N.M. Admin. Code § 13.10.9.8 - ELIGIBILITY CRITERIA
A.
Pursuant to Section 59A-23B-3B NMSA 1978, the individual, family or group
obtaining coverage under the policy or plan shall have been without healthcare
insurance, a health services plan or employer sponsored healthcare coverage for
the six-month period immediately preceding the effective date of their coverage
under a policy or plan except that for groups in existence for less than six
months, the group has been without healthcare coverage since the formation of
the group.
B. For purposes of the
Minimum Healthcare Protection Act and this rule, a group which is otherwise
eligible will be deemed to have been without healthcare coverage whether or not
individuals within the group have other healthcare coverage either individually
or as the dependents of other persons.
C. With respect to individuals eligible for
medicaid benefits, the provisions of Sections
59A-18-31,
59A-22-38,
59A-23-7,
59A-46-34 and
59A-47-36 NMSA 1978 shall apply
to policies or plans issued in the state on or after the effective date of the
Minimum Healthcare Protection Act.
Notes
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