COVID-19 Insurance Updates

In March, the Superintendent of Insurance issued an emergency rule, two orders, and two bulletins in response to the COVID-19 outbreak. These actions apply to insurance plans regulated by the state.

On March 12, 2020, the superintendent ordered that insurers providing major medical coverage and insurers providing limited benefits coverage to notify their members whether and to what extent their policies cover testing and health care services related to COVID-19. Additionally, if an insurer only offers limited coverage, they must notify their members of available full coverage options. The Superintendent also ordered limited benefit plans (such as workers’ compensation and automobile medical payment insurance) to provide notice to their members that their plans do not provide comprehensive medical coverage and to give members information on where they should go to check on their eligibility to apply for and obtain such coverage.

On March 12, 2020, the superintendent ordered an emergency amendment to an existing cost sharing rule that creates a presumption that it is unreasonable and prohibit any cost sharing requirement for the provision of health care services for COVID-19, pneumonia, influenza or any disease or condition that is the cause of, or the subject of, a public health emergency. This amendment was ordered under the authority of Gov. Grisham, who issued Executive Order 2020-004 that directed the superintendent to promulgate emergency rules maximizing the available insurance coverage for New Mexicans suffering from COVID-19, pneumonia or influenza, while simultaneously ensuring that medical costs do not create a barrier to testing and treatment. The amendment would apply to insurance policies regulated by the state.

On March 17, 2020, the superintendent issued Bulletin 2020-005. The bulletin reminds insurers that New Mexico law requires them to treat telemedicine visits and in-person visits equally. In addition, the bulletin reminds insurers that they cannot impose prior authorization requirements or cost sharing requirements upon services to person with COVID-19 and that limits or barriers to telemedicine visits may cause their plans to fail network adequacy requirements.

On March 20, 2020, the Superintendent of Insurance issued Bulletin 2020-006. The bulletin requests that all insurance companies refrain from cancelling or nonrenewing policies of businesses and individuals negatively impacted by the disruption due to the nonpayment of premiums during this public health emergency, or at a minimum, provide extended grace periods for payment of premiums. It also requests that all insurance companies work with their insureds after the public health emergency is over to allow the insureds to catch up on past due premiums in installments without loss of coverage.

Employers with policies regulated by New Mexico should be aware of these developments.

Press Release »
Emergency Rule »
Excepted Benefit Plan Order »
Bulletin 2020-005 »
Bulletin 2020-006 »