February 3, 2023 Bulletins REQUIREMENTS FOR MARCH 1st MEMBER GRIEVANCE COMPLIANCE FILING BULLETIN 2023-003: All major medical health insurers subject to the jurisdiction of the Office of Superintendent of Insurance shall file their annual member grievance compliance filing on March 1st of each year. This compliance filing requirement shall apply to all major medical insurers currently offering comprehensive major medical coverage with 250 or more insureds. Null filings are […] Read More
February 3, 2023 Bulletins TIMELINESS AND COMPLETENESS OF CORRESPONDENCE RELATED TO MEMBER GRIEVANCES Bulletin 2023-002: This Bulletin is issued to improve the processes required by the Member Grievance Rule, 13.10.17 NMAC, and to remind insurers of their obligations under that Rule. Specifically, that insurers must timely provide complete documents and responses to the OSI Managed Health Care Bureau (MHCB). TIMELINESS AND COMPLETENESS OF CORRESPONDENCE RELATED TO MEMBER GRIEVANCES Read More
January 18, 2023 News Releases FOR IMMEDIATE RELEASE The Office of Superintendent of Insurance (OSI) announces the retirement of Superintendent Russell Toal and the appointment of Jennifer A. Catechis as Interim Superintendent for the agency, effective January 21, 2023. FOR IMMEDIATE RELEASE Read More
January 4, 2023 Announcements OSI Audit Report, June 30, 2022 Independent Auditor’s Report performed by Jaramillo Accounting Group. OSI Audit Report, June 30, 2022 Read More
January 3, 2023 Bulletins PHARMACY BENEFIT MANAGER LICENSURE AND LICENSURE RENEWAL REQUIREMENTS FOR 2023 AND THEREAFTER BULLETIN 2023-001: This Bulletin applies to any Pharmacy Benefit Manager (PBM) seeking licensure or renewal of licensure in New Mexico pursuant to the Pharmacy Benefit Manager Act Section 59A-61-1 et seq. N.M.S.A. 1978. PBM licensure renewal and annual reports are due before March 1, 2023. PHARMACY BENEFIT MANAGER LICENSURE AND LICENSURE RENEWAL REQUIREMENTS FOR 2023 AND THEREAFTER Read More
December 28, 2022 Bulletins PROVIDER CREDENTIALING REPORTING BULLETIN 2022-024: Pursuant to 13.10.28.10(D) NMAC, “[e]ach health carrier shall submit a report to the superintendent regarding its credentialing process for the prior two-year period beginning December 31, 2018, and on December 31 for all even numbered years thereafter, or as otherwise directed by the superintendent.” The December 31st reporting deadline does not account for the time […] Read More
December 27, 2022 Bulletins WILDFIRE DISASTER CLAIMS DATA CALL BULLETIN 2022-023: Beginning April 22, 2022, the Honorable Michelle Lujan-Grisham, Governor, declared a series of wildfire emergencies in New Mexico. Subsequent to the declaration, the Superintendent of Insurance issued Bulletin 2022-012, requiring companies to submit monthly reports of claims information associated with the wildfire events taking place in 2022. WILDFIRE DISASTER CLAIMS DATA CALL Read More
December 14, 2022 Bulletins 2023 HEALTH INSURANCE MARKETPLACE AFFORDABILITY PROGRAM; DATA REPORTING PROCESS; PAYMENT PROCESS AND TIMELINE FOR THE 2023 Bulletin 2022-022: THIS BULLETIN is issued pursuant to NMSA 1978, Section 59A-23F-11, which established the Health Care Affordability Fund (HCAF) to “reduce health care premiums and cost sharing for New Mexico residents who purchase health care coverage on the New Mexico health insurance exchange” and 13.10.36 NMAC. This Bulletin sets forth requirements for individual market health insurance […] Read More
December 9, 2022 Bulletins DATA CALL FOR FULLY-INSURED STUDENT HEALTH INSURANCE PLANS BULLETIN 2022-021: Pursuant to NMSA 1978 §59A-4-3, the Superintendent orders any entity that sells fully-insured student health insurance plans to students attending school in New Mexico to report the following: 1. Company name; 2. NAIC company number; 3. Market type; 4. Product type; 5. SERFF form approval number(s) of any plans sold to New Mexico students; 6. […] Read More
December 8, 2022 Announcements NOTICE AND EMERGENCY ORDER NOTICE IS HEREBY GIVEN to every person subject to the jurisdiction of the Superintendent of Insurance (“Superintendent”) pursuant to the Health Care Benefits Jurisdiction Act, NMSA 1978, §§ 59A-15-14 through 59A-15-19. Pursuant to the December 5, 2022 Public Health Emergency Order declared by the New Mexico Department of Health (“DOH”), the emergency powers conferred under […] Read More
