New Mexico Administrative Code
Title 13 - INSURANCE
Chapter 10 - HEALTH INSURANCE
Part 5 - GROUP COVERAGE DISCONTINUANCE AND REPLACEMENT
Section 13.10.5.11 - LIABILITY OF PRIOR CARRIER WHEN GROUP CONTRACT REPLACED
Universal Citation: 13 NM Admin Code 13.10.5.11
Current through Register Vol. 35, No. 18, September 24, 2024
A. The prior carrier remains liable only to the extent of its accrued liabilities and extensions of benefits. The position of the prior carrier shall be the same whether the group contract holder or other entity secures replacement coverage from a new carrier, the same carrier, self-insures, or foregoes the provision of coverage.
B. The prior carrier, if an HMO, may limit the extension of benefits for a totally disabling illness, injury, or condition to services provided by or through its participating providers, unless services are rendered on an emergency basis.
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