reglab/statecodes huggingface dataset:
New Mexico Administrative Code › Title 6 - PRIMARY AND SECONDARY EDUCATION › Chapter 50 - INSURANCE › Part 2 - CONTRACTS FOR PURCHASE OF PROFESSIONAL SERVICES AND INSURANCE › Section 6.50.2.21 - DESIGNEE

Current through Register Vol. 35, No. 13, July 16, 2024
A. At any point
				during a protest proceeding the executive director or the board may appoint a
				designee, to act in place of the executive director. The designee will have all
				of the powers described in these rules regarding protest procedures except the
				power to issue a written determination under 6.50.2.18 NMAC. The designee only
				has authority to recommend a resolution to the executive director under that
				section.
B. The designee may be any
				person other than any person having made a proposal in response to the request
				for proposal.
C. A designee shall
				present a recommended written resolution to the executive director or the board
				and mail a copy to each of the parties. No party may appeal from the
				recommended resolution of the designee.
D. The executive director or the board shall
				approve, disapprove or modify the recommended resolution of the designee in
				writing. Such approval, disapproval or modification shall be the written
				determination required by 6.50.2.18 NMAC.
New Mexico Administrative Code › Title 6 - PRIMARY AND SECONDARY EDUCATION › Chapter 50 - INSURANCE › Part 2 - CONTRACTS FOR PURCHASE OF PROFESSIONAL SERVICES AND INSURANCE › Section 6.50.2.22 - FINAL DETERMINATION

Current through Register Vol. 35, No. 13, July 16, 2024
A. In
				those proceedings in which no motion for reconsideration is filed, the written
				determination issued pursuant to 6.50.2.18 NMAC shall be the final
				determination for purposes of the time limits for seeking judicial review under
				Section
				13-1-183 NMSA
				1978.
B. In those proceedings in
				which a motion for reconsideration is filed, the written response to the motion
				issued pursuant to Subsection C of 6.50.2.20 NMAC shall be the final
				determination for purposes of the time limits for seeking judicial review under
				Section
				13-1-183 NMSA
				1978.
New Mexico Administrative Code › Title 6 - PRIMARY AND SECONDARY EDUCATION › Chapter 50 - INSURANCE › Part 2 - CONTRACTS FOR PURCHASE OF PROFESSIONAL SERVICES AND INSURANCE › Section 6.50.2.23 - COPIES OF COMMUNICATIONS

Current through Register Vol. 35, No. 13, July 16, 2024
A.
				Each party to a protest proceeding shall certify that it has provided every
				other party with copies of all documents or correspondence addressed or
				delivered to the executive director.
B. No party shall submit any material,
				evidence, explanation, analysis, or advice, whether written or oral, to the
				executive director or the board ex parte, regarding any matter at issue in a
				protest.
New Mexico Administrative Code › Title 6 - PRIMARY AND SECONDARY EDUCATION › Chapter 50 - INSURANCE › Part 2 - CONTRACTS FOR PURCHASE OF PROFESSIONAL SERVICES AND INSURANCE › Section 6.50.2.24 - PROTESTS REGARDING HEALTH CARE CONTRACT PURCHASING

Current through Register Vol. 35, No. 13, July 16, 2024
Protests concerning the authority's purchase of health care
				  contracts shall be resolved by the procurement manager pursuant to the Heath
				  Care Purchasing Act, Section
				  13-7-1 et
				  seq., NMSA 1978.
New Mexico Administrative Code › Title 6 - PRIMARY AND SECONDARY EDUCATION › Chapter 50 - INSURANCE › Part 2 - CONTRACTS FOR PURCHASE OF PROFESSIONAL SERVICES AND INSURANCE › Section 6.50.2.25 - CONTRACTS - AUDITS

Current through Register Vol. 35, No. 13, July 16, 2024
A. The
				authority has the primary responsibility for contract compliance monitoring.
				The board or its consultant if any, shall audit contracts on a random basis to
				determine:
(1) if the tasks called for in the
				scope of services have been performed;
(2) if the contract was completed in time and
				within budget; and
(3) if the
				services were performed to the satisfaction of the authority.
New Mexico Administrative Code › Title 6 - PRIMARY AND SECONDARY EDUCATION › Chapter 50 - INSURANCE › Part 2 - CONTRACTS FOR PURCHASE OF PROFESSIONAL SERVICES AND INSURANCE › Section 6.50.2.26 - VOUCHER APPROVAL - PROFESSIONAL SERVICES

Current through Register Vol. 35, No. 13, July 16, 2024
A. No voucher for payment of professional
				services will be approved by the board or its third party administrators, other
				than a payroll voucher or travel voucher, unless the contract and any
				amendments to the contract have been approved where required by these rules.
				All vouchers must contain the contract identification number.
B. The board or its third party
				administrators shall not approve any voucher for the payment of professional
				services unless the voucher certifies that the services have been
				rendered.
New Mexico Administrative Code › Title 6 - PRIMARY AND SECONDARY EDUCATION › Chapter 50 - INSURANCE › Part 3 - PROCUREMENT OF OR SELF-INSURANCE OF RISK-RELATED AND EMPLOYEE-BENEFITS COVERAGES › Section 6.50.3.1 - ISSUING AGENCY

Current through Register Vol. 35, No. 13, July 16, 2024
New Mexico Public School Insurance
				  Authority.
New Mexico Administrative Code › Title 6 - PRIMARY AND SECONDARY EDUCATION › Chapter 50 - INSURANCE › Part 3 - PROCUREMENT OF OR SELF-INSURANCE OF RISK-RELATED AND EMPLOYEE-BENEFITS COVERAGES › Section 6.50.3.2 - SCOPE

Current through Register Vol. 35, No. 13, July 16, 2024
This part applies to all school districts, charter schools,
				  other educational entities, eligible employees, eligible retired employees,
				  eligible dependents, eligible participating entity governing body members, and
				  persons or entities authorized to participate in the authority's employee
				  benefits, risk-related and due process reimbursement
				  coverages.
New Mexico Administrative Code › Title 6 - PRIMARY AND SECONDARY EDUCATION › Chapter 50 - INSURANCE › Part 3 - PROCUREMENT OF OR SELF-INSURANCE OF RISK-RELATED AND EMPLOYEE-BENEFITS COVERAGES › Section 6.50.3.3 - STATUTORY AUTHORITY

Current through Register Vol. 35, No. 13, July 16, 2024
Subsection D of Section
				  22-29-7 NMSA
				  1978, directs the authority to promulgate necessary rules, regulations and
				  procedures for the implementation of the New Mexico Public School Insurance
				  Authority Act, Section
				  22-29-1 et
				  seq. NMSA 1978.
New Mexico Administrative Code › Title 6 - PRIMARY AND SECONDARY EDUCATION › Chapter 50 - INSURANCE › Part 3 - PROCUREMENT OF OR SELF-INSURANCE OF RISK-RELATED AND EMPLOYEE-BENEFITS COVERAGES › Section 6.50.3.5 - EFFECTIVE DATE

Current through Register Vol. 35, No. 13, July 16, 2024
September 1, 2014 unless a later date is cited at the end of
				  a section.
New Mexico Administrative Code › Title 6 - PRIMARY AND SECONDARY EDUCATION › Chapter 50 - INSURANCE › Part 3 - PROCUREMENT OF OR SELF-INSURANCE OF RISK-RELATED AND EMPLOYEE-BENEFITS COVERAGES › Section 6.50.3.6 - OBJECTIVE

Current through Register Vol. 35, No. 13, July 16, 2024
The objective of this part is to delineate the powers of the
				  authority to procure insurance or to self-insure risk-related exposures and to
				  provide for employee-benefit programs and due process reimbursement coverage
				  and the general methods by which these coverages will be
				  offered.
New Mexico Administrative Code › Title 6 - PRIMARY AND SECONDARY EDUCATION › Chapter 50 - INSURANCE › Part 3 - PROCUREMENT OF OR SELF-INSURANCE OF RISK-RELATED AND EMPLOYEE-BENEFITS COVERAGES › Section 6.50.3.8 - AUTHORIZATION TO PROCURE INSURANCE OR TO SELF-INSURE RISK-RELATED, EMPLOYEE BENEFIT AND DUE PROCESS REIMBURSEMENT COVERAGES

Current through Register Vol. 35, No. 13, July 16, 2024
The authority is authorized to provide for risk-related
				  exposures, employee benefit programs and due process reimbursement coverage in
				  the following ways.
A. Obtain basic,
				excess, reinsurance or retrospectively rated insurance policies for any
				combination of risk-related or employee-benefit coverages on behalf of all
				persons or entities authorized to participate in the authority's coverages in
				compliance with the Procurement Code, Section 13-1-1 et seq. NMSA 1978, the
				Health Care purchasing Act, Section
				13-7-1
				NMSA 1978, and the competitive sealed proposal process of Section
				13-1-28
				NMSA 1978.
B. Self-insure all or
				any part of risk-related, employee benefit and due process reimbursement
				coverages offered to persons or entities authorized to participate in the
				authority's coverages.
C. Establish
				pooling and participation arrangements to provide risk-related or
				employee-benefit coverages on behalf of all persons or entities authorized to
				participate in the authority's coverages.
D. Establish reasonable self-insured
				retention or self-insured liability levels.
E. Establish reasonable deductibles, stop
				loss, out of pocket, co-pays or other cost containment mechanisms.
F. Modify any basic, excess, reinsurance or
				retrospectively rated insurance policies, pooling or participation agreements
				or other insurance coverage.
G. Add
				or delete one or more risks, one or more perils, one or more benefits or one or
				more lines in any self- insurance, insurance contract, pooling or participation
				agreement.
New Mexico Administrative Code › Title 6 - PRIMARY AND SECONDARY EDUCATION › Chapter 50 - INSURANCE › Part 3 - PROCUREMENT OF OR SELF-INSURANCE OF RISK-RELATED AND EMPLOYEE-BENEFITS COVERAGES › Section 6.50.3.9 - AUTHORIZATION TO OFFER RISK RELATED COVERAGES

Current through Register Vol. 35, No. 13, July 16, 2024
The authority is authorized to offer risk-related coverages
				  to all school districts and charter schools. The authority may offer
				  risk-related coverages to individual other educational entities by special
				  agreement.
New Mexico Administrative Code › Title 6 - PRIMARY AND SECONDARY EDUCATION › Chapter 50 - INSURANCE › Part 3 - PROCUREMENT OF OR SELF-INSURANCE OF RISK-RELATED AND EMPLOYEE-BENEFITS COVERAGES › Section 6.50.3.10 - AUTHORIZATION TO OFFER EMPLOYEE-BENEFIT COVERAGES

Current through Register Vol. 35, No. 13, July 16, 2024
A. The authority is authorized to offer
				employee-benefit coverages to all school districts, charter schools, other
				educational entities, eligible employees, eligible retired employees, eligible
				dependents and persons or entities authorized to participate in the authority's
				coverage.
B. The authority is
				authorized to offer mandatory benefit coverages as follows: Basic
				non-contributory life insurance and medical benefit plans whether insured or
				self-insured.
C. The authority is
				authorized to offer optional benefit coverages as follows: dental, vision,
				disability, or additional life and such other line or lines of coverage as the
				board may determine from time to time.
New Mexico Administrative Code › Title 6 - PRIMARY AND SECONDARY EDUCATION › Chapter 50 - INSURANCE › Part 3 - PROCUREMENT OF OR SELF-INSURANCE OF RISK-RELATED AND EMPLOYEE-BENEFITS COVERAGES › Section 6.50.3.11 - AUTHORIZATION TO OFFER DUE PROCESS REIMBURSEMENT COVERAGE

Current through Register Vol. 35, No. 13, July 16, 2024
A. The authority is authorized to include due
				process reimbursement coverage in its self-insured retention risk pool pursuant
				to Section
				22-29-12
				NMSA 1978, as amended and supplemented.
B. The board shall determine at the beginning
				of each fiscal year the amount available in the fund for reimbursements. The
				provisions for distribution of the fund amount shall be set forth in the
				general liability memorandum of coverage including the process for submitting
				claims and the method of distribution.
New Mexico Administrative Code › Title 6 - PRIMARY AND SECONDARY EDUCATION › Chapter 50 - INSURANCE › Part 4 - OTHER EDUCATIONAL ENTITIES PARTICIPATION › Section 6.50.4.3 - STATUTORY AUTHORITY

Current through Register Vol. 35, No. 13, July 16, 2024
Subsection D of Section
				  22-29-7 NMSA
				  1978, directs the authority to promulgate necessary rules, regulations and
				  procedures for the implementation of the New Mexico Public School Insurance
				  Authority Act, Section
				  22-29-1 et
				  seq. NMSA 1978.
New Mexico Administrative Code › Title 6 - PRIMARY AND SECONDARY EDUCATION › Chapter 50 - INSURANCE › Part 4 - OTHER EDUCATIONAL ENTITIES PARTICIPATION › Section 6.50.4.6 - OBJECTIVE

Current through Register Vol. 35, No. 13, July 16, 2024
The objective of this part is to set forth the procedures for
				  other educational entities to join or exit the authority as well as rules and
				  procedures concerning participation in authority coverages by other educational
				  entities.
New Mexico Administrative Code › Title 6 - PRIMARY AND SECONDARY EDUCATION › Chapter 50 - INSURANCE › Part 4 - OTHER EDUCATIONAL ENTITIES PARTICIPATION › Section 6.50.4.8 - PROCEDURE FOR ENTERING THE AUTHORITY

Current through Register Vol. 35, No. 13, July 16, 2024
A. Other educational entities who desire to
				join the authority shall provide the following to the authority:
(1) an up-to-date employee census including
				for all employees their age, gender and classification;
(2) a minimum of three years loss reports and
				claims experience for all lines of authority coverages the other educational
				entity wishes to participate in;
(3) submission of financial and benefit
				information which meets standards set by the board;
(4) a resolution of the governing body of the
				other educational entity stating that it is requesting authority membership and
				participation in the authority's offerings of risk related and employee
				benefits coverages and a statement that the other educational entity will abide
				by the Public School Insurance Authority Act, Section
				22-29-1 et
				seq. NMSA 1978, and all authority rules and board policies and will keep in
				force all authority coverages for the duration of the then existing carrier
				agreements;
(5) an agreement in a
				form acceptable to the authority whereby the governing body of the other
				educational entity agrees that it will abide by and be bound by the Public
				School Insurance Authority Act, Section
				22-29-1 et
				seq. NMSA 1978, and all other authority rules and board policies, including
				authority claims processing, settlement practices and the authority schedule
				for payment of premiums, late penalties and applicable interest, and will take,
				pay for and keep in force for the duration of the carrier agreements all
				applicable authority coverages; and
(6) payment of an excess premium deposit
				equal to (10%) of the total annual first year premiums for the coverages
				selected by the educational entity desiring to join the authority.
New Mexico Administrative Code › Title 6 - PRIMARY AND SECONDARY EDUCATION › Chapter 50 - INSURANCE › Part 4 - OTHER EDUCATIONAL ENTITIES PARTICIPATION › Section 6.50.4.9 - PROCEDURE FOR EXITING THE AUTHORITY BY OTHER EDUCATIONAL ENTITIES

Current through Register Vol. 35, No. 13, July 16, 2024
A. Other
				educational entities can voluntarily exit the authority only at the expiration
				of the carrier agreements for the authority coverages they have
				selected.
B. Under no circumstances
				can other educational entities voluntarily exit the authority prior to having
				been a member for a minimum of three years.
C. An other educational entity desiring to
				exit the authority shall make a request to the board in writing stating the
				reasons why it desires to exit no later than 90 days prior to the expiration
				date of the carrier agreements for the authority coverages the other
				educational entity has selected. The board shall vote whether to accept the
				resignation of the other educational entity at its next regular meeting
				following receipt of the other educational entity's request to exit.
D. The board shall reevaluate other
				educational entities who violate authority rules, regulations or board
				policies, which have poor loss histories or which evidence clear signs of
				fiscal irresponsibility and the board may at its discretion terminate the other
				educational entity's membership in the authority upon 90 day notice.
New Mexico Administrative Code › Title 6 - PRIMARY AND SECONDARY EDUCATION › Chapter 50 - INSURANCE › Part 4 - OTHER EDUCATIONAL ENTITIES PARTICIPATION › Section 6.50.4.10 - PENALTIES AGAINST OTHER EDUCATIONAL ENTITIES FOR FAILURE TO PARTICIPATE AFTER JOINING THE AUTHORITY

Current through Register Vol. 35, No. 13, July 16, 2024
A. Other
				educational entities may not drop any authority coverages prior to the
				expiration of carrier contracts. However, should a successor governing body of
				a participating other educational entity drop participation by refusing
				continued premium payments, the other educational entity shall be terminated
				from all coverages by the authority upon 30 day notice and the following
				penalties shall be incurred.
(1) For
				risk-related coverages, the other educational entity shall forfeit to the
				authority any right to any reserves held on its behalf and shall pay to the
				authority the cost of any losses in excess of premium.
(2) For health and life employee benefits
				coverages, the other educational entity shall forfeit to the authority any
				right to any return premiums or reserves it may otherwise be entitled to. It
				shall pay to the authority any funds the authority has paid for or will pay for
				incurred claims related to the other educational entity in excess of premiums
				paid by the other educational entity as well as administrative expenses
				directly or indirectly related to claim payments including third party
				administrator costs and a reasonable percentage of the authority administrative
				costs.
New Mexico Administrative Code › Title 6 - PRIMARY AND SECONDARY EDUCATION › Chapter 50 - INSURANCE › Part 4 - OTHER EDUCATIONAL ENTITIES PARTICIPATION › Section 6.50.4.11 - DUE DATES FOR ACCOUNTING BY THE AUTHORITY

Current through Register Vol. 35, No. 13, July 16, 2024
An accounting of funds and amounts owed by or to the other
				  educational entity which has failed to participate, dropped coverages or exited
				  the authority for any reason shall not be due from the authority any earlier
				  than two years for employee benefits coverages and for risk-related coverages
				  after the failure to participate, early exit or dropping of coverage by the
				  other educational entity.
New Mexico Administrative Code › Title 6 - PRIMARY AND SECONDARY EDUCATION › Chapter 50 - INSURANCE › Part 5 - EMPLOYEE-BENEFITS AND RISK-RELATED COVERAGES DETERMINATION OF PREMIUM LEVELS › Section 6.50.5.2 - SCOPE

Current through Register Vol. 35, No. 13, July 16, 2024
This part applies to all school districts, charter schools
				  and other educational entities, eligible employees, eligible retired employees,
				  eligible dependents, eligible participating entity governing body members and
				  persons or entities authorized to participate in the authority's employee
				  benefits, risk-related and due process reimbursement
				  coverages.
New Mexico Administrative Code › Title 6 - PRIMARY AND SECONDARY EDUCATION › Chapter 50 - INSURANCE › Part 5 - EMPLOYEE-BENEFITS AND RISK-RELATED COVERAGES DETERMINATION OF PREMIUM LEVELS › Section 6.50.5.3 - STATUTORY AUTHORITY

Current through Register Vol. 35, No. 13, July 16, 2024
Subsection D of Section
				  22-29-7 NMSA
				  1978 directs the authority to promulgate necessary rules, regulations and
				  procedures for the implementation of the New Mexico Public School Insurance
				  Authority Act, Section
				  22-29-1 et
				  seq. NMSA 1978.
New Mexico Administrative Code › Title 6 - PRIMARY AND SECONDARY EDUCATION › Chapter 50 - INSURANCE › Part 5 - EMPLOYEE-BENEFITS AND RISK-RELATED COVERAGES DETERMINATION OF PREMIUM LEVELS › Section 6.50.5.5 - EFFECTIVE DATE

Current through Register Vol. 35, No. 13, July 16, 2024
September 1, 2014 unless a later date is cited at the end of
				  a section.
New Mexico Administrative Code › Title 6 - PRIMARY AND SECONDARY EDUCATION › Chapter 50 - INSURANCE › Part 5 - EMPLOYEE-BENEFITS AND RISK-RELATED COVERAGES DETERMINATION OF PREMIUM LEVELS › Section 6.50.5.6 - OBJECTIVE

Current through Register Vol. 35, No. 13, July 16, 2024
The objective of this part is to establish the policy for
				  determining premium levels.
New Mexico Administrative Code › Title 6 - PRIMARY AND SECONDARY EDUCATION › Chapter 50 - INSURANCE › Part 5 - EMPLOYEE-BENEFITS AND RISK-RELATED COVERAGES DETERMINATION OF PREMIUM LEVELS › Section 6.50.5.8 - ESTABLISHMENT OF EMPLOYEE-BENEFIT AND RISK RELATED PREMIUMS

Current through Register Vol. 35, No. 13, July 16, 2024
A. The authority shall establish premiums
				necessary to protect the solvency of the fund considering all expenses,
				potential expenses and costs of the authority programs.
B. Whenever possible, the authority shall
				obtain loss experience for each line of coverage for each participating
				entity.
C. Whenever possible and
				economically feasible, the authority shall obtain professional actuarial advice
				to establish premium levels.
D.
				Whenever possible, the authority shall consider the loss experience of each
				particular participating entity as a primary factor in establishing the
				premiums for that entity. However, the authority shall also use other factors
				as necessary to protect the stability and solvency of the fund.
E. Exposure information, which includes, but
				is not limited to, property values, vehicle counts, payroll, average daily
				attendance, budgets, new or hazardous exposures, is requested from each member
				typically in December of each year. This information is one of the factors used
				to allocate premiums among the members. The deadline for submission of this
				information to the authorized representative of the authority is the second
				Friday in January. The authorized representative shall have three to four weeks
				to review the data, ask and answer any questions and verify the information.
				The final deadline for the submission of all additional or amended exposure
				information by the members to the authorized representative is the second
				Friday in February. The board will have the final decision to approve or reject
				any late received exposure information. If the exposure information is not
				received by the deadlines described above, the board may, at its discretion,
				impose a 10% penalty increase to that member's prior year's exposure
				information.
F. If, at any time,
				the authority becomes aware that a member has under reported exposure
				information, an additional premium will be charged at a rate to be determined
				by the board.
G. If, at any time,
				the authority becomes aware that a member over reports exposure information,
				the member will not receive any return of premiums paid. However, if there are
				extenuating circumstances, the member can request that the board waive the
				forfeiture of the return premium.
New Mexico Administrative Code › Title 6 - PRIMARY AND SECONDARY EDUCATION › Chapter 50 - INSURANCE › Part 5 - EMPLOYEE-BENEFITS AND RISK-RELATED COVERAGES DETERMINATION OF PREMIUM LEVELS › Section 6.50.5.9 - ESTABLISHMENT OF DUE PROCESS REIMBURSEMENT PREMIUMS

Current through Register Vol. 35, No. 13, July 16, 2024
Due process reimbursement coverage premiums shall be
				  established in accordance with Section
				  22-29-12
				  NMSA 1978 and the applicable memorandum of coverage.
New Mexico Administrative Code › Title 6 - PRIMARY AND SECONDARY EDUCATION › Chapter 50 - INSURANCE › Part 5 - EMPLOYEE-BENEFITS AND RISK-RELATED COVERAGES DETERMINATION OF PREMIUM LEVELS › Section 6.50.5.10 - NONDISCLOSURE OF PREMIUM CHANGES

Current through Register Vol. 35, No. 13, July 16, 2024
Authority staff, actuaries or consultants shall not discuss
				  or disclose to participating entities, employees, retirees or the public any
				  premium changes until authorized to do so by the board.
New Mexico Administrative Code › Title 6 - PRIMARY AND SECONDARY EDUCATION › Chapter 50 - INSURANCE › Part 6 - NOTICE OF RISK-RELATED AND EMPLOYEE BENEFITS COVERAGE › Section 6.50.6.2 - SCOPE

Current through Register Vol. 35, No. 13, July 16, 2024
This part applies to all school districts, charter schools,
				  other educational entities, eligible employees, eligible retired employees,
				  eligible dependents, eligible participating entity governing body members, and
				  persons or entities authorized to participate in the authority's employee
				  benefits, risk-related and due process reimbursement
				  coverages.
New Mexico Administrative Code › Title 6 - PRIMARY AND SECONDARY EDUCATION › Chapter 50 - INSURANCE › Part 6 - NOTICE OF RISK-RELATED AND EMPLOYEE BENEFITS COVERAGE › Section 6.50.6.3 - STATUTORY AUTHORITY

Current through Register Vol. 35, No. 13, July 16, 2024
Subsection D of Section
				  22-29-7, NMSA
				  1978, directs the authority to promulgate necessary rules, regulations and
				  procedures for the implementation of the New Mexico Public School Insurance
				  Authority Act, Section
				  22-29-1 et
				  seq., NMSA 1978.
New Mexico Administrative Code › Title 6 - PRIMARY AND SECONDARY EDUCATION › Chapter 50 - INSURANCE › Part 6 - NOTICE OF RISK-RELATED AND EMPLOYEE BENEFITS COVERAGE › Section 6.50.6.5 - EFFECTIVE DATE

Current through Register Vol. 35, No. 13, July 16, 2024
September 1, 2014 unless a later date is cited at the end of
				  a section.
New Mexico Administrative Code › Title 6 - PRIMARY AND SECONDARY EDUCATION › Chapter 50 - INSURANCE › Part 6 - NOTICE OF RISK-RELATED AND EMPLOYEE BENEFITS COVERAGE › Section 6.50.6.6 - OBJECTIVE

Current through Register Vol. 35, No. 13, July 16, 2024
The objective of this part is to establish the procedure for
				  providing notice of coverage of risk-related, employee benefits and due process
				  reimbursement coverages.
New Mexico Administrative Code › Title 6 - PRIMARY AND SECONDARY EDUCATION › Chapter 50 - INSURANCE › Part 6 - NOTICE OF RISK-RELATED AND EMPLOYEE BENEFITS COVERAGE › Section 6.50.6.8 - COVERAGE NOTIFICATION

Current through Register Vol. 35, No. 13, July 16, 2024
The authority will issue notification of coverage for each
				  offering to each participating entity within 30 days of the inception of the
				  coverage. The coverage notification may specify the types, limits, amounts and
				  general terms of coverage to be provided to the participating entity. The
				  notification shall state that a complete copy of the memorandum of coverage
				  which governs risk-related and due process reimbursement coverages will be made
				  available to all interested parties upon request. Each covered employee under
				  employee benefits coverages shall receive a summary plan description or
				  insurance certificate. The terms of the insurance policy or memorandum of
				  coverage, not the coverage notification or summary shall control in any dispute
				  over coverage. Final determination of whether a claim is covered rests solely
				  with the authority.
New Mexico Administrative Code › Title 6 - PRIMARY AND SECONDARY EDUCATION › Chapter 50 - INSURANCE › Part 7 - EMPLOYEE-BENEFIT AND RISK-RELATED MINIMUM BENEFIT AND FINANCIAL STANDARDS PARTICIPATION WAIVER › Section 6.50.7.1 - ISSUING AGENCY

Current through Register Vol. 35, No. 13, July 16, 2024
New Mexico Public School Insurance
				  Authority.
New Mexico Administrative Code › Title 6 - PRIMARY AND SECONDARY EDUCATION › Chapter 50 - INSURANCE › Part 7 - EMPLOYEE-BENEFIT AND RISK-RELATED MINIMUM BENEFIT AND FINANCIAL STANDARDS PARTICIPATION WAIVER › Section 6.50.7.2 - SCOPE

Current through Register Vol. 35, No. 13, July 16, 2024
This part applies to all school districts and charter
				  schools.
New Mexico Administrative Code › Title 6 - PRIMARY AND SECONDARY EDUCATION › Chapter 50 - INSURANCE › Part 7 - EMPLOYEE-BENEFIT AND RISK-RELATED MINIMUM BENEFIT AND FINANCIAL STANDARDS PARTICIPATION WAIVER › Section 6.50.7.3 - STATUTORY AUTHORITY

Current through Register Vol. 35, No. 13, July 16, 2024
Subsection D of Section
				  22-29-7, NMSA
				  1978, directs the authority to promulgate necessary rules, regulations and
				  procedures for the implementation of the New Mexico Public School Insurance
				  Authority Act, Section
				  22-29-1 et
				  seq., NMSA 1978.
New Mexico Administrative Code › Title 6 - PRIMARY AND SECONDARY EDUCATION › Chapter 50 - INSURANCE › Part 7 - EMPLOYEE-BENEFIT AND RISK-RELATED MINIMUM BENEFIT AND FINANCIAL STANDARDS PARTICIPATION WAIVER › Section 6.50.7.5 - EFFECTIVE DATE

Current through Register Vol. 35, No. 13, July 16, 2024
September 1, 2014 unless a later date is cited at the end of
				  a section.
New Mexico Administrative Code › Title 6 - PRIMARY AND SECONDARY EDUCATION › Chapter 50 - INSURANCE › Part 7 - EMPLOYEE-BENEFIT AND RISK-RELATED MINIMUM BENEFIT AND FINANCIAL STANDARDS PARTICIPATION WAIVER › Section 6.50.7.6 - OBJECTIVE

Current through Register Vol. 35, No. 13, July 16, 2024
The objective of this part is to establish the procedures for
				  school districts and charter schools to obtain a waiver of participation in
				  authority coverage offerings.
New Mexico Administrative Code › Title 6 - PRIMARY AND SECONDARY EDUCATION › Chapter 50 - INSURANCE › Part 7 - EMPLOYEE-BENEFIT AND RISK-RELATED MINIMUM BENEFIT AND FINANCIAL STANDARDS PARTICIPATION WAIVER › Section 6.50.7.7 - DEFINITIONS

Current through Register Vol. 35, No. 13, July 16, 2024
A.
"Individual line of coverage"
means either "risk-related" or "group
				health insurance" as those terms are defined in Section
				22-29-3
				NMSA 1978.
B.
"Minimum
				benefit standards"
means the coverages required by the authority in its
				requests for proposal to the various insurance carriers.
C.
"Minimum financial
				standards"
means the premiums, deductibles, limits of liability,
				coinsurance and other financial parameters associated with the authority
				coverages as set forth in the requests for proposal sent to the various
				insurance carriers.
New Mexico Administrative Code › Title 6 - PRIMARY AND SECONDARY EDUCATION › Chapter 50 - INSURANCE › Part 7 - EMPLOYEE-BENEFIT AND RISK-RELATED MINIMUM BENEFIT AND FINANCIAL STANDARDS PARTICIPATION WAIVER › Section 6.50.7.8 - WAIVER OF PARTICIPATION

Current through Register Vol. 35, No. 13, July 16, 2024
School districts and charter schools shall participate in and
				  accept all authority offerings, unless the school district or charter school
				  has applied for and been granted a waiver for an individual line of coverage by
				  the authority board. If a waiver is granted for an individual line of coverage,
				  the school district or charter school will not be provided any insurance
				  protection or coverage by the authority for the perils covered by that
				  individual line of coverage. The school district or charter school receiving
				  the waiver accepts the obligation to obtain its own insurance protection for
				  the perils covered by the individual line of coverage for which the waiver is
				  granted. A school district or charter school that has been granted a waiver for
				  an individual line of coverage shall be prohibited from participating in that
				  individual line of coverage during the contract period, provided, however, the
				  district or charter school may, if the authority contract period exceeds four
				  years, again seek participation. However, a school district or charter school
				  may, if the authority contract period exceeds four years, again seek
				  participation as if it were another educational entity pursuant to
				  6.50.4.8
				  NMAC.
New Mexico Administrative Code › Title 6 - PRIMARY AND SECONDARY EDUCATION › Chapter 50 - INSURANCE › Part 7 - EMPLOYEE-BENEFIT AND RISK-RELATED MINIMUM BENEFIT AND FINANCIAL STANDARDS PARTICIPATION WAIVER › Section 6.50.7.9 - RESPONSIBILITIES OF SCHOOL DISTRICTS AND CHARTER SCHOOLS WHICH WAIVE PARTICIPATION IN AUTHORITY COVERAGES

Current through Register Vol. 35, No. 13, July 16, 2024
A. A
				school district or charter school may waive participation in either the risk
				related or group health insurance or both. Pursuant to Subsections C and D of
				Section
				22-29-9, a
				school district or charter school must waive all risk-related or all group
				health insurance coverages or must petition for participation in the remaining
				coverages offered by the authority in that particular individual line of
				coverage.
B. Should a school
				district or charter school waive participation in an individual line of
				coverage, the school district or charter school shall be responsible for the
				following charges:
(1) For risk related
				coverages, the school district or charter school shall forfeit to the authority
				any right to any return premiums or reserves and shall be responsible to pay to
				the authority on demand the cost of any prior losses in excess of premium and
				all the appropriate expenses of the authority in defending, settling and
				administering any such losses;
(2)
				For group health insurance, the school district or charter school shall forfeit
				to the authority any right to any return premium or reserves it may be entitled
				to. The school district or charter school shall also pay to the authority any
				funds paid for prior incurred claims of the school district or charter school
				in excess of premium paid by the school district or charter school and shall
				pay to the authority all the appropriate expenses of the authority in
				defending, settling and administering such claims.
New Mexico Administrative Code › Title 6 - PRIMARY AND SECONDARY EDUCATION › Chapter 50 - INSURANCE › Part 7 - EMPLOYEE-BENEFIT AND RISK-RELATED MINIMUM BENEFIT AND FINANCIAL STANDARDS PARTICIPATION WAIVER › Section 6.50.7.10 - MINIMUM BENEFIT AND FINANCIAL STANDARDS

Current through Register Vol. 35, No. 13, July 16, 2024
Minimum benefit and financial standards shall be established
				  by the authority pursuant Subsection B of Section
				  22-29-9,
				  NMSA 1978, at the time of the request for proposal process for the line or
				  lines of coverage proposed to be solicited by the authority. The terms and
				  conditions of the requests for proposal which specify the minimum benefits and
				  financial standards which the authority requires potential carriers to respond
				  to shall also constitute the minimum benefit and financial standards which any
				  district seeking a waiver of coverage must match.
New Mexico Administrative Code › Title 6 - PRIMARY AND SECONDARY EDUCATION › Chapter 50 - INSURANCE › Part 7 - EMPLOYEE-BENEFIT AND RISK-RELATED MINIMUM BENEFIT AND FINANCIAL STANDARDS PARTICIPATION WAIVER › Section 6.50.7.12 - APPROVAL OR DISAPPROVAL OF REQUEST FOR WAIVER OF PARTICIPATION

Current through Register Vol. 35, No. 13, July 16, 2024
The authority board shall approve or disapprove a waiver of
				  participation based on the documentation submitted by the school district or
				  charter school. The board shall grant a waiver to a school district or charter
				  school that shows evidence to the satisfaction of the board that:
A. In the event the waiver is with regard to
				group health insurance:
(1) that the school
				district or charter school has secured a valid written enforceable commitment
				from an insurer to provide group health insurance;
(2) that the coverage committed to the school
				district or charter school and the plan benefits for their employees is at
				least as beneficial as the plan being procured by the authority;
(3) that there are no more exclusions from
				coverage and the exclusions are not broader than those set out in the
				authority's request for proposals;
(4) that the deductibles, stop loss, out of
				pocket costs, etc., if any, result in no more costs to the employees than would
				occur pursuant to the authority's request for proposals;
(5) that any cost containment features not
				result in any higher costs or burdens on the employees than would result under
				the authority's request for proposals;
(6) that the prospective insurer of the
				school district or charter school have the same or greater rating as that
				required in the authority's request for proposals;
(7) that the notice of intent to request a
				waiver has been timely filed;
(8)
				that the request for waiver of participation has been timely filed;
(9) that all the data required to be included
				in the request for waiver of participation has been timely supplied;
(10) that the proposed insurer for the school
				district or charter school has satisfactorily demonstrated to the school
				district or charter school and to the authority that the insurer in its
				proposal to the school district or charter school has adequately accounted in
				its rates for such items as school district or charter school experience,
				incurred but not reported losses, medical inflation trends and other relevant
				factors for the purpose of allowing the school district or charter school and
				the authority to determine the future viability of the plan, if rates are
				under-quoted at inception and whether the proposed insurer for the school
				district or charter school meets the minimum financial standards of the
				authority; and
(11) that the total
				group health insurance offering available in that school district or charter
				school compares favorably in all respects with the authority's request for
				proposals;
New Mexico Administrative Code › Title 6 - PRIMARY AND SECONDARY EDUCATION › Chapter 50 - INSURANCE › Part 7 - EMPLOYEE-BENEFIT AND RISK-RELATED MINIMUM BENEFIT AND FINANCIAL STANDARDS PARTICIPATION WAIVER › Section 6.50.7.13 - WITHDRAWAL, FAILURE TO FOLLOW PROCEDURES, EXPIRATION OF WAIVERS

Current through Register Vol. 35, No. 13, July 16, 2024
A. A request for
				waiver may be withdrawn at any time prior to or at the scheduled
				meeting.
B. Failure to follow the
				procedures set forth in this rule shall be adequate reason for rejection of the
				request for waiver.
C. Any waiver
				granted shall automatically expire at the end of the authority insurance
				contract for the line of coverage.
New Mexico Administrative Code › Title 6 - PRIMARY AND SECONDARY EDUCATION › Chapter 50 - INSURANCE › Part 7 - EMPLOYEE-BENEFIT AND RISK-RELATED MINIMUM BENEFIT AND FINANCIAL STANDARDS PARTICIPATION WAIVER › Section 6.50.7.14 - AUTOMATIC WAIVER ALLOWED

Current through Register Vol. 35, No. 13, July 16, 2024
School districts and charter schools are entitled to an
				  automatic waiver for any line of coverage where the employee pays the full
				  amount of the premium. If the school district or charter school desires
				  insurance protection for a particular line of employee-pay-all coverage, the
				  school district or charter school must affirmatively petition the authority for
				  coverage. In granting the coverage the board shall first determine that the
				  school district or charter school meets the minimum participation requirements
				  as established by the board from time to time, that the school district or
				  charter school will carry the coverage through the end of the contract period
				  and that approval will not jeopardize the stability of the
				  fund.
New Mexico Administrative Code › Title 6 - PRIMARY AND SECONDARY EDUCATION › Chapter 50 - INSURANCE › Part 7 - EMPLOYEE-BENEFIT AND RISK-RELATED MINIMUM BENEFIT AND FINANCIAL STANDARDS PARTICIPATION WAIVER › Section 6.50.7.15 - OTHER EDUCATIONAL ENTITY

Current through Register Vol. 35, No. 13, July 16, 2024
Any other educational entity may, but is not required to,
				  participate in any offering of the authority. To participate, the other
				  educational entity desiring coverage, must affirmatively and in a timely manner
				  petition the authority pursuant to Part 4 [6.50.4 NMAC] to obtain coverage. To
				  protect the stability of the fund the board in Part 4 [6.50.4 NMAC] has
				  established reasonable terms and conditions to be imposed upon the educational
				  entity being granted coverage. If the other educational entity is unable to
				  agree to adequate terms and conditions to fully protect the integrity of the
				  fund the board shall deny the petition for coverage.
New Mexico Administrative Code › Title 6 - PRIMARY AND SECONDARY EDUCATION › Chapter 50 - INSURANCE › Part 7 - EMPLOYEE-BENEFIT AND RISK-RELATED MINIMUM BENEFIT AND FINANCIAL STANDARDS PARTICIPATION WAIVER › Section 6.50.7.16 - AUTHORITY BOARD ACTION FINAL

Current through Register Vol. 35, No. 13, July 16, 2024
A.
				After the authority receives a request for waiver the authority shall send a
				notice to the school district setting forth the time and place for a public
				board meeting to consider approval or rejection of the waiver. Time is of the
				essence and, if necessary, the meeting of the board will be called as a special
				meeting in accordance with the Open Meetings Act.
B. At the meeting, the school district will
				present its proposed coverages and the costs of the coverage. Thereafter, the
				authority director will explain the coverages to be offered by the authority
				and the costs of the coverage. The board will review all documents and
				information presented orally and in writing and then make its decision at the
				meeting or notify the school district of the decision in writing within five
				calendar days after the meeting.
C.
				The decision of the authority board on any questions of district waiver of
				participation is final. Any district denied a waiver of participation may
				appeal such decision if the appeal is taken within thirty days from the day of
				the board action. Such appeal is on the record made before the authority board
				and the board decision may be reversed only if shown on a review of the whole
				record to be arbitrary, capricious or in violation of law.
New Mexico Administrative Code › Title 6 - PRIMARY AND SECONDARY EDUCATION › Chapter 50 - INSURANCE › Part 7 - EMPLOYEE-BENEFIT AND RISK-RELATED MINIMUM BENEFIT AND FINANCIAL STANDARDS PARTICIPATION WAIVER › Section 6.50.7.17 - WITHDRAWAL, FAILURE TO FOLLOW PROCEDURES, EXPIRATION OF WAIVERS

Current through Register Vol. 35, No. 13, July 16, 2024
A. A request for
				waiver may be withdrawn at any time prior to or at the scheduled
				meeting.
B. Failure to follow the
				procedures set forth in this rule shall be adequate reason for rejection of the
				request for waiver.
C. Any waiver
				granted shall automatically expire at the end of the authority insurance
				contract for the line of coverage.
New Mexico Administrative Code › Title 6 - PRIMARY AND SECONDARY EDUCATION › Chapter 50 - INSURANCE › Part 8 - EMPLOYEE-BENEFIT AND RISK-RELATED PREMIUM PAYMENTS › Section 6.50.8.2 - SCOPE

Current through Register Vol. 35, No. 13, July 16, 2024
This part applies to all school districts, charter schools,
				  other educational entities, eligible employees, eligible retired employees,
				  eligible dependents, eligible participating entity governing body board members
				  and persons or entities authorized to participate in the authority's employee
				  benefits, risk-related and due process reimbursement
				  coverages.
New Mexico Administrative Code › Title 6 - PRIMARY AND SECONDARY EDUCATION › Chapter 50 - INSURANCE › Part 8 - EMPLOYEE-BENEFIT AND RISK-RELATED PREMIUM PAYMENTS › Section 6.50.8.3 - STATUTORY AUTHORITY

Current through Register Vol. 35, No. 13, July 16, 2024
Subsection D of Section
				  22-29-7 NMSA
				  1978, directs the authority to promulgate necessary rules, regulations and
				  procedures for the implementation of the New Mexico Public School Insurance
				  Authority Act, Section
				  22-29-1 et
				  seq. NMSA 1978.
New Mexico Administrative Code › Title 6 - PRIMARY AND SECONDARY EDUCATION › Chapter 50 - INSURANCE › Part 8 - EMPLOYEE-BENEFIT AND RISK-RELATED PREMIUM PAYMENTS › Section 6.50.8.5 - EFFECTIVE DATE

Current through Register Vol. 35, No. 13, July 16, 2024
September 1, 2014, unless a later date is cited at the end of
				  a section.
New Mexico Administrative Code › Title 6 - PRIMARY AND SECONDARY EDUCATION › Chapter 50 - INSURANCE › Part 8 - EMPLOYEE-BENEFIT AND RISK-RELATED PREMIUM PAYMENTS › Section 6.50.8.6 - OBJECTIVE

Current through Register Vol. 35, No. 13, July 16, 2024
The objective of this part is to set forth the requirements
				  for premium payment by participating entities.
New Mexico Administrative Code › Title 6 - PRIMARY AND SECONDARY EDUCATION › Chapter 50 - INSURANCE › Part 8 - EMPLOYEE-BENEFIT AND RISK-RELATED PREMIUM PAYMENTS › Section 6.50.8.8 - PREMIUM PAYMENT FOR RISK RELATED AND DUE PROCESS REIMBURSEMENT COVERAGES

Current through Register Vol. 35, No. 13, July 16, 2024
The authority shall invoice each member for risk-related and
				  due process reimbursement coverages. Payment for risk-related and due process
				  reimbursement coverages is due in full within 30 days after the billing date.
				  Premium payments not received by the 10th day of the month following the due
				  date shall be subject to an interest charge of 1.5% of the premium due for each
				  month they are overdue.
New Mexico Administrative Code › Title 6 - PRIMARY AND SECONDARY EDUCATION › Chapter 50 - INSURANCE › Part 8 - EMPLOYEE-BENEFIT AND RISK-RELATED PREMIUM PAYMENTS › Section 6.50.8.9 - PREMIUM PAYMENT FOR EMPLOYEE BENEFITS COVERAGES

Current through Register Vol. 35, No. 13, July 16, 2024
The authority shall invoice each member, or the individual
				  participant where direct billing is used, for the premiums for employee
				  benefits coverages. Premium payments are due in full within 10 days after
				  billing. Premiums are due no later than the 10th of the month for which
				  coverage is intended.
New Mexico Administrative Code › Title 6 - PRIMARY AND SECONDARY EDUCATION › Chapter 50 - INSURANCE › Part 8 - EMPLOYEE-BENEFIT AND RISK-RELATED PREMIUM PAYMENTS › Section 6.50.8.10 - PREMIUM PAYMENT PLAN

Current through Register Vol. 35, No. 13, July 16, 2024
Any member unable to make its premium payment timely and in
				  full must obtain a recommendation from the state secretary of education for any
				  alternate payment schedule, which shall then be submitted to the board for
				  approval. The board may accept or reject the secretary's
				  recommendation.
New Mexico Administrative Code › Title 6 - PRIMARY AND SECONDARY EDUCATION › Chapter 50 - INSURANCE › Part 8 - EMPLOYEE-BENEFIT AND RISK-RELATED PREMIUM PAYMENTS › Section 6.50.8.11 - FAILURE TO PAY PREMIUMS WHEN DUE

Current through Register Vol. 35, No. 13, July 16, 2024
If any member or individual participant responsible for
				  making a premium payment fails to make the premium payments when due, the
				  member or individual participant shall be subject to suspension of coverage or
				  in an extreme case, as determined by the board, to termination of coverage.
				  Notice of suspension or termination of coverage shall be given to the member or
				  to the individual as appropriate. Where the coverage has been suspended for
				  non-payment of premiums, the authority shall act to protect the stability of
				  the fund in determining whether to reinstate coverage.
New Mexico Administrative Code › Title 6 - PRIMARY AND SECONDARY EDUCATION › Chapter 50 - INSURANCE › Part 8 - EMPLOYEE-BENEFIT AND RISK-RELATED PREMIUM PAYMENTS › Section 6.50.8.12 - PROCEDURE FOR HANDLING DISPUTED BILLINGS

Current through Register Vol. 35, No. 13, July 16, 2024
In the event any member or individual disputes the amount of
				  the authority's billing, the member or individual shall pay the bill and then
				  file a written statement requesting a refund of the disputed amount setting
				  forth the amount and the reasons the member or individual believes the billing
				  constitutes an overcharge. The request shall be filed within 60 days after the
				  submission of the billing. Requests for refunds that are not timely filed shall
				  be deemed to be rejected. The board shall place complaints regarding the amount
				  of the authority's billings that are timely filed on the agenda of one of its
				  meetings and give notice to the affected member or individual so the member or
				  individual may attend and be heard.