A. There is created a nonprofit entity to be known as the "New Mexico medical insurance pool". All insurers shall organize and remain members of the pool as a condition of their authority to transact insurance business in this state. The board is a governmental entity for purposes of the Tort Claims Act [41-4-1 to 41-4-27 NMSA 1978].
B. The superintendent shall, within sixty days after the effective date of the Medical Insurance Pool Act, give notice to all insurers of the time and place for the initial organizational meetings of the pool. Each member of the pool shall be entitled to one vote in person or by proxy at the organizational meetings.
C. The pool shall operate subject to the supervision and approval of the board. The board shall consist of the superintendent or his designee, who shall serve as the chairman of the board, four members appointed by the members of the pool and six members appointed by the superintendent. The members appointed by the superintendent shall consist of four citizens who are not professionally affiliated with an insurer, at least two of whom shall be individuals who are insured by the pool, who would qualify for pool coverage if they were not eligible for particular group coverage or who are a parent, guardian, relative or spouse of such an individual. The superintendent's fifth appointment shall be a representative of a statewide health planning agency or organization. The superintendent's sixth appointment shall be a representative of the medical community.
D. The members of the board appointed by the members of the pool shall be appointed for initial terms of four years or less, staggered so that the term of one member shall expire on June 30 of each year. The members of the board appointed by the superintendent shall be appointed for initial terms of five years or less, staggered so that the term of one member expires on June 30 of each year. Following the initial terms, members of the board shall be appointed for terms of three years. If the members of the pool fail to make the initial appointments required by this subsection within sixty days following the first organizational meeting, the superintendent shall make those appointments. Whenever a vacancy on the board occurs, the superintendent shall fill the vacancy by appointing a person to serve the balance of the unexpired term. The person appointed shall meet the requirements for initial appointment to that position. Members of the board may be reimbursed from the pool subject to the limitations provided by the Per Diem and Mileage Act [10-8-1 to 10-8-8 NMSA 1978] and shall receive no other compensation, perquisite or allowance.
E. The board shall submit a plan of operation to the superintendent and any amendments to it necessary or suitable to assure the fair, reasonable and equitable administration of the pool.
F. The superintendent shall, after notice and hearing, approve the plan of operation, provided it is determined to assure the fair, reasonable and equitable administration of the pool and provides for the sharing of pool losses on an equitable, proportionate basis among the members of the pool. The plan of operation shall become effective upon approval in writing by the superintendent consistent with the date on which coverage under the Medical Insurance Pool Act is made available. If the board fails to submit a plan of operation within one hundred eighty days after the appointment of the board, or any time thereafter fails to submit necessary amendments to the plan of operation, the superintendent shall, after notice and hearing, adopt and promulgate such rules as are necessary or advisable to effectuate the provisions of the Medical Insurance Pool Act. Rules promulgated by the superintendent shall continue in force until modified by him or superseded by a subsequent plan of operation submitted by the board and approved by the superintendent.
G. Any reference in law, rule, division bulletin, contract or other legal document to the New Mexico comprehensive health insurance pool shall be deemed to refer to the New Mexico medical insurance pool.
History: 1978 Comp., § 59A-54-4, enacted by Laws 1987, ch. 154, § 4; 1991, ch. 200, § 2; 2001, ch. 352, § 4; 2003, ch. 395, § 2.
ANNOTATIONSThe 2003 amendment, effective June 20, 2003, in Subsection C, substituted "six" for "five" preceding "members appointed by", deleted the second sentence which read: "The members appointed by the members of the pool shall consist of one representative of a nonprofit health care plan one representative of a health maintenance organization and two representatives of other types of members of the pool", and added the last sentence.
The 2001 amendment, effective June 15, 2001, in Subsection A, substituted "medical insurance pool" for "comprehensive health insurance pool" and deleted "of the pool" following "The board"; substituted "Medical Insurance Pool Act" for "Comprehensive Health Insurance Pool Act" in Subsections B and F; deleted "of directors" following "appointment of the board" in Subsection F; and added Subsection G.
The 1991 amendment, effective June 14, 1991, added the last sentence in Subsection A; in Subsection C, substituted "representatives of other types of members of the pool" for "members who are members of the pool" at the end of the third sentence and substituted the final two sentences for a sentence which read "The members appointed by the superintendent shall consist of four citizens who are not professionally affiliated with an insurer, at least two of whom shall be individuals reasonably expected to qualify for coverage under the plan or the parent or spouse of such an individual and a representative of statewide health planning"; and, in Subsection D, substituted the fifth sentence for "The superintendent shall appoint a qualified person to fill a vacancy on the board for the balance of the unexpired term," and added the sixth sentence.