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Mandated Benefits Task Force Update

Mandated Benefits Task Force Update. Insure New Mexico! Council October 6, 2005. Focus of Discussions. Possible statutory changes that would allow insurers flexibility to sell products that provide basic coverage Looked at approaches in other jurisdictions

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Mandated Benefits Task Force Update

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  1. Mandated Benefits TaskForce Update Insure New Mexico! Council October 6, 2005

  2. Focus of Discussions • Possible statutory changes that would allow insurers flexibility to sell products that provide basic coverage • Looked at approaches in other jurisdictions • Discussion direction focused on possibly amending the Minimum Healthcare Protection Act (“MHPA”)

  3. Purpose of Amendments • Provide insurer product flexibility with some limits (e.g., must also offer comprehensive coverage) • Basic coverage product could be offered in the $50-$100/month range for an individual (other state experience) • Target Market: those who are currently uninsured

  4. Example - Possible Products • Services could include well adult and well child care with typical copayments, tiered physician visits ($10 copay for 2 office visits, 80% coverage after 2 visits) • Hospital coverage at 100% with $100 copay; prescription drug coverage with tiered copayments or coinsurance

  5. Proposal to Amend MHPA • Revises and updates outdated language • Eliminates some mandated benefits • Requires insurer offering a scaled down product to also offer comprehensive insurance (Texas model) • Requires insurer to provide full disclosure re: scaled down product (Texas model)

  6. Other thoughts • Could add in some mandated benefits (would change product pricing structure) • Could include sunset provision if needed • Other concerns raised

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