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New Mexico State Insurance Exhchange
Summary:
 
 
Current Status in Establishing Exchange:
 
Declared State-based Exchange.
 
Decision Process:
 
Executive Order.
 
Exchange Funding:
 
 
  • A federal Exchange Planning grant of $1 million was given to the New Mexico Department of Human Services in 2010. The Office of Health Care Reform requested and was granted a 12-month budget extension on Planning grant funds for a new project end date of September 29, 2012.
  • The New Mexico Department of Human Services received a federal Level One Establishment grant of almost $35 million, on November 29, 2011. The grant funding will be used to refine the vision and objective of the exchange, continue stakeholder engagement, develop a multi-year business and operational plan, and examine the information technology infrastructure and functionality necessary to operate the exchange by 2014.
  • In addition, New Mexico, along with nine other states, is receiving technical assistance from the Robert Wood Johnson Foundation through the State Health Reform Assistance Network; this assistance includes help with setting up health insurance exchanges, expanding Medicaid to newly eligible populations, streamlining eligibility and enrollment systems, instituting insurance market reforms and using data to drive decisions.
 
Benchmark Plan:
 
 
·         Small Group Plan
 
·         EHB Benchmark Plan: small-group plan Lovelace Classic PPO.
 
Additional Information:
 
  • Conducted an analysis of existing state benefit mandates, assessed benchmark plan options, held a public comment period, formed a workgroup on essential health benefits.  
  • The exchange will be established within the New Mexico Health Insurance Alliance, created in 1994. A task force created by the Department of Human Serivces heads several workgroups to advise on different areas of the exchange development.
  • If New Mexico wants to operate a state-based exchange or a state-federal partnership exchange, it must submit an exchange blueprint consisting of a declaration letter signed by the Governor and an application to the U.S. Department of Health and Human Services (HHS) by December 14, 2012. HHS will review the submitted blueprint application and approve or conditionally approve the state’s exchange.

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