New Mexico Health Insurance Exchange Starting New Regulations

By September 6, 2019 Uncategorized

Individuals and small businesses signing up for the state’s health insurance exchange are in store for new changes during the open enrollment period.

As of October 1st, small businesses will be able to contribute any dollar amount, including zero, down to employee plans. Previously a 40% contribution was necessary.

Eliminating the minimum contribution gives employers “the flexibility to decide what might match their upcoming budget,” said Jeffery Bustamante, interim CEO of beWellnm, the state insurance exchange, and director of policy and compliance for the exchange.

Typically small employer groups purchase coverage through the state exchange, paying approximately 75% of employee health insurance premiums, Bustamante told the Journal.

According to Bustamante, New Mexico is “A competitive marketplace for coverage,” each county having four carriers, some offering four tiers of coverage ranging from bronze, silver, gold and platinum. Typically bronze plans have the lowest premiums but highest copays and deductibles, with Platinum having higher premiums but lower out of pocket expenses.

Prior to the change, employees had to stay within tiers in plans to which their employers contributed, however a new feature enables employees to buy up or down within their employer provided health plans.

New Mexico’s health insurance exchange for individuals, which currently can be accessed online at HealthCare.gov, eventually will join small businesses on a new state-run platform at beWellnm.com. The new platform will be launched in the fall of 2021, with enrollment beginning on January 1, 2022.

“We’re doing it because we anticipate it will come at a cost savings to the state, and give us more control over our own destiny and more control over our own data,” Bustamante said. The change will put administrators of the exchange in a position to “know our population with much more clarity.”

More than 600 employer groups and 47,000 individuals have already bought health insurance on the state exchange.