2006 New Mexico Statutes - Section 59A-56-18 — Deductibles; co-insurance; maximum out-of-pocket payments.
59A-56-18. Deductibles; co-insurance; maximum out-of-pocket payments.
A. Subject to the limitations provided in Subsection C of this section, an approved health plan offered through the alliance may impose a deductible on a per-person calendar year basis. An approved health plan offered by a health maintenance organization shall provide equivalent cost-benefit structures. The board may authorize deductibles in other amounts and equivalent cost-benefit structures.
B. Subject to the limitations provided in Subsection C of this section, a mandatory co-insurance requirement for an approved health plan may be imposed as a percentage of eligible expenses in excess of a deductible. Health maintenance organizations shall impose equivalent cost-benefit structures.
C. The maximum aggregate out-of-pocket payments for eligible expenses by the covered individual shall be determined by the board.
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