New Mexico Administrative Code

A. An insurer or the assigned risk pool may require the following information from an employer, client or leasing contractor making application for coverage: (1) a list by jurisdiction of every name under which an employer, client or leasing contractor has operated at any time du…

When any employee leasing arrangement terminates, all prior experience of the client's own direct workers and its previously leased workers shall be used in rating the client. Every rating organization and insurer shall make a reasonable effort, including a special audit if neces…

A. Any rating determination made pursuant to this rule may be appealed as provided under Section 59A-17-30B NMSA 1978. B. Any other determination or decision made pursuant to this rule may be reviewed through seeking a hearing pursuant to Section 59A-4-15 NMSA 1978. C. If the app…

A. In addition to any other penalty provided by law or rule, violation of any provision of this rule by an employer, client or leasing contractor is grounds for cancellation or non-renewal of workers' compensation insurance. Notice of such cancellation or non-renewal, stating the…

All leasing contractors and all employers providing temporary workers covered through the assigned risk pool on the effective date of this rule shall submit a new application for coverage to the pool on or before September 30, 1991, in order to establish eligibility for pool cove…

This rule applies to workers' compensation and employer's liability insurance as defined in Section 59A-7-6 A(3) NMSA 1978.

Sections 59A-2-9, 59A-3-6, 59A-17-5, 59A-18-29, 59A-33-9.1, and 59A-33-10 and 59A-2-9.1 NMSA 1978.

Permanent.

September 6, 1991, unless a later date is cited at the end of a section or paragraph. Repromulgated in NMAC format effective July 1, 1997.

The purpose of this rule is to carry out the requirements of Laws 1990 (2nd Special Session), Chapter 2 relating to proper workers' compensation classification and rating, including defining temporary and leased employees, providing for proper classification and rating, providing…

A. "Assigned risk pool or pool" means the workers' compensation insurance assigned risk facility established by Chapter 59A, Article 33 NMSA 1978. B. "Client" means an employer which obtains workers through an employee leasing arrangement. C. "Employee leasing arrangement" means …

A. The use of subterfuge or any other action to evade the proper application of workers' compensation insurance classifications, ratings based upon experience or other premium rating procedures is prohibited. B. In addition to any other penalty provided by law or this rule, any p…

In the voluntary market and in the assigned risk pool, coverage for temporary workers shall be through a standard workers' compensation policy issued to that employer which has the right to control hiring, salary, assignment and payment of the temporary workers.

New Mexico Public Regulation Commission, Insurance Division.

Upon audit at the end of the policy term, the carrier shall use the same credits in the calculation of the insured's final earned premium, provided that the carrier may verify the original qualification criteria as well as the data originally provided by the insured for the compu…

The average hourly wage and premium credit shall be calculated in the following manner: A. The average hourly wage for each policy's qualifying classifications shall be determined by dividing the total payroll or remuneration for each classification by the number of actual hours …

Pursuant to NMSA 1978 Section 59A-17-8 D the rate classification system relied on for workers' compensation shall be updated and revised periodically to reflect changes in the workplace.

A. By rate service organization or insurer. Any rating determination made pursuant to this rule may be appealed as provided in NMSA 1978 Section 59A-17-30B. B. By Superintendent. Any other determination or decision made pursuant to this rule may be reviewed by requesting a hearin…

The Superintendent may revoke, suspend or refuse to continue the license or certificate of authority of any person who fails to comply with this rule and may impose such other applicable administrative penalties as may be authorized by the Insurance Code.

This rule authorizes premium credits for workers' compensation and employer's liability insurance as defined in NMSA 1978 Section 59A-7-6 A(3) for those employers utilizing certain qualifying classifications. The premium credit calculation in this rule shall apply to new or renew…

NMSA 1978 Sections 59A-2-9, 59A-3-6, and 59A-17-5.

Permanent.

April 1, 1992, unless a later date is cited at the end of a section.

The purpose of this rule is to implement NMSA 1978 Section 59A-17-8 C directing the Superintendent of Insurance to equalize and calculate workers' compensation premium rates on a basis that does not discriminate against or penalize employers who pay higher wages than other employ…

In addition to the definitions in the Workers' Compensation Act, NMSA 1978 Sections 52-1-1 et seq., as used in this rule: A. aggregate call for experience means the requests by the WCSO to workers' compensation carriers for summaries of payroll, premium or loss experience data; B…

A. The Superintendent may amend this rule to add or delete classifications from the schedule by providing at least thirty (30) days' notice to the WCSO and otherwise furnishing public notice as required by the Insurance Code. B. NOC means "not otherwise classified". C. The premiu…

The premium credit program shall be administered in the following manner: A. Each workers' compensation carrier shall issue a premium credit application form for each qualifying policy. This form must be issued by each individual carrier and shall be sent to each insured employer…

Office of Superintendent of Insurance

A. Upon the termination of such continuing claim within the original scheduled term of insurance a refund shall be made of any then unearned premium. If, however, during the pendency of an accident and health insurance claim the insurer elects to prepay and discharge the full rem…

A. Excess benefit checks or drafts made in accordance with Subsection B of Section 59A-25-7 NMSA 1978 shall be delivered only by the insurer or, at the option of the insurer, by the creditor. In any case, the insurer shall be responsible for the delivery of such excess benefit ch…

A. The policy or certificate shall not contain provisions which would encourage misrepresentation or are unjust, unfair, inequitable, misleading, deceptive, or contrary to the law of this state. B. Provisions in individual policies or group certificates pertaining to underwriting…

A. If a group certificate of insurance is issued to a debtor under any plan charging the debtor an identifiable amount for insurance for a period of time greater than that of the shortest premium payment period of the group policy issued to the creditor, the following rules shall…

The following provisions apply to termination of coverage under a group policy. A. If a debtor is covered by a group credit insurance policy providing for the payment of a single premium to the insurer, the master policy and certificate shall provide that in the event of terminat…

If the creditor adds identifiable insurance charge or premiums for credit insurance to the indebtedness, and any direct or indirect finance, carrying credit or service charge is made to the debtor on such insurance charge or premiums, the charge to the debtor shall be of the same…

The following rules shall apply to open-end transaction forms. A. The policy and certificate must be identified when used for open-end transactions by either a form number followed by the suffix (25-OE) or a check-off block and may be used for coverage of any other types of indeb…

A. Every insurance company, when submitting a schedule of rates for consideration by the superintendent of insurance, shall identify the rates to be used with the policy form submitted for approval. In the alternative, specific reference in the case of each submission shall be ma…

The superintendent of insurance may presume (subject, however, to a rebuttal of the presumption) that the benefits of a credit life insurance policy are reasonable in relation to the premium charged if the premium rate for death benefits as filed does not exceed an amount equal, …

Joint lives as used in Subsections C and D of 13.18.2.18 NMAC above means only spouses or business partners, and such person must be jointly and severally liable for repayment of the single indebtedness and be joint signers of the instrument of indebtedness. Endorsers and guarant…

This rule applies to all life insurance and accident and health insurance sold in connection with loans or other credit transactions, except such insurance sold in connection with a loan or other credit transaction of more than 10 years' duration, and except for such insurance th…

A. Joint life rates may not be charged for single life coverage, except that a composite single joint outstanding balance life rate may be used for open-end accounts where more than fifty percent of a creditor's open-end accounts are held jointly. Such rate shall be completed as …

Premiums and premium rates for insurance concerning obligations payable in other than substantially equal monthly installments during the period of coverage, or for coverage which declines on other than a straight line basis, shall be determined in a manner which produces a rate …

The presumptively reasonable premiums for credit life insurance shall apply only to plans containing provisions consistent with the following. A. That the credit life insurance contract may require submission of the debtor's written and signed evidence of the debtor's insurabilit…

If the premiums are determined according to the age of the insured debtor or by age brackets, appropriate adjustments in the rate and premium may be made according to age if such adjustments are actuarially consistent with the foregoing rates when applied regardless of actual age…

If a contract of insurance includes other lawful benefit or benefits for which standards of reasonableness of benefits in relation to premiums are not elsewhere in this rule determined or described, any premium charged therefor shall be shown to the satisfaction of the superinten…

If a debtor has credit life insurance under an open-end outstanding balance policy, the policy may provide that an increase in the amount of insurance because of an increase in the amount of indebtedness will be subject to conditions of insurability. Any policy provision regardin…

A. The superintendent may presume (subject, however, to a rebuttal of the presumption) that the benefits of an accident and health insurance form are reasonable in relation to the premium charged if the premium rate schedule for such accident and health benefits, as filed, does n…

The standards and principles for the application of the rates set forth for credit accident and health insurance are as follows. A. The initial amount of insured indebtedness to which the rate is applied shall not exceed the aggregate of the insured portion of the periodic schedu…

A. If a debtor has credit accident and health insurance under an open-end outstanding balance policy, the policy may provide that an increase in the insurance benefits because of an increase in the indebtedness will be subject to conditions of insurability. Any policy provision r…

A. Notwithstanding the determination of presumptively acceptable maximum rates which are reasonable in relation to the benefits of a policy providing the coverage to which the rates are applicable:(1) an insurer who has experienced excessive loss ratios for a case consisting of a…

Sections 59A-2-9, and 59A-25-1 to 59A-25-14 NMSA 1978.