Insurance Agents And Brokers

Any person, including a licensed agent, broker or other individual, soliciting, offering or selling a health benefit plan on behalf of a MEWA to a New Mexico employer or a New Mexico resident shall comply with the following requirements: A. Prior to completing a sale of individual or small group coverage, disclose to the employer or resident that: (1) the agent or broker is being compensated for the sale of the health benefit plan; (2) that the small employer or individual has the option of purchasing insurance on the New Mexico health insurance marketplace; (3) the eligibility guidelines for Medicaid coverage and financial assistance for coverage through the New Mexico health insurance exchange; (4) contact information for the New Mexico health insurance exchange; and (5) a comparison table showing the similarities and differences in coverages between a MEWA with qualified health plans sold in the individual and small group market; and 13.19.4 NMAC 12 B. Prior to engaging in or assisting any person to engage in selling health benefits plans through a MEWA, shall document appropriate due diligence to establish, at a minimum; the following: (1) that the MEWA’s insurer or third-party administrator is licensed in the state; (2) that the MEWA has registered, permitting it to operate in the state; (3) that the disclosures listed in Paragraph (1) are in the policy document; and (4) that the advertising and marketing materials that the agent or broker is using have been approved by the superintendent.