The proposed rates reflect the impact of New Mexico legislation items and/or regulatory changes effective on January 1, 2025, as well as the New Mexico Office of the Superintendent of Insurance (OSI)’s requirement for issuers to use a 44% CSR adjustment factor for Silver plans sold on the Exchange.
Plan offerings comply with 2025 Plan Year Individual QHP and Small Group Market Rate Filing Guidance to set the tobacco rating multiplier at 1.0 for all individual on-and-off-exchange plans, offer only two on-exchange non-standardized Silver and Gold plans in any rating area, and keep the minimum premium differential for a 21-year-old between any two non-standardized silver plans in a single area above $10 PMPM.
In addition, Turquoise variants are made available for each Silver and Gold plan with the expansion of Turquoise 3 eligibility to 200-400% FPL and the introduction of -13 variant for Native Americans between 300-400% FPL and participate in Gold plans, as mandated by the Health Insurance Marketplace Affordability Program Policy and Procedures Manual.