2021 New Mexico Statutes
Chapter 59A - Insurance Code
Article 23F - New Mexico Health Insurance Exchange
Section 59A-23F-5 - Plan of operation.

A. No later than September 1, 2020, the board, in coordination with insurance producers appointed and compensated by the insurance industry, shall review its plan of operation and approve amendments to it as appropriate to ensure that the exchange is operated using best practices for state-based exchanges in business administration, consumer engagement and public outreach and marketing.

B. The board shall provide for public notice and hearing prior to approving amendments to the plan of operation.

C. The plan of operation shall contain:

(1) procedures to implement the provisions of the New Mexico Health Insurance Exchange Act, consistent with state and federal law;

(2) procedures for handling and accounting for the exchange's assets and money;

(3) regular times and meeting places for meetings of the board;

(4) a statewide consumer assistance program, including a navigator program;

(5) procedures for consumer complaints and grievances for issues relating to the exchange;

(6) procedures for alternative dispute resolution between the exchange and contractors or health insurance issuers;

(7) policies that:

(a) promote effective communication and collaboration between the exchange and Indian nations, tribes and pueblos, including communicating and collaborating on those nations', tribes' and pueblos' plans for creating or participating in health insurance exchanges; and

(b) promote cultural competency in providing effective services to Native Americans;

(8) conflict-of-interest policies and procedures;

(9) details on the contents of the reports required pursuant to the New Mexico Health Insurance Exchange Act; and

(10) provisions necessary and proper for the execution of the powers and duties of the board and exchange.

History: Laws 2013, ch. 54, § 5; 2019, ch. 266, § 2; 2020, ch. 35, § 4.

The 2020 amendment, effective May 20, 2020, required the board of directors of the exchange to review its plan of operation, removed provisions related to the board's preliminary plan of operation, required the board to provide for public notice and hearing prior to approving amendments to the plan of operation, and required the plan of operation to contain details on the contents of the reports required pursuant to the New Mexico Health Insurance Exchange Act; in Subsection A, completely rewrote the subsection; and in Subsection B, after "approving", added "amendments to"; and deleted subsection designation "D." and redesignated former Paragraphs D(1) through D(5) and D(6) as Paragraphs C(4) through C(8) and C(10), respectively, and added Paragraph C(9).

The 2019 amendment, effective June 14, 2019, required the board of directors of the New Mexico health insurance exchange to create and implement a final plan of operation to ensure the health insurance exchange is administered using best practices in business administration; and in Subsection A, after "ensure", deleted "the fair, reasonable and equitable administration of" and added "that", and after "the exchange", added "is administered using best practices in business administration".

Severability. — Laws 2013, ch. 54, § 16 provided that if any part or application of Laws 2013, ch. 54, §§ 1 through 15 are held invalid, the remainder or its application to other situations or persons shall not be affected.