Employees

(1) there is a change in status which makes someone newly eligible as your dependent (e.g., marriage, birth); (2) an unenrolled eligible dependent involuntarily loses his or her medical coverage; or (3) upon submission and approval of a Change Request Form and an NMRHCA Plan Health Statement certifying the state of your dependent’s health. For newly eligible dependents, you must apply for dependent coverage within 31 days of the event that caused the new eligibility (copies of marriage, birth, or court documents required). Late enrollment approvals will be decided by our medical underwriter’s medical evaluation of the applicant’s medical history. In each case above, you will be required to pay the first two months of premiums up front.

You are an “eligible retiree” (eligible to participate in the NMRHCA) if you receive a disability or normal retirement benefit from public service in New Mexico with an NMRHCA participating employer, and you retired with a pension before your employer’s effective date with the NMRHCA program, or you and/or your employer (on your behalf) made contributions to the NMRHCA fund from your employer’s NMRHCA effective date until your date of retirement, or you and/or your employer (on your behalf) made contributions to the NMRHCA fund for at least five years before your date of retirement.

In the 2009 Legislative session, a bill was passed that requires payment of Retiree Health Care Authority (RHCA) contributions for service credit purchased from PERA and ERB toward retirement. Effective July 1, 2009, members who enroll in RHCA at the time of retirement must pay contributions on the PERA and ERB service credit before being eligible for insurance coverage. RHCA will calculate the cost of the RHCA contributions owed on the purchased service credit. Click here to see a rate table for purchasing service credit.

SPLIT COVERAGE: If the retiree is covering a spouse or dependents under their plan, they must have the same level of benefits as the retiree (with the exception of one of the members in the household is Medicare eligible and the other member is not Medicare eligible). 

CANCELLATION OF COVERAGE: Subscribers may cancel coverage by submitting written notification to the New Mexico Retiree Health Care Authority. Cancellation will take effect beginning with the first day of the month following receipt of notification by the NMRHCA. Effective date of cancellation is not retroactive.

RETURN TO WORK: If you take new employment after your retirement or choose to be covered under your spouse’s coverage, you may choose one of the two NMRHCA options. (1). Delay or terminate your enrollment in the NMRHCA and take your employer’s plan or spouse’s plan. You are allowed to enroll into the NMRHCA at a later date without being required to submit an NMRHCA Plan Health Statement, if you apply within 31 days of your involuntary loss of coverage. (2). Take the new employer’s plan of benefits and enroll yourself and your eligible dependents in the NMRHCA, thus receiving care benefits from both plans. Please note that your employer’s benefit plan will be the primary payer and the NMRHCA will be the secondary payer.