Clarification of Small Groups Sales Going Forward

# 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  DEPUTY SUPERINTENDENT Robert Doucette (505) 827-5832 # BULLETIN NO. 2015-029 TO: EVERY INSURER, NONPROFIT HEALTH CARE PLAN, HEALTH MAINTENANCE ORGANIZATION AND PRE-PAID DENTAL PLAN, TRANSACTING BUSINESS IN NEW MEXICO FROM: JOHN G. FRANCHINI, SUPERINTENDENT OF INSURANCE DATE: NOVEMBER 16, 2015 RE: CLARIFICATION OF SMALL GROUP SALES GOING FORWARD This Bulletin is issued pursuant to Section 59A-2-8 NMSA 1978 of the New Mexico Insurance Code, 13.1.2 et seq. NMAC It is the desire of NM OSI to see all groups of 51-100 enrolled in large group plans. Carriers quoting some groups of 51-100 a small group price, while allowing other groups of 51-100 to enroll in a large group, is a violation of OSI Bulletin 2015 - 024. However, groups of 51-100 that have already been enrolled in a small group plan to begin Nov. 1 will be allowed to continue until their renewal date, at which time they must enroll into a large group plan. NM OSI acknowledges that moving them into a large group plan at this time would be disruptive to the consumer, so we see the consumer-protective value in this decision. # These actions will not be allowed: - Enrolling or re-enrolling groups of 51-100 into a small group plan will not be allowed at all beginning today. The groups that are being allowed to go forward must already have been enrolled before today. - Plans effective November 2, 2015 or thereafter must only sell large group plans to groups of 51-100. NM OFFICE OF SUPERINTENDENT OF INSURANCE - Any other action that results in an unenrolled group of 51-100 being enrolled in a small group plan that was not enrolled in such a plan on October 26, 2015 will be considered a violation. ISSUED at Santa Fe, New Mexico on November 16, 2015. re today. - Plans effective November 2, 2015 or thereafter must only sell large group plans to groups of 51-100. NM OFFICE OF SUPERINTENDENT OF INSURANCE - Any other action that results in an unenrolled group of 51-100 being enrolled in a small group plan that was not enrolled in such a plan on October 26, 2015 will be considered a violation. ISSUED at Santa Fe, New Mexico on November 16, 2015. # OFFICE OF NEW MEXICO SUPERINTENDENT OF INSURANCE John G. Franchini Superintendent of Insurance