A. Blanket health insurance is declared to be that form of health insurance covering special groups of not fewer than ten persons as enumerated in one of the following paragraphs:
(1) under a policy or contract issued to a common carrier, which shall be deemed the policyholder, covering a group defined as all persons who may become passengers on the common carrier;
(2) under a policy or contract issued to an employer that shall be deemed the policyholder, covering a group of employees defined by reference to exceptional hazards incident to employment;
(3) under a policy or contract issued to a college, school or other institution of learning or to the head or principal thereof, who or which shall be deemed the policyholder, covering students and teachers;
(4) under a policy or contract issued in the name of a volunteer fire department or first aid or other such volunteer group, which shall be deemed the policyholder, covering all of the members of the department or group; or
(5) under a policy or contract issued to any other substantially similar group that, in the discretion of the superintendent, may be subject to the issuance of a blanket health policy or contract.
B. An individual application shall not be required from a person covered under a blanket sickness or accident policy or contract.
C. All benefits under any blanket sickness and accident policy shall be payable to the person insured or the person's agent, or to the person's designated beneficiary or beneficiaries, or to the person's estate, except that if the person insured is a minor, such benefits may be made payable to the minor's parent, guardian or other person actually supporting the minor.
D. A blanket sickness or accident policy or contract issued to a college, school or other institution of learning or to the head or principal thereof shall not be identified or sold as a student health plan.
History: Laws 1984, ch. 127, § 461; 2017, ch. 130, § 15.
Cross references. — For existing forms and filings, see notes following 59A-5-21 NMSA 1978.
The 2017 amendment, effective July 1, 2017, prohibited certain blanket sickness or accident policies from being sold as student health plans; in Subsection A, in the introductory language, after "groups of not", deleted "less" and added "fewer", after "ten", deleted "(10)", and after "the following paragraphs", deleted "(1) to (5) inclusive"; and added Subsection D.
Structure New Mexico Statutes
Article 23 - Group and Blanket Health Insurance Contracts
Section 59A-23-1 - Scope of article.
Section 59A-23-2 - Blanket health insurance.
Section 59A-23-3 - Group health insurance.
Section 59A-23-3.1 - Group insurance reports required.
Section 59A-23-4 - Other provisions applicable.
Section 59A-23-5 - Extended disability benefit.
Section 59A-23-6 - Alcohol dependency coverage.
Section 59A-23-6.1 - Coverage of alpha-fetoprotein IV screening test.
Section 59A-23-6.2 - Prior authorization for gynecological or obstetrical ultrasounds prohibited.
Section 59A-23-7.2 - Coverage of children.
Section 59A-23-7.3 - Maximum age of dependent.
Section 59A-23-7.4 - Coverage of circumcision for newborn males.
Section 59A-23-7.5 - Coverage of part-time employees.
Section 59A-23-7.6 - Coverage of colorectal cancer screening.
Section 59A-23-7.7 - General anesthesia and hospitalization for dental surgery.
Section 59A-23-7.8 - Hearing aid coverage for children required.
Section 59A-23-7.9 - Coverage for autism spectrum disorder diagnosis and treatment.
Section 59A-23-7.11 - Coverage of prescription eye drop refills.
Section 59A-23-7.12 - Coverage for telemedicine services.
Section 59A-23-7.13 - Prescription drugs; prohibited formulary changes; notice requirements.
Section 59A-23-7.14 - Coverage for contraception.
Section 59A-23-7.15 - Coverage exclusion. (Contingent repeal. See note.)
Section 59A-23-7.16 - Heart artery calcium scan coverage.
Section 59A-23-8 - Group formed to purchase health insurance; limitations.
Section 59A-23-10 - Employer utilization and loss data availability.
Section 59A-23-11 - Private health insurance cooperatives; incorporation.
Section 59A-23-12 - Prescription drug prior authorization protocols.
Section 59A-23-12.2 - Pharmacist prescriptive authority services; reimbursement parity.
Section 59A-23-13 - Pharmacy benefits; prescription synchronization.
Section 59A-23-14 - Provider credentialing; requirements; deadline.
Section 59A-23-15 - Physical rehabilitation services; limits on cost sharing.