Chapter 59A, Article 18 NMSA 1978 applies as to all insurance policies and annuity contracts of authorized insurers covering individuals resident, or risks located, or insurance protection to be rendered in this state, other than: A. reinsurance; B. policies or contracts not issued for delivery in this state nor delivered in this state, except for […]
A. The insured shall not be bound by any statement made in the application, and no application for issuance of any life or health insurance policy or annuity contract shall be admissible in evidence in any action relative to such policy or contract, unless a true copy of the application was attached to or otherwise […]
A. The insured shall not be bound by any statement made in an application for a policy unless a copy of such application is attached to or endorsed on the policy when issued as a part thereof. If any such policy delivered or issued for delivery to any person in this state shall be reinstated […]
A. An insurance policy, health care plan or annuity contract shall not be delivered or issued for delivery in this state, nor shall an assumption certificate, endorsement, rider or application that becomes a part of a policy or health care plan be used, until a copy of the form and the classification of risks pertaining […]
A. With policy, endorsement, rider and application forms and classification of risks filed by the insurer with the superintendent under Section 59A-18-12 NMSA 1978 as to health insurance and health care plans, the insurer shall also file with the superintendent its rates applicable to such health insurance forms. An insurer shall not use any form […]
A. Every insurer, fraternal benefit society, multiple employer welfare arrangement, health maintenance organization or nonprofit health care plan that provides primary health insurance or health care coverage insuring or covering major medical expenses shall, in determining the initial year’s premium charged for an individual, use only the rating factors of age, geographic area of the […]
A. All health insurance or health care plan rates filed by an insurer with the superintendent pursuant to Section 59A-18-12 NMSA 1978 shall include all related forms. B. An insurer shall not use a rate without prior approval of the superintendent pursuant to Section 6 [59A-18-13.3 NMSA 1978] of this 2011 act and compliance with […]
A. The superintendent shall issue a final order within sixty days of the filing date for health insurance filings made on rates. The superintendent shall consider any public comment made pursuant to Subsection H of Section 59A-18-13.2 NMSA 1978. The superintendent shall issue findings and shall approve any rates on the following grounds: (1) the […]
History: Laws 2011, ch. 144, § 7; repealed by Laws 2013, ch. 74, § 40. ANNOTATIONS Repeals. — Laws 2013, ch. 74, § 40 repealed 59A-18-13.4 NMSA 1978, as enacted by Laws 2011, ch. 144, § 7, relating to review of health insurance or plan rates, appeals to the public regulation commission, hearings, hearing examiner […]
A. In a matter arising from an order of the superintendent on appeal pursuant to Section 59A-18-13.3 NMSA 1978, an aggrieved party may appeal to the court of appeals. B. The court of appeals shall consider the superintendent’s order on appeal and reverse the order only if the court determines: (1) after evaluation of the […]
For the purpose of determining the rate of any policy within a closed block of business, the superintendent may require an insurer to pool the experience of a closed block of business with all appropriate blocks of business that are not closed in accordance with Section 59A-18-13.1 NMSA 1978. An insurer shall not apply a […]
A. The superintendent shall review any filing, except any filing by a health insurance issuer for a change in rate, made pursuant to Section 59A-18-12 or 59A-18-13 NMSA 1978 within sixty days of the filing date. The superintendent shall approve any form if the superintendent finds that it complies with the Insurance Code [Chapter 59A […]
ANNOTATIONS Repeals. — Laws 2003, ch. 202, § 16 repealed 59A-18-15 NMSA 1978, as enacted by Laws 1984, ch. 127, § 345, relating to use of disapproved health insurance forms and associated penalties, effective June 20, 2003. For provisions of former section, see the 2002 NMSA 1978 on NMOneSource.com.
Subject to the provisions of the Health Insurance Portability Act: A. every accident and health insurance policy that provides hospital, surgical and medical expense benefits and that is delivered, issued for delivery or renewed in this state on or after January 1, 1985 shall provide: (1) if an individual policy, covered family members the right […]
The superintendent may promulgate reasonable rules and regulations to establish requirements for group coverage discontinuance and replacement. History: 1978 Comp., § 59A-18-16.1, enacted by Laws 1993, ch. 320, § 58.
A. A small group health plan and a health insurance issuer or multiple employer welfare arrangement offering a small group or individual health insurance plan that provides benefits other than excepted benefits shall: (1) provide the essential health benefits defined by the superintendent under Subsection B of this section; (2) limit cost sharing for such […]
A. Insurance contracts shall contain such standard or uniform provisions as are required by applicable provisions of the Insurance Code [Chapter 59A NMSA 1978] pertaining to contracts of particular kinds of insurance. B. No policy shall contain a provision inconsistent with or contradictory to a standard or uniform provision used or required to be used, […]
No policy shall contain any provision purporting to make any portion of the charter, bylaws or other constituent document of the insurer (other than the subscriber’s agreement or power of attorney of a reciprocal insurer) a part of the contract unless such portion is set forth in full in the policy. History: Laws 1984, ch. […]
A. Every policy shall be executed in the name of and on behalf of the insurer by its officer, attorney-in-fact, employee or representative duly authorized by the insurer. B. A facsimile signature of any such executing individual may be used in lieu of an original signature. C. No policy which is otherwise valid shall be […]
As used in this article “policy” means any contract of insurance, indemnity, health care, suretyship or annuity between the insurer and the insured, by whatever name such contract is called, and includes all clauses, riders, endorsements and papers which are a part thereof. History: Laws 1984, ch. 127, § 332.
