NMSA 1978, § 52-6-1 Short title
52-6-1. Short title
Chapter 52, Article 6 NMSA 1978 may be cited as the "Group Self-Insurance Act".
Laws 1986, ch. 22, § 75; 1990 (2nd S.S.), ch. 2, § 66.
Group Self-Insurance
NMSA 1978 ch. 52, art. 6
in effectNMSA 1978, § 52-6-2 Definitions
52-6-2. Definitions
As used in the Group Self-Insurance Act:
A. "administrator" means an individual, partnership or corporation engaged by a group's board of trustees to carry out the policies established by that board and to provide day-to-day management of the group;
B. "group" means a not-for-profit unincorporated association consisting of two or more public hospital employers or private employers that are engaged in the same or similar type of business, are members of the same bona fide trade or professional association that has been in existence for not less than five years and that enter into agreements to pool their liabilities for workers' compensation benefits; except that public hospital employers shall segregate their accounting records and investment accounts from those of private employers in accordance with applicable state law;
C. "insolvent" means that a group is unable to pay its outstanding lawful obligations as they mature in the regular course of business, as shown both by having an excess of required reserves and other liabilities over assets and by not having sufficient assets to reinsure all outstanding liabilities after paying all accrued claims owed;
D. "net premium" means premium derived from standard premium adjusted by any advance premium discounts;
E. "private employer" means every employer that is not a public employer or a public hospital employer;
F. "public employer" means the state of New Mexico or any of its branches, agencies, departments, boards, instrumentalities or institutions and all school districts and all political subdivisions of the state or any of their agencies, instrumentalities or institutions. "Public employer" does not include a public hospital employer;
G. "public hospital employer" means any local, county, district, city-county or other public hospital or health-related facility, whether operating in wholly or partially owned or leased premises;
H. "service company" means a person or entity that provides services not provided by the administrator, including claims adjustment; safety engineering; compilation of statistics and the preparation of premium, loss and tax reports; preparation of other required self-insurance reports; development of members' assessments and fees; and administration of a claim fund;
I. "standard premium" means the premium derived from the manual rates adjusted by experience modification factors but before advance premium discounts;
J. "superintendent" means the superintendent of insurance; and
K. "workers' compensation benefits" means benefits pursuant to the Workers' Compensation Act [Chapter 52, Article 1 NMSA 1978] or the New Mexico Occupational Disease Disablement Law [52-3-1 NMSA 1978].
Laws 1986, ch. 22, § 76; 1987, ch. 11, § 1; 1989, ch. 263, § 88; 1990 (2nd S.S.), ch. 2, § 67; 2013, ch. 74, § 6.
NMSA 1978, § 52-6-3 Scope
52-6-3. Scope
The provisions of the Group Self-Insurance Act apply to groups. Except as provided by the provisions of that act, groups that are issued a certificate of approval by the director shall not be deemed to be insurers or businesses of insurance and shall not be subject to the provisions of the Insurance Code or other insurance laws and regulations.
Laws 1986, ch. 22, § 77; 1990 (2nd S.S.), ch. 2, § 68.
NMSA 1978, § 52-6-4 Authority to act as a group
52-6-4. Authority to act as a group
No person, association or other entity shall act as a group unless it has been issued a certificate of approval by the director.
Laws 1986, ch. 22, § 78; 1990 (2nd S.S.), ch. 2, § 69.
NMSA 1978, § 52-6-5 Initial approval and continued approval to act as a group; qualifications
52-6-5. Initial approval and continued approval to act as a group; qualifications
A. A proposed group shall file with the director an application for a certificate of approval accompanied by a nonrefundable filing fee in an amount established by the director. The application shall include the group's name, the location of its principal office, the date of organization, the name and address of each member and such other information as the director may reasonably require, together with the following:
(1) proof of compliance with the provisions of Subsection B of this section;
(2) a copy of the articles of association, if any;
(3) a copy of agreements with the administrator and with any service company;
(4) a copy of the bylaws of the proposed group;
(5) a copy of the agreement between the group and each member securing the payment of workers' compensation and occupational disease disablement benefits, which shall include provision for payment of assessments as provided for in Section 52-6-20 NMSA 1978;
(6) designation of the initial board of trustees and administrator;
(7) the address in this state where the books and records of the group will be maintained at all times;
(8) a pro-forma financial statement on a form acceptable to the director showing the financial ability of the group to pay the workers' compensation and occupational disease disablement obligations of its members; and
(9) proof of payment to the group by each member of not less than twenty-five percent of that member's first-year estimated annual net premium on a date approved by the director. Each payment shall be considered to be part of the first-year premium payment of each member if the proposed group is granted a certificate of approval.
B. To obtain and to maintain its certificate of approval, a group shall comply with the following requirements as well as any other requirements established by law or regulation not inconsistent with the following:
(1) a combined net worth of all members of a group of private employers of three million dollars ($3,000,000) or greater, as determined by the director; provided that if a group's annual financial statement for the prior calendar year shows that at the end of that year the group had a surplus of at least one-third of its claim reserves and not less than five million dollars ($5,000,000), then for the current calendar year, the group shall not be required to provide the director with evidence of the net worth of all of the group's members;
(2) security in a form and amount prescribed by the director, which shall be provided by either a surety bond, security deposit or financial security endorsement or any combination thereof. If a surety bond is used to meet the security requirement, it shall be issued by a corporate surety company authorized to transact business in this state. If a security deposit is used to meet the security requirement, securities shall be limited to bonds or other evidences of indebtedness issued, assumed or guaranteed by the United States or by an agency or instrumentality thereof; certificates of deposit in a federally insured bank; shares or savings deposits in a federally insured savings and loan association or credit union; or any bond or security issued by a state of the United States and backed by the full faith and credit of the state. Any such securities shall be deposited with the director and assigned to and made negotiable by the director pursuant to a trust document acceptable to the director. Interest accruing on a negotiable security so deposited shall be collected and transmitted to the depositor, provided the depositor is not in default. A financial security endorsement, issued as part of an acceptable excess insurance contract, may be used to meet all or part of the security requirement. The bond, security deposit or financial security endorsement shall be for the benefit of the state solely to pay claims and associated expenses and payable upon the failure of the group to pay workers' compensation or occupational disease disablement benefits it is legally obligated to pay. The director may establish and adjust requirements of the amount of security based on differences among groups in their size, types of local government services provided by members of the group, years in existence and other relevant factors; provided that the director shall not require an amount lower than one hundred thousand dollars ($100,000) for any group during its first year of operation. Subsequent to the first year of operation, the director may waive the requirements of this paragraph;
(3) specific and aggregate excess insurance in a form, in an amount and by an insurance company acceptable to the director. The director may establish minimum requirements for the amount of specific and aggregate excess insurance based on differences among groups in their size, types of employment, years in existence and other relevant factors and may permit a group to meet this requirement by placing in a designated depository securities of the type referred to in Paragraph (2) of this subsection;
(4) an estimated annual standard premium of at least two hundred fifty thousand dollars ($250,000) during a group's first year of operation. Thereafter, the annual standard premium shall be at least five hundred thousand dollars ($500,000);
(5) an indemnity agreement jointly and severally binding the group and each member of the group to meet the workers' compensation and occupational disease disablement obligations of each member. The indemnity agreement shall be in a form prescribed by the director and shall include minimum uniform substantive provisions prescribed by the director. Subject to the director's approval, a group may add other provisions needed because of its particular circumstances. The requirements of this paragraph shall only apply to private employers;
(6) a fidelity bond for the administrator in a form and amount prescribed by the director; and
(7) a fidelity bond for the service company in a form and amount prescribed by the director. The director may also require the service company providing claim services to furnish a performance bond in a form and amount prescribed by the director.
C. A group shall notify the director of any change in the information required to be filed under Subsection A of this section or in the manner of its compliance with Subsection B of this section no later than thirty days after that change.
D. The director shall evaluate the information provided by the application required to be filed under Subsection A of this section to assure that no gaps in funding exist and that funds necessary to pay workers' compensation and occupational disease disablement benefits will be available on a timely basis.
E. The director shall act upon a completed application for a certificate of approval within sixty days. If, because of the number of applications, the director is unable to act upon an application within that period, the director shall have an additional sixty days to so act.
F. The director shall issue to the group a certificate of approval upon finding that the proposed group has met all requirements, or the director shall issue an order refusing the certificate, setting forth reasons for refusal, upon finding that the proposed group does not meet all requirements.
G. Each group shall be deemed to have appointed the director as its attorney to receive service of legal process issued against it in this state. The appointment shall be irrevocable, shall bind any successor in interest and shall remain in effect as long as there is in this state any obligation or liability of the group for workers' compensation or occupational disease disablement benefits.
Laws 1986, ch. 22, § 79; 1989, ch. 263, § 89; 1990 (2nd S.S.), ch. 2, § 70; 2007, ch. 112, § 1.
NMSA 1978, § 52-6-6 Certificate of approval; termination
52-6-6. Certificate of approval; termination
A. The certificate of approval issued by the director to a group authorizes the group to provide workers' compensation and occupational disease disablement benefits. The certificate of approval remains in effect until terminated at the request of the group or revoked by the director, pursuant to provisions of Section 52-6-23 NMSA 1978.
B. The director shall not grant the request of any group to terminate its certificate of approval unless the group has insured or reinsured all incurred workers' compensation or occupational disease disablement obligations with an authorized insurer under an agreement filed with and approved in writing by the director. Such obligations shall include both known claims and associated expenses and claims incurred but not reported and associated expenses.
C. Subject to approval of the director, a group may merge with another group engaged in the same or similar type of business only if the resulting group assumes in full all obligations of the merging groups. The director may hold a hearing on the merger and shall do so if any party, including a member of either group, so requests.
Laws 1986, ch. 22, § 80; 1989, ch. 263, § 90; 1990 (2nd S.S.), ch. 2, § 71.
NMSA 1978, § 52-6-7 Examinations
52-6-7. Examinations
The director may examine the affairs, transactions, accounts, records and assets and liabilities of each group as often as the director deems advisable. The expense of such examinations shall be assessed against the group in the same manner that insurers are assessed for examinations.
Laws 1986, ch. 22, § 81; 1990 (2nd S.S.), ch. 2, § 72.
NMSA 1978, § 52-6-8 Board of trustees; membership, powers, duties and prohibitions
52-6-8. Board of trustees; membership, powers, duties and prohibitions
Each group shall be operated by a board of trustees that shall consist of not less than five persons whom the members of a group elect for stated terms of office. At least two-thirds of the trustees shall be employees, officers or directors of members of the group. The group's administrator or service company, or any owner, officer or employee of, or any other person affiliated with, the administrator or service company shall not serve on the board of trustees of the group. All trustees shall be residents of this state or officers of corporations authorized to do business in this state. The board of trustees of each group shall ensure that all claims are paid promptly and take all necessary precautions to safeguard the assets of the group, including all of the following:
A. the board of trustees shall:
(1) maintain responsibility for all money collected or disbursed from the group and segregate all money into a claims fund account and an administrative fund account. At least seventy percent of the net premium shall be placed into a designated depository, to be called the "claims fund account", for the sole purpose of paying claims, allocated claims expenses, reinsurance or excess insurance and special fund contributions, including second-injury and other loss-related funds; provided that income taxes may be paid from the actuarially determined surplus portion of the claims fund account at the discretion of the board of trustees. The remaining net premium shall be placed into a designated depository, to be called the "administrative fund account", for the payment of taxes, general regulatory fees and assessments and administrative costs. The director may approve an administrative fund account of more than thirty percent and a claims fund account of less than seventy percent only if the group shows to the director's satisfaction that:
(a) more than thirty percent is needed for an effective safety and loss-control program; or
(b) the group's aggregate excess insurance attaches at less than seventy percent;
(2) maintain minutes of its meetings and make the minutes available to the director;
(3) designate an administrator to carry out the policies established by the board of trustees and to provide day-to-day management of the group and delineate in the written minutes of its meetings the areas of authority it delegates to the administrator; and
(4) retain an independent certified public accountant to prepare the statement of financial condition required by Subsection A of Section 52-6-12 NMSA 1978; and
B. the board of trustees shall not:
(1) extend credit to individual members for payment of a premium except pursuant to payment plans approved by the director; or
(2) borrow any money from the group or in the name of the group except in the ordinary course of business, without first advising the director of the nature and purpose of the loan and obtaining prior approval from the director.
Laws 1986, ch. 22, § 82; 1987, ch. 11, § 2; 1990 (2nd S.S.), ch. 2, § 73; 1997, ch. 184, § 1.
NMSA 1978, § 52-6-9 Group membership; termination; liability
52-6-9. Group membership; termination; liability
A. An employer joining a group after the group has been issued a certificate of approval shall:
(1) submit an application for membership to the board of trustees or its administrator; and
(2) if applicable, enter into the indemnity agreement required by Paragraph (5) of Subsection B of Section 52-6-5 NMSA 1978.
Membership takes effect no earlier than each member's date of approval. The application for membership and its approval shall be maintained as permanent records of the board of trustees.
B. Individual members of a group shall be subject to cancellation by the group pursuant to the bylaws of the group. In addition, individual members may elect to terminate their participation in the group. The group shall notify the director of the termination or cancellation of a member within ten days and shall maintain coverage of each canceled or terminated member for thirty days after such notice, at the terminating member's expense, unless the group is notified sooner by the director that the canceled or terminated member has procured workers' compensation and occupational disease disablement insurance, has become an approved self-insurer or has become a member of another group.
C. The group shall pay all workers' compensation and occupational disease disablement benefits for which each member incurs liability during its period of membership. A private employer member who elects to terminate his membership or is canceled by a group remains jointly and severally liable for workers' compensation and occupational disease disablement obligations of the group and its members that were incurred during the canceled or terminated member's period of membership.
D. A group member is not relieved of his workers' compensation or occupational disease disablement liabilities incurred during his period of membership except through payment by the group or the member of required workers' compensation and occupational disease disablement benefits.
E. The insolvency or bankruptcy of a member does not relieve the group or any other member of liability for the payment of any workers' compensation or occupational disease disablement benefits incurred during the insolvent or bankrupt member's period of membership.
Laws 1986, ch. 22, § 83; 1989, ch. 263, § 91; 1990 (2nd S.S.), ch. 2, § 74.
NMSA 1978, § 52-6-10 Administrators and service companies; conflicts
52-6-10. Administrators and service companies; conflicts
A. Each group shall have an administrator. In providing day-to-day management for the group, the administrator may provide claims adjustment; safety engineering; compilation of statistics and the preparation of premium, loss and tax reports; preparation of other required self-insurance reports; development of members' assessments and fees; and administration of a claim fund.
B. Each group may have a service company. The service company may provide services the administrator delegates to it or does not itself provide.
C. No service company or its employees, officers or directors shall be an employee, officer or director of, or have either a direct or indirect financial interest in, an administrator for the same group. No administrator or its employees, officers or directors shall be an employee, officer or director of, or have either a direct or indirect financial interest in, a service company for the same group. Nothing in this section shall prohibit an administrator or service company for one group from being an administrator or service company for another group.
D. An administrator, officer, trustee or employee of a group or an employee of an administrator shall disclose in writing to the group's board of trustees and director a conflict of interest. For purposes of this subsection, a "conflict of interest" means that a person accepts or is a beneficiary of a fee, brokerage, gift or other thing of value, other than fixed salary or compensation, as consideration for an investment, loan, deposit, purchase, sale, exchange, insurance, reinsurance or other similar transaction made by or for the group, or that a person is financially interested in any capacity in a transaction for the group except on behalf of the group.
E. No group shall pay remuneration, compensation or any thing of value to an officer, administrator or director of the group unless the payment has been authorized by the group's board of trustees.
F. A service contract shall state that, unless the director permits otherwise, the service company shall handle, to their conclusion, all claims and other obligations incurred during the contract period.
Laws 1986, ch. 22, § 84; 1990 (2nd S.S.), ch. 2, § 75; 1993, ch. 96, § 1.
NMSA 1978, § 52-6-11 Licensing of agent
52-6-11. Licensing of agent
Except for a salaried employee of a group, its administrator or its service company, any person soliciting membership in a group shall be a licensed solicitor or agent pursuant to the provisions of the Insurance Code.
Laws 1986, ch. 22, § 85.
NMSA 1978, § 52-6-12 Financial statements; other reports
52-6-12. Financial statements; other reports
A. Each group shall submit to the director a statement of financial condition audited by an independent certified public accountant on or before the last day of the sixth month following the end of the group's fiscal year. The financial statement shall be on a form prescribed by the director and shall include actuarially appropriate reserves for:
(1) known claims and associated expenses;
(2) claims incurred but not reported and associated expenses;
(3) unearned premiums; and
(4) bad debts, which reserves shall be shown as liabilities. An actuarial opinion regarding reserves for:
(a) known claims and associated expenses; and
(b) claims incurred but not reported and associated expenses shall be included in the audited financial statement. The actuarial opinion shall be given by a member of the American academy of actuaries or other qualified loss reserve specialist as defined in the annual statement adopted by the national association of insurance commissioners.
B. The director may prescribe the format and frequency of other reports, which may include payroll audit reports, summary loss reports and quarterly financial statements.
Laws 1986, ch. 22, § 86; 1990 (2nd S.S.), ch. 2, § 76.
NMSA 1978, § 52-6-14 Subsequent injury fund
52-6-14. Subsequent injury fund
A group shall be subject to the provisions of the Subsequent Injury Act.
Laws 1986, ch. 22, § 88.
NMSA 1978, § 52-6-15 Misrepresentation prohibited
52-6-15. Misrepresentation prohibited
No person shall make a material misrepresentation or omission of a material fact in connection with the solicitation of membership of a group.
Laws 1986, ch. 22, § 89.
NMSA 1978, § 52-6-16 Investments
52-6-16. Investments
Funds not needed for current obligations may be invested by the board of trustees in accordance with the provisions of Chapter 59A, Article 9 NMSA 1978 applicable to investments, except that, notwithstanding the provisions of Section 59A-9-18 NMSA 1978:
A. the board of trustees may make loans or investments not otherwise expressly permitted under Chapter 59A, Article 9 NMSA 1978, in an aggregate amount not exceeding ten percent of the group's assets and not exceeding two percent of such assets as to any one such loan or investment, provided that such loans and investments do not constitute an amount that is greater than total surplus, if the loan or investment meets the requirements of Section 59A-9-3 NMSA 1978 and by reason of safety of principal and yield otherwise qualifies as a sound investment; and
B. the calculation of the group's other loans and investments described in Subsection A of this section shall not include the fair market value of any real property occupied by the group.
Laws 1986, ch. 22, § 90; 2007, ch. 205, § 1.
NMSA 1978, § 52-6-17 Rates; reporting
52-6-17. Rates; reporting
A. Every group shall adhere to the uniform classification system, uniform experience-rating plan and manual rules filed with the superintendent by an advisory organization designated by the director.
B. Premium contributions to the group shall be determined by applying the manual rates and rules to the appropriate classification of each member, which shall be adjusted by each member's experience credit or debit. Subject to approval by the director, premium contributions may also be reduced by an advance premium discount reflecting the group's expense levels and loss experience.
C. Notwithstanding Subsection B of this section, a group may apply to the director for permission to make its own rates. Such rates shall be based on at least three years of the group's experience.
D. Each group shall be audited at least annually by an auditor acceptable to the director to verify proper classifications, experience rating, payroll and rates. A report of the audit shall be filed with the director in a form acceptable to him. A group or any member thereof may request a hearing on any objections to the classifications. If the director determines that, as a result of an improper classification, a member's premium contribution is insufficient, he shall order the group to assess that member an amount equal to the deficiency. If the director determines that, as a result of an improper classification, a member's premium is excessive, he shall order the group to refund to the member the excess collected. The audit shall be at the expense of the group.
Laws 1986, ch. 22, § 91; 1987, ch. 11, § 3; 1990 (2nd S.S.), ch. 2, § 77.
NMSA 1978, § 52-6-18 Refunds
52-6-18. Refunds
A. Any money for a fund year in excess of the amount necessary to fund all obligations for that fund year may be declared to be refundable by the board of trustees not less than twelve months after the end of the fund year.
B. Each member shall be given a written description of the refund plan at the time of application for membership. A refund for any fund year shall be paid only to those employers who remain participants in the group for the entire fund year. Payment of a refund based on a previous fund year shall not be contingent on continued membership in the group after that fund year.
Laws 1986, ch. 22, § 92.
NMSA 1978, § 52-6-19 Premium payment; reserves
52-6-19. Premium payment; reserves
A. Each group shall establish to the satisfaction of the director a premium payment plan that shall include:
(1) an initial payment by each member of at least twenty-five percent of that member's annual premium before the start of the group's fund year; and
(2) payment of the balance of each member's annual premium in monthly or quarterly installments during that fund year.
B. Upon approval by the director, a group may establish an alternative premium payment plan that shall include:
(1) provision by each member of premium security by surety bond in an amount equal to at least twenty-five percent of the member's annual premium; provided that the surety bond shall be in a form acceptable to the group, shall be issued by a corporate surety company authorized to transact business in this state and shall be effective before the start of the group's fund year; and
(2) payment by each member of the member's annual premium in monthly or quarterly installments during the group's fund year.
C. Each group shall establish and maintain actuarially appropriate loss reserves that shall include reserves for:
(1) known claims and associated expenses; and
(2) claims incurred but not reported and associated expenses.
D. Each group shall establish and maintain bad debt reserves based on the historical experience of the group or other groups.
Laws 1986, ch. 22, § 93; 1990 (2nd S.S.), ch. 2, § 78; 1997, ch. 146, § 1.
NMSA 1978, § 52-6-20 Deficits and insolvencies
52-6-20. Deficits and insolvencies
A. If the assets of a group are at any time insufficient to enable the group to discharge its legal liabilities and other obligations and to maintain the reserves required of it under the Group Self-Insurance Act, it shall forthwith make up the deficiency or levy an assessment upon its members for the amount needed to make up the deficiency.
B. In the event of a deficiency in any fund year, such deficiency shall be made up immediately, either from:
(1) surplus from a fund year other than the current fund year;
(2) administrative funds;
(3) assessment of the membership, if ordered by the group; or
(4) such alternate method as the director may approve or direct.
The director shall be notified prior to any transfer of surplus funds from one fund year to another.
C. If the group fails to assess its members or to otherwise make up such deficit within thirty days, the director shall order it to do so.
D. If the group fails to make the required assessment of its members within thirty days after the director orders it to do so, or if the deficiency is not fully made up within sixty days after the date on which such assessment is made, or within such longer period of time as may be specified by the director, the group shall be deemed to be insolvent.
E. The director shall proceed against an insolvent group in the same manner as the superintendent would proceed against an insolvent domestic insurer in this state as prescribed by the Insurance Code. The director shall have the same powers and limitations in such proceedings as are provided to the superintendent under that code, except as otherwise provided in the Group Self-Insurance Act.
F. In the event of the liquidation of a group, the director shall levy an assessment upon its members for such an amount as the director determines to be necessary to discharge all liabilities of the group, including the reasonable cost of liquidation.
Laws 1986, ch. 22, § 94; 1990 (2nd S.S.), ch. 2, § 79.
NMSA 1978, § 52-6-21 Monetary penalties
52-6-21. Monetary penalties
After notice and opportunity for a hearing, the director may impose a monetary penalty on any person or group found to be in violation of any provision of the Group Self-Insurance Act or of any rules or regulations promulgated thereunder. The monetary penalty shall not exceed one thousand dollars ($1,000) for each act or violation and shall not exceed ten thousand dollars ($10,000) in the aggregate. The amount of the monetary penalty shall be paid to the director for credit to the workers' compensation administration fund.
Laws 1986, ch. 22, § 95; 1990 (2nd S.S.), ch. 3, § 4.
NMSA 1978, § 52-6-22 Cease and desist orders
52-6-22. Cease and desist orders
A. After notice and opportunity for a hearing, the director may issue an order requiring a person or group to cease and desist from engaging in an act or practice found to be in violation of any provision of the Group Self-Insurance Act or of any rules or regulations promulgated thereunder.
B. Upon a finding, after notice and opportunity for a hearing, that any person or group has violated any cease and desist order, the director may do either or both of the following:
(1) impose a monetary penalty of not more than ten thousand dollars ($10,000) for each and every act or violation of such order not to exceed an aggregate monetary penalty of one hundred thousand dollars ($100,000); and
(2) revoke the group's certificate of approval or any insurance license held by the person.
Laws 1986, ch. 22, § 96; 1990 (2nd S.S.), ch. 2, § 80.
NMSA 1978, § 52-6-23 Revocation of certificate of approval
52-6-23. Revocation of certificate of approval
A. After notice and opportunity for a hearing, the director may revoke a group's certificate of approval if it:
(1) is found to be insolvent;
(2) fails to pay any premium tax, regulatory fee or assessment or special fund contribution imposed upon it; or
(3) fails to comply with any of the provisions of the Group Self-Insurance Act, with any rules or regulations promulgated thereunder or with any lawful order of the director within the time prescribed.
B. The director may revoke a group's certificate of approval if, after notice and opportunity for hearing, he finds that:
(1) any certificate of approval that was issued to the group was obtained by fraud;
(2) there was a material misrepresentation in the application for the certificate of approval; or
(3) the group or its administrator has misappropriated, converted, illegally withheld or refused to pay over, upon proper demand, any money that belongs to a member, an employee of a member or a person otherwise entitled to it and that has been entrusted to the group or its administrator in its fiduciary capacities.
Laws 1986, ch. 22, § 97; 1990 (2nd S.S.), ch. 2, § 81.
NMSA 1978, § 52-6-24 Notice and hearing; appeal
52-6-24. Notice and hearing; appeal
Notice and hearing required by the provisions of Sections 52-6-21, 52-6-22 and 52-6-23 NMSA 1978 shall be given and held pursuant to the applicable provisions of Chapter 59A, Article 4 NMSA 1978. A party may appeal from an order of the director made after a hearing, pursuant to Section 39-3-1.1 NMSA 1978.
Laws 1986, ch. 22, § 98; 2003, ch. 259, § 11.
NMSA 1978, § 52-6-25 Rules and regulations
52-6-25. Rules and regulations
The director may make rules and regulations necessary to implement the provisions of the Group Self-Insurance Act.
Laws 1986, ch. 22, § 99; 1990 (2nd S.S.), ch. 2, § 82.
Source: New Mexico Compilation Commission (nmonesource.com)URL: https://nmonesource.com/nmos/nmsa-unanno/en/item/18555/index.doFetched: 10/20/2026