New Mexico Administrative Code
Title 13 - INSURANCE
Chapter 10 - HEALTH INSURANCE
Part 5 - GROUP COVERAGE DISCONTINUANCE AND REPLACEMENT
Section 13.10.5.9 - REQUIREMENTS FOR NOTICE OF DISCONTINUANCE
Universal Citation: 13 NM Admin Code 13.10.5.9
Current through Register Vol. 35, No. 18, September 24, 2024
A. The carrier shall notify the group contract holder of the date the group contract will discontinue and that, unless otherwise provided in the group contract, the carrier shall not be liable for claims for losses incurred after the date of discontinuance.
B. The carrier shall also be responsible for notifying all persons covered by the group contract of the discontinuance within ten working days of notice to the group contract holder in whatever manner the carrier customarily uses to provide such notice. The notice shall:
(1) indicate the
effective date of the discontinuance;
(2) advise, in any instance in which the plan
involves employee contributions, that if the group contract holder continues to
collect contributions for the coverage after the date of discontinuance, the
group contract holder may be held solely liable for the benefits with respect
to the period for which the contributions have been collected;
(3) state that, unless otherwise provided in
the group contract, the carrier shall not be liable for claims for losses
incurred after the date of discontinuance; and
(4) encourage covered persons to refer to
their certificates in order to determine what rights, if any, are available to
them upon the discontinuance.
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