A group health plan and a health insurance issuer offering group or individual health insurance coverage shall not establish rules for eligibility or continued eligibility of any individual to enroll or continue to participate in a health plan, or eligibility or continued eligibility for benefits, based on any of the following factors in relation to the individual or a dependent of the individual:
A. health status;
B. medical condition, including both physical and mental illnesses;
C. claims experience;
D. receipt of health care;
E. medical history;
F. genetic information;
G. evidence of insurability, including conditions arising out of acts of domestic violence;
H. disability;
I. gender;
J. national origin;
K. sexual orientation; or
L. any other health status-related factor that the superintendent specifies in rules of the office of superintendent of insurance.
History: Laws 1997, ch. 243, § 11; 1998, ch. 41, § 15; 2019, ch. 259, § 10.
The 2019 amendment, effective June 14, 2019, provided that factors such as health status, gender, national origin and sexual orientation may not be taken into account by an insurer in establishing eligibility for coverage; in the section heading, deleted "Group health plan; group health insurance"; deleted subsection designation A and redesignated former Paragraphs A(1) through A(8) as Subsections A through H, respectively; in the introductory clause, deleted "Except as provided in Subsection B of this section", after "participate in a health plan", added "or eligibility or continued eligibility for benefits", and after "the following", deleted "health status related"; deleted former Subsection B; and added new Subsections I through L.
The 1998 amendment, effective March 6, 1998, substituted "Group health plan; group health insurance" for "Prohibiting discrimination based on health status against individual participants and beneficiaries in eligibility to enroll" in the section heading and "59A-23E-3 NMSA 1978" for "3 of the Health Insurance Portability Act" near the beginning in Subsection B.
Structure New Mexico Statutes
Article 23E - Health Insurance Portability
Section 59A-23E-1 - Short title.
Section 59A-23E-2 - Definitions.
Section 59A-23E-3 - Limitation on preexisting condition exclusion period.
Section 59A-23E-9 - Group health plan; special enrollment periods for dependent beneficiaries.
Section 59A-23E-14 - Health insurance issuers; guaranteed availability of coverage.
Section 59A-23E-15 - Disclosure of information by health insurance issuers.
Section 59A-23E-19 - Individual health insurance coverage; guaranteed renewability; exceptions.
Section 59A-23E-20 - Certification of coverage by issuers in the individual market.