New Mexico Health Insurance Exchange created; board created – N.M. Stat. Ann. § 59A-23F-3

The law establishes the New Mexico Health Insurance Exchange as a nonprofit public corporation to provide individuals and employers with access to health insurance.  The Exchange is governed by a Board of Directors.  The Exchange is a governmental entity only for purposes of the Tort Claims Act, and is not considered a governmental entity for any other purpose. 

The Exchange must not duplicate or infringe upon any of the duties of Superintendent of Insurance, including the Superintendent’s rate review and approval process. 

The Exchange must not purchase qualified health plans to offer on the Exchange.  All health insurance issuers and health maintenance organizations who meet the criteria under state and federal law, are eligible to participate in the Exchange. 

The Board of Directors of the Exchange has 13 voting members appointed by various governmental leaders.  Full time Exchange staff must not have any direct or indirect affiliation with a health care provider, health insurance issuer or health service provider.  Each board member must also comply with certain conflict-of-interest provisions. Each director and employee has a fiduciary duty to the Exchange.  The Board must be composed to fairly represent the state’s Native American population, ethnic and cultural diversity.  Directors must have some knowledge of experience in certain areas, including purchasing coverage in the individual and employer markets, health care finance, health care policy, enrollment of underserved individuals, and information technology.  The Governor may not appoint more than four Directors from the same political party.  The law also discusses the term periods of the Directors, manner of voting by Directors, and removal of a Director by a 2/3 majority of the Directors.  Appointed Directors may receive a per diem and mileage, but may not receive compensation. 

The Board must meet at least once per calendar quarter or at the call of the Chair.  The Board must also create an advisory committee of members insured through the New Mexico health insurance alliance and the New Mexico medical insurance pool to make recommendations to the board regarding the transition of the insured members to the Exchange.  The Board must also create an advisory committee of Native Americans to assist in the implementation of Native-American specific provisions of the Affordable Care Act.  The Board must also designate a Native American liaison between the Exchange and the Native American groups.