A. A blanket or group health insurance policy or contract shall not contain a provision relative to notice or proof of loss or the time for paying benefits or the time within which suit may be brought upon the policy that in the superintendent's opinion is less favorable to the insured than would be permitted in the required or optional provisions for individual health insurance policies as set forth in Chapter 59A, Article 22 NMSA 1978.
B. The following provisions of Chapter 59A, Article 22 NMSA 1978 shall also apply as to Chapter 59A, Article 23 NMSA 1978 and blanket and group health insurance contracts:
(1) Section 59A-22-1 NMSA 1978, except Subsection C of that section; and
(2) Section 59A-22-32 NMSA 1978.
C. The following provisions of Chapter 59A, Article 22 NMSA 1978 shall also apply as to group health insurance contracts:
(1) Section 59A-22-2 NMSA 1978;
(2) Section 59A-22-3 NMSA 1978;
(3) Section 59A-22-4 NMSA 1978;
(4) Section 59A-22-5 NMSA 1978;
(5) Section 59A-22-6 NMSA 1978;
(6) Section 59A-22-7 NMSA 1978;
(7) Section 59A-22-8 NMSA 1978;
(8) Section 59A-22-9 NMSA 1978;
(9) Section 59A-22-10 NMSA 1978;
(10) Section 59A-22-11 NMSA 1978;
(11) Section 59A-22-12 NMSA 1978;
(12) Section 59A-22-13 NMSA 1978;
(13) Section 59A-22-14 NMSA 1978;
(14) Section 59A-22-25 NMSA 1978;
(15) Section 59A-22-28 NMSA 1978;
(16) Section 59A-22-29 NMSA 1978;
(17) Section 59A-22-32 NMSA 1978;
(18) Section 59A-22-32.1 NMSA 1978;
(19) Section 59A-22-33 NMSA 1978;
(20) Section 59A-22-34 NMSA 1978;
(21) Section 59A-22-34.1 NMSA 1978;
(22) Section 59A-22-34.3 NMSA 1978;
(23) Section 59A-22-35 NMSA 1978;
(24) Section 59A-22-36 NMSA 1978;
(25) Section 59A-22-39 NMSA 1978;
(26) Section 59A-22-39.1 NMSA 1978;
(27) Section 59A-22-40 NMSA 1978;
(28) Section 59A-22-40.1 NMSA 1978;
(29) Section 59A-22-41 NMSA 1978;
(30) Section 59A-22-42 NMSA 1978;
(31) Section 59A-22-43 NMSA 1978;
(32) Section 59A-22-44 NMSA 1978; and
(33) Section 59A-22-50 NMSA 1978.
History: Laws 1984, ch. 127, § 463; 1988, ch. 89, § 3; 1990, ch. 5, § 3; 1992, ch. 56, § 3; 1997, ch. 7, § 2; 1997, ch. 249, § 2; 1997, ch. 250, § 2; 1997, ch. 255, § 2; 2001, ch. 14, § 2; 2003, ch. 337, § 2; 2007, ch. 278, § 2; 2009, ch. 212, § 3; 2021, ch. 108, § 23.
The 2021 amendment, effective July 1, 2021, added to the list of individual health insurance contracts provisions, pursuant to Chapter 59A, Article 22 NMSA 1978, that also apply to group health insurance contracts; and in Subsection C, added new Paragraphs C(1) through C(18) and redesignated former Paragraphs C(1) through C(14) as Paragraphs C(19) through C(32), respectively, and added Paragraph C(33).
The 2009 amendment, effective June 19, 2009, added Paragraph (13) of Subsection B.
The 2007 amendment, effective June 15, 2007, added Paragraph (10) of Subsection C.
The 2003 amendment, effective June 20, 2003, inserted Paragraph C(4), (8), (11), (12) and redesignated the subsequent paragraphs accordingly.
The 2001 amendment, effective June 15, 2001, inserted current Paragraphs C(4), (8) and (11) and renumbered the remaining paragraphs accordingly.
The second 1997 amendments. — Laws 1997, ch. 7 § 2 and Laws 1997, ch. 255, § 2, both effective January 1, 1998, enacted identical amendments to this section which substituted "of that section" for "thereof" in Paragraph B(1) and added Paragraph C(8). See also the first 1997 amendments.
The first 1997 amendments. — Laws 1997, ch. 249, § 2, effective June 20, 1997, added a new Paragraph C(7) relating to 59A-22-39.1 NMSA 1978 and redesignated the following paragraph. However, the section was also amended by Laws 1997, ch. 250, § 2, effective June 20, 1997, which added a new Paragraph C(7) relating to 59A-22-34.3 NMSA 1978 and redesignated the following paragraph accordingly. This section was set out as amended by Laws 1997, ch. 250, § 2. See 12-1-8 NMSA 1978. See also the second 1997 amendments.
The 1992 amendment, effective May 20, 1992, substituted "that" for "which" near the middle of Subsection A and added Subsection C(7).
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.