A. A group health plan and a health insurance issuer offering group or individual health insurance coverage shall not require an individual as a condition of enrollment or continued enrollment under the plan to pay a premium or contribution that is greater than the premium or contribution for a similarly situated individual enrolled in the plan on the basis of the health status related factor in relation to the individual or a person enrolled under the plan as a dependent of the individual.
B. The provisions of Subsection A of this section shall not be construed to:
(1) restrict the amount that an employer or an individual may be charged for coverage under a group health plan or individual health coverage; or
(2) prevent a group health plan or a health insurance issuer offering group health insurance coverage from establishing premium discounts or rebates or modifying otherwise applicable copayments or deductibles in return for adherence to programs of health promotion and disease prevention.
C. A group health benefits plan or a health insurance issuer that offers group health insurance coverage in connection with a group health benefits plan shall not adjust premiums or contribution amounts for the group covered under the plan on the basis of genetic information.
History: Laws 1997, ch. 243, § 12; 1998, ch. 41, § 16; 2019, ch. 259, § 11.
The 2019 amendment, effective June 14, 2019, provided that a group health benefits plan or a health insurance issuer may not adjust premiums or contribution amounts on the basis of genetic information; in the section heading, deleted "Group health plan; group health insurance"; in Subsection A, deleted "Except as provided in Subsection B of this section", after "health status related", deleted "factors specified in Subsection A of Section 59A-23E-11 NMSA 1978" and added "factor"; in Subsection B, added paragraph designations "(1)" and "(2)"; and added Subsection C.
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 premium contributions" in the section heading, and in Subsection A, substituted "59A-23E-11 NMSA 1978" for "11 of the Health Insurance Portability Act" and "a person" for "an individual" near the end.
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.