MANDATORY EXCEPTED BENEFIT PLANS DISCLOSURE (THIS BULLETIN SUPERSEDES AND REPLACED BULLETIN 2016-010

ST ATE OF NEW MEXICO OFFICE OF SUPERINTENDENT OF INSURANCE DEPUTY StJPERINTENDENT Robert E. Doucette, Jr. DEPUTY SUPERINTENDENT Andy Romero SUPERINTENDENT OF INStJRANCE d zT,Bp John G. Franchini BULLETIN 2019-013 t sJll August 1, 2019 This Bulletin supersedes and replaces Bulletin 2016-010. TO: ALLINSURANCECARRIERSOFFERINGINDIVIDUALANDGROUPLIMITED BENEFITS PLANS AND SPECIFIED DISEASE PLANS ("EXCEPTED BENEFIT PLANS") - EXCLUDING DISABILITY PLANS RE: MANDATORYEXCEPTEDBENEFITPLANSDISCLOSURE THE FOLLOWING BULLETIN is issued pursuant to Sections 59A-2-8 and 59A-2-10 NMSA 1978 and 13.1.2.1 etseq. NMAC. The purpose of this Bulletin is to notify all involved parties that the New Mexico Office of Superintendent of Insurance ("OSI") requires health insurance carriers to disclose to consumers that limited benefits plans and specified disease plans ("excepted benefit plans") are not major medical health benefits plans or disability-only plans. Issuers of excepted benefit plans shall include the following notice in at least 14-point bold type at the top of all applications and policies or certificates issued or renewed after the issue date of this Bulletin. MainOffice:1120PaseodePeralta,Room428,SantaFe,NM 87501 Satellite Office: 6200 Uptown Blvd HE, Suite 100, Albuquerque, NM 87110 Main Phone: (505) 827-4601 i Satellite Phone: (505) 322-2186i Toll Free: (855) 4 - ASK - OSI www.ost.state.nm.us notice in at least 14-point bold type at the top of all applications and policies or certificates issued or renewed after the issue date of this Bulletin. MainOffice:1120PaseodePeralta,Room428,SantaFe,NM 87501 Satellite Office: 6200 Uptown Blvd HE, Suite 100, Albuquerque, NM 87110 Main Phone: (505) 827-4601 i Satellite Phone: (505) 322-2186i Toll Free: (855) 4 - ASK - OSI www.ost.state.nm.us B U kl E 'I- I N 2 0 l 9 - () l 2 I) a H c- 12 NOTICE TO CONSUMER: This is a limited benefits health plan. The benefits provided are supplemental to, and not a substitute for, major medical coverage, even in combination with other limited benefits plans. To apply for an individual or small-group major medical plan, please visit the website of the New Mexico Health Insurance Exchange at www.bewellnm.com or call 1-833-862-3935 (TTY: 711). Any person aggrieved by a bulletin may request a hearing before the Superintendent in accordance with Section 59A-4-15 NMSA 1978. If you have questions regarding this Bulletin, please contact the Life and Health Product Filing Bureau at (505) 827-4601 or LHRFF.osi@state.ni'n.us. DONE AND ORDERED this Ist day of August 2019. HN G. FRANCHINI Superintendent of Insurance Main Office: 1120 Paseo de Peralta, Room 428, Santa Fe, NM 87501 Satellite Office: 6200 Uptown Blvd NE, Suite 100, Albuquerque, NM 87110 Main Phone: (505) 827-4601 Satellite Phone: (505) 322-2186i Toll Free: (855) 4 - ASK - OSI www.osi.state.nm.us