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SENATE BILL 80
57
TH LEGISLATURE
-
STATE
OF
NEW
MEXICO
-
FIRST SESSION
,
2025
INTRODUCED BY
Elizabeth "Liz" Stefanics and Tara L. Lujan
AN ACT
RELATING TO HEALTH INSURANCE; REQUIRING ISSUERS OF MEDICARE
SUPPLEMENT POLICIES TO PROVIDE OPEN ENROLLMENT PERIODS.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF NEW MEXICO:
SECTION 1. Section 59A-24A-3 NMSA 1978 (being Laws 1989,
Chapter 28, Section 3, as amended) is amended to read:
"59A-24A-3. DEFINITIONS.--As used in the Medicare
Supplement Act:
A. "applicant" means:
(1) in the case of an individual medicare
supplement policy, the person who seeks to contract for
insurance benefits; [and ] or
(2) in the case of a group medicare supplement
policy, the proposed certificate holder;
B. "certificate" means any certificate delivered or
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issued for delivery in this state under a group medicare
supplement policy;
C. "certificate form" means the document on which a
certificate is delivered or issued for delivery;
D. "eligible policyholder" means a medicare
beneficiary who is sixty-five years or older and insured under
a medicare supplement policy;
[D.] E. "issuer" means insurance companies,
fraternal benefit societies, nonprofit health care plans,
health maintenance organizations and any other entities that
deliver or issue for delivery in this state medicare supplement
policies or certificates;
[E.] F. "medicare" means the federal Health
Insurance for the Aged Act, Title XVIII of the Social Security
Amendments of 1965, as then constituted or later amended;
[F.] G. "medicare supplement policy" means:
(1) a group policy as defined in Chapter 59A,
Article 23 NMSA 1978;
(2) an individual policy as defined in Chapter
59A, Article 22 NMSA 1978; or
(3) a group or individual certificate issued
pursuant to the Nonprofit Health Care Plan Law or the Health
Maintenance Organization [Act ] Law that is advertised, marketed
or designed as a supplement to reimbursements under medicare
for the hospital, medical or surgical expenses of persons
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eligible for medicare;
[G.] H. "policy form" means the document on which a
policy is delivered or issued for delivery by the issuer; and
[H.] I. "superintendent" means the superintendent
of insurance."
SECTION 2. A new section of the Medicare Supplement Act
is enacted to read:
"[NEW MATERIAL] ANNUAL OPEN ENROLLMENT.--
A. Every issuer participating in the market for
medicare supplement policies shall offer an annual open
enrollment period to all eligible policyholders. Each eligible
policyholder's open enrollment period shall commence with the
first day of the eligible policyholder's birthday month and
remain open for at least sixty days thereafter. During the
open enrollment period:
(1) each eligible policyholder may purchase
any medicare supplement policy offered in this state; and
(2) an issuer shall not deny, delay or
condition the issuance or effectiveness, or discriminate in the
price of coverage, of a medicare supplement policy based on the
health status, claims, experience, receipt of health care or
medical condition of an eligible policyholder.
B. At least thirty days before the beginning of an
eligible policyholder's open enrollment period, but not more
than sixty days before the beginning of the open enrollment
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period, the issuer of an eligible policyholder's medicare
supplement policy shall notify the eligible policyholder of:
(1) the dates on which the open enrollment
period begins and ends;
(2) the rights provided to the eligible
policyholder by this section; and
(3) any modifications to the medicare
supplement policy currently held by the eligible policyholder
or any adjustments to the premiums charged for that policy."
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