2006 New Mexico Statutes - Section 40-4C-6 — Obligations; employers, unions and insurers; plan.

40-4C-6. Obligations; employers, unions and insurers; plan.

A.     Upon receipt of a national medical support notice or the court order for health insurance coverage or dental insurance coverage pursuant to Section 40-4C-5 NMSA 1978 or upon application of the obligor pursuant to the court order, the employer or union shall enroll the minor child as an eligible dependent in the health insurance plan or dental insurance plan and withhold any required premium from the obligor's income or wages. If more than one health insurance plan or dental insurance plan is offered by the employer, union or insurer, the minor child shall be enrolled in the plan in which the obligor is enrolled. If the obligor is not enrolled in a plan, the child shall be enrolled in a plan that meets the minimum coverage criteria required pursuant to the Mandatory Medical Support Act [ 40-4C-1 NMSA 1978]. If the obligor is not enrolled in a plan, the premiums charged for the child or children of the obligor shall be those charged for the enrollment of the obligor only.   

B.     In any instance in which the obligor is required by a court order to provide health insurance coverage or dental insurance coverage for the minor child and the obligor is eligible for health insurance coverage or dental insurance coverage through an employment-related or other group health care insurance plan, the employer, union or insurer shall do the following:   

(1)     permit the obligor to enroll for health insurance coverage or dental insurance coverage the minor child who is otherwise eligible for coverage without regard to any enrollment season restrictions;   

(2)     enroll the minor child for health insurance coverage or dental insurance coverage if the obligor fails to enroll the minor child upon application by the obligee or the department;   

(3)     not disenroll or eliminate coverage of any minor child so enrolled unless:   

(a)     the employer is provided with satisfactory written evidence that the court order is no longer in effect;   

(b)     the minor child is or will be enrolled in comparable health coverage that meets the coverage criteria required pursuant to the Mandatory Medical Support Act and that will take effect not later than the effective date of the disenrollment;   

(c)     the obligor has terminated employment; or   

(d)     the employer has eliminated health insurance coverage or dental insurance coverage for all of its employees; and   

(4)     withhold from the obligor's compensation the obligor's share, if any, of premiums for health insurance coverage or dental insurance coverage and to pay the share of premiums to the insurer, unless otherwise provided in law or regulation.   

C.     In those instances where the obligor fails or refuses to execute any document necessary to enroll the minor child in the health insurance plan or dental insurance plan ordered by the court, the required information and authorization may be provided by the department or the custodial parent or guardian of the minor child.   

D.     Information and authorization provided by the department or the custodial parent or guardian of the minor child shall be valid for the purpose of meeting enrollment requirements of the health insurance plan or dental insurance plan and shall not affect the obligation of the employer or union and the insurer to enroll the minor child in the health insurance plan or dental insurance plan for which other eligibility, enrollment, underwriting terms and other requirements are met. In instances in which the minor child is insured through the obligor, the insurer shall provide all information to the obligee that may be helpful or necessary for the minor child to obtain benefits.   

E.     A minor child that an obligor is required to cover as an eligible dependent pursuant to the Mandatory Medical Support Act shall be considered for insurance coverage purposes as a dependent of the obligor until the child is emancipated or until further order of the court.   

F.     In instances in which the minor child is insured through the obligor, the insurer is prohibited from denying health insurance coverage or dental insurance coverage of the minor child on the grounds that the minor child was born out of wedlock, that the minor child is not claimed as a dependent on the obligor's federal income tax return or that the minor child does not reside with the obligor or reside in the insurer's service area.   

G.     In instances in which the minor child is insured through the obligor, the insurer is prohibited from imposing requirements on the department that are different from requirements applicable to an agent or assignee of any other individual covered by the insurer.   

H.     In instances in which the minor child is insured through the obligor, the insurer shall permit the obligee or health care provider, with the approval of the obligee, to submit claims for covered services without the approval of the obligor. The insurer shall make payments on submitted claims directly to the obligee or the health care provider.   

I.     When the obligor is terminated, the employer shall notify the department of the termination.