New Mexico Administrative Code
Title 13 - INSURANCE
Chapter 10 - HEALTH INSURANCE
Part 11 - HEALTH INSURANCE ALLIANCE PLAN OF OPERATION AND ELIGIBILITY CRITERIA
Section 13.10.11.28 - EFFECTIVE DATES
Current through Register Vol. 35, No. 18, September 24, 2024
A. If the documentation required by the alliance is received by the 15th of the month, coverage shall be reviewed for an effective date as of the first day of the following month. If the documentation required by the alliance is received after the 15th of the month, coverage shall not be effective until the first day of the month after the month following that in which the complete documentation is received. (Note: If the 15th of the month falls on a weekend or holiday, the documentation must be received by the alliance, or delivered to its post office box, before 5:00 p.m. on the next business day.)
B. Coverage for an eligible employee and/or dependent shall be effective as of the first day of the month following fulfillment of enrollment and eligibility requirements, unless an earlier effective date is required by law (as in the case of newborn or adopted children). (See 13.10.11.29 NMAC.)
C. Coverage for persons eligible to enroll and enrolling during an open enrollment period held pursuant to Subsection B of 13.10.11.27 NMAC shall be effective as of the first day of the month following enrollment.
D. The small employer shall notify the alliance of the termination of, or cancellation of insurance for, any employee or dependent by the end of the month following the month in which the employee was terminated or his coverage cancelled. Premiums for the month following the month in which termination or cancellation is effective shall be refunded if previously paid, provided that the alliance has been timely notified in writing.
E. The small employer shall notify the alliance of its intent to terminate its group insurance through the alliance no later than the 10th of the month following the last month of coverage. Premiums for any month following the last intended month of coverage will not be refunded unless notice of termination is received by the alliance on or before the 10th of that month. (Note: If the 10th of the month falls on a weekend or holiday, the documentation must be received by the alliance, or delivered to its post office box, before 5:00 pm on the next business day.)
