New Mexico Administrative Code
Title 13 - INSURANCE
Chapter 10 - HEALTH INSURANCE
Part 11 - HEALTH INSURANCE ALLIANCE PLAN OF OPERATION AND ELIGIBILITY CRITERIA
Section 13.10.11.24 - DOCUMENTATION FOR GROUPS RENEWING WITH THE SAME CARRIER
Universal Citation: 13 NM Admin Code 13.10.11.24
Current through Register Vol. 35, No. 6, March 26, 2024
A. For groups that file New Mexico department of labor employer's quarterly wage and contribution report (schedule A - SUTA), tseq level1 \h \r0 he employer's most recent SUTA.
(1) The employer must identify on the SUTA
form each employee who is not eligible for coverage and must specify the reason
that the employee is ineligible, (e.g., on medicare, working part time (i.e.,
less 20 hours per week), terminated, etc). For each employee who is not
eligible, the employer must specify the employee's date of hire and hours per
week worked.
(2) The employer must
submit an enrollment application for each employee desiring coverage who has
not previously submitted an application and a waiver of coverage, in the form
specified by the alliance, for each eligible employee who does not
desire coverage and who has not previously submitted a waiver to the
alliance. If the employee has other coverage, the name of the
carrier, as well as the subscriber and group names must be specified;
(3) If an employer submits a SUTA but desires
to enroll employees who are not identified on that report, the employer must
submit the following applicable documentation for each such employee:
(a) for any new employees not yet identified
on the most recent SUTA, W-4 forms;
(b) for each owner, working spouse or partner
not identified on the SUTA, a witnessed affidavit that the individual is
working in the business at least 20 hours per week on a regular
basis.
B. If the employer group is not required to file a SUTA, the employer must submit its current business license, if it is required to have a business license, anda witnessed affidavit by each individual requesting coverage as a subscriber, that the individual is working in the business at least 20 hours per week on a regular basis.
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