A. Solicitation of subscriberships for a health care plan shall be made only by insurance producers of the plan who are duly qualified, appointed and licensed as such under the Insurance Code. This provision shall not apply to salaried officers or employees of health care plans who are visiting or instructing their licensed insurance producers and who do not receive any part of the commission for any business written by such insurance producers with their assistance.
B. No person shall be appointed or licensed as a health care plan insurance producer unless qualified as follows:
(1) is an individual at least eighteen years of age;
(2) has had, or will receive, reasonable experience or instruction in the health care plan for which license is applied;
(3) is trustworthy and of good business reputation;
(4) intends to engage in a bona fide way in the business of the health care plan; and
(5) passes an examination for license given by or under authorization of the superintendent.
C. A health care plan insurance producer shall be appointed by and at any one time represent only one health care plan.
D. Subject to the other provisions of this section, procedures for appointment and licensing insurance producers, examination, issuance or denial of license, continuation or expiration, suspension, revocation or refusal to continue license and other applicable matters relating to licensing and licenses shall be as provided as to licenses of insurance producers as to health insurance under Chapter 59A, Article 11 NMSA 1978. Fee for application for license and continuation of license shall be as specified in Section 59A-6-1 NMSA 1978, and neither fee shall be refundable.
History: Laws 1984, ch. 127, § 879.29; 1999, ch. 272, § 23; 1999, ch. 289, § 35; 2016, ch. 89, § 67.
The 2016 amendment, effective July 1, 2017, replaced "agent" and "solicitor" with "insurance producer" throughout the section; in Subsection A, after the next "of", deleted "such" and added "the", after "plan", deleted "or solicitors of such agents", after "shall not apply", deleted "as", after "instructing their licensed", deleted "agents" and added "insurance producers", and after "written by such", deleted "agents" and added "insurance producers"; in Subsection B, in the introductory sentence, after "health care plan", deleted "agent or solicitor" and added "insurance producer", and after "qualified", deleted "therefor", in Paragraph (3), after "is", deleted "be", and in Paragraph (5), after "passes", deleted "to the superintendent's satisfaction"; in Subsection C, after "health care plan", deleted "agent" and added "insurance producer" and after "only one", deleted "such" and added "health care"; and in Subsection D, after "appointment and licensing", deleted "such agents and solicitors" and added "insurance producers", after "matters relating to", deleted "such", and after "provided as to licenses of", deleted "agents and solicitors" and added "insurance producers".
Severability. — Laws 2016, ch. 89, § 71 provided that if any part or application of Laws 2016, ch. 89 is held invalid, the remainder or its application to other situations or persons shall not be affected.
The 1999 amendment, effective June 18, 1999, deleted former Paragraph B(2), which read "must be a resident of New Mexico", redesignated the subsequent paragraphs accordingly, updated the statutory references in Subsection D and made minor stylistic changes.
Structure New Mexico Statutes
Article 47 - Nonprofit Health Care Plans
Section 59A-47-1 - Short title.
Section 59A-47-2 - Purpose; exemptions.
Section 59A-47-3 - Definitions.
Section 59A-47-5 - Qualifications for health care plan authority.
Section 59A-47-6 - Preliminary permit for solicitations.
Section 59A-47-7 - Escrow of preliminary premiums.
Section 59A-47-8 - Certificate of authority required; application and conditions; exceptions.
Section 59A-47-9 - Issuance and denial of initial certificate of authority.
Section 59A-47-10 - Trust deposit.
Section 59A-47-11 - Expiration, continuance of certificate of authority.
Section 59A-47-12 - Suspension, revocation or refusal to continue certificate of authority.
Section 59A-47-13 - Service of process; superintendent as attorney.
Section 59A-47-14 - Annual statement.
Section 59A-47-17 - Examination.
Section 59A-47-18 - Investments.
Section 59A-47-19 - Limitation upon acquisition and administration expenses.
Section 59A-47-20 - Conflicts of interest as to certain transactions.
Section 59A-47-21 - Joint coverage, reinsurance.
Section 59A-47-22 - Transfer of subscribership.
Section 59A-47-23 - Subscriber contracts; coverage period.
Section 59A-47-24 - Subscriber contracts; requirements and provisions.
Section 59A-47-25 - Subscriber contracts; filing, approval.
Section 59A-47-26 - Premium rates; filing and approval.
Section 59A-47-27 - Coverage for newly born children, maternity transport, home health care.
Section 59A-47-27.1 - Coverage of circumcision for newborn males.
Section 59A-47-28 - Coverage for service of chiropractor.
Section 59A-47-28.1 - Coverage for service of certified nurse-midwives and registered lay midwives.
Section 59A-47-28.2 - Doctor of oriental medicine discrimination prohibited.
Section 59A-47-28.3 - Provider discrimination prohibited.
Section 59A-47-28.4 - Coverage for collaborative practice; dental therapists; dental hygienists.
Section 59A-47-29 - Settlement of disputes; appeal.
Section 59A-47-31 - Rehabilitation, liquidation or dissolution.
Section 59A-47-32 - Unauthorized contract or adjustment transactions; penalty.
Section 59A-47-33 - Other provisions applicable.
Section 59A-47-34 - Continuation of coverage and conversion rights; health care plans.
Section 59A-47-35 - Alcohol dependency coverage.
Section 59A-47-37 - Coverage of children. (Effective July 1, 2020.)
Section 59A-47-37.1 - Hearing aid coverage for children required.
Section 59A-47-38 - Coverage for medical diets for genetic inborn errors of metabolism.
Section 59A-47-39 - Employer utilization and loss experience availability.
Section 59A-47-40 - Maximum age of dependent.
Section 59A-47-41 - Coverage of alpha-fetoprotein IV screening test.
Section 59A-47-41.1 - Prior authorization for gynecological or obstetrical ultrasounds prohibited.
Section 59A-47-42 - Coverage of part-time employees.
Section 59A-47-43 - Coverage of colorectal cancer screening.
Section 59A-47-44 - General anesthesia and hospitalization for dental surgery.
Section 59A-47-45 - Coverage for autism spectrum disorder diagnosis and treatment.
Section 59A-47-45.2 - Coverage of prescription eye drop refills.
Section 59A-47-45.3 - Coverage for telemedicine services.
Section 59A-47-45.4 - Prescription drugs; prohibited formulary changes; notice requirements.
Section 59A-47-45.5 - Coverage for contraception.
Section 59A-47-45.6 - Coverage exclusion. (Contingent repeal. See note.)
Section 59A-47-45.7 - Heart artery calcium scan coverage.
Section 59A-47-47 - Prescription drug prior authorization protocols.
Section 59A-47-47.2 - Pharmacist prescriptive authority services; reimbursement parity.
Section 59A-47-48 - Pharmacy benefit; prescription synchronization.
Section 59A-47-49 - Provider credentialing; requirements; deadline.
Section 59A-47-50 - Physical rehabilitation services; limits on cost sharing.