reglab/statecodes huggingface dataset:
New Mexico Administrative Code › Title 13 - INSURANCE › Chapter 19 - NON-ADMITTED OR SURPLUS LINES INSURANCE › Part 3 - REPORTING REQUIREMENTS FOR MULTIPLE EMPLOYER WELFARE ARRANGEMENTS › Section 13.19.3.11 - INSURANCE ADMINISTRATORS AND AUTHORIZED INSURERS PROHIBITED FROM ASSISTING REPORTABLE MEWAS PRIOR TO FILING

Current through Register Vol. 35, No. 13, July 16, 2024
A. No insurance administrator may solicit or
				effect coverage of, underwrite for, collect charges or premium for, or adjust
				or settle claims of a resident of this state for, or enter into any agreement
				to perform any of those functions for a reportable MEWA which provides coverage
				to residents to this state unless the insurance administrator first files the
				information required under 13 NMAC 19.3.12 [now 13.19.3.12 NMAC].
B. No authorized insurer may solicit or
				effect coverage of, underwrite for, collect charges or premiums for, or adjust
				or settle claims of a resident of this state for, or enter into any agreement
				to perform any of those functions for a reportable MEWA which provides coverage
				to residents of this state unless the insurer first files the information
				required under 13 NMAC 19.3.12 [now 13.19.3.12 NMAC].
C. An authorized insurer which issues or has
				issued any insurance coverage to a reportable MEWA which covers residents of
				this state including, but not limited to, specific or aggregate stop-loss
				coverage shall file the information required under 13 NMAC 19.3.12 [now
				13.19.3.12 NMAC] within thirty (30) days after the coverage is issued or within
				thirty (30) days after the date the reportable MEWA first provides coverage to
				a resident of this state, or within thirty (30) days of the effective date of
				this rule, whichever is later.
New Mexico Administrative Code › Title 13 - INSURANCE › Chapter 19 - NON-ADMITTED OR SURPLUS LINES INSURANCE › Part 3 - REPORTING REQUIREMENTS FOR MULTIPLE EMPLOYER WELFARE ARRANGEMENTS › Section 13.19.3.12 - INFORMATION REQUIRED TO BE FILED AND KEPT CURRENT

Current through Register Vol. 35, No. 13, July 16, 2024
A. An agent, insurance consultant, insurance
				administrator or insurer required to file under 13 NMAC 19.3.8 through 19.3.11
				[now 13.19.3.8 NMAC through 13.19.3.11 NMAC], inclusive, shall file all of the
				following information on a form approved by the superintendent:
(1) a copy of the organizational documents of
				the reportable MEWA, employee leasing firm or collectively bargained
				arrangement, including the articles of incorporation and bylaws, partnership
				agreement or trust instrument;
(2)
				a copy of each insurance or reinsurance contract which concerns all or any
				portion of benefits or coverage offered by the reportable MEWA, employee
				leasing firm or collectively bargained arrangement;
(3) a clear and complete statement describing
				the extent to which the benefits provided or offered by the reportable MEWA,
				employee leasing firm or collectively bargained arrangement are insured or
				reinsured;
(4) the names and
				addresses of any person performing or expected to perform the functions of an
				insurance administrator for the reportable MEWA, employee leasing firm or
				collectively bargained arrangement; and
(5) a copy of the most recent financial
				statement of the reportable MEWA, employee leasing firm or collectively
				bargained arrangement, or a sworn statement that no such financial statement is
				available.
New Mexico Administrative Code › Title 13 - INSURANCE › Chapter 19 - NON-ADMITTED OR SURPLUS LINES INSURANCE › Part 3 - REPORTING REQUIREMENTS FOR MULTIPLE EMPLOYER WELFARE ARRANGEMENTS › Section 13.19.3.13 - LACK OF KNOWLEDGE NOT A DEFENSE

Current through Register Vol. 35, No. 13, July 16, 2024
A. Lack of knowledge or intent with respect
				to the status, organization or filings of a reportable MEWA, employee leasing
				firm or collectively bargained arrangement is not a defense to a violation of
				this rule.
B. A filing under this
				rule is solely for the purpose of providing information to the superintendent.
				This rule and filings hereunder do not authorize or license a reportable MEWA,
				employee leasing firm, collectively bargained arrangement or any other
				arrangement to engage in business in this state if otherwise prohibited by
				law.
New Mexico Administrative Code › Title 13 - INSURANCE › Chapter 19 - NON-ADMITTED OR SURPLUS LINES INSURANCE › Part 3 - REPORTING REQUIREMENTS FOR MULTIPLE EMPLOYER WELFARE ARRANGEMENTS › Section 13.19.3.14 - LIABILITY FOR VIOLATION OF THIS RULE

Current through Register Vol. 35, No. 13, July 16, 2024
Any agent, insurance consultant, insurance administrator or
				  insurer who or which assists in any way the transaction of insurance with any
				  arrangement and who or which fails to report in accordance with this regulation
				  shall be liable to any insured in the event that an arrangement fails to pay a
				  claim or loss in this state within the terms of the policy or contract with any
				  insured. The licensee's liability in each such instance shall be coextensive
				  with the arrangement's contractual obligation to its insured, subject to
				  proportional contributions from any other licensee(s) involved in the
				  transaction of insurance with an arrangement in violation of this
				  rule.
New Mexico Administrative Code › Title 13 - INSURANCE › Chapter 19 - NON-ADMITTED OR SURPLUS LINES INSURANCE › Part 3 - REPORTING REQUIREMENTS FOR MULTIPLE EMPLOYER WELFARE ARRANGEMENTS › Section 13.19.3.15 - PENALTIES

Current through Register Vol. 35, No. 13, July 16, 2024
The superintendent of insurance may revoke, suspend or refuse
				  to continue the license or certificate of authority or other authorization of
				  any person who fails to comply with this rule and may impose such other
				  administrative penalties as may be authorized by the Insurance
				  Code.
New Mexico Administrative Code › Title 13 - INSURANCE › Chapter 19 - NON-ADMITTED OR SURPLUS LINES INSURANCE › Part 4 - MULTIPLE EMPLOYER WELFARE ARRANGEMENTS › Section 13.19.4.2 - SCOPE

Current through Register Vol. 35, No. 13, July 16, 2024
A.
Applicability.
These rules apply to any group establishing or
				maintaining a multiple employer welfare arrangement ("MEWA") providing health
				benefits in accordance with Section
				59A-15-16
				NMSA 1978 for its participants or their beneficiaries. An unregistered MEWA
				shall not:
(1) advertise in the state as a
				benefit of membership for any group health insurance policy available to its
				members or beneficiaries;
(2) issue
				a certificate for delivery in New Mexico to any resident of the state;
				or
(3) solicit membership in the
				state on the basis of the existence or availability of such health insurance
				coverage.
New Mexico Administrative Code › Title 13 - INSURANCE › Chapter 19 - NON-ADMITTED OR SURPLUS LINES INSURANCE › Part 4 - MULTIPLE EMPLOYER WELFARE ARRANGEMENTS › Section 13.19.4.3 - STATUTORY AUTHORITY

Current through Register Vol. 35, No. 13, July 16, 2024
Sections
				  59A-1-8,
				  59A-1-18,
				  59A-2-9,
				  59A-4-14,
				  59A-10-3,
				  59A-15-17,
				  59A-15-20,
				  59A-16-1,
				  59A-16-27,
				  59A-18-13.2,
				  59A-18-13.3,
				  59A-18-13.5,
				  59A-23-3,
				  59A-23C-3 NMSA
				  1978.
New Mexico Administrative Code › Title 13 - INSURANCE › Chapter 19 - NON-ADMITTED OR SURPLUS LINES INSURANCE › Part 4 - MULTIPLE EMPLOYER WELFARE ARRANGEMENTS › Section 13.19.4.5 - EFFECTIVE DATE

Current through Register Vol. 35, No. 13, July 16, 2024
February 25, 2020, unless a later date is cited at the end of
				  a section.
New Mexico Administrative Code › Title 13 - INSURANCE › Chapter 19 - NON-ADMITTED OR SURPLUS LINES INSURANCE › Part 4 - MULTIPLE EMPLOYER WELFARE ARRANGEMENTS › Section 13.19.4.6 - OBJECTIVE

Current through Register Vol. 35, No. 13, July 16, 2024
The purpose of this rule is to establish eligibility
				  requirements, registration, reporting, oversight and transparency requirements
				  for multiple employer welfare arrangements. This rule also applies state and
				  federal statutes protecting consumers' access to care to
				  MEWAs.
New Mexico Administrative Code › Title 13 - INSURANCE › Chapter 19 - NON-ADMITTED OR SURPLUS LINES INSURANCE › Part 4 - MULTIPLE EMPLOYER WELFARE ARRANGEMENTS › Section 13.19.4.7 - DEFINITIONS

Current through Register Vol. 35, No. 13, July 16, 2024
For definitions of terms contained in this rule, refer to
				  13.10.29 NMAC, unless otherwise noted below.
A.
"Association health plan or
				association or AHP"
means any foreign or domestic association that
				provides a health benefits plan that covers the employees of multiple employers
				or union members. All association health plans are multiple employer welfare
				arrangements.
B.
"By
				laws"
means the statements adopted by a MEWA that prescribe its purpose,
				government and administration.
C.
"Discretionary group"
means a group that does not meet the
				standard, eligible group requirements under state or federal law, but have
				otherwise obtained insurance by the discretion of the superintendent to
				operate.
D.
"Employer"
means:
(1) a person who is an employer as
				that term is defined in Section 3(5) of the federal Employee Retirement Income
				Security Act of 1974, and who employs two or more employees; and
(2) a partnership in relation to a partner
				pursuant to Section
				59A-23E-17
				NMSA 1978.
New Mexico Administrative Code › Title 13 - INSURANCE › Chapter 19 - NON-ADMITTED OR SURPLUS LINES INSURANCE › Part 4 - MULTIPLE EMPLOYER WELFARE ARRANGEMENTS › Section 13.19.4.8 - ELIGIBILITY TO OPERATE

Current through Register Vol. 35, No. 13, July 16, 2024
A.
Eligibility to operate as or offer coverage through a MEWA.
(1)  Self-funded MEWA. A self-funded MEWA
				shall be eligible to offer health benefits plans only after meeting the
				requirements outlined in this section
(2) Fully-insured MEWA. A fully-insured MEWA
				shall confirm that its offered coverage conforms with the requirements of this
				section prior to the sale or delivery of any health benefits plan to MEWA
				members.
New Mexico Administrative Code › Title 13 - INSURANCE › Chapter 19 - NON-ADMITTED OR SURPLUS LINES INSURANCE › Part 4 - MULTIPLE EMPLOYER WELFARE ARRANGEMENTS › Section 13.19.4.9 - MULTIPLE EMPLOYER WELFARE ARRANGEMENT OR ASSOCIATION HEALTH PLAN NAME

Current through Register Vol. 35, No. 13, July 16, 2024
A.
Name.
No MEWA formed pursuant to this rule shall take any name
				that is the same as or closely resembles the name of any other MEWA possessing
				registration and doing business in this state. A MEWA must complete its
				application for registration to transact business under its own name and shall
				not adopt any assumed name, except that a MEWA by amending its articles may
				change its name or take a new name with the approval of the superintendent. A
				MEWA shall clearly state this name on all advertising materials.
B.
Legal proceedings.
Whenever
				it shall be necessary in any legal proceeding to prove the existence of a MEWA,
				a certified copy of the MEWA registration in this state shall be prima facie
				evidence of the existence of the MEWA.
New Mexico Administrative Code › Title 13 - INSURANCE › Chapter 19 - NON-ADMITTED OR SURPLUS LINES INSURANCE › Part 4 - MULTIPLE EMPLOYER WELFARE ARRANGEMENTS › Section 13.19.4.10 - DUTIES AND COMPENSATION OF TRUSTEES, OFFICERS OR DIRECTORS

Current through Register Vol. 35, No. 13, July 16, 2024
A.
Responsibilities of trustees, officers or directors.
The trustees,
				officers or directors of a MEWA shall give the attention and exercise the
				vigilance, diligence, care and skill that prudent persons use in like or
				similar circumstances.
B.
Authority of trustees, officers or directors.
The board of
				trustees, officers or directors shall select such directors as designated in
				the articles or bylaws or trust agreement and may appoint agents as deemed
				necessary for the transaction of the business of the MEWA. All directors and
				agents shall respectively have such authority and perform such duties in the
				management of the property and affairs of the MEWA as may be delegated by the
				board of trustees, officers or directors. Any director or agent may be removed
				by the board of trustees, officers or directors whenever in their judgment the
				business interests of the MEWA will be served by the removal. The board of
				trustees, officers or directors shall secure by bond or otherwise the fidelity
				of any or all such directors or agents who handle the funds of the
				MEWA.
C.
Duties of the
				trustees, officers or directors.
The trustees, officers or directors of
				a MEWA are responsible for die operations of the MEWA. The directors shall
				have, at minimum, the following duties:
(1)
				fiduciary responsibility for the MEWA operation and financial
				condition;
(2) selection,
				supervision, and evaluation of die service company, financial administrator,
				accountant, insurer, and any other contractors;
(3) on the basis of the plan's overall
				financial condition, authorizing changes in premium, reserve, or investment
				practices; and declaring assessments or dividends as appropriate:
(4) approving all reports concerning the
				plan's operations and status to the superintendent and the members;
(5) monitoring delinquent premiums, loss
				experience, and the financial condition of individual members; and authorizing
				disciplinary action or expulsion as appropriate;
(6) authorizing acceptance or rejection of
				applications for membership;
(7) as
				permitted by the bylaws, making or recommending changes to the bylaws for the
				improvement of the plan's operation and financial integrity; and
(8) monitoring the plan's compliance with all
				statutes and rules governing its operation.
New Mexico Administrative Code › Title 13 - INSURANCE › Chapter 19 - NON-ADMITTED OR SURPLUS LINES INSURANCE › Part 4 - MULTIPLE EMPLOYER WELFARE ARRANGEMENTS › Section 13.19.4.12 - APPLICATION REVIEW AND APPROVAL PROCESS FOR MEWAS

Current through Register Vol. 35, No. 13, July 16, 2024
A.
Application completion
				requirements.
An application is not complete until the MEWA has met all
				the requirements of this section to the satisfaction of the superintendent. The
				superintendent shall examine the application and supporting documents submitted
				by the applicant and shall conduct any investigation that the superintendent
				deems necessary. Incomplete applications shall be denied.
B.
Application review.
The
				superintendent shall register the MEWA upon finding that:
(1) the persons responsible for the conduct
				of the MEWA are competent, financially responsible and of good moral
				character;
(2) the applicant MEWA
				satisfies the requirements of 13.19.4.14 -13.19.4.19
				NMAC; and
(3) the applicant MEWA
				satisfies the requirements of 13.19.4.23 NMAC.
New Mexico Administrative Code › Title 13 - INSURANCE › Chapter 19 - NON-ADMITTED OR SURPLUS LINES INSURANCE › Part 4 - MULTIPLE EMPLOYER WELFARE ARRANGEMENTS › Section 13.19.4.13 - REVOCATION

Current through Register Vol. 35, No. 13, July 16, 2024
The superintendent may revoke a MEWAs registration upon
				  determining that the MEWA is no longer in compliance with any applicable
				  provision of federal law, the Insurance Code or these rules, even if the
				  non-compliance pre-dated registration.
New Mexico Administrative Code › Title 13 - INSURANCE › Chapter 19 - NON-ADMITTED OR SURPLUS LINES INSURANCE › Part 4 - MULTIPLE EMPLOYER WELFARE ARRANGEMENTS › Section 13.19.4.14 - SELF-FUNDED MEWA DEPOSIT REQUIREMENTS

Current through Register Vol. 35, No. 13, July 16, 2024
A.
Deposit requirement.
Every
				self-funded MEWA shall make and maintain deposits in trust of for the benefit
				and protection of all of its participants and their beneficiaries as specified
				by the superintendent in the certificate of registration. The deposit shall
				consist of assets eligible under Section
				59A-10-3
				NMSA 1978, and shall be deposited with or through the superintendent or in a
				commercial depository located in the state of New Mexico approved by the
				superintendent subject to Section
				59A-10-1
etseq.,
NMSA 1978.
B.
Deposit release conditions.
Any such deposit shall be released only in the following instances:
(1) upon extinguishment of all fixed and
				contingent liabilities of the MEWA secured by the deposit;
(2) upon the assumption by an authorized
				insurer of the MEWA's fixed and contingent liabilities secured by the deposit;
				or
(3) upon order of a court of
				competent jurisdiction the reserve deposit may be released to the receiver,
				conservator, rehabilitator or liquidator of the MEWA for whose account the
				deposit is held.
New Mexico Administrative Code › Title 13 - INSURANCE › Chapter 19 - NON-ADMITTED OR SURPLUS LINES INSURANCE › Part 4 - MULTIPLE EMPLOYER WELFARE ARRANGEMENTS › Section 13.19.4.15 - SELF-FUNDED MEWA MINIMUM SOLVENCY REQUIREMENTS

Current through Register Vol. 35, No. 13, July 16, 2024
A.
Net worth requirements.
Every
				self-funded MEWA shall maintain an unallocated reserve level of not less than
				the greater of twenty percent of the total premiums in the preceding plan year
				or twenty percent of the total estimated premiums for the current plan year.
				The superintendent may require a self-funded MEWA to maintain a minimum net
				worth in an amount lesser or greater than otherwise required in this
				rule.
B.
Reserve accounting
				principles.
Every self-funded MEWA shall establish and maintain loss and
				loss adjustment reserves determined by sound actuarial principles in a format
				consistent with that required by the national association of insurance
				commissioners for commercial health insurers. These principles shall give
				proper actuarial regard for known claims, paid and outstanding, a history of
				incurred but not reported claims, claims handling expenses, unearned premium,
				an estimate for bad debts, a trend factor and a margin for error.
C.
Reserve
requirements.
				Reserves shall be maintained in liquid admitted assets.
New Mexico Administrative Code › Title 13 - INSURANCE › Chapter 19 - NON-ADMITTED OR SURPLUS LINES INSURANCE › Part 4 - MULTIPLE EMPLOYER WELFARE ARRANGEMENTS › Section 13.19.4.16 - ACCOUNTING STANDARDS AND REPORTING REQUIREMENTS

Current through Register Vol. 35, No. 13, July 16, 2024
A.
Annual statement required.
Each self-funded MEWA transacting business in this state shall file annually
				with the superintendent statements and reports in compliance with 13.2.5 NMAC.
				Additionally, each annual statement shall be filed:
(1) by June 1st of each year, financial
				statements audited by a certified public accountant; and
(2) by March 1st of each year, an actuarial
				opinion prepared and certified by an actuary who is not an employee of the
				self-funded MEWA and who is a fellow of the society of actuaries, a member of
				the American academy of actuaries, or an enrolled actuary under the Employee
				Retirement Income Security Act of 1974 (
				29 United States Code
				§§
											1241 and
				1242
				). The actuarial opinion shall include:
(a) a
				description of the actuarial soundness of the self-funded MEWA, including any
				recommended actions that the self-funded MEWA should take to improve its
				actuarial soundness:
(b) the
				recommended amount of cash reserves the self-funded MEWA should maintain, which
				shall not be less than the greater of twenty percent of the total contributions
				in the preceding plan year or twenty percent of the total estimated
				contributions for the current plan year:
(c) a calculation of cash reserves with
				proper actuarial regard for known claims, paid and outstanding, a history of
				incurred but not reported claims, claims handling expenses, unearned premiums,
				an estimate for bad debts, a trend factor, and a margin for error;
				and
(d) the recommended level of
				specific and aggregate stop-loss insurance the MEWA arrangement should
				maintain.
New Mexico Administrative Code › Title 13 - INSURANCE › Chapter 19 - NON-ADMITTED OR SURPLUS LINES INSURANCE › Part 4 - MULTIPLE EMPLOYER WELFARE ARRANGEMENTS › Section 13.19.4.17 - INVESTMENT REQUIREMENTS OF SELF-FUNDED MEWAS

Current through Register Vol. 35, No. 13, July 16, 2024
Every self-funded MEWA shall comply fully with the investment
				  requirements of Section
				  59A-9-2 NMSA
				  1978. In addition, a MEWA must not invest in securities or debt of a member
				  employer, or a member employer's parent, subsidiary, or affiliate; or any
				  person or entity under contract with the MEWA.
New Mexico Administrative Code › Title 13 - INSURANCE › Chapter 19 - NON-ADMITTED OR SURPLUS LINES INSURANCE › Part 4 - MULTIPLE EMPLOYER WELFARE ARRANGEMENTS › Section 13.19.4.18 - FINANCIAL INTEGRITY OF SELF FUNDED-MEWAS

Current through Register Vol. 35, No. 13, July 16, 2024
A.
Fidelity bond.
All persons
				who handle MEWA funds or who will have authority to gain access to MEWA funds,
				including trustees, officers or directors must be covered by a fidelity bond.
				The bond must cover losses from dishonesty, robbery, forgery or alteration,
				misplacement, and mysterious and unexplainable disappearance. The amount of
				coverage for each occurrence must be at least $300,000. The MEWA must submit a
				fidelity bond covering the required persons, or submit proof of coverage for
				all required individuals not covered under the MEWAs bond.
B.
Integrity of assets.
A MEWA's
				assets:
(1) must not be commingled with the
				assets of any employer member;
(2)
				must not be loaned to anyone for any purpose, or used as security for a loan,
				except as permitted under subsection C of this section for
				investments.
(3) must be employed
				solely for the purposes stated in the bylaws, and in compliance with this
				chapter and related statutes; and
(4) must not be considered the property or
				right of any member, covered employee, or other covered person, except:
(a) for benefits under the coverage
				documents:
(b) for dividends
				declared in accordance with Section
				59A-37-22
				NMSA 1978.
(c) for a portion of the
				assets remaining after the plan's dissolution.
New Mexico Administrative Code › Title 13 - INSURANCE › Chapter 19 - NON-ADMITTED OR SURPLUS LINES INSURANCE › Part 4 - MULTIPLE EMPLOYER WELFARE ARRANGEMENTS › Section 13.19.4.20 - ENDING SELF-FUNDED, RUNOFF PERIOD, AND PLAN DISSOLUTION

Current through Register Vol. 35, No. 13, July 16, 2024
A.
Ending
				self-funded registration.
A MEWA may decide to end its self-funded
				registration and cease to provide coverage, effective at the end of a fund
				year. The MEWA shall notify the superintendent within 14 days of such a
				decision. A MEWA may not elect to end its self-funded registration less than 45
				days prior to the end of the fund year in question. Voluntary ending of
				self-funded registration does not constitute MEWA dissolution under Subsection
				D of this section.
B.
Revocation of self-funded registration.
The superintendent shall,
				by order, revoke die registration of a MEWA to self-insure upon ten days'
				written notice if any of the following events occur or conditions develop, and
				if the superintendent judges them to be material:
(1) failure of die MEWA to comply with this
				rule and all applicable statutes under the Insurance Code;
(2) failure of the MEWA to comply with any
				lawful order of the superintendent:
(3) commission by the MEWA of an unfair or
				deceptive practice or fraud as defined in Chapter 59A, Articles 16, 16b, or 16c
				of the Insurance Code or in related rules; or
(4) a deterioration of the MEWA's financial
				integrity to the extent that its present or future ability to meet obligations
				promptly and in full is or will be significantly impaired.
New Mexico Administrative Code › Title 13 - INSURANCE › Chapter 19 - NON-ADMITTED OR SURPLUS LINES INSURANCE › Part 4 - MULTIPLE EMPLOYER WELFARE ARRANGEMENTS › Section 13.19.4.21 - EFFECT OF REGISTRATION

Current through Register Vol. 35, No. 13, July 16, 2024
A.
Deemed to be an insurer.
Upon approval of the application for
				registration, a self-funded MEWA is deemed to be an "insurer" under Subsection
				A of Section
				59A-1-8
				NMSA 1978.
B.
Deemed to be an
				authorized issuer.
Upon approval of the application for registration, a
				self-funded MEWA is deemed to be an authorized insurer for purposes of
				compliance with state and federal law.
C.
Plan deemed to be a contract.
The health benefits plan of a registered self-funded MEWA is deemed to be a
				health benefits plan under state and federal law.
New Mexico Administrative Code › Title 13 - INSURANCE › Chapter 19 - NON-ADMITTED OR SURPLUS LINES INSURANCE › Part 4 - MULTIPLE EMPLOYER WELFARE ARRANGEMENTS › Section 13.19.4.22 - RENEWAL OF REGISTRATION

Current through Register Vol. 35, No. 13, July 16, 2024
A.
Renewal requirements.
A MEWA's registration shall continue in
				force as long as the MEWA complies with these rules and all other applicable
				state and federal laws, unless suspended or revoked by the superintendent or
				terminated at the MEWA's request, subject to continuance of the registration by
				the MEWA each year by:
(1) payment on or
				before March 1 of a $200.00 continuation fee;
(2) filing on or before March 1, by the MEWA
				or its authorized insurer(s), of an audited financial statement for the
				preceding year;
(3) timely payment
				by the MEWA, or its authorized insurer(s), of premium taxes for the preceding
				calendar year;
(4) reporting on
				demographic information, on a form approved by the superintendent, providing
				MEWA, and any third party administrator, intermediary, regulatory compliance,
				and insurer contacts that comply with the following requirements:
(a) the MEWA contact shall be the person
				responsible for filing all applicable forms and changes in information with the
				superintendent; and
(b) the
				regulatory contact shall be the person responsible for receiving notice of
				laws, rules, bulletins and the like that may affect the plan;
(5) notice of any changes in
				information previously filed with the superintendent, which shall include, but
				is not limited to, the following items:
(a)
				biographical affidavits of any new trustees, officers, directors, or other
				members of the association's or MEWA's governing body:
(b) the names, addresses, and qualifications
				of any new individuals responsible for the conduct of the plan's affairs,
				including third-party administrators:
(c) any new policy or amendment:
(d) any new trust agreement, plan document,
				plan summary, or bylaws:
(e) any
				new advertising and marketing material:
(f) any new members of the MEWA;
				and
(g) any other new
				agreements.
New Mexico Administrative Code › Title 13 - INSURANCE › Chapter 19 - NON-ADMITTED OR SURPLUS LINES INSURANCE › Part 4 - MULTIPLE EMPLOYER WELFARE ARRANGEMENTS › Section 13.19.4.23 - RATE AND FORM FILING REQUIREMENTS

Current through Register Vol. 35, No. 13, July 16, 2024
A.
Rate and form filing requirements.
A MEWA selling health benefits
				plans to New Mexico residents or employers, or an insurance company offering
				coverage through a MEWA, shall set premiums in accordance with sound actuarial
				methods and the standards outlined below:
(1)
				All forms of contracts evidencing benefits provided and all premium rates
				proposed, including any and all amendments, endorsements, riders, certificates
				or other modifications to contracts or premiums, shall conform to the filing
				and approval requirements contained in Sections
				59A-18-13.2,
				59A-18-13.3
				and 59 A-18-13.5 NMSA 1978, and any other applicable state or federal
				law.
(2) All MEWAs covering New
				Mexico residents shall charge premium rates in compliance with state and
				federal law, consistent with the market in which employer member is part; that
				is, a self-employed individual will have an individual policy, a small business
				will have a small group policy, and a large employer will have a large group
				policy.
(3) All MEWAs covering New
				Mexico residents shall file forms and rates in compliance with state and
				federal law, consistent with the market in which employer member is part, that
				is, a self-employed individual will have an individual policy, a small business
				will have a small group policy, a large employer will have a large group
				policy.
(4) All MEWAs covering New
				Mexico residents shall cover consumer protections in compliance with state and
				federal law, consistent with the market in which employer member is part, that
				is, a self-employed individual will have an individual policy, a small business
				will have a small group policy, a large employer will have a large group
				policy.
New Mexico Administrative Code › Title 13 - INSURANCE › Chapter 19 - NON-ADMITTED OR SURPLUS LINES INSURANCE › Part 4 - MULTIPLE EMPLOYER WELFARE ARRANGEMENTS › Section 13.19.4.24 - MANAGED HEALTH CARE COMPLIANCE PLAN AND BENEFITS REQUIREMENTS

Current through Register Vol. 35, No. 13, July 16, 2024
A healthcare plan offered by a MEWA, or by an insurer
				  offering coverage through a MEWA, shall comply with all state and federal laws
				  that mandate benefits, that mandate consumer protections and that mandate
				  managed health care requirements.
New Mexico Administrative Code › Title 13 - INSURANCE › Chapter 19 - NON-ADMITTED OR SURPLUS LINES INSURANCE › Part 4 - MULTIPLE EMPLOYER WELFARE ARRANGEMENTS › Section 13.19.4.25 - NOTICE REQUIREMENTS

Current through Register Vol. 35, No. 13, July 16, 2024
A.
Notice language.
The following notice shall be provided by a MEWA
				or third-party administrator within the policy documents to employers and
				employees who obtain coverage from a MEWA:
"Notice
The [Insert the name of the MULTIPLE EMPLOYER WELFARE
				  ARRANGEMENT in all capital letters] IS NOT AN INSURANCE COMPANY. FOR ADDITIONAL
				  INFORMATION ABOUT THE [Insert the name of the MULTIPLE EMPLOYER WELFARE
				  ARRANGEMENT in all capital letters] YOU SHOULD ASK QUESTIONS OF THE
				  ADMINISTRATOR OF THE [Insert the name of the MULTIPLE EMPLOYER WELFARE
				  ARRANGEMENT in all capital letters], OR YOU MAY CONTACT THE NEW MEXICO OFFICE
				  OF THE SUPERINTENDENT OF INSURANCE USING THE CONTACT INFORMATION PROVIDED ON
				  THE OSI WEBSITE."
B.
Contact for superintendent.
Each MEWA related notice shall include
				the superintendent's current consumer service telephone number and website in
				this notice.
C.
Notice to
				individual and small group prospective enrollees.
Any MEWA, third-party
				administrator or agent or producer acting on behalf of a MEWA shall provide the
				following information to prospective purchasers of an individual or small group
				health benefits plan:
(1) A statement that
				the individual or small group has the option of purchasing insurance on the New
				Mexico Health Insurance Exchange;
(2) Contact information for the New Mexico
				health insurance marketplace, including website and phone number:
(3) A statement that purchasing a health
				benefits plan through the MEWA may result in preventing the employer or
				individual from accessing premium subsidies, cost sharing reductions, or other
				financial assistance that may otherwise be available through the New Mexico
				health insurance exchange; and
(4)
				A table showing current income eligibility guidelines for Medicaid and
				individual and family marketplace coverage through the New Mexico health
				insurance exchange.
New Mexico Administrative Code › Title 13 - INSURANCE › Chapter 19 - NON-ADMITTED OR SURPLUS LINES INSURANCE › Part 4 - MULTIPLE EMPLOYER WELFARE ARRANGEMENTS › Section 13.19.4.26 - ENROLLMENT PERIODS

Current through Register Vol. 35, No. 13, July 16, 2024
A self-funded or fully-insured MEWA shall offer open and
				  special enrollment periods consistent with state and federal law and consistent
				  with the market in which the employer member is a part; that is, a
				  self-employed individual will have an individual policy, a small business will
				  have a small group policy, and a large employer will have a large group
				  policy.
New Mexico Administrative Code › Title 13 - INSURANCE › Chapter 19 - NON-ADMITTED OR SURPLUS LINES INSURANCE › Part 4 - MULTIPLE EMPLOYER WELFARE ARRANGEMENTS › Section 13.19.4.27 - RECORD RETENTION

Current through Register Vol. 35, No. 13, July 16, 2024
A MEWA doing business in New Mexico shall maintain its books
				  and records for a minimum period of seven years. Records shall be made
				  available to the superintendent for review upon request.
New Mexico Administrative Code › Title 13 - INSURANCE › Chapter 19 - NON-ADMITTED OR SURPLUS LINES INSURANCE › Part 4 - MULTIPLE EMPLOYER WELFARE ARRANGEMENTS › Section 13.19.4.28 - ENFORCEMENT

Current through Register Vol. 35, No. 13, July 16, 2024
A.
Enforcement action for failure to comply with rule.
The
				superintendent may revoke, suspend or refuse to continue the registration of a
				MEWA that fails to comply with this rule and may impose such other applicable
				administrative penalties authorized under the Insurance Code.
B.
Cease and desist.
When the
				superintendent believes that a MEWA or any other person is operating in this
				state without a registration or has violated the law or a rule or order of the
				superintendent, the superintendent may issue an order to cease and desist such
				violation or take any other action set forth in Section
				59A-16-27
				NMSA 1978.
C.
Penalty.
Any person or entity who violates any provision of this rule is subject to the
				penalties provided in Section
				59A-1-18 NMSA
				1978.
New Mexico Administrative Code › Title 13 - INSURANCE › Chapter 19 - NON-ADMITTED OR SURPLUS LINES INSURANCE › Part 4 - MULTIPLE EMPLOYER WELFARE ARRANGEMENTS › Section 13.19.4.29 - FRAUD REPORTING REQUIREMENT

Current through Register Vol. 35, No. 13, July 16, 2024
Any regulated entity who knowingly aids, assists or abets
				  violations of these rules is subject to the same penalties as the
				  MEWA.
New Mexico Administrative Code › Title 13 - INSURANCE › Chapter 19 - NON-ADMITTED OR SURPLUS LINES INSURANCE › Part 4 - MULTIPLE EMPLOYER WELFARE ARRANGEMENTS › Section 13.19.4.30 - INSURANCE AGENTS AND BROKERS

Current through Register Vol. 35, No. 13, July 16, 2024
Any person, including a licensed agent, broker or other
				  individual, soliciting, offering or selling a health benefit plan on behalf of
				  a MEWA to a New Mexico employer or a New Mexico resident shall comply with the
				  following requirements:
A. Prior to
				completing a sale of individual or small group coverage, disclose to the
				employer or resident that:
(1) the agent or
				broker is being compensated for the sale of the health benefit plan;
(2) that the small employer or individual has
				the option of purchasing insurance on the New Mexico health insurance
				marketplace;
(3) the eligibility
				guidelines for Medicaid coverage and financial assistance for coverage through
				the New Mexico health insurance exchange;
(4) contact information for the New Mexico
				health insurance exchange; and
(5)
				a comparison table showing the similarities and differences in coverages
				between a MEWA with qualified health plans sold in the individual and small
				group market; and
New Mexico Administrative Code › Title 13 - INSURANCE › Chapter 19 - NON-ADMITTED OR SURPLUS LINES INSURANCE › Part 4 - MULTIPLE EMPLOYER WELFARE ARRANGEMENTS › Section 13.19.4.31 - SHORT TERM LIMITED DURATION AND EXCEPTED BENEFIT PLANS

Current through Register Vol. 35, No. 13, July 16, 2024
Only a fully-insured MEWA shall offer a short-term or
				  excepted benefits plan. A MEWA offering short-term or excepted benefits plans
				  shall comply with all sections of this rule pertaining to fully-insured MEWA
				  plan.
New Mexico Administrative Code › Title 13 - INSURANCE › Chapter 19 - NON-ADMITTED OR SURPLUS LINES INSURANCE › Part 4 - MULTIPLE EMPLOYER WELFARE ARRANGEMENTS › Section 13.19.4.32 - VACCINE PURCHASING ACT COMPLIANCE

Current through Register Vol. 35, No. 13, July 16, 2024
A MEWA offering a major medical health benefits plan shall
				  comply with the reporting requirements under the Vaccine Purchasing Act at
				  24-5a-l et seq. NMSA 1978.
New Mexico Administrative Code › Title 13 - INSURANCE › Chapter 19 - NON-ADMITTED OR SURPLUS LINES INSURANCE › Part 4 - MULTIPLE EMPLOYER WELFARE ARRANGEMENTS › Section 13.19.4.33 - PHARMACY BENEFIT MANAGERS

Current through Register Vol. 35, No. 13, July 16, 2024
Any self-funded or fully-insured MEWA offering drug coverage
				  through a pharmacy benefit manager shall comply with Section
				  59A-61-1 et seq. NMSA
				  1978.
New Mexico Administrative Code › Title 13 - INSURANCE › Chapter 19 - NON-ADMITTED OR SURPLUS LINES INSURANCE › Part 4 - MULTIPLE EMPLOYER WELFARE ARRANGEMENTS › Section 13.19.4.34 - COMPLIANCE FOR EXISTING MEWAS OR DISCRETIONARY GROUPS

Current through Register Vol. 35, No. 13, July 16, 2024
A MEWA subject to this rule on its effective date shall
				  comply with the provisions of this rule no later than 45 days following its
				  effective date.
New Mexico Administrative Code › Title 13 - INSURANCE › Chapter 19 - NON-ADMITTED OR SURPLUS LINES INSURANCE › Part 4 - MULTIPLE EMPLOYER WELFARE ARRANGEMENTS › Section 13.19.4.35 - DEADLINES

Current through Register Vol. 35, No. 13, July 16, 2024
The superintendent, for good cause, may shorten or extend any
				  deadline set by this rule or under the Insurance Code.
New Mexico Administrative Code › Title 13 - INSURANCE › Chapter 19 - NON-ADMITTED OR SURPLUS LINES INSURANCE › Part 4 - MULTIPLE EMPLOYER WELFARE ARRANGEMENTS › Section 13.19.4.36 - RULE NONCOMPLIANCE

Current through Register Vol. 35, No. 13, July 16, 2024
Failure to comply with any provision of these rules is a
				  violation of the Insurance Code and punishable pursuant to Section
				  59A-5-30
				  NMSA 1978.
New Mexico Administrative Code › Title 13 - INSURANCE › Chapter 19 - NON-ADMITTED OR SURPLUS LINES INSURANCE › Part 4 - MULTIPLE EMPLOYER WELFARE ARRANGEMENTS › Section 13.19.4.37 - HEARING RIGHTS

Current through Register Vol. 35, No. 13, July 16, 2024
Any person aggrieved by any action, threatened action, or
				  failure to act by the superintendent shall have the same right to a hearing
				  before the superintendent with respect thereto as provided for in general under
				  Chapter 5 9A, Article 4 NMSA 1978 and the implementing rules.
New Mexico Administrative Code › Title 13 - INSURANCE › Chapter 19 - NON-ADMITTED OR SURPLUS LINES INSURANCE › Part 4 - MULTIPLE EMPLOYER WELFARE ARRANGEMENTS › Section 13.19.4.38 - SEVERABILITY

Current through Register Vol. 35, No. 13, July 16, 2024
If any provision of this rule, or the application thereof to
				  any person or circumstance, is held invalid, such invalidity shall not affect
				  other provisions or applications of this rule that can be given effect without
				  the invalid provision or application, and to that end the provisions of this
				  rule are severable.
New Mexico Administrative Code › Title 13 - INSURANCE › Chapter 20 - MISCELLANEOUS INSURANCE › Part 2 - BAIL BONDSMEN AND SOLICITORS › Section 13.20.2.1 - ISSUING AGENCY

Current through Register Vol. 35, No. 13, July 16, 2024
Office of Superintendent of Insurance (OSI), Post Office Box
				  1689, Santa Fe, NM 87504-1689.
New Mexico Administrative Code › Title 13 - INSURANCE › Chapter 20 - MISCELLANEOUS INSURANCE › Part 2 - BAIL BONDSMEN AND SOLICITORS › Section 13.20.2.2 - SCOPE

Current through Register Vol. 35, No. 13, July 16, 2024
This rule applies to all persons seeking licensure to
				  transact, or all persons transacting bail bond business in New
				  Mexico.
New Mexico Administrative Code › Title 13 - INSURANCE › Chapter 20 - MISCELLANEOUS INSURANCE › Part 2 - BAIL BONDSMEN AND SOLICITORS › Section 13.20.2.3 - STATUTORY AUTHORITY

Current through Register Vol. 35, No. 13, July 16, 2024
Sections
				  59A-2-8,
				  59A-2-9
				  NMSA 1978 and 59A-51-1 NMSA 1978
et seq
.
New Mexico Administrative Code › Title 13 - INSURANCE › Chapter 20 - MISCELLANEOUS INSURANCE › Part 2 - BAIL BONDSMEN AND SOLICITORS › Section 13.20.2.5 - EFFECTIVE DATE

Current through Register Vol. 35, No. 13, July 16, 2024
July 11, 2017
Compiler's note: The words or paragraph, above, are no
					 longer applicable. Later dates are now cited only at the end of sections, in
					 the history notes appearing in brackets.
New Mexico Administrative Code › Title 13 - INSURANCE › Chapter 20 - MISCELLANEOUS INSURANCE › Part 2 - BAIL BONDSMEN AND SOLICITORS › Section 13.20.2.6 - OBJECTIVE

Current through Register Vol. 35, No. 13, July 16, 2024
The purpose of this rule is to implement the Bail Bondsmen
				  Licensing Law, Section
				  59A-51-1 NMSA 1978
et seq
.
New Mexico Administrative Code › Title 13 - INSURANCE › Chapter 20 - MISCELLANEOUS INSURANCE › Part 2 - BAIL BONDSMEN AND SOLICITORS › Section 13.20.2.7 - DEFINITIONS

Current through Register Vol. 35, No. 13, July 16, 2024
All of the definitions contained in the bail bondsmen
				  licensing law are applicable in this section. Additionally, as used in this
				  rule:
A.
"Accredited provider"
means a provider of either continuing education or of the required
				pre-licensing formal classroom education as described in Sections
				13.20.2.11
				NMAC and
				13.20.2.12
				NMAC, who has been awarded official approval by the insurance education
				committee and the superintendent.
B.
"Clock hour"
means 50 minutes
				of continuous formal pre-licensing or continuing education classroom
				education.
C.
"Extraterritorial recovery"
means travel outside of a 60-mile
				radius from the bail bondsman's physical office address for purposes of
				recovering and delivering an absconder to the court.
D.
"Limited surety agent"
has
				the same meaning as defined in Subsection C of Section 59A-51-2 NMSA
				1978.
E.
"Principal"
means a person acting on behalf of the defendant to arrange for or execute a
				surety bond and who bears the risk upon forfeiture.
F.
"Property bondsman"
has the
				same meaning as defined in Subsection D of Section 59A-51-2 NMSA
				1978.
G.
"Solicitor"
has the same meaning as defined in Subsection E of Section 59A-51-2 NMSA
				1978.
H.
"Sponsoring
				bondsman"
means a licensed bail bondsman that has been accredited and
				awarded official approval by the insurance education committee and the
				superintendent to sponsor a solicitor and provide on-the-job training for bail
				bondsmen and solicitor applicants, as described in Section
				13.20.2.12
				NMAC.
I.
"Superintendent"
means the Superintendent of Insurance.
New Mexico Administrative Code › Title 13 - INSURANCE › Chapter 20 - MISCELLANEOUS INSURANCE › Part 2 - BAIL BONDSMEN AND SOLICITORS › Section 13.20.2.8 - LICENSING RESTRICTIONS

Current through Register Vol. 35, No. 13, July 16, 2024
A.
All applicants.
(1)
										18
				U.S.C. Sections 1033 and
				1034
				of the Violent Crime Control and Law Enforcement Act of 1994, and the New
				Mexico Criminal Offender Employment Act, Section
				28-2-1
				NMSA 1978
et seq
., apply to all bail bondsmen and solicitor
				applicants.
(2) Pursuant to
				Subsection A of Section
				59A-51-3
				NMSA 1978,no person shall act as a property bondsman, limited surety agent or
				solicitor, or perform any functions or duties or exercise any of the powers
				prescribed for bail bondsmen or solicitors in the bail bondsmen licensing law,
				unless such person is qualified and licensed.
New Mexico Administrative Code › Title 13 - INSURANCE › Chapter 20 - MISCELLANEOUS INSURANCE › Part 2 - BAIL BONDSMEN AND SOLICITORS › Section 13.20.2.9 - APPLICATION FOR LICENSE

Current through Register Vol. 35, No. 13, July 16, 2024
The requirements in this section are in addition to the
				  requirements of Section 59A-51-5 NMSA 1978.
A.
All applicants.
(1) The applicant shall complete
				pre-licensing education, as described in Subsection B of
				13.20.2.11
				NMAC.
(2) The applicant shall
				complete on-the-job training requirements, as described in Subsection B of
				13.20.2.12
				NMAC.
(3) The applicant shall
				register for and complete the required examination. Proof of the applicant's
				identity, including a recent legible credential-sized full-face photograph of
				the applicant shall be provided by the applicant at the time of the exam and
				shall be submitted to the superintendent by the exam vendor along with the
				applicant's exam result.
(4) The
				applicant shall complete the license application, which shall be signed by the
				applicant, under oath if required by the form.
(a) The application shall state the type of
				license applied for.
(b) The
				application shall be accompanied by the license application filing
				fee.
(5) The application
				shall require such information about the applicant as:
(a) the applicant's name, date of birth,
				social security number, residence address, mailing address, business address
				and a valid electronic mail (email) address;
(b) the applicant's personal history and
				business experience;
(c) the
				applicant's experience or special training or education in the bail bond
				business;
(d) whether the applicant
				was ever previously licensed to transact bail bonds or any other insurance
				business in this state or elsewhere;
(e) whether any bail bondsman, insurance or
				other professional license of the applicant was ever refused, suspended or
				revoked;
(f) whether any insurer or
				bail bondsman claims that the applicant is indebted to it, and if so, the
				details of the claim;
(g) whether
				the applicant has ever had an insurance agency contract cancelled and the facts
				concerning the cancellation; and
(h) such other pertinent information about
				the applicant as the superintendent may reasonably require.
New Mexico Administrative Code › Title 13 - INSURANCE › Chapter 20 - MISCELLANEOUS INSURANCE › Part 2 - BAIL BONDSMEN AND SOLICITORS › Section 13.20.2.10 - SCOPE OF EDUCATION AND EXAMINATION

Current through Register Vol. 35, No. 13, July 16, 2024
Pre-licensing and continuing education courses, on-the-job
				  training, and examinations shall be based on the following subjects, laws and
				  rules:
A.
Subjects:
(1) ethics;
(2) bond forfeiture procedures;
(3) rights of the accused;
(4) permitted and prohibited rates and
				charges;
(5) receipt and return of
				collateral security;
(6) financial
				management, accounting, trust account maintenance, and fiscal
				responsibilities;
(7) violations of
				law and applicable penalties;
(8)
				procedures for recovering a defendant who fails to appear and for returning a
				defendant to custody;
(9)
				record-keeping requirements;
(10)
				reporting requirements; and
(11)
				other relevant issues confronting the bail bond business in New
				Mexico.