• Health Care Affordability Fund

    The Life and Health Division of the New Mexico Office of Superintendent of Insurance (OSI) protects New Mexicans by ensuring that all life insurance and health insurance policies sold commercially in the State of New Mexico comply with all federal and state laws and regulations.

During the 2021 Legislative Session, the New Mexico Legislature passed and Governor Michelle Lujan Grisham signed Senate Bill 317, which placed a moratorium on out-of-pocket costs for mental health services for state-regulated plans and created a Health Care Affordability Fund to lower health care costs for New Mexicans. The law allows the Fund to be used to:

  1. Reduce premiums and out-of-pocket health care costs for New Mexicans who qualify for coverage on beWellnm, the state’s Health Insurance Marketplace;

  2. Reduce premiums for small businesses and their employees;

  3. Provide resources for planning, design and implementation of health care coverage initiatives for uninsured New Mexico residents; and

  4. Provide resources for administration of state health care coverage initiatives for uninsured New Mexico residents.

The Fund and its programs are administered by the New Mexico Office of Superintendent of Insurance (OSI).

Materials Published in 2024

Final 2025 Health Insurance Marketplace Affordability Program Guidance

Materials Published in 2023

2024 Health Insurance Marketplace Affordability Program Guidance

Final 2023 Plan Year SOPA Reconciliation Guidance for Health Insurance Issuers

  1. Final SOPA Reconciliation Guidance (Version 2)
  2. OSI Responses to Carrier Questions Following Jan 2023 SOPA Reconciliation Training – Mar 2023
  3. Template A – Issuer and Plan Level SOPA
  4. Template B – Policy Level SOPA-Reconciliation
  5. Template C – SOPA Request for Reconsideration
  6. Attestation Form A – EHB Inclusion
  7. Attestation Form B – EHB Inclusion
  8. Attestation Form C – Simplified Methodology Forms

Materials Published in 2022

Health Insurance Marketplace Affordability Program Information for the 2023 Plan Year

2023 Health Insurance Marketplace Affordability Program Guidance

Small Business Health Insurance Premium Relief Initiative

Materials Published in 2021

beWellnm Coverage Affordability Initiatives

Small Business Coverage Affordability Initiatives

Recent News

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November 18, 2025 Bulletins

CLARIFICATION ON COORDINATION OF BENEFITS (COB) PROVISIONS FOR MINOR CHILDREN

BULLETIN 2025-015: This bulletin is issued in accordance with Sections 59-2-8, 59A-2-10, 59A-16-11(B) and 59A-46-31 NMSA 1978, and 13.1.2 and 13.10.13.11(B)(2) NMAC. The purpose of this bulletin is to clarify the position of the Office of Superintendent of Insurance (OSI) regarding allowable coordination of benefits provisions for a dependent child covered under more than one health insurance […]

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December 8, 2025 Announcements

Mandatory Reporting Requirements Under the New Mexico Insurance Fraud Act

NOTICE TO ALL LICENSEES, INSURERS, AND INSURANCE PROFESSIONALS Subject: Mandatory Reporting Requirements Under the New Mexico Insurance Fraud Act   This notice serves as an official reminder that all insurers and licensed insurance professionals are required to comply with the mandatory reporting and cooperation requirements established under the New Mexico Insurance Fraud Act. These obligations […]

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November 17, 2025 News Releases

NEW MEXICO OFFICE OF THE SUPERINTENDENT OF INSURANCE HOSTS TOWN HALL IN SILVER CITY ON WILDFIRE PREPAREDNESS, MITIGATION AND INSURANCE RESOURCES

Contact: Elouisa Macias, Consumer Assistance Bureau ChiefEmail: Elouisa.Macias@osi.nm.gov Santa Fe, NM – On Wednesday, the Office of the Superintendent of Insurance (OSI) hosted a town hall in Silver City, NM related to wildfire preparedness and insurance resources. The town hall was moderated by Elouisa Macias, Consumer Assistance Bureau Chief, Civil Investigations Bureau at OSI. The […]

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