SENATE BILL 534

46th legislature - STATE OF NEW MEXICO - second session, 2004

INTRODUCED BY

Ramsay L. Gorham

AN ACT

RELATING TO HEALTH INSURANCE; AUTHORIZING INSURERS TO OFFER CATASTROPHIC GROUP HEALTH INSURANCE POLICIES TO EMPLOYERS FOR THEIR EMPLOYEES; ENACTING A SECTION OF CHAPTER 59A, ARTICLE 23 NMSA 1978.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF NEW MEXICO:

     Section 1. A new section of Chapter 59A, Article 23 NMSA 1978 is enacted to read:

     "[NEW MATERIAL] SMALL EMPLOYER OPTION--CATASTROPHIC GROUP HEALTH INSURANCE.--

          A. Notwithstanding any other provision of law, an insurer may issue a catastrophic group health insurance policy to a small employer for the benefit of the small employer's employees.

          B. As used in this section, "catastrophic group health insurance policy" means a policy for group health insurance:

                (1) to which the following provisions are not applicable:

                     (a) Section 59A-16-13.1 NMSA 1978;

                     (b) Section 59A-22-33 NMSA 1978;

                     (c) Section 59A-22-34 NMSA 1978;

                     (d) Section 59A-22-34.1 NMSA 1978;

                     (e) Section 59A-22-34.3 NMSA 1978;

                     (f) Section 59A-22-35 NMSA 1978;

                     (g) Section 59A-22-36 NMSA 1978;

                     (h) Section 59A-22-39 NMSA 1978;

                     (i) Section 59A-22-39.1 NMSA 1978;

                     (j) Section 59A-22-40 NMSA 1978;

                     (k) Section 59A-22-41 NMSA 1978;

                     (l) Section 59A-22-41.1 NMSA 1978;

                     (m) Section 59A-22-42 NMSA 1978;

                     (n) Section 59A-22-43 NMSA 1978;

                     (o) Section 59A-22-44 NMSA 1978;

                     (p) Section 59A-23-6 NMSA 1978;

                     (q) Section 59A-23E-18 NMSA 1978; and

                     (r) any other provision of law that mandates coverage of specific health care services; and

                (2) that contains the following deductible provisions:

                     (a) self-only coverage with an annual deductible of not less than seven hundred dollars ($700); and

                     (b) family coverage with an annual deductible of not less than one thousand five hundred dollars ($1,500).

          C. As used in this section, "small employer" means a person, firm, corporation, partnership or association actively engaged in business that, on at least fifty percent of its working days during either of the two preceding years, employed no less than two and no more than fifty eligible employees; provided that:

                (1) in determining the number of eligible employees, the spouse or dependent of an employee may, at the employer's discretion, be counted as a separate employee;

                (2) companies that are affiliated companies or that are eligible to file a combined tax return for purposes of state income taxation shall be considered one employer; and

                 (3) in the case of an employer that was not in existence throughout a preceding calendar year, the determination of whether the employer is a small or large employer shall be based on the average number of employees that it is reasonably expected to employ on working days in the current calendar year."

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