TITLE 6               PRIMARY AND SECONDARY EDUCATION

CHAPTER 50     INSURANCE

PART 8                 EMPLOYEE-BENEFIT AND RISK-RELATED PREMIUM PAYMENTS

 

6.50.8.1                 ISSUING AGENCY:  New Mexico Public School Insurance Authority.

[6.50.8.1 NMAC - Rp, 6 NMAC 50.8.1, 09/01/2014]

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

 

6.50.8.2                 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 board members and persons or entities authorized to participate in the authority's employee benefits, risk-related and due process reimbursement coverages.

[6.50.8.2 NMAC - Rp, 6 NMAC 50.8.2, 09/01/2014]

 

6.50.8.3                 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.

[6.50.8.3 NMAC - Rp, 6 NMAC 50.8.3, 09/01/2014]

 

6.50.8.4                 DURATION:  Permanent.

[6.50.8.4 NMAC - Rp, 6 NMAC 50.8.4, 09/01/2014]

 

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

[6.50.8.5 NMAC - Rp, 6 NMAC 50.8.5, 09/01/2014]

 

6.50.8.6                 OBJECTIVE:  The objective of this part is to set forth the requirements for premium payment by participating entities.

[6.50.8.6 NMAC - Rp, 6 NMAC 50.8.6, 09/01/2014]

 

6.50.8.7                 DEFINITIONS: [RESERVED]

 

6.50.8.8                 PREMIUM PAYMENT FOR RISK RELATED AND DUE PROCESS REIMBURSEMENT COVERAGES:  The authority shall invoice each member for risk-related and due process reimbursement coverages.  Payment for risk-related and due process reimbursement coverages is due in full within 30 days after the billing date.  Premium payments not received by the 10th day of the month following the due date shall be subject to an interest charge of 1.5% of the premium due for each month they are overdue.   

[6.50.8.8 NMAC - Rp, 6 NMAC 50.8.8, 09/01/2014]

 

6.50.8.9                 PREMIUM PAYMENT FOR EMPLOYEE BENEFITS COVERAGES:  The authority shall invoice each member, or the individual participant where direct billing is used, for the premiums for employee benefits coverages.  Premium payments are due in full within 10 days after billing. Premiums are due no later than the 10th of the month for which coverage is intended.

[6.50.8.9 NMAC - N, 09/01/2014]

 

6.50.8.10               PREMIUM PAYMENT PLAN:  Any member unable to make its premium payment timely and in full must obtain a recommendation from the state secretary of education for any alternate payment schedule, which shall then be submitted to the board for approval. The board may accept or reject the secretary’s recommendation.

[6.50.8.10 NMAC - Rp, 6 NMAC 50.8.9, 09/01/2014]

 

6.50.8.11               FAILURE TO PAY PREMIUMS WHEN DUE:  If any member or individual participant responsible for making a premium payment fails to make the premium payments when due, the member or individual participant shall be subject to suspension of coverage or in an extreme case, as determined by the board, to termination of coverage. Notice of suspension or termination of coverage shall be given to the member or to the individual as appropriate. Where the coverage has been suspended for non-payment of premiums, the authority shall act to protect the stability of the fund in determining whether to reinstate coverage.

[6.50.8.11 NMAC - Rp, 6 NMAC 50.8.10, 09/01/2014]

 

6.50.8.12               PROCEDURE FOR HANDLING DISPUTED BILLINGS:  In the event any member or individual disputes the amount of the authority’s billing, the member or individual shall pay the bill and then file a written statement requesting a refund of the disputed amount setting forth the amount and the reasons the member or individual believes the billing constitutes an overcharge. The request shall be filed within 60 days after the submission of the billing. Requests for refunds that are not timely filed shall be deemed to be rejected. The board shall place complaints regarding the amount of the authority’s billings that are timely filed on the agenda of one of its meetings and give notice to the affected member or individual so the member or individual may attend and be heard.

[6.50.8.12 NMAC - Rp, 6 NMAC 50.8.11, 09/01/2014]

 

HISTORY of 6.50.8 NMAC:

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

NMPSIA 86-105, Risk-Related Premium Payments, filed 10-31-86;

NMPSIA 86-205, Employee Benefit Premium Payments, filed 10-31-86;

NMPSIA 93-11, Employee-Benefit and Risk Related Premium Payments, filed 03-22-93.

 

History of Repealed Material:

6 NMAC 50.8, Employee-Benefit and Risk-Related Premium Payments, filed 10/1/97 - Repealed effective 09/01/2014.