New Mexico Health Connections

TO ESTABLISH A CONSUMER OPERATED AND ORIENTED PLAN (COOP) CONSISTENT WITH THE PROVISIONS OF THE PATIENT PROTECTION AND AFFORDABLE CARE ACT. NMHC WILL GENERATE FUNDING, ANALYSIS, AND SUSTAINABILITY CRITERIA FOR A COOP HEALTH PLAN, INCLUDING AN ORGANIZATIONAL MODEL THAT ACCOMMODATES REGIONAL AND POPULATION-SPECIFIC PLANS FOR DELIVERING AFFORDABLE, COMMUNITY-SPECIFIC HEALTH CARE ACROSS THE STATE.

ON MARCH 19, 2021 THE SECOND JUDICIAL DISTRICT COURT, BERNALILLO COUNTY ORDERED NEW MEXICO HEALTH CONNECTIONS ("NMHC OR THE "COMPANY") INTO LIQUIDATION. RISK AND REGULATORY CONSULTING, LLC WAS APPOINTED AS SPECIAL DEPUTY RECEIVER. NEW MEXICO HEALTH CONNECTIONS IS A PRIVATE, NONPROFIT COMPANY ESTABLISHED UNDER INTERNAL REVENUE CODE 501(C)(29) THAT WAS INCORPORATED IN THE STATE OF NEW MEXICO IN FEBRUARY 2011. ON FEBRUARY 17, 2012, THE COMPANY BECAME A QUALIFIED NONPROFIT HEALTH INSURANCE ISSUER UNDER THE CONSUMER-OPERATED AND ORIENTED PLAN (CO-OP) PROGRAM ESTABLISHED BY SECTION 1322 OF THE AFFORDABLE CARE ACT AND APPLICABLE REGULATIONS. UNDER THIS PROGRAM, THE COMPANY RECEIVED STARTUP AND SOLVENCY LOANS FROM THE UNITED STATES DEPARTMENT OF HEALTH AND HUMAN SERVICES, CENTERS FOR MEDICARE AND MEDICAID SERVICES (CMS). THE COMPANY WAS GOVERNED BY ITS BOARD OF DIRECTORS, WHICH HAVE THE AUTHORITY AND RESPONSIBILITY FOR MANAGEMENT, CONTROL, AND ADMINISTRATION OF THE COMPANY. THE COMPANY RECEIVED ITS CERTIFICATE OF AUTHORITY FROM THE STATE OF NEW MEXICO PUBLIC REGULATION COMMISSION, INSURANCE DIVISION IN FEBRUARY 2013. THE PRIMARY MISSION OF THE COMPANY WAS TO PROVIDE AFFORDABLE COMMUNITY HEALTH CARE INSURANCE ACROSS THE STATE OF NEW MEXICO TO THE INDIVIDUAL AND SMALL GROUP MARKETS. THE COMPANY BEGAN OPEN ENROLLMENT IN OCTOBER 2013, FOR AN EFFECTIVE INSURANCE COVERAGE DATE OF JANUARY 1, 2014. THE COMPANY WAS FOCUSED ON THE WELL-BEING OF PARTIES BY MAKING SURE THEIR HEALTH CARE WAS COORDINATED AT EVERY LEVEL AND THAT A STRONG NETWORK OF PRIMARY-CARE PROVIDERS WAS AVAILABLE TO ENSURE GOOD HEALTH OF OUR MEMBERS. THE COMPANY'S PRIORITY WAS TO KEEP MEMBERS HEALTHY, LOWERING PREMIUM COSTS AND DELIVERING APPROPRIATE LEVELS OF CARE AT THE RIGHT TIME TO KEEP MEMBERS HOME AND OUT OF UNNECESSARY HOSPITAL STAYS. THIS WAS ACCOMPLISHED BY PROVIDING COMMUNITY-BASED CASE MANAGEMENT TO ENSURE THE MEMBERS WERE WELL CARED FOR.