At this time, there is no state law requiring employers to offer healthcare insurance to their employees. However, if it is offered, New Mexico’s insurance law requires that selected policies cover mandated benefits and provide employees the right to convert to individual policies or continue with group coverage.
The State of New Mexico is not permitted to control self-insured benefit plans. Instead, an employer’s healthcare is self-insured if the employer is taking the risk of paying off the claims instead of the insurance company. In this instance, some self-insured plans contract with third-party companies, such as insurance companies, who then process those claims.
The contracted company pays the claims directly and is then reimbursed by the employer. Many of these plans also purchase “stop-loss” insurance which was created to pay large claims. This type of insurance is not exempt from the state insurance law regulation.
Affordable Care Act
The Affordable Care Act (ACA) was created for those individuals and small employers who have access to affordable insurance coverage starting on January 1st, 2014. The Act allowed states to have the flexibility to operate and design an exchange that met their specific requirements while maintaining compliance with the ACA’s regulatory standards. The goal was not a one-size-fits-all approach and is unique to each situation.
New Mexico Health Insurance Facts
There are a few state-specific facts to consider:
- New Mexico runs a state health insurance exchange but uses the federal enrollment platform for individual enrollments.
- Short-term health plans are available with terms up to 364 days.
- The average 2019 premium has decreased by 1%.
- The state added the ACA’s Medicaid expansion five-years ago.
- Approximately 20% of the New Mexico population is currently enrolled in Medicare.
If you are uninsured or do not like your current healthcare plan through your provider, contact ORION Insurance & Financial Services LLC today! ORION Insurance & Financial Services LLC can help you find the insurance plan you need to live a healthy life!