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2017 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 the regulatory responsibility of form and rate compliance.

You can follow Health Reform Timeline for a general overview of the Health Reform.

 

For Carriers submitting Qualified Health Plans for review:  


Similar to the QHP certification process in 2014 and 2015, the New Mexico Office of Superintendent (NMOSI) will conduct reviews of qualified health plans (QHPs) and stand-alone dental plans (SADPs) and provide to CMS the determinations for year 2016. NMOSI evaluates health and dental plans against QHP and SADP certification standards as part of the state’s traditional regulatory role for the insurance industry and/or enforcement of Title XXVII of the Public Health Service Act (PHS Act), or otherwise for state purpose.

 

Timelines

 


General Carrier Assistance for 2016 QHP and SADP plans:

  • The Frequently Asked Questions (FAQ's) for QHP Requirements can be found here: QHP FAQ's
  • Frequently Asked Questions (FAQ's) for Pediatric Dental & Vision Requirements can be found here: 2016 Dental FAQ's

 


QHP and SADP Company Licensing Bureau Assistance for Carriers:

  • Submit Statement of Attestation to Company Licensing Bureau. Guidance can be found here.
  • Certificate of Authority information can be found under our Company Licensing Bureau

 


QHP and SADP Life & Health Rate and Form Filing Bureau Assistance for Carriers:

QHP and SADP forms and rates are submitted via System for Electronic Rate and Form Filing (SERFF)


New Mexico Health Insurance Exchange Information:


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