COVERAGE FOR IMMUNIZATIONS IN 2025 AND 2026 PLAN YEARS

# STATE OF NEW MEXICO ## OFFICE OF SUPERINTENDENT OF INSURANCE  OFFICE OF SUPERINTENDENT OF INSURANCE SUPERINTENDENT OF INSURANCE Alice T. Kane DEPUTY SUPERINTENDENT Timothy Vigil BULLETIN 2025-009 September 17, 2025 TO: ALL HEALTH INSURERS AND HEALTH MAINTENANCE ORGANIZATIONS PROVIDING MAJOR MEDICAL OR COMPREHENSIVE COVERAGE IN NEW MEXICO RE: COVERAGE FOR IMMUNIZATIONS IN 2025 AND 2026 PLAN YEARS This bulletin is issued in accordance with Sections 59A-2-8, 59A-2-10, 59A-18-13.2, 59A-18-13.3, and 59A-18-16.2(G)(2) NMSA 1978. The purpose of this bulletin is to clarify: - since carriers considered and included cost and coverage for immunizations in rates for plan years 2025 and 2026; and - since the coverage and rates considered and included Advisory Committee on Immunization practices (ACIP) in place at the time of submittal to the Office of Superintendent of Insurance (OSI) by the carrier; and - since the coverage and rates were then reviewed and approved by OSI based upon the guidance from the ACIP at the time of rate approval; - then immunizations should be covered in plan years 2025 and 2026 regardless of any changes to guidance made by ACIP during a plan year. Any changes to coverage for immunizations based on ACIP immunization guidance should be prospective to the 2027 plan year. Questions concerning these directives should be directed to the Life and Health Bureau at life.health@osi.nm.gov. ISSUED this 17th day of September 2025 Alice T Kane ALICE T. KANE Superintendent of Insurance Main Office: 1120 Paseo de Peralta, Fourth Floor, Santa Fe, NM 87501 Satellite Office: 6200 Uptown Blvd NE, Suite 400, Albuquerque, NM 87110 Main Phone: (505) 827-4601 | Toll Free: (855) 4 - ASK - OSI www.osi.state.nm.us