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New Mexico - Compensation & Benefit Legislation

NEW MEXICO - AASHOWME

Demonstrates www.BenefitsReview.com™ site. Illustrates insurance carriers' coverages within the State.

 

NEW MEXICO - ADOPTED CHILD HEALTH CARE MANDATE

OBRA 1993 (Federal) requires group health plans to honor medical and child support orders. Also, plans must treat adopted children like biological children covered by the plan, and plans are precluded from applying pre-existing condition exclusions to an adopted child where no such exclusion applies to a newborn biological child. Health plans that covered the cost of pediatric vaccines as of May 1, 1993, and fail to continue that level of coverage, will be subject to an excise tax penalty applicable to plans that fail to meet the health care continuation coverage requirements under OBRA 1993.

 

Mandatory coverage of birth of adopted children and transportation of newborn to nearest available facility is included in state's newborn health care mandate.

 

Preventive care for children: No.

 

(New Mexico Stat. Ann. Sections 59A-22-33, 59A-22-34, 59A-22-34.1, 59-22-35)

 

NEW MEXICO - ALCOHOLISM & DRUG ABUSE

Employer option (alcoholism treatment only.)

 

Minimum yearly inpatient coverage: 30 days.

 

Minimum yearly outpatient coverage: 30 visits.

 

Minimum lifetime coverage: 2 benefit periods.

 

(New Mexico Stat. Ann. Section 59-A-23-6)

 

NEW MEXICO - CAFETERIA PLAN TAX LAWS

State income tax, unemployment insurance tax on salary reduction: For state Unemployment Insurance purposes, employer contributions toward health and retirement plans are not taxable, even if provided under a cafeteria plan.

 

NEW MEXICO - CONTINUATION OF COVERAGE CONVERSIONS

Events Triggering Continuation of Coverage:

 

NEW MEXICO - COORDINATION OF BENEFITS

State reports no statutory requirements.

 

NEW MEXICO - COST-OF-LIVING

ERI's Relocation Assessor™ is a recommended source for U.S./Canadian cost-of-living data and U.S. Automobile Cost Survey.

 

NEW MEXICO - DRUG TESTING AND EMPLOYEE ASSISTANCE BENEFITS

State has no statutory requirements.

 

NEW MEXICO - GROUP HEALTH CODE ADDITIONS (MANDATED)

Adopted Children: Policies must cover adopted children from the date of placement with the insured. (New Mexico Stat. Ann. Sections 59A-22-34.1, 59A-46-33.)

 

Alcoholism Treatment: Group policies must cover costs of at least 30 days of treatment in an alcohol dependency treatment center and 30 outpatient visits per year, subject to the same co-insurance and deductibles as imposed for other kinds of treatment under the policy. A lifetime maximum of two treatment episodes is permissible. (New Mexico Stat..Ann. Sections 59A-23-6, 59A-47-35.)

 

Coverage Continuation and Conversion: Individual policies must provide covered family members the same right to continue coverage as the insured. Group policies must provide continuation rights to employees for six months following termination of membership or employment and subsequent conversion rights. Policies must provide conversion privileges to covered family members who cease eligibility due to death of the insured or dissolution or marriage. (New Mexico Stat. Ann. Section 59A-18-16, 59A-46-30, 59A-47-34.)

 

Diabetes: Effective January 1, 1998, group health policies (HMOs included) must provide benefits for medical treatments and for medially necessary equipment and supplies for individuals with diabetes. Covered equipment and supplies for diabetes treatments include blood glucose monitors, test strips for blood glucose monitors, visual reading urine and ketone strips, lancets and lancet devices, insulin, injection aids, syringes, prescriptive oral agents for controlling blood sugar levels, medically necessary podiatric appliances for prevention of foot complications associated with diabetes, and glucagon emergency kits. New or improved equipment, supplies, or medications for diabetes treatment must be added to the list of covered items after approval by the FDA. (S682, 1997.) (New Mexico Insurance Code Section 59A-11-41, NMSA 1978.)

 

Domestic Abuse: Effective July 1, 997, health insurers (HMOs included) must not discriminate against individuals because they are victims of domestic abuse. Prohibited discriminatory acts which relate to insurance coverage for victims of domestic abuse include denial or refusal to issue, renew, or reissue policies; cancellation or termination of policies; restrictions or exclusions of coverages or benefits; or requirements of higher policy premiums. (S346, 1997) (New Mexico Insurance Code.)

 

Handicapped Dependents: Coverage for dependent children cannot be terminated while the dependent is incapable of employment due to mental retardation or physical handicap and chiefly dependent on the insured. (New Mexico Stat. Ann. Section 59A-22-33.)

 

Health Maintenance Organizations: HMOs which do not impose pre-existing conditions exclusions to any particular coverage options may impose an affiliation period as an alternative measure. An affiliation period must begin on the enrollment date, run concurrently with any waiting period of a plan, be applied uniformly without regard to any health status related factors, and must not exceed two months or three months in the case of the coverage for late enrollees. During affiliation periods, premium payments must not be charged for coverage and health care services or benefits are not required to be provided. (H832, 1997.)

 

Home Health Care: Insurers must offer policyholders coverage for home health care as described. (New Mexico Stat. Ann. Section 59A-22-36, 59A-46-29, 59A-47-27.)

 

Mammography Screening: Group health insurance policies must cover the costs of baseline mammography screening for women between the ages of 35 and 40; a mammogram every two years for women between the ages of 40 and 50; and an annual mammogram for women 50 years of age and older, subject to deductible and co-insurance provisions consistent with those to other benefits. (New Mexico Stat. Ann. Sections 59A-22-39, 59A-46-35.)

 

Mastectomy: Group health policies, including HMOs, must provide coverage for inpatient breast cancer treatment of not less than 48 hours following a mastectomy and of not less than 24 hours following a lymph node dissection. Inpatient breast treatments of lesser duration following a mastectomy are not prohibited where deemed appropriate by an attending physician and a patient. (S964, 1997) (New Mexico Stat. Ann. Section 59A-22-39.1.)

 

Maternity Transport: Policies providing maternity coverage on an expense incurred basis must cover, where necessary to protect the life of the infant or mother, transportation for the medically high risk pregnant woman with an impending delivery of a potentially viable infant to the nearest tertiary care facility for newborns. (New Mexico Stat. Ann. Sections 59A-22-35, 59A-46-28, 59A-47-27.)

 

Newborns: Policies providing family coverage must provide benefits for newborns from the moment of birth for injury or sickness including treatment of medically diagnosed congenital defects, birth abnormalities, and, where necessary to protect the life of the infant, transportation to the nearest tertiary care facility for newborns. (New Mexico Stat. Ann. Sections 59A-22-34, 59A-46-27.)

 

Policies for Small Employers: The Minimum Healthcare Protection Act now includes a group that has been in existence for less than six months and has been without health care coverage since formation, an employee whose coverage has been terminated by an employer, dependents who no longer qualify for coverage under an employer's plan, and an individual and dependents who no longer have coverage as a result of change in employment. Coverage under the Act also was expanded to include cytologic screening. (New Mexico Stat. Ann. Section 59A-23B-3.) The Health Insurance Alliance Act of 1994 created non-profit independent public corporation authorized to direct a member to issue certificate of coverage of health insurance, establish rate schedules, and set re-insurance premiums. All plans submitted by Alliance members for approval must meet certain requirements regarding coverage of eligible dependents, benefits, deductibles, and pre-existing conditions. A small employer will be eligible for coverage under an approved plan if, on the effective date, at least 50 percent of its employees not otherwise insured elect to be covered under the approved health plan, and the small employer has not terminated coverage with an approved health plan within three years of the date of application except to change to another approved health plan. "Small employer" is defined as a person that is a resident of the state, at least half of whose employees are state residents, is actively engaged in business, and that on at least 50 percent of working days during the preceding calendar year employed at least two but no more than 50 eligible employees. The "Small Group Rate and Renewability Act" restricts certain rating practices and use of pre-existing conditions. Small employer carriers cannot transfer involuntarily a small employer into or out of a class of business. (New Mexico Insurance Code Sections 1-25, New Mexico Stat. Ann. Sections 59A-18, 59A-23C.)

 

Pre-existing conditions: Under group health plans, pre-existing conditions provisions relate to physical or mental ailments for which medical advice, diagnosis, care, or treatment has been recommended or received within a six month period ending on the date of enrollment in a plan. Genetic information, in the absence of a diagnosis of a related condition, is excluded under pre-existing conditions provision. (H832, 1997.)

 

Providers: Optometrists, psychologists, podiatrists, certified nurse midwives, registered nurses in expanded practice, and practitioners of the healing arts: Costs for services must be covered if the provider is licensed, the services is within the providers scope of services, and the service is covered by the policy. (New Mexico Stat. Ann. Sections 59A-22-32, 59A-47-28.1.)

 

NEW MEXICO - GROUP HEALTH FOR SMALL EMPLOYERS

For insurance plans offered to small employers:

 

NEW MEXICO - GROUP LIFE CODE ADDITIONS

Employer required to pay part of premium: No.

 

Percent of employees who must elect coverage (if employees pay part of premium): No statutory requirement.

 

Percent of employees who must be covered if employer pays all of premium: 100%.

 

Minimum number of employees in group plan: No statutory requirement.

 

Employer prohibited as beneficiary: Yes.

 

Grace period (days): 31.

 

Mandatory conversion: Yes.

 

Other provisions: None.

 

(New Mexico Stat. Ann. Sections 59A-21-4, 59A-21-12, 59A-21-20)

 

NEW MEXICO - HOLIDAYS

January 1, Washington's Birthday (or 3rd Monday in February), Memorial Day (or last Monday in May), July 4, Labor Day (or 1st Monday in September), Veterans Day, and December 25 are state holidays in all 50 states and in the District of Columbia. Other holidays under State law include: Martin Luther King's birthday (or 3rd Monday in January), Columbus Day (or 2nd Monday in October), Thanksgiving. Other: If holiday falls on Sunday, following Monday is a holiday. (New Mexico Stat. Ann. Sections 12-5-1 through 12-5-5, 12-5-7, 12-5-9)

 

NEW MEXICO - IMMIGRATION (PREVAILING WAGE POLICY)

See U.S. Federal General Administrative Letter 1-2000

 

NEW MEXICO - JURY DUTY & WITNESS TIME OFF

Employer Restriction For Discharging Employee For Taking Leave For Jury Service: Yes.

 

Remedies and Penalties: Violator is guilty of a petty misdemeanor.

 

Other Requirements: None reported. (New Mexico Stat. Ann. Sections 38-5-18, 35-5-19.)

 

Employer Restriction For Discharging Employee For Taking Leave to be a Witness: State reports no statutory requirements.

 

Remedies and Penalties: State reports no statutory requirements.

 

Other Requirements: State reports no statutory requirements.

 

NEW MEXICO - LEAVES OF ABSENCE

State reports no statutory requirements.

 

See U.S. Federal Family and Medical Leave Act

 

NEW MEXICO - LONG TERM DISABILITY CODE ADDITIONS

State does not require employer to provide long term disability benefits; although many employers do in order to remain competitive in hiring/retention of employees.

 

See LEAVES OF ABSENCE (above), WORKERS' COMPENSATION (below) and U.S. Federal Americans With Disabilities Act

 

NEW MEXICO - MANDATED PROVIDERS

Optometrists, psychologists, podiatrists, social workers, and nurse midwives. Mandatory coverage for lay midwives or registered nurses in expanded practice. (New Mexico Stat. Ann. Sections 59A-22-32, 59A, 22-32.1)

 

NEW MEXICO - MENTAL HEALTH CARE

State reports no statutory requirements.

 

NEW MEXICO - MINIMUM WAGE

$4.25 per hour. Refer to the Federal minimum wage: $5.15 per hour (effective September 1, 1997).

 

Exemptions: Certain professionals, agriculture workers, domestics, outside sales, students, and apprentices. Handicapped workers in special environments may be exempt by special certificate. (New Mexico Stat. Ann. Sections 50-3-21-50-4-23)

 

See U.S. Minimum Wage

 

NEW MEXICO - NEW HIRE REPORTING

Who is required to report: All employers.

 

Who must be reported: All new employees and rehires.

 

Exempt from reporting: No exemptions.

 

Form(s) to file: W-4 form of equivalent including required information.

 

Filing deadline: Within 20 days of hire.

 

Employer information to be included: Name, address, and EIN.

 

Employee information to be included: Name, address, and SSN.

 

Penalty for failure to report: Fines from $20 to $500 may be imposed.

 

(N.M. Stat Ann. Section 50-13-1 - 50- 13-4)

 

NEW MEXICO - NEWBORN CARE MANDATE

Mandated coverage including transportation of newborn to nearest facility.

 

Preventive care for children: No. (New Mexico Stat. Ann. Sections 59A-22-33, 59A-22-34, 59A-22-34.1, 59-22-35)

 

NEW MEXICO - PARENTAL LEAVE

See U.S. Federal Family and Medical Leave Act

 

NEW MEXICO - PRE-EXISTING CONDITIONS

For insurance plans offered to small employers, coverage for losses shall not be excluded more than 6 months following effective date of coverage due to a pre-existing condition. (New Mexico Stat. Ann. Sections 59A-23B, 59A-23C-3, 59A-23C-5, 59A-23C-5.1)

 

See U.S. Federal Health Insurance Portability & Accountability Act

 

NEW MEXICO - PROTECTED CLASSIFICATIONS

Age: Yes.

Race: Yes.

Color: Yes.

National Origin: Yes.

Ancestry: Yes.

Religion: Yes.

Sex: Yes.

Pregnancy: No specific law. State has expressed policy against discrimination.

Sexual Harassment: No specific law. State has expressed policy against discrimination.

 

(N.M. Stat. Ann. Sections 28-1-2, 28-1-7.)

 

NEW MEXICO - SALARY SURVEY

ERI's Relocation Assessor™ is a recommended source for U.S./Canadian wages & salaries (covering 3,000 positions).

 

NEW MEXICO - SHORT TERM DISABILITY CODE ADDITIONS

State does not require employer or employee participation in short term disability plans.

 

NEW MEXICO - TERMINATION & SEVERANCE PAY

Date pay is due if employee is discharged: Within 5 days.

 

Date due if employee resigns: Within 5 days.

 

Wages: Yes. (Wages or other compensation, including commissions).

 

Vacation Pay: No.

 

Holiday: No.

 

Sick leave: No.

 

Severance: No.

 

(New Mexico Stat. Ann. Sections 50-4-1, 50-4-4, 50-4-5)

       

NEW MEXICO - UNEMPLOYMENT TAX

Employer Contributions:

 

 

Voluntary Contribution Provision: Yes. If paid on or before March 1.

 

(New Mexico Stat. Ann. Sections 51-1-11, 51-1-27.)

 

NEW MEXICO - VACATION PAY

State reports no statutory requirements.

 

NEW MEXICO - VOTING TIME OFF

2 hours, unless the workday begins more than 2 hours after polls open or ends more than 3 hours before polls close. (New Mexico Stat. Ann. Sections 1-12-42, 1-20-13.)

 

NEW MEXICO - WORKERS' COMPENSATION

Private Employers: Mandatory as to employers with 3 or more employees. Corporate officers who are 10% shareholders may reject coverage. Elective as to partner or self-employed. All employers licensed under the Construction Industries Licensing Act must secure coverage regardless of number of employees.

 

Public Employers: Mandatory coverage to state, counties, cities and town; drainage, irrigation, conservancy, or school districts; public instruction of administrative boards; includes elected or appointed officials.

 

Exceptions: Farm or ranch labor, domestic servants, casual employee, and real estate salespersons.

 

Special Coverage Provisions: Voluntary as to farm labor, domestic service, and where less that 3 are employed. Mandatory for charitable organizations employing workers.

 

(U.S. Chamber of Commerce, 1994 Analysis of Workers' Compensation Laws.)