New Mexico Administrative Code › Title 13 - INSURANCE › Chapter 10 - HEALTH INSURANCE › Part 11 - HEALTH INSURANCE ALLIANCE PLAN OF OPERATION AND ELIGIBILITY CRITERIA › Section 13.10.11.12 - OPERATIONS

Current through Register Vol. 35, No. 13, July 16, 2024
A. The board, in
				addition to the powers prescribed in the act, shall have the specific authority
				to enter into contracts and undertake such other activities as are necessary or
				proper to carry out the provisions and purposes of the act, including the
				authority, with the approval of the superintendent, to enter into contracts
				with similar alliances of other states for the joint performance of common
				administrative functions. The board may employ such persons, firms or
				corporations to perform such administrative or other functions as are necessary
				for the operations of the
alliance
. Such persons, firms or
				corporations shall keep such records of their activities as may be required by
				the board.
B. The board may open
				one or more bank accounts for use in
alliance
business. Reasonable
				delegation of deposit and withdrawal authority for such accounts for
alliance
business may be made, consistent with prudent fiscal
				policy. The board may borrow money from any person, or organization as the
				board may deem advantageous for the
alliance
and the public. The
alliance
administration is responsible, within such authority as
				may be granted to it by the board, for the handling, safe-guarding, and
				disbursement of funds of the
alliance
, subject to and responsible
				to the board. The
alliance
administration may maintain the
				financial records of the
alliance
as directed by the
				board.
C. The board may review the
				act and other appropriate insurance laws and regulations in order to make
				recommendations to the superintendent for the improved operation of the
alliance
.
D. The board
				shall provide and accept applications for health insurance in accordance with
				the eligibility criteria set forth in this rule, and for any other insurance
				plans developed by the board of directors, which contain standard policy
				provisions as specified by the act.
E. The board shall adopt a plan for the
				periodic advertising of the general availability of health insurance coverage
				from the
alliance
and the eligibility requirements and procedures
				for enrollment in an approved health plan and to maintain public awareness of
				the
alliance
.
F. The
				board shall establish procedures to determine the amount of and method for
				collecting on assessments pursuant to the act. The board shall impose the
				initial administrative assessment. The board shall promptly inform the
				superintendent of the failure of any member to pay an assessment after 30 days'
				written notice to the member that payment is due. A minimum penalty of $1000,
				plus interest at the rate used by the IRS on the assessment, will be assessed
				against any member who fails to pay the assessment within the time prescribed
				by the board unless such other minimum penalty is established by the board and
				approved by the superintendent.
G.
				The board annually shall review operating expenses and outstanding contractual
				obligations and determine if an assessment is necessary for the proper
				administration of the
alliance
and, if so, the amount. If such
				assessment is deemed to be necessary, the board shall levy such assessment
				based upon the criteria set forth in Section 59A-56-11 NMSA 1978. The board may
				adopt other or additional methods of adjusting the formula to achieve equity of
				assessments among
alliance
members, within the provisions of the
				act. The board may abate or defer in any part the assessment of a member, if,
				in the opinion of the board, payment of the assessment would endanger the
				ability of the member to fulfill its contractual obligations. The assessment
				shall be imposed annually.
H. The
alliance
may adopt any additional policies or procedures necessary
				or proper for the execution of the powers and duties of the
alliance
.