Carriers

As New Mexico transitions to a State-Based Exchange for 2022 plan year, here’s a list of meetings and related materials.

 FREQUENTLY ASKED QUESTIONS-NMHIX SBE Transition

 

July 27, 2021  Provider Directories Bulletin 2021-013

Document:

Title:    Policy Manual Final for PY2022

Topic:    Policy Manual for operations of the state-based marketplace.

 Considerations:

  • Not all links are active, but will be before “Go-Live” on October 1.
  • The Customer Engagement Center, referenced throughout this document, is scheduled to open October 1.
  • The “Eligibility Verification Plan” referenced in this document is also attached. beWellnm Eligibility Verification Plan 2021 09.07

 

If you have any questions, please send them to SBE-Transition@nmhix.com.

 

Topic:  As New Mexico is transitioning to an SBE for 2022 plan year, carriers will need a platform where they can check their plan, rate and benefit information before it is published and made available to consumers for shopping on the beWellnm exchange.  The Plan Management Portal will be used by the Carriers and Exchange administrators as a platform to review the SERFF plan data and provide approval to push the plan data to the production environment.

Outline:  The session provided an overview of:

  •  Functioning of Plan Management Module (for Carriers)
    1. Carrier On-Boarding Process
    2. Plan Review & Approval Process
  • Plan Data Consumption, Review & Approval Timeline
  • Plan Management Module (for Carriers) User Interface

Title: Letter to Issuers
Topic: Operational and technical guidance for the 2022 Plan Year for issuers seeking to offer qualified health plans (QHPs), including stand-alone dental plans (SADPs), through the New Mexico Health Insurance Exchange.

Date:  August 5, 2021
Topic: Carrier Discussion
Presentation 8.5.21

Date: July 15, 2021
Topic: Plan Management Module
Presentation

Date: May 26, 2021
Topic: Carrier Integration                                                                                                                                                                                                                             NMHIX Enrollment Reconciliation Meeting Presentation
NMHIX Reconciliation Guide

Date: December 15, 2020
Topic: Carrier Integration Testing (EDI Integration with NFP Health)
Presentation

Date: November 17, 2020 (rescheduled from 10/20)
Topic: Plan Management, Carrier Onboarding and Testing
Presentation
Question & Answers

Date: October 6, 2020
Topic: Data Migration and Renewals
Presentation
Questions & Answers

Date: September 30, 2020
Topic: NMHIX-Carrier Reconciliation
Presentation

Date: September 2, 2020
Topic: EDI 820 Companion Guide Review
Presentation
820 Companion Guide

Date: August 18, 2020
Topic: EDI 834 Companion Guide Review
Presentation
834 Companion Guide

 

You can learn more through our stakeholders advisory meetings