A. The board may establish no more than three standardized health plans for each of three levels of coverage with increasing benefits, designated bronze, silver and gold plans.
B. In establishing standardized health plans, the board may design those plans to:
(1) limit increases in health plan premium rates;
(2) reduce the deductible portion of a benefit an insured individual is required to pay;
(3) make more services available before a deductible amount is applied to a benefit;
(4) provide predictable cost sharing;
(5) maximize available subsidies;
(6) limit adverse premium impacts;
(7) reduce barriers to maintaining and improving health; and
(8) encourage choice based on value.
C. The board may update the standardized health plans annually.
D. The board shall provide for notice and public comment before finalizing each year's standardized health plans.
E. The board shall establish a procedure and time line for providing written notice of the standardized health plans to health insurance issuers before the year in which the health plans are to be offered on the exchange.
F. Beginning on January 1, 2022, the board may require a health insurance issuer offering a qualified health plan through the exchange to offer one silver standardized health plan and one gold standardized health plan on the exchange. If a health insurance issuer offers a bronze health plan through the exchange, the exchange may also require the issuer to offer one bronze standardized health plan through the exchange.
G. A health insurance issuer offering standardized health plans through the exchange may also offer nonstandardized health plans through the exchange.
H. The actuarial value of nonstandardized silver health plans offered through the exchange shall not be less than the actuarial value of the standardized silver health plan with the lowest actuarial value.
History: Laws 2020, ch. 35, § 7.
ANNOTATIONSEffective dates. — Laws 2020, ch. 35 contained no effective date provision, but, pursuant to N.M. Const., art. IV, § 23, was effective May 20, 2020, 90 days after adjournment of the legislature.