N.M. Stat. § 59A-23F-6.1
Board; additional duties and powers.
In addition to other duties and powers in the New Mexico Health Insurance
Exchange Act, the board shall:
A. in consultation with the superintendent:
(1)
establish policies and procedures for the review and recommendation of
health benefits plans to be offered on the exchange;
(2)
determine additional minimum requirements for a health insurance issuer
to be considered for participation in the exchange; and
(3)
determine standards and criteria for health benefits plans to be offered
through the exchange that offer an optimal level of choice, value, quality and service
and that are in the best interests of qualified individuals and qualified small employers;
B. establish policies and procedures that allow city, county and state governments,
Indian nations, tribes and pueblos, tribal organizations, urban Native American
organizations, private foundations and other entities to pay premiums and cost-sharing
on behalf of qualified individuals consistent with federal requirements;
C. provide for the operation of a toll-free hotline to respond to requests for
assistance, using staff that is trained to provide assistance in a culturally and
linguistically appropriate manner;
D. provide for an annual regular enrollment period and special enrollment periods in
the best interest of qualified individuals and qualified small employers;
E. maintain an internet website through which enrollees and prospective enrollees
of qualified health plans may obtain standardized comparative information on those
plans;
F. use a standardized format for presenting health benefit plan options in the
exchange;
G. determine the criteria and process for eligibility, enrollment and disenrollment of
enrollees and potential enrollees in the exchange and coordinate that process with the
human services department [health care authority department] in order to ensure
consistent eligibility and enrollment processes and seamless transitions between
coverages;
H. inform individuals of eligibility requirements for medicaid, the children's health
insurance program or other applicable state or local public programs. If the exchange
assesses that an individual may be eligible for a program, the board shall share
information with that program to facilitate the eligibility determination and enrollment of
the individual;
I. establish and make available by electronic means a calculator to determine the
actual cost of coverage after the application of any premium tax credits and cost-sharing
reductions under applicable federal or state law;
J. perform duties required of, or delegated to, the exchange by the secretary of the
United States department of health and human services or the United States secretary
of the treasury related to determining eligibility for premium tax credits or reduced cost
sharing;
K. maintain a statewide consumer assistance program, including a navigator
program; and
L. maintain a small business health options program exchange through which
qualified employers may access coverage for their employees, providing as appropriate
premium aggregation and other related services to minimize the administrative burdens
for qualified employers and to:
(1)
enable a qualified employer to specify a level of coverage so that its
employees may enroll in a qualified health plan offered through the small business
health options program exchange at the specified level of coverage; or
(2)
enable a qualified employer to provide a specific amount or other payment
formulated in accordance with federal law to be used as part of an employee's choice of
plan.