2019 New Mexico Statutes
Chapter 59A - Insurance Code
Article 23 - Group and Blanket Health Insurance Contracts
Section 59A-23-3.1 - Group insurance reports required.

A. At least quarterly, upon request by the employer, each insurer who has delivered or issued for delivery a policy of group insurance covering twenty-six or more employees, all or a portion of the premiums for which is paid by the employer of the insureds, shall submit to the employer a financial summary report by coverage of expenses incurred by or on behalf of the employees of that employer since the last report. The report shall include the number and amount of monthly paid claims, monthly covered lives and an accounting of reserves and retention costs.

B. Upon request by the employer, each insurer shall provide to the employer claims information that provides sufficient detail, subject to state and federal privacy laws, to enable the employer to obtain and compare group health insurance rates from multiple insurers or establish a plan of self-insurance.

C. The report and claims information required by this section shall be provided within thirty days from the date of request.

History: 1978 Comp., § 59A-23-3.1, enacted by Laws 1985, ch. 167, § 1; 1987, ch. 281, § 2; 1993, ch. 164, § 1; 2007, ch. 53, § 1.

The 2007 amendment, effective June 15, 2007, required insurers to provide claims experience information to employers to permit the employer to obtain and compare group health care rates and coverage from other carriers.

The 1993 amendment, effective June 18, 1993, substituted "twenty-six" for "fifty" in the first sentence, inserted "and amount" in the second sentence, and deleted former Subsection B, relating to submission to the employer of premium and claim data 180 days after expiration of a policy covering more than 24 but less than 50 employees for which all or a portion of the premium is paid by the employer.