Policy or plan disclosure requirements – N.M. Stat. Ann. §59A-23B-5

Once insurance coverage is offered, an insurer must provide a written disclosure statement to the beneficiary of a plan under the Minimum Healthcare Protection Act that  includes the following :

1. General information about the services the plan does not cover;
2. An explanation of the managed care and cost control measures of the plan, including relevant contact information;
3. An explanation of the primary and preventative care features of the plan.

The disclosure statement must be in a form and language that is easily understandable, and must be separate from the policy. 

Before an insurer issues the policy, the insurer must receive from the beneficiary a signed, written statement that:

1. Certifies the eligibility of the beneficiary;
2. Acknowledges the limited nature of the plan’s coverage;
3. Acknowledges that if misrepresentations are made by the beneficiary, he or she will lose coverage;
4. Acknowledges that the beneficiary was given the chance to purchase a full benefit package, but rejected that option. 

The insurance company must provide the beneficiary a copy of the signed statement when the policy is delivered, and must retain the original for at least 3 years. 

If the beneficiary, in the application makes a material false statement about his or her eligibility, the insurer can terminate coverage for that reason.  Additionally, any media advertisements put out by the insurer are subject to review by the Superintendent of Insurance.