NM State Updates - 2015 May 19 No.03

On April 1, 2015, Superintendent of Insurance Franchini issued Bulletin No. 2015-015 repealing and replacing Bulletin No. 2014-003. Superintendent Franchini is still concerned that some individuals are not aware that limited benefit plans (excepted benefit plans) do not provide an individual with MEC, the coverage required to avoid PPACA’s individual mandate penalty. As such, this bulletin requires that issuers of group and individual hospital plans (except disability plans) notify every individual insured under such plans that the coverage does not satisfy the individual mandate’s MEC requirement.

The following disclosure should be made:

“This type of plan is NOT considered ‘minimum essential coverage’ under the Affordable Care Act and therefore does NOT satisfy the individual mandate that you have health insurance coverage. If you do not have other health insurance coverage, you may be subject to a tax penalty. Please consult your tax advisor.”

This notice should also be provided will all policies issued or renewed on or after Jan. 1, 2014, in at least 10-point font on the cover page of the policy. While the bulletin adds no new employer compliance obligations, employers that sponsor such non-MEC plans should look for the disclosure from insurers, which may also help employees understand their obligations under the individual mandate.

Bulletin No. 2015-015 »