have the right to refuse to designate a beneficiary if evidence satisfactory to the insurer of such beneficiary's insurable interest in the life of the insured is not furnished on request. Any such policy may provide in substance that any payment thereunder may be made to the insured or the insured's estate or to any relative by blood or connection by marriage of the insured, or, to the extent of such portion of any payment under the policy as may reasonably appear to the insurer to be due to such person, to any other person equitably entitled thereto by reason of having incurred expense occasioned by the maintenance or illness or burial of the insured; provided that, if the policy shall be in force at the death of the insured, the proceeds thereof shall be payable to the named beneficiary if living, but upon the expiration of fifteen (15) days after the death of the insured, unless proof of the claim in the manner and form required by the policy, accompanied by the policy for surrender, has theretofore been made by such beneficiary, the insurer may pay to any other person permitted by the policy. History: Laws 1984, ch. 127, § 452. ANNOTATIONSAm. Jur. 2d, A.L.R. and C.J.S. references. — 46 C.J.S. Insurance §§ 1367, 1518.
NM Stat § 59A-22-32.1 (2021)
2021 New Mexico Statutes|Chapter 59A - Insurance Code|Article 22 - Health Insurance Contracts|Section 59A-22-32.1 - Freedom of choice.

A. Within the area and limits of coverage offered an insured and selected by him in the application for insurance, the right of any person to exercise full freedom of choice in the selection of any independent social worker as defined in Subsection B of this section, for treatment within his scope of practice shall not be restricted under any new policy of health insurance, contract or health care plan issued after July 1, 1989 in this state or in the processing of any claim thereunder. Any person insured or claiming benefits under any such health insurance policy, contract or health care plan providing within its coverage for payment of service benefits or indemnity for treatment of persons for the cure or correction of any mental condition shall be deemed to have complied with the requirements of the policy, contract or health care plan as to submission of proof of loss upon submitting written proof supported by any independent social worker. B. As used in this section "independent social worker" means a person licensed as an independent social worker by the board of social work examiners pursuant to the Social Work Practice Act [61-31-1 to 61-31-24 NMSA 1978]. History: Laws 1989, ch. 51, § 25.
NM Stat § 59A-22-33 (2021)
2021 New Mexico Statutes|Chapter 59A - Insurance Code|Article 22 - Health Insurance Contracts|Section 59A-22-33 - Children with disabilities; coverage continued.

An individual or group hospital or medical expense insurance policy delivered or issued for delivery in this state that provides that coverage of a dependent child of an insured, or of an employee or other member of the covered group, shall terminate upon attainment of the limiting age for dependent children specified in the policy shall also provide, in substance, that attainment of the limiting age shall not operate to terminate the coverage of a child while the child is, and continues to be both incapable of self-sustaining employment, by reason of intellectual or developmental disability or physical disability, and chiefly dependent upon the policyholder for support and maintenance. However, proof of the incapacity and dependency of the child must be furnished to the insurer by the insured employee or member within thirty-one days of the child's attainment of the limiting age and subsequently, as may be required by the insurer, but not more frequently than annually after the two-year period following the child's attainment of the limiting age. History: Laws 1984, ch. 127, § 455; 2021, ch. 108, § 18.ANNOTATIONSThe 2021 amendment, effective July 1, 2021, revised terms used in the section; in the section heading, deleted "Handicapped" and added "with disabilities"; and after "by reason of", deleted "mental retardation" and added "intellectual or developmental disability", and after "or physical", deleted "handicap" and added "disability".
NM Stat § 59A-22-34 (2021)
2021 New Mexico Statutes|Chapter 59A - Insurance Code|Article 22 - Health Insurance Contracts|Section 59A-22-34 - Newly born children coverage.

A. All individual and group health insurance policies delivered or issued for delivery in this state and which provide coverage on an expense-incurred basis for a family member of the insured shall, as to such family members' coverage, also provide that the health insurance benefits applicable for children shall be payable with respect to a newly born child of the insured from the moment of birth. B. All individual and group health insurance policies delivered or issued for delivery in this state that do not provide coverage for a family member of the insured shall provide for an option to add to the coverage any newly born child of the insured provided that the requirements of Subsection D of this section have been met. C. The coverage for newly born children shall consist of coverage of injury or sickness, including the necessary care and treatment of medically diagnosed congenital defects and birth abnormalities and, where necessary to protect the life of the infant, transportation, including air transport, to the nearest available tertiary care facility for newly born infants. D. If payment of a specific premium is required to provide coverage for a child, the policy may require that a notification of birth of a newly born child and payment of the required premium must be furnished to the insurer within thirty-one days after the date of birth in order to have the coverage from birth. E. As used in this section and in Section 59A-22-35 NMSA 1978, "tertiary care facility" means a hospital unit which provides complete perinatal care and intensive care of intrapartum and perinatal high-risk patients with responsibilities for coordination of transport, communication, education and data analysis systems for the geographic area served. History: Laws 1984, ch. 127, § 456; 1993, ch. 169, § 1. ANNOTATIONSThe 1993 amendment, effective June 18, 1993, substituted "basis" for "bases" in Subsection A; added Subsection B; redesignated former Subsections B through D as present Subsections C through E; in Subsection D, substituted "from birth" for "continue beyond such thirty-one day period" and made a minor stylistic change; and substituted "Section 59A-22-35 NMSA 1978" for "Section 457 of this article" in Subsection E. Applicability. — Laws 1993, ch. 169, § 3 provides that the provisions of the act apply to policies, plans, contracts and certificates delivered or issued for delivery or renewed, extended or amended in the state on or after July 1, 1993. Am. Jur. 2d, A.L.R. and C.J.S. references. — Unborn child as insured or injured person within meaning of insurance policy, 15 A.L.R.4th 548.
NM Stat § 59A-22-34.1 (2021)
2021 New Mexico Statutes|Chapter 59A - Insurance Code|Article 22 - Health Insurance Contracts|Section 59A-22-34.1 - Coverage for adopted children.

A. No individual or group health insurance policy or contract or health care plan shall be offered, issued or renewed in New Mexico on or after July 1, 1988, unless the policy, plan or contract covers adopted children of the insured, subscriber or enrollee on the same basis as other dependents. B. The coverage required by this section is effective from the date of placement for the purpose of adoption and continues unless the placement is disrupted prior to legal adoption and the child is removed from placement. Coverage shall include the necessary care and treatment of medical conditions existing prior to the date of placement. C. As used in this section, "placement" means in the physical custody of the adoptive parent. History: Laws 1978 Comp., § 59A-22-34.1, enacted by Laws 1988, ch. 89, § 1.
NM Stat § 59A-22-34.3 (2021)
2021 New Mexico Statutes|Chapter 59A - Insurance Code|Article 22 - Health Insurance Contracts|Section 59A-22-34.3 - Childhood immunization coverage required.

A. Each individual and group health insurance policy, health care plan and certificate of health insurance delivered or issued for delivery in this state shall provide coverage for childhood immunizations, as well as coverage for medically necessary booster doses of all immunizing agents used in child immunizations, in accordance with the current schedule of immunizations recommended by the American academy of pediatrics. B. The provisions of this section shall not apply to short-term travel, accident-only or limited or specified disease policies. C. Coverage for childhood immunizations and necessary booster doses may be subject to deductibles and co-insurance consistent with those imposed on other benefits under the same policy, plan or certificate. History: 1978 Comp., § 59A-22-34.3, enacted by Laws 1997, ch. 250, § 1.
NM Stat § 59A-22-34.4 (2021)
2021 New Mexico Statutes|Chapter 59A - Insurance Code|Article 22 - Health Insurance Contracts|Section 59A-22-34.4 - Coverage of circumcision for newborn males.

An individual 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, § 4. ANNOTATIONSEffective dates. — Laws 2004, ch. 122, § 13 made Laws 2004, ch. 122, § 4 effective July 1, 2004.
NM Stat § 59A-22-34.5 (2021)
2021 New Mexico Statutes|Chapter 59A - Insurance Code|Article 22 - Health Insurance Contracts|Section 59A-22-34.5 - Hearing aid coverage for children required.

A. An individual 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 an individual 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, § 2. ANNOTATIONSEffective dates. — Laws 2007, ch. 356, § 6 made Laws 2007, ch. 356, § 2 effective July 1, 2007.
NM Stat § 59A-22-35 (2021)
2021 New Mexico Statutes|Chapter 59A - Insurance Code|Article 22 - Health Insurance Contracts|Section 59A-22-35 - Maternity transport required.

All individual and group health insurance policies delivered or issued for delivery in this state which provide maternity coverage on an expense-incurred basis, shall also provide, where necessary to protect the life of the infant or mother, coverage for transportation, including air transport, for the medically high-risk pregnant woman with an impending delivery of a potentially viable infant to the nearest available tertiary care facility (as defined in Section 456 [59A-22-34 NMSA 1978] of this article) for newly-born infants. History: Laws 1984, ch. 127, § 457. ANNOTATIONSAm. Jur. 2d, A.L.R. and C.J.S. references. — 46 C.J.S. Insurance §§ 1367, 1518.
NM Stat § 59A-22-36 (2021)
2021 New Mexico Statutes|Chapter 59A - Insurance Code|Article 22 - Health Insurance Contracts|Section 59A-22-36 - Home health care service option required.

A. Each insurer which delivers or issues for delivery in this state an individual or group hospital expense or major medical expense insurance policy shall make available to the policyholder the option of home health care coverage which includes benefits for the services described in this section. B. Home health care coverage offered shall include: (1) services provided by a registered nurse or a licensed practical nurse; (2) health services provided by physical, occupational and respiratory therapists and speech pathologists; (3) health services provided by a home health aide; and (4) medical supplies, drugs and medicines and laboratory services, to the extent they would have been covered if provided to the insured on an in-patient basis. C. Home health care coverage may be limited to: (1) services provided on the written order of a licensed physician, provided such order is renewed at least every sixty (60) days; (2) services provided, directly or through contractual agreements, by a home health agency licensed in the state in which the home health services are delivered; and (3) services, as set forth in Subsection B of the section, without which the insured would have to be hospitalized. D. Coverage shall be provided for at least one hundred (100) home visits per insured per year, with each home visit including up to four (4) hours of home health care services. E. For the purposes of this section, "home health care" means health services provided on a part-time, intermittent basis to an individual confined to his home due to physical illness. History: Laws 1984, ch. 127, § 458.
NM Stat § 59A-22-37 (2021)
2021 New Mexico Statutes|Chapter 59A - Insurance Code|Article 22 - Health Insurance Contracts|Section 59A-22-37 - Repealed.

History: Laws 1984, ch. 127, § 459; 1987, ch. 259, § 22; repealed by Laws 2019, ch. 259, § 22. ANNOTATIONSRepeals. — Laws 2019, ch. 259, § 22 repealed 59A-22-37 NMSA 1978, as enacted by Laws 1984, ch. 127, § 459, relating to "franchise" insurance, effective June 14, 2019. For provisions of former section, see the 2018 NMSA 1978 on NMOneSource.com.
NM Stat § 59A-22-38 (2021)
2021 New Mexico Statutes|Chapter 59A - Insurance Code|Article 22 - Health Insurance Contracts|Section 59A-22-38 - Individual health insurance; policy provisions relating to individuals who are eligible for medical benefits under the medicaid program.

A. Each individual health insurance policy 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 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 individual health insurance policy 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 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 individual health insurance policy 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 an insurer has a legal liability to make payments, the state is considered to have acquired the rights of the individual to payment by the insurer for those health care items or services. History: 1978 Comp., § 59A-22-38, enacted by Laws 1989, ch. 183, § 2; 1994, ch. 64, § 3. ANNOTATIONSThe 1994 amendment, effective July 1, 1994, added Subsection E.