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Information about the next meeting of the New Mexico Insurance Exchange is available on the Health Insurance Exchange website: www.nmhix.com

 

Carrier questions about the New Mexico Health Insurance Exchange can be e-mailed to: CarrierQuestions@nmhix.com

 

2015 Plan Year Qualified Health Plan Submission Information:

 

For Consumers:


Office of Superintendent of Insurance has the regulatory responsibility for licensing Qualified Health Plan (QHP) issuers and reviewing and approving/disapproving QHP policies.

 

The upcoming enrollment period of the New Mexico Health Insurance Exchange beings October 1, 2014. As we draw nearer to that date, we will post updated consumer access information. Please see this NAIC FAQ for an overview of general health insurance exchange information.



For Carriers submitting Qualified Health Plans for review:



NOTICE: Only QHP’s and QDP’s that were certified to sell on the Exchange in 2014 are eligible to participate in the Exchange

                for the 2015 Plan Year.

 

The Office of Superintendent of Insurance (OSI) has established the following deadlines for the 2015 plan year Exchange filings:

  • Individual QHP's and Stand‐Alone Dental Plan (QDP) Form & Rate filings must be submitted between March 1, 2014 - March 31, 2014; subsequently the corresponding Binders must be submitted in SERFF between May 1st and May 15th.

  • Small Business Health Options Program (SHOP) QHP's Form & Rate filings must be submitted to OSI between April 1, 2014 - April 30, 2014; subsequently the corresponding Binders must be submitted in SERFF between May 15th and May 31st.

The timeframe's will remain the same, however, to avoid complications of incorrect data and figures based on an outdated AV calculator and incorrect templates, Superintendent Franchini is granting a Rate Amendment Period for 2015 Plan Year Exchange filings. The Rate Amendment Period is set to coincide with the Federal FFM deadlines imposed by CMS; Qualified Health Plans (QHPs) and Qualified Dental Plans (QDPs) will be allowed to amend their rates between May 26 and June 27, 2014.


Qualified Health & Dental Plans Summary

  • Step 1 - Submit renewal and affiliated fees to Office of Superintendent of Insurance, Company Licensing Bureau
  • Step 2 - Submit Statement of Attestation to Company Licensing Bureau. Guidance can be found here.
  • Step 3 -Submit QHP policies (via SERFF). The Submission deadlines for the 2015 plan year can be found in the guide, available at the link below:

                                        The 2015 New Mexico Qualified Health Plan Submission Guide.

 

  • The Frequently Asked Questions (FAQ's) for QHP Requirements can be found here: 2015 QHP FAQ's.
  • The Frequently Asked Questions (FAQ's) for Pediatric Dental & Vision Requirements can be found here: 2015 Dental FAQ's

  

2015 Checklist



DEADLINE FOR PLANS OUTSIDE THE EXCHANGE – Submission of plans to be sold outside the exchange will be required to be submitted between September 1, 2014 and September 15, 2014. 


More guidance on submission of outside the exchange plans will be forthcoming.


2014 Plan Year Qualified Health Plan Submission Information