New Mexico Administrative Code
Title 13 - INSURANCE
Chapter 10 - HEALTH INSURANCE
Part 11 - HEALTH INSURANCE ALLIANCE PLAN OF OPERATION AND ELIGIBILITY CRITERIA
Section 13.10.11.19 - ELIGIBILITY CRITERIA

Universal Citation: 13 NM Admin Code 13.10.11.19

Current through Register Vol. 35, No. 18, September 24, 2024

A. The eligibility criteria in 13.10.11.20 NMAC through 13.10.11.33 NMAC apply to approved health plans for small employers; the eligibility criteria in 13.10.11.34 NMAC apply to approved health plans for individual coverage.

B. Members may utilize their normal business practices in implementing an approved health plan to the extent such practices are not inconsistent with the act, this rule, other applicable laws and regulations, or the approved health plan's benefit design.

C. Any misrepresentation relating to an employer's eligibility as a small employer or to an individual's eligibility for coverage may be grounds for rescission or cancellation of coverage and such other action as may be appropriate under law.

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