Group underwriting, eligibility, contributory and noncontributory plans, COBRA and coordination of benefits are covered in the national Group Health Insurance guide. This guide covers New Mexico's state continuation and conversion law for group health coverage (NMSA 1978, 59A-18-16) and a few related group rules.

State continuation and conversion (NMSA 1978, 59A-18-16)

New Mexico requires group hospital, surgical and medical policies to protect members whose coverage ends. This applies alongside federal COBRA.

Continuation, then conversion. A member whose group coverage ends may continue it for six months and then convert to individual coverage (59A-18-16(A)(2)(a)).

Family members. If the member dies, or on divorce, annulment or legal separation, covered family members may keep coverage through a converted or separate policy (59A-18-16(A)(2)(b)).

How to elect. The member elects and pays within 30 days after the termination notice. There's no gap in coverage while the conversion right is open (59A-18-16(F)).

No new underwriting. Continuation or conversion coverage requires no evidence of insurability and can't impose new pre-existing condition limits or other waiting periods (59A-18-16(G)).

When there's no right to continue or convert. Coverage that ended because of nonpayment of premium, nonrenewal of the group policy or expiration of its term (59A-18-16(B)).

Medicare. For members or family members eligible for Medicare, continuation or conversion is limited to a Medicare supplement policy (59A-18-16(B)).

Extended disability benefit at death

A group health policy may include an extended disability benefit payable at death of up to $1,000, and it isn't treated as life insurance (NMSA 1978, 59A-23-5).

Dependent coverage

Group coverage, like individual coverage, can't end a dependent's coverage because of age before the 26th birthday, whether or not the dependent is a student (NMSA 1978, 59A-23-7.3).

Common exam traps

• Six months of continuation, then conversion.
• 30 days to elect and pay after the termination notice.
• No continuation or conversion after termination for nonpayment, nonrenewal or expiration of the policy.
• Medicare-eligible people are limited to a Medicare supplement policy.
• No evidence of insurability and no new pre-existing condition limits on continuation or conversion coverage.