San Juan County, NM
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State of NM Healthcare Insurance
- To be eligible, an employee must work at least 30 hours per week.
- Compliance with the Affordable Care Act
- Coverage begins on 1st day of the month coinciding with or following completion of 30 days of employment
Example: Hire date is 3/13/23, 30 days 4/13/2023 - coverage begins 5/1/23
NO LATE ENROLLMENT
You will not be eligible for coverage if you DO NOT make benefit elections within 30 DAYS from your hire date.
If you do not make your benefit elections, you must wait until Open Enrollment in the Fall, and your elected benefits will be effective January 1st.
Dependent Eligibility
Supporting documentation
- Marriage Certificate
- Affidavit of Domestic Partnership (Must be notarized)
For Children
- Birth Certificate
- Court Document(s) that show legal custody/guardianship
Life Change Events
With Qualifying Life Change Events, you may update your coverage outside of the open enrollment period. The event must be reported to HR within 31 days from when the event occurred.
- Change in job status
- Marriage
- Divorce
- Birth of a child (You must complete an Enrollment/Change Form and submit to HR within 31 days from DOB in order for the baby to have coverage from DOB.)
- Adoption
- Death of a spouse/ domestic partner or dependent child.
- Domestic Partner becomes eligible.
If you want to add/remove a dependent and is NOT Life Change Event, you must wait until Open Enrollment to make revisions.
What is the difference?
| HMO- Health Maintenance Organization | PPO – Preferred Provider Organization |
|
|
|
Plan Name |
Employee Only |
Employee + Family |
|
|
$71.54 |
$211.06 |
|
|
$71.54 |
$211.06 |
|
|
$83.20 |
$245.48 |
Note: Table above reflects semi-monthly premiums from Employee’s paycheck. There are additional tiers for Employee and Spouse, Employee and Domestic Partner, Employee and Child(ren), and Employee with Domestic Partner and Child(ren).
