Provider Directories (Revised)

SUPERINTENDENT OF INSURANCE John G. Franchini 505-827-4299 [LOGO] OFFICE OF SUPERINTENDENT OF INSURANCE FILED 2016 NOV 29 PM 2 OF INSURANCE DEPUTY SUPERINTENDENT Robert Doucette 505-827-5832 Bulletin 2016-025 NOVEMBER 29, 2016 TO: ALL HEALTH INSURANCE CARRIERS THAT OFFER OR ADMINISTER HEALTH-RELATED INSURANCE PLANS ON THE NEW MEXICO MARKETPLACE FROM: JOHN G. FRANCHINI, SUPERINTENDENT OF INSURANCE DATE: NOVEMBER 29, 2016 RE: REVISED - PROVIDER DIRECTORIES THE FOLLOWING Bulletin is issued pursuant to NMSA 1978 sections 59A-2-8, 59A-2-10, 59A-4-3, and 59A-57-4 and sections 13.1.2.1 to 13.1.2.10 and 13.10.13.8 NMAC. # I. BACKGROUND AND PURPOSE The State of New Mexico Office of the Superintendent of Insurance (OSI) regulates and conducts marketplace plan management that is required for insurers' participation in the federally-supported, state-based marketplace (SSBM). Included and in conjunction with these duties, OSI reviews and approves forms, templates, network adequacy, and rates for all health plans sold in New Mexico. This Bulletin clarifies certain reporting requirements and revises Bulletin 2016-014, issued May 26, 2016. Main Phone: 505-827-4601 Main Fax: 505-827-4734 Toll Free: 1-855-4-ASK-OSI Mailing Address: P.O. Box 1689 Santa Fe, NM 87504-1689 Physical Address: 1120 Paseo de Peralta Santa Fe, NM 87501 Website: WWW.OSI.STATE.NM.US ## II. PROVIDER DIRECTORIES Beginning October 15, 2016, and on the 15th of each month thereafter, all insurance carriers offering qualified health plans through New Mexico's Health Insurance Marketplace (BeWellNM) are required to submit their health plan provider contracted network lists in a standardized format. Qualified health plan carriers must provide their lists of network providers and facilities using standardized template provided for this purpose on the 15th of each month thereafter, all insurance carriers offering qualified health plans through New Mexico's Health Insurance Marketplace (BeWellNM) are required to submit their health plan provider contracted network lists in a standardized format. Qualified health plan carriers must provide their lists of network providers and facilities using standardized template provided for this purpose. In addition to the two templates, instructions for completing the templates and a glossary of look-up fields that will be used to create a health plan provider/facility comparison tool can be downloaded from OSI's, Life and Health Rate and Form Filing website located at: http://www.osi.state.nm.us/LifeHealthFiling/index.aspx. The template instructions include information on submitting the completed files using a secured log-in for the server upload. If you have additional questions regarding this Bulletin, please contact: - Paige Duhamel at Paige.Duhamel@state.nm.us - Viara Ianakieva at Viara.Ianakieva@state.nm.us ISSUED at Santa Fe, New Mexico on November 29, 2016. OFFICE OF NEW MEXICO SUPERINTENDENT OF INSURANCE JOHN G. FRANCHINI Superintendent of Insurance Main Phone: 505-827-4601 Main Fax: 505-827-4734 Toll Free: 1-855-4-ASK-OSI Mailing Address: P.O. Box 1689 Santa Fe, NM 87504-1689 Physical Address: 1120 Paseo de Peralta Santa Fe, NM 87501 Website: WWW.OSI.STATE.NM.US Bulletin 2016-025 -2-