Extended transition for small group plans

STATE OF NEW MEXICO OFFICE OF SUPERINTENDENT OF INSURANCE P.O. Box 1689, Santa Fe, NM 87504-1689 1120 Paseo de Peralta, Room 428, Santa Fe, NM 87501 Phone: (505) 827-4601; Fax (505) 827-4734 SUPERINTENDENT OF INSURANCE John G. Franchini (505) 827-4299  ACTING DEPUTY SUPERINTENDENT Alan Seeley (505) 827-4307 ## BULLETIN NO. 2015-012 TO: EVERY INSURER, NONPROFIT HEALTH CARE PLAN, HEALTH MAINTENANCE ORGANIZATION, AND PREPAID DENTAL PLAN TRANSACTING BUSINESS IN NEW MEXICO FROM: JOHN G. FRANCHINI, SUPERINTENDENT OF INSURANCE DATE: MARCH 25, 2015 RE: EXTENDED TRANSITION FOR SMALL GROUP PLANS This Bulletin is issued pursuant to Section 59A-2-8 NMSA 1978 of the New Mexico Insurance Code, 13.1.2 et seq. NMAC. On March 5, 2014, the CMS Center for Consumer Information and Insurance Oversight (CCIIO) issued an Insurance Standards Bulletin outlining transitional policies and their options. The ACA includes a directive to change, as of January 1, 2016, the definition of small group from 2-50 employees to 2-100 employees. The March 5th letter indicates that states may choose whether to implement this change as of January 1, 2016, or allow states and small group insurance carriers to renew groups of 51-100 into their existing large group policies through October 1, 2016. All renewed policies under this latter option must end by December 31, 2016. The Superintendent of Insurance has consulted with employee and carrier stakeholders and will choose the latter option. Effectively, this means that large groups of 51-100 employees will be able to re-enroll into their existing policies through October 1, 2016 with coverage extending to December 31, 2016. As of January 1, 2017, all groups 51-100 must be included in the small group market. , 2016. The Superintendent of Insurance has consulted with employee and carrier stakeholders and will choose the latter option. Effectively, this means that large groups of 51-100 employees will be able to re-enroll into their existing policies through October 1, 2016 with coverage extending to December 31, 2016. As of January 1, 2017, all groups 51-100 must be included in the small group market. This bulletin will be in effect until January 1, 2017, unless pre-empted by federal guidance. The Superintendent has expressed his concerns to CCIIO over announcements containing new guidance issued at late dates. This bulletin is being released in order to allow carriers to have sufficient lead time to create actuarial evaluation of risk pools before Qualified Health Plan submission deadlines. ISSUED at Santa Fe, New Mexico on March 25, 2015. OFFICE OF NEW MEXICO SUPERINTENDENT OF INSURANCE John G. Franchini Superintendent of Insurance