New Mexico Administrative Code › Title 2 - PUBLIC FINANCE › Chapter 81 - RETIREE HEALTH CARE FUNDS › Part 7 - BENEFITS ELIGIBILITY OR NON ELIGIBILITY FOR RETIREES OF INDEPENDENT PUBLIC EMPLOYERS › Section 2.81.7.10 - RETIREES/TIME IN SERVICE OF INDEPENDENT PUBLIC EMPLOYER AND RETIREMENT SYSTEM PUBLIC EMPLOYER

Current through Register Vol. 35, No. 13, July 16, 2024
A.
Normal Retirement:
The service requirement for coverage for those
				persons having served a participating employer affiliated with a public pension
				plan, but having been individually excluded from the public pension plan, or
				having served an independent public employer which has opted to become a
				participating employer is five or more years of creditable service. Periods of
				employment with, or retirement from, a non-participating employer shall not
				affect an employee's eligibility, so long as the employee has met the minimum
				requirement for years of creditable service with a participating employer and
				is eligible to receive a pension from the participating employer's pension
				system.
B.
Duty
				Disability:
Without regard to age or length of service, an applicant for
				coverage based on duty disability shall be granted coverage if the incident
				resulting in the disability arose from and in the course of performance of
				duties by the applicant for the participating employer and if the applicant is
				unable, after the incident, to perform the job which the applicant was
				performing prior to the time of the incident resulting in the disability. In
				the event there is a determination that the applicant is unable to perform the
				job being performed by the applicant at the time of the incident leading to the
				duty disability, the applicant will be granted temporary duty disability for a
				period up to one year. Prior to the end of the temporary period of duty
				disability, there shall be a second inquiry to determine whether or not the
				applicant can perform any gainful employment. In the event, on the initial
				inquiry it is determined that the applicant can perform the job that was being
				performed at the time of the incident resulting in the disability or in the
				second inquiry it is determined that the applicant is capable of performing any
				gainful employment, the applicant shall be denied coverages provided by the
				act.
C.
Non-Duty
				Disability:
A person shall be entitled to coverages under the act
				provided that person has five or more years of credited service with a
				participating employer. The applicant must show that the applicant is not
				capable of any gainful employment. In the event the applicant fails to show
				that the applicant has five or more years of credited service in employment
				with a participating employer or fails to show that he is incapable of holding
				any gainful employment, the applicant shall not be entitled to coverages under
				the act.
D.
Survivor's
				benefit:
survivor pension beneficiary means a person entitled to a
				survivors benefit either pursuant to the retirement program of a participating
				Independent public employer or if the person meets the tests that would be
				applicable pursuant to
				10-11-1 et
				seq. NMSA 1978.
E.
Administrative Determination:
The executive director of the retiree
				health care authority shall review and grant or deny the opportunity for
				coverage under the act on a form approved by the executive director. The
				executive director shall provide notice of the determination by regular mail
				and notify the applicant of the right of appeal.
F.
Appeal:
The applicant may
				appeal an adverse decision of the executive director. The appeal shall be filed
				with the office of executive director thirty days following the day on which
				the executive director's determination is deposited in the mail.
G.
Board Determination Final:
The board, at a time mutually convenient for the applicant, executive director
				and board shall review the appeal. A formal hearing shall not be held unless
				the board determines that substantial material factual issues are present that
				cannot be resolved satisfactorily through an examination of written documents
				in the record. The applicant may request a hearing, but such requests shall be
				deemed denied unless specifically granted. Hearings, when held, should be as
				informal as practicable under the circumstances, but the board has absolute
				discretion in establishing the degree of formality for any particular hearing.
				In no event is the executive director or board required to adhere to formal
				rules of evidence or procedure. The decision of the board shall be final and
				not subject to appeal.
H.
Retirees Not Eligible For Coverage:
Persons who retire from an employer
				which does not become or does not remain a participating employer shall not be
				eligible for retiree, spouse, domestic partner or dependent coverage unless
				they have been employed by a participating employer under the act and have
				satisfied prior to or after July 1, 1990, the age and service requirements of
				2.81.7.10 NMAC while employed by a participating employer under the act. The
				time during which employees have exempted themselves from the employer-provided
				retirement system shall not be considered time in service.