CLARIFICATION OF BULLETIN 2019-003

STATE OF NEW MEXICO OFFICE OF SUPERINTENDENT OF INSURANCE SUPERINTENDENT OF INSURANCE Russell Toal DEPUTY SUPERINTENDENT Robert E. Doucette, Jr. 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) 322-2186 | Toll Free: (855) 4 - ASK - OSI www.osi.state.nm.us BULLETIN 2020-021 December 03, 2020 TO: EVERY ENTITY THAT PROVIDES ACA GRANDFATHERED INDIVIDUAL OR GROUP MAJOR MEDICAL HEALTH INSURANCE TO A NEW MEXICO RESIDENT RE: CLARIFICATION OF BULLETIN 2019-003 In Bulletin 2019-003, the superintendent of insurance announced “that non-ACA compliant plans may not be renewed, and that any person covered under any such policy or plan shall be transitioned to ACA compliant plans as of their 2019 renewal date.” Some insurers have questioned whether this directive applies to policies or plans that qualify for “grandfathered” status under the ACA. The superintendent agrees that the determination whether an ACA grandfathered policy or plan may be renewed, or enroll new members, must be made on a case-by-case basis. Because Bulletin 2019-003 suggests that no ACA grandfathered plan may be renewed or enroll new members after January 1, 2020, that bulletin requires clarification. To clarify, Bulletin 2019-003 does not apply to an ACA grandfathered plan. Every ACA grandfathered plan that currently provides coverage for a New Mexico resident may be continued, subject to all applicable ACA and New Mexico Insurance Code requirements. Nothing in this bulletin precludes the superintendent from determining, on a case-by-case basis, whether a policy or plan that purports to be ACA grandfathered should be ordered not to renew or enroll new members. If you have questions regarding this Bulletin, please contact Viara Ianakieva at viara.ianakieva@state.nm.us Thank you for your cooperation. ISSUED this 3rd day of December, 2020. ______________________________ RUSSELL TOAL Superintendent of Insurance DEC 03 2020 11:52PM