NM
New Mexico Senate Bill SB376

New Mexico 2025 Regular Session

New Mexico Senate Bill SB376 Compare Versions

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28+SENATE BILL 376
29+57
30+TH LEGISLATURE
31+-
32+
33+STATE
34+
35+OF
36+
37+NEW
38+
39+MEXICO
40+
41+-
42+ FIRST SESSION
43+,
44+
45+2025
46+INTRODUCED BY
47+Elizabeth "Liz" Stefanics and George K. Muñoz
2848 AN ACT
29-RELATING TO STATE EMPLOYEE BENEFITS; AMENDING THE
30-CONTRIBUTION PERCENTAGES FOR STATE EMPLOYEE HEALTH BENEFITS;
31-AUTHORIZING THE SECRETARY OF HEALTH CARE AUTHORITY TO USE
32-FUNDS APPROPRIATED FROM THE HEALTH CARE AFFORDABILITY FUND TO
33-REDUCE OR ELIMINATE PREMIUMS FOR CERTAIN GOVERNMENT
34-EMPLOYEES.
49+RELATING TO STATE EMPLOYEE BENEFITS; AMENDING THE CONTRIBUTION
50+PERCENTAGES FOR STATE EMPLOYEE HEALTH BENEFITS; AUTHORIZING THE
51+SECRETARY OF HEALTH CARE AUTHORITY TO USE FUNDS APPROPRIATED
52+FROM THE HEALTH CARE AFFORDABILITY FUND TO REDUCE OR ELIMINATE
53+PREMIUMS FOR CERTAIN GOVERNMENT EMPLOYEES.
3554 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF NEW MEXICO:
3655 SECTION 1. Section 10-7-4 NMSA 1978 (being Laws 1941,
3756 Chapter 188, Section 1, as amended) is amended to read:
3857 "10-7-4. GROUP INSURANCE--CAFETERIA PLAN--CONTRIBUTIONS
3958 FROM PUBLIC FUNDS.--
4059 A. All state departments and institutions and all
41-political subdivisions of the state, excluding
42-municipalities, counties and political subdivisions of the
43-state with twenty-five employees or fewer, shall cooperate in
44-providing group term life, medical or disability income
45-insurance for the benefit of eligible employees or salaried
46-officers of the respective departments, institutions and
47-political subdivisions.
48-B. The group insurance contributions of the state
49-or any of its departments or institutions, including
50-institutions of higher education, shall be made as follows:
51-(1) at least seventy-five percent of the SFC/SB 376
52-Page 2
60+political subdivisions of the state, excluding municipalities,
61+counties and political subdivisions of the state with twenty-
62+five employees or fewer, shall cooperate in providing group
63+.229406.3SA underscored material = new
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78-cost of the insurance of an employee whose annual salary is
79-less than fifteen thousand dollars ($15,000);
90+term life, medical or disability income insurance for the
91+benefit of eligible employees or salaried officers of the
92+respective departments, institutions and political
93+subdivisions.
94+B. The group insurance contributions of the state
95+or any of its departments or institutions, including
96+institutions of higher education, shall be made as follows:
97+(1) at least seventy-five percent of the cost
98+of the insurance of an employee whose annual salary is less
99+than fifteen thousand dollars ($15,000);
80100 (2) at least seventy percent of the cost of
81-the insurance of an employee whose annual salary is
82-fifteen thousand dollars ($15,000) or more but less than
83-twenty thousand dollars ($20,000);
84-(3) at least sixty-five percent of the cost
85-of the insurance of an employee whose annual salary is
86-twenty thousand dollars ($20,000) or more but less than
87-twenty-five thousand dollars ($25,000); and
88-(4) at least sixty percent of the cost of
89-the insurance of an employee whose annual salary is
90-twenty-five thousand dollars ($25,000) or more.
101+the insurance of an employee whose annual salary is fifteen
102+thousand dollars ($15,000) or more but less than twenty
103+thousand dollars ($20,000);
104+(3) at least sixty-five percent of the cost of
105+the insurance of an employee whose annual salary is twenty
106+thousand dollars ($20,000) or more but less than twenty-five
107+thousand dollars ($25,000); and
108+(4) at least sixty percent of the cost of the
109+insurance of an employee whose annual salary is twenty-five
110+thousand dollars ($25,000) or more.
91111 C. The group insurance contributions of school
92112 districts and charter schools shall be made as follows:
93-(1) at least eighty percent of the cost of
94-the insurance of an employee whose annual salary is less than
95-fifty thousand dollars ($50,000);
96-(2) at least seventy percent of the cost of
97-the insurance of an employee whose annual salary is
98-fifty thousand dollars ($50,000) or more but less than
99-sixty thousand dollars ($60,000); and
100-(3) at least sixty percent of the cost of
101-the insurance of an employee whose annual salary is
102-sixty thousand dollars ($60,000) or more. SFC/SB 376
103-Page 3
113+(1) at least eighty percent of the cost of the
114+insurance of an employee whose annual salary is less than fifty
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143+thousand dollars ($50,000);
144+(2) at least seventy percent of the cost of
145+the insurance of an employee whose annual salary is fifty
146+thousand dollars ($50,000) or more but less than sixty thousand
147+dollars ($60,000); and
148+(3) at least sixty percent of the cost of the
149+insurance of an employee whose annual salary is sixty thousand
150+dollars ($60,000) or more.
129151 D. Effective July 1, 2004, the group insurance
130-contributions of the state or any of its executive, judicial
131-or legislative departments, including agencies, boards or
152+contributions of the state or any of its executive, judicial or
153+legislative departments, including agencies, boards or
132154 commissions, shall be made as follows; provided that the
133155 contribution percentage shall be the same for all affected
134156 public employees in a given salary bracket:
135157 (1) up to eighty percent of the cost of the
136158 insurance of an employee whose annual salary is less than
137159 thirty thousand dollars ($30,000);
138160 (2) up to seventy percent of the cost of the
139-insurance of an employee whose annual salary is
140-thirty thousand dollars ($30,000) or more but less than
141-forty thousand dollars ($40,000); and
161+insurance of an employee whose annual salary is thirty thousand
162+dollars ($30,000) or more but less than forty thousand dollars
163+($40,000); and
142164 (3) up to sixty percent of the cost of the
143-insurance of an employee whose annual salary is
144-forty thousand dollars ($40,000) or more.
165+insurance of an employee whose annual salary is forty thousand
166+dollars ($40,000) or more.
145167 E. Except as provided in Subsection H of this
146-section, effective July 1, 2025, the group insurance
147-contributions of the state or any of its executive, judicial
148-or legislative departments, including agencies, boards or
149-commissions, shall be eighty percent of the cost of
150-insurance.
151-F. Effective July 1, 2013, the employer shall pay
152-one hundred percent of basic life insurance premiums for
153-employees, and employees who choose to carry disability SFC/SB 376
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196+section, effective July 1, [2005 ] 2025, the group insurance
197+contributions of the state or any of its executive, judicial or
198+legislative departments, including agencies, boards or
199+commissions, shall be [made as follows; provided that the
200+contribution percentage shall be the same for all affected
201+public employees in a given salary bracket;
202+(1) up to eighty percent of the cost of the
203+insurance of an employee whose annual salary is less than fifty
204+thousand dollars ($50,000);
205+(2) up to seventy percent of the cost of the
206+insurance of an employee whose annual salary is fifty thousand
207+dollars ($50,000) or more but less than sixty thousand dollars
208+($60,000); and
209+(3) up to sixty percent of the cost of the
210+insurance of an employee whose annual salary is sixty thousand
211+dollars ($60,000) or more ] eighty percent of the cost of
212+insurance.
213+F. Effective July 1, 2013, the employer shall pay
214+one hundred percent of basic life insurance premiums for
215+employees, and employees who choose to carry disability
180216 insurance shall pay one hundred percent of the premium.
181217 G. The state shall not make any group insurance
182-contributions for legislators. A legislator shall be
183-eligible for group benefits only if the legislator
184-contributes one hundred percent of the cost of the insurance.
185-H. An employer shall pay one hundred percent of
186-the employee group insurance contributions due and payable on
187-or after July 1, 2016 for an employee who is injured while
188-performing a public safety function or duty and, as a result
189-of the injury, is placed on approved workers' compensation
190-leave.
191-I. As used in this section, "cost of the
192-insurance" means the premium required to be paid to provide
193-coverages. Any contributions of the political subdivisions
194-of the state, except the public schools and political
195-subdivisions of the state with twenty-five employees or
196-fewer, shall not exceed sixty percent of the cost of the
197-insurance.
198-J. When a public employee elects to participate in
199-a cafeteria plan as authorized by the Cafeteria Plan Act and
200-enters into a salary reduction agreement with the
201-governmental employer, the provisions of Subsections B
202-through G of this section with respect to the maximum
203-contributions that can be made by the employer are not
204-violated and will still apply. The employer percentage or SFC/SB 376
205-Page 5
218+contributions for legislators. A legislator shall be eligible
219+for group benefits only if the legislator contributes one
220+hundred percent of the cost of the insurance.
221+.229406.3SA
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231-dollar contributions as provided in Subsections B through E
232-of this section shall be determined by the employee's gross
233-salary prior to any salary reduction agreement.
249+H. An employer shall pay one hundred percent of the
250+employee group insurance contributions due and payable on or
251+after July 1, 2016 for an employee who is injured while
252+performing a public safety function or duty and, as a result of
253+the injury, is placed on approved workers' compensation leave.
254+I. As used in this section, "cost of the insurance"
255+means the premium required to be paid to provide coverages.
256+Any contributions of the political subdivisions of the state,
257+except the public schools and political subdivisions of the
258+state with twenty-five employees or fewer, shall not exceed
259+sixty percent of the cost of the insurance.
260+J. When a public employee elects to participate in
261+a cafeteria plan as authorized by the Cafeteria Plan Act and
262+enters into a salary reduction agreement with the governmental
263+employer, the provisions of Subsections B through G of this
264+section with respect to the maximum contributions that can be
265+made by the employer are not violated and will still apply.
266+The employer percentage or dollar contributions as provided in
267+Subsections B through E of this section shall be determined by
268+the employee's gross salary prior to any salary reduction
269+agreement.
234270 K. Any group medical insurance plan offered
235-pursuant to this section shall include effective
236-cost-containment measures to control the growth of health
237-care costs and maximize benefits for the least cost. If a
238-state agency that is responsible for providing state employee
239-health benefits under the Health Care Purchasing Act
240-establishes a reference-based pricing program for in-network
241-or out-of-network hospital services, hospitals subject to the
242-program shall not charge or collect from a member of the
243-health benefit plan an amount in addition to the maximum
244-payment established by the secretary of health care
245-authority, except that a hospital may charge an amount for
246-cost-sharing that is authorized by the terms of the member's
247-health benefit plan. The responsible public body that
248-administers a plan offered pursuant to this section shall
249-report annually by September 1 to appropriate interim
250-legislative committees on the effectiveness of the
251-cost-containment measures required by this subsection.
252-L. Within available revenue, school districts,
253-charter schools and participating entities pursuant to the
254-Public School Insurance Authority Act may contribute up to
255-one hundred percent of the cost of the insurance of all SFC/SB 376
256-Page 6
271+pursuant to this section shall include effective cost-
272+containment measures to control the growth of health care
273+costs. If a state agency that is responsible for providing
274+.229406.3SA
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282-employees and institutions of higher education may contribute
283-up to eighty percent of the cost of the insurance of all
284-employees.
302+state employee health benefits under the Health Care Purchasing
303+Act establishes a reference-based pricing program for
304+in-network or out-of-network hospital services, hospitals
305+subject to the program shall not charge or collect from a
306+member of the health benefit plan an amount in addition to the
307+maximum payment established by the secretary of health care
308+authority, except that a hospital may charge an amount for
309+cost-sharing that is authorized by the terms of the member's
310+health benefit plan. The responsible public body that
311+administers a plan offered pursuant to this section shall
312+report annually by September 1 to appropriate interim
313+legislative committees on the effectiveness of the cost-
314+containment measures required by this subsection.
315+L. Within available revenue, school districts,
316+charter schools and participating entities pursuant to the
317+Public School Insurance Authority Act may contribute up to one
318+hundred percent of the cost of the insurance of all employees
319+and institutions of higher education may contribute up to
320+eighty percent of the cost of the insurance of all employees.
285321 M. When the secretary of health care authority
286322 submits the health care authority's annual budget request to
287323 the legislature, the secretary shall include a budget request
288-for purchasing state employee health benefits that has
289-actuarially sound rates for the following fiscal year.
290-Beginning July 1, 2025, the secretary shall set actuarially
291-sound rates sufficient to cover projected claims, subject to
292-legislative appropriation. By September 1 of each year, the
293-projected actuarially sound rate adjustment for the following
294-fiscal year, subject to legislative appropriation, shall be
295-communicated to the local public bodies who are part of the
296-state employee health benefit program.
297-N. The secretary of health care authority shall
298-establish a program to make state health benefit premiums
299-more affordable for certain employees using appropriations
300-from the health care affordability fund. The secretary shall
301-establish a system for determining eligibility for the
302-program and may annually update program eligibility and
303-contribution criteria.
304-O. By July 1, 2026, the health care authority
305-shall ensure that state employees are provided the
306-opportunity to purchase a variety of health benefit plans SFC/SB 376
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324+for purchasing state employee health benefits that reflects
325+actuarially sound rate adjustments. Beginning July 1, 2025,
326+the secretary shall set actuarially sound rates sufficient to
327+.229406.3SA
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333-with varying plan designs and cost-sharing options."
334-SECTION 2. Section 59A-23F-11 NMSA 1978 (being
335-Laws 2021, Chapter 136, Section 4, as amended) is amended to
336-read:
355+cover projected claims, subject to legislative appropriation.
356+N. The secretary of health care authority shall
357+establish a program to make state health benefit premiums more
358+affordable for certain employees using appropriations from the
359+health care affordability fund. The secretary shall establish
360+a system for determining eligibility for the program and may
361+annually update program eligibility and contribution criteria. "
362+SECTION 2. Section 59A-23F-11 NMSA 1978 (being Laws 2021,
363+Chapter 136, Section 4, as amended) is amended to read:
337364 "59A-23F-11. HEALTH CARE AFFORDABILITY FUND.--
338365 A. The "health care affordability fund" is created
339366 in the state treasury. The fund consists of distributions,
340-appropriations, gifts, grants and donations. Money in the
341-fund at the end of a fiscal year shall not revert to any
342-other fund. The health care authority shall administer the
343-fund, and money in the fund is subject to appropriation by
344-the legislature for purposes provided by this section.
345-Disbursements from the fund shall be made by warrant of the
346-secretary of finance and administration pursuant to vouchers
347-signed by the secretary of health care authority or the
348-secretary's authorized representative.
367+appropriations, gifts, grants and donations. Money in the fund
368+at the end of a fiscal year shall not revert to any other fund.
369+The health care authority shall administer the fund, and money
370+in the fund is subject to appropriation by the legislature for
371+purposes provided by this section. Disbursements from the fund
372+shall be made by warrant of the secretary of finance and
373+administration pursuant to vouchers signed by the secretary of
374+health care authority or the secretary's authorized
375+representative.
349376 B. The purpose of the fund is to:
350377 (1) reduce health care premiums and cost
351378 sharing for New Mexico residents who purchase health care
352379 coverage on the New Mexico health insurance exchange;
353-(2) reduce premiums for small businesses and
354-their employees purchasing health care coverage in the fully
355-insured small group market;
356-(3) provide resources for planning, design
357-and implementation of health care coverage initiatives for SFC/SB 376
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384-uninsured New Mexico residents;
408+(2) reduce premiums for small businesses and
409+their employees purchasing health care coverage in the fully
410+insured small group market;
411+(3) provide resources for planning, design and
412+implementation of health care coverage initiatives for
413+uninsured New Mexico residents; [and ]
385414 (4) provide resources for administration of
386-state health care coverage initiatives for uninsured
387-New Mexico residents;
388-(5) cover a portion or all of the net
389-premium health benefit contributions for state employees
390-enrolled in health benefit plans covered by the Health Care
391-Purchasing Act who do not qualify for medicaid and:
392-(a) have a modified adjusted gross
393-income up to two hundred fifty percent of the federal poverty
394-level; or
395-(b) purchase employee-only coverage and
396-receive an annual salary from the state of fifty thousand
397-dollars ($50,000) or less; and
398-(6) cover a portion or all of the net
399-premiums for members of the New Mexico national guard who
400-qualify for a federal TRICARE reserve select policy.
401-C. If the federal Patient Protection and
402-Affordable Care Act is repealed in full or in part by an act
403-of congress or invalidated by the United States supreme court
404-and eliminates or reduces comprehensive health care coverage
405-for New Mexico residents through medicaid or the New Mexico
406-health insurance exchange, the fund may be used to maintain
407-coverage through the New Mexico health insurance exchange or
408-through medical assistance programs administered by the SFC/SB 376
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415+state health care coverage initiatives for uninsured New Mexico
416+residents;
417+(5) cover a portion or all of the net premium
418+health benefit contributions for state employees enrolled in
419+health benefit plans covered by the Health Care Purchasing Act
420+who do not qualify for medicaid and have a modified adjusted
421+gross income up to two hundred fifty percent of the federal
422+poverty level; and
423+(6) cover a portion or all of the net premiums
424+for members of the New Mexico national guard who qualify for a
425+federal TRICARE reserve select policy.
426+C. If the federal Patient Protection and Affordable
427+Care Act is repealed in full or in part by an act of congress
428+or invalidated by the United States supreme court and
429+eliminates or reduces comprehensive health care coverage for
430+New Mexico residents through medicaid or the New Mexico health
431+insurance exchange, the fund may be used to maintain coverage
432+through the New Mexico health insurance exchange or through
433+.229406.3SA
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435-health care authority; provided that coverage is prioritized
436-for New Mexico residents with incomes below two hundred
437-percent of the federal poverty level.
461+medical assistance programs administered by the health care
462+authority; provided that coverage is prioritized for New Mexico
463+residents with incomes below two hundred percent of the federal
464+poverty level.
438465 D. Prior to July 1, 2025, the staff of the
439466 legislative finance committee shall conduct a program
440467 evaluation to measure the impact of changes to the health
441468 insurance premium surtax and the creation of the health care
442469 affordability fund as it relates to the purpose of the fund.
443470 E. Prior to July 1 of each year, the health care
444471 authority shall provide actuarial data from the health care
445472 affordability fund to the legislative finance committee.
446473 F. Prior to July 1 of each year, the secretary of
447-health care authority, in consultation with the
448-superintendent, the secretary of taxation and revenue and the
449-chief executive officer of the New Mexico health insurance
450-exchange, shall work with the legislative finance committee
451-and the department of finance and administration to develop
452-and report on performance measures relating to the health care
453-affordability fund and any programs or initiatives funded by
454-the fund."
474+health care authority, in consultation with the superintendent,
475+the secretary of taxation and revenue and the chief executive
476+officer of the New Mexico health insurance exchange, shall work
477+with the legislative finance committee and the department of
478+finance and administration to develop and report on performance
479+measures relating to the health care affordability fund and any
480+programs or initiatives funded by the fund."
481+- 9 -
482+.229406.3SA