What are you looking for? Patients Debt Collection Protection ActReport Insurance Fraud in New MexicoInsurance TypesTitle InsuranceHomeowners InsuranceCondo InsuranceRenters InsuranceAuto InsuranceHealth InsuranceManaged Health Care ReviewBilling ExamplesHealthcare Provider ArrangementsMultiple Employer Welfare Arrangement (MEWA)Grievance Procedures RulesWhat Consumers need to know about Surprise BillingIndependent Review OrganizationLife InsuranceOther Types of Health InsuranceStay Ready for Disasters!FloodWildfireWind & HailWinter Storm OSI Events Calendar View our calendar of events Exclusive providers Enrollees must go to providers associated with the plan for all non-emergency care in order for the costs to be covered. Any providers Enrollees may go to providers of their choice with no cost incentives to use a particular subset of providers. Usual, customary, and reasonable (UCR) charges conventional Indemnity plans operate based on usual, customary, and reasonable (UCR) charges. UCR charges mean that the charge is the provider’s usual fee for a service that does not exceed the customary fee in that geographic area, and is reasonable based on the circumstances. Instead of UCR charges, PPO plans often operate based on a negotiated (fixed) schedule of fees that recognize charges for covered services up to a negotiated fixed dollar amount. Reference Sources Survey definitions from The National Compensation Survey definitions (BLS), The Medical Expenditure Panel Survey definitions (AHRQ), and The National Employer Health Insurance Survey definitions (NCHS). Definitions from other Federal agencies and surveys, such as: The Current Population Survey (BLS/Census) ERISA Related definitions (from PWBA) Glossaries and informational papers from websites such as: OPM’s Federal Employees Health Benefits Plans (glossary and specific plan booklets), Blue Cross / Blue Shield, The National Center for Policy Analysis, and The Health Insurance Association of America Publications such as: Employee Benefit Plans: A Glossary of Terms, Ninth Edition 1997, Judith A. Sankey – editor, International Foundation of Employee Benefit Plans. “Fundamentals of Employee Benefit Programs, Fourth addition” “Managed Care Plans and Managed Care Features: Data from the EBS to the NCS”, Cathy A. Baker and Iris S. Díaz, Compensation and Working Conditions, Spring 2001 EBRI Notes Vol. 16, no. 7, July 1995 HIAA Source Book Personal communications with staff from some of the data sources cited.
February 11, 2026 Bulletins NOTICES REGARDING UNFAVORABLE CHANGES TO PUBLIC PROTECTION CLASSIFICATIONS AS REQUIRED BY INSURANCE CODE§59A-18-33, NMSA 1978 UPDATED BULLETIN 2026-003: This Bulletin updates Bulletin No. 2026-003 by correcting the sentence “This Bulletin is issued as required by general OSI Bulletin 2026-003” to properly say, “This Bulletin is issued as required by general OSI Bulletin No. 2024-022.” The OSI has been notified by ISO, a rating/advisory organization, about a recent Public Protection Classification (PPC) survey involving […] Read More
January 14, 2026 Bulletins REPEAL OF BULLETIN NO. 2022-004 BULLETIN 2026-002: Repeal Note: This bulletin hereby repeals Bulletin No. 2022-004 issued on April 4, 2022. ISSUED this 12th day of January, 2026. REPEAL OF BULLETIN NO. 2022-004 Read More
