What are you looking for? Fraud AssessmentsCompany LicensingRenewalsStatutory DepositsFeesApplying for Admission & ApplicationsLife and Health DivisionProduct FilingPharmacy Benefit Managers (PBM) Reports, New Mexico Health Access Survey, and BriefsContracted and External ReportsOSI Health Insurance BriefsThe 2023 New Mexico Health Access SurveyResource BinderMiscellaneous Resource Binder ContentSmall Business Health Insurance Premium Relief InitiativePrescription Drug Price TransparencyMember GrievanceHealth Rate ReviewProvider GrievanceHealth Care Affordability FundRequest for Confidential StatusContinuous Quality ImprovementUtilization ManagementProvider CredentialingNetwork AdequacyManaged Health Care Compliance DeadlinesMental Health ParityDebt Collection Protection Act - Provider ResourceVaccine Purchasing ActGuidance for CarriersProperty & CasualtyFinancial RegulationAccredited ReinsurersFinancial StatementsFinancial Statements ArchiveFinancial Examinations Financial Examinations ArchiveFinancial and Market Conduct Examinations - ArchiveTitle Insurance Forms & TablesASR USR Schedules & InstructionsStatistical ReportsIndividuals and AgenciesContinuing Education (CE)Criminal OffenseLicense Status Verification OSI Events Calendar View our calendar of events The Grievance Procedures, as outlined in 13.10.17 NMAC states the requirements for filing and processing grievances against health care insurers that provide, offer or administer health benefit plans, including those with a point-of-service option that allows covered persons to obtain health care services out of network; provided by an entity that purchases or is authorized to purchase health care benefits pursuant to the New Mexico Health Care Purchasing Act; and utilizing a preferred provider network, as defined under NMSA 1978 Section 59A-22A-3. OSI regulates member and provider grievances for major medical health insurance plans. See details below on OSI’s member grievance regulatory requirements. “OSI is currently working on updating the guidance and documents for these submissions. Please continue to check for updates, as OSI plans to have the materials re-posted by the end of the year to give carriers time to prepare prior to the March 1, 2026 submission deadline.” Guidance Chart Updated Guidance Chart Coming Soon! Regulations 13.10.17 NMAC Summary of Health Insurance Grievance Procedures – Updated 2025 Bulletins and News Bulletin 2023-003 Member Complaint Form Download Insurance Health Care Provider Complaint Form Grievance Logs Annual Grievance Log 2025 v1 Sample 2025 Grievance Log
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 […] Read More
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 […] Read More
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 […] Read More
