TITLE 6 PRIMARY AND SECONDARY EDUCATION

CHAPTER 50 INSURANCE

PART 6 NOTICE OF RISK-RELATED, EMPLOYEE-BENEFITS AND DUE PROCESS

REIMBURSEMENT COVERAGES

6.50.6.1 ISSUING AGENCY: New Mexico Public School Insurance Authority.

[6.50.6.1 NMAC - Rp, 6 NMAC 50.6.1, 09/01/2014]

[The address of the New Mexico Public School Insurance Authority is 410 Old Taos Highway, Santa Fe, New Mexico 87501.]

6.50.6.2 SCOPE: This part applies to all school districts, charter schools, other educational entities, eligible employees, eligible retired employees, eligible dependents, eligible participating entity governing body members, and persons or entities authorized to participate in the authority's employee benefits, risk-related and due process reimbursement coverages.

[6.50.6.2 NMAC - Rp, 6 NMAC 50.6.2, 09/01/2014]

6.50.6.3 STATUTORY AUTHORITY: Subsection D of Section 22-29-7, NMSA 1978, directs the authority to promulgate necessary rules, regulations and procedures for the implementation of the New Mexico Public School Insurance Authority Act, Section 22-29-1 et seq., NMSA 1978.

[6.50.6.3 NMAC - Rp, 6 NMAC 50.6.3, 09/01/2014]

6.50.6.4 DURATION: Permanent.

[6.50.6.4 NMAC - Rp, 6 NMAC 50.6.4, 09/01/2014]

6.50.6.5 EFFECTIVE DATE: September 1, 2014 unless a later date is cited at the end of a section.

[6.50.6.5 NMAC - Rp, 6 NMAC 50.6.5, 09/01/2014]

6.50.6.6 OBJECTIVE: The objective of this part is to establish the procedure for providing notice of coverage of risk-related, employee benefits and due process reimbursement coverages.

[6.50.6.6 NMAC - Rp, 6 NMAC 50.6.6, 09/01/2014]

6.50.6.7 DEFINITIONS: [RESERVED]

6.50.6.8 COVERAGE NOTIFICATION: The authority will issue notification of coverage for each offering to each participating entity within 30 days of the inception of the coverage. The coverage notification may specify the types, limits, amounts and general terms of coverage to be provided to the participating entity. The notification shall state that a complete copy of the memorandum of coverage which governs risk-related and due process reimbursement coverages will be made available to all interested parties upon request. Each covered employee under employee benefits coverages shall receive a summary plan description or insurance certificate. The terms of the insurance policy or memorandum of coverage, not the coverage notification or summary shall control in any dispute over coverage. Final determination of whether a claim is covered rests solely with the authority.

[6.50.6.8 NMAC - Rp, 6 NMAC 50.6.8, 09/01/2014]

HISTORY OF 6.50.6 NMAC:

Pre-NMAC History: The material in this part was derived from that previously filed with the State Records Center and Archives under:

NMPSIA 86-103, Notice of Risk-Related Coverage, filed 10/31/86.

NMPSIA 86-206, Notice of Coverage, filed 10/31/86.

NMPSIA 93-9, Notice of Risk-Related and Employee Benefits Coverage, filed 3/22/93.

History of Repealed Material:

6 NMAC 50.6, Notice of Risk-Related and Employee Benefits Coverage, filed 10/1/97 - Repealed effective 09/01/2014.