§ 59A-23E-10 — Group health plan; group health insurance; use of

affiliation period by health maintenance organizations as alternative to preexisting condition exclusion. A. A health maintenance organization that offers health insurance coverage in connection with a group health plan and does not impose any preexisting condition exclusion allowed pursuant to Section 59A-23E-3 NMSA 1978 with respect to any particular coverage option may impose an affiliation period for the coverage option if that period: (1) is applied uniformly without regard to any health status related factors; and (2) does not exceed two months, or three months in the case of a late enrollee. B. During an affiliation period, a health maintenance organization is not required to provide health care services or benefits to a participant or beneficiary, and it shall not charge a premium to a participant or beneficiary for any coverage. C. An affiliation period begins to run on the enrollment date and shall run concurrently with any waiting period under the plan. D. A health maintenance organization described in Subsection A of this section may use alternative methods different from those described in that subsection to address adverse selection as approved by the superintendent.

Legislative History

Laws 1997, ch. 243, § 10; 1998, ch. 41, § 14.