New Mexico Statutes
Article 54 - Medical Insurance Pool
Section 59A-54-14 - Deductibles; coinsurance; maximum out-of-pocket payments.

A. Subject to the limitation provided in Subsection C of this section, a pool policy offered in accordance with the Medical Insurance Pool Act shall impose a deductible on a per-person calendar-year basis. Deductible plans of five hundred dollars ($500) and one thousand dollars ($1,000) shall initially be offered. The board may authorize deductibles in other amounts. The deductible shall be applied to the first five hundred dollars ($500) or one thousand dollars ($1,000) of eligible expenses incurred by the covered person.
B. Subject to the limitations provided in Subsection C of this section, a mandatory coinsurance requirement shall be imposed at the rate determined by the board.
C. The maximum aggregate out-of-pocket payments for eligible expenses by the insured shall be determined by the board.
History: 1978 Comp., § 59A-54-14, enacted by Laws 1987, ch. 154, § 14; 1991, ch. 200, § 11; 2001, ch. 352, § 9; 2021, ch. 108, § 34.
The 2021 amendment, effective July 1, 2021, provided the medical insurance pool board the discretion to determine the appropriate coinsurance requirements for pool policies; and in Subsection B, after "shall be imposed at the rate", deleted "of twenty percent of eligible expenses in excess of the mandatory deductible" and added "determined by the board".
The 2001 amendment, effective June 15, 2001, substituted "Medical Insurance Pool Act" for "Comprehensive Health Insurance Pool Act" in Subsection A.
The 1991 amendment, effective June 14, 1991, in Subsection C, substituted "shall be determined by the board" for specific limitations on maximum out-of-pocket payments; and made a minor stylistic change in Subsection A.

Structure New Mexico Statutes