2013 New Mexico Statutes
Chapter 59A - Insurance Code
Article 23C - Small Group Rate and Renewability
Section 59A-23C-6 - Provisions on renewability of coverage. (1991)

A.   Except as provided in Subsection B of this section, a health benefit plan subject to the Small Group Rate and Renewability Act [Chapter 59A, Article 23C NMSA 1978] shall be renewable to all eligible employees and dependents at the option of the small employer, except for the following reasons:   

(1)   nonpayment of required premiums;   

(2)   fraud or misrepresentation of the small employer, or with respect to coverage of an insured individual, fraud or misrepresentation by the insured individual or that individual's representative;   

(3)   noncompliance with plan provisions;   

(4)   the number of individuals covered under the plan is less than the number or percentage of eligible individuals required by percentage requirements under the plan; or   

(5)   the small employer is no longer actively engaged in the business in which it was engaged on the effective date of the plan.   

B.   A small employer carrier may cease to renew all plans under a class of business.  The carrier shall provide notice to all affected health benefit plans and to the superintendent in each state in which an affected insured individual is known to reside at least ninety days prior to termination of coverage. A carrier which exercises its right to cease to renew all plans in a class of business shall not:   

(1)   establish a new class of business for a period of five years after the nonrenewal of the plans without prior approval of the superintendent; or   

(2)   transfer or otherwise provide coverage to any of the employers from the nonrenewed class of business unless the insurer offers to transfer or provide coverage to all affected employers and eligible employees and dependents without regard to case characteristics, claim experience, health status or duration of coverage.   

C.   A small employer carrier may not change eligibility classifications upon renewal or replacement within twelve months of its termination of its own coverage if the change in classification eliminates from coverage any individual who was insured previous to the change and would have continued to be insured if the change in eligibility had not occurred.