Excepted Benefit Plan Disclosure

# STATE OF NEW MEXICO ## OFFICE OF SUPERINTENDENT OF INSURANCE SUPERINTENDENT OF INSURANCE John G. Franchini - (505) 827-4299  PO Box 1689 Santa Fe, NM 87504-1689 1120 Paseo de Peralta Room 519 Santa Fe, NM 87504 Insurance Bulletin 2014-003 January 14, 2014 To: All health care insurers offering limited benefit insurance coverage in the group and individual markets (excepted benefit plans). RE: Excepted Benefit Plans Disclosure  THE FOLLOWING BULLETIN is issued pursuant to Insurance Bulletin Rules, 13 NMAC 1.2.1 to 1.2.10. The purpose of this Bulletin is to notify all involved parties of the mandatory disclosure required. It is possible that some individuals are not aware that limited benefit plans (excepted benefit plans) are exempt from the ACA's "essential health benefits" requirement and therefore, do not provide an individual with "minimum essential coverage", as required by the ACA. In addition, those individuals may not be aware that they will be subject to penalties under the ACA if they do not obtain more comprehensive medical insurance. To reduce confusion during and after the transition period, and to protect consumers from inadvertently incurring penalties under the ACA; OSI requests that issuers of group and individual hospital indemnity and other fixed indemnity plans notify every individual insured under such plans that the coverage does not satisfy the "minimum essential coverage" requirement of the ACA with the following disclosure: "This type of plan is NOT considered "minimum essential coverage" under the Affordable Care Act and therefore does NOT satisfy the individual mandate that you have health insurance coverage. If you do not have other health insurance coverage, you may be subject to a tax penalty. Please consult your tax advisor." he "minimum essential coverage" requirement of the ACA with the following disclosure: "This type of plan is NOT considered "minimum essential coverage" under the Affordable Care Act and therefore does NOT satisfy the individual mandate that you have health insurance coverage. If you do not have other health insurance coverage, you may be subject to a tax penalty. Please consult your tax advisor." This notice should be provided at the issuer's earliest opportunity to current insureds by endorsement, and should also be provided with all such policies issued or renewed on or after January 1, 2014 in at least 10 point font on the cover page of the policy/certificate. This bulletin is also available on the Office of Superintendent of Insurance's website, listed below. Office of Superintendent of Insurance Life and Health Rate & Form Filing Bureau P.O. Box 1689, Santa Fe, NM 87504-1689 Bulletin 2014-003 Telephone: 1-855-427-5674 Website: http://www.osi.state.nm.us If you have additional questions regarding this Bulletin, please contact the Bureau at 1-505-827-4601. DONE AND ORDERED this 14th day of January, 2014. JOHN G. FRANCHINI Superintendent of Insurance Bulletin 2014-003