All the health plans available through the SHOP include the following benefits:
Your employer will send you an email that includes a link to the Employee Portal, as well as a user name. Click on the link to open the Employee Portal in an Internet browser window. Then input your user name and follow a simple process to log in to your account.
After you log in, you should see a welcome greeting with your name in the upper left corner of the Dashboard screen.
To change your password, click the My Account tab on the top of the screen. Then click on the Account Settings tab in the dropdown. Click on the "Change Your Password" button then make the desired changes and click Save.
After you log in to your account, you must complete four main steps to enroll in a healthcare plan. These steps include:
The Dashboard walks you through these four steps and indicates which steps have already been completed. Click the corresponding blue buttons to complete the steps.
Open enrollment is a designated period of time each year when employees can make changes to their health insurance coverage. An open enrollment period is 30 days. During this time you can evaluate the available health insurance plans and make your selections. You can also make changes to your selections up to the last day of the open enrollment period. And, if desired, you can also waive coverage.
On the Employee Portal, the dates of the open enrollment period are shown at the top of the Dashboard screen.
After the open enrollment period ends, you cannot make changes to your health coverage until the next open enrollment period unless you qualify for a special enrollment period due to a qualifying life event.
A special enrollment period is also available to current employees who experience changes in their lives such as marriage or divorce or the birth or adoption of a baby. These changes are referred to as qualifying life events. You can let your employer know if you experience a qualifying event by indicating the change on the Employee Special Enrollment screen.
A qualifying event is an event that results in a life change for the employee, such as the birth of a child. These life changes can also make it necessary for an employee to make changes to their health coverage.
Qualifying events include the following:
If you experience a qualifying event, you have 30 days to report the event and make the change to your enrollment.
Members of federally recognized tribes are eligible for special enrollment once every month.
If you choose to waive coverage during the open enrollment period, it means that you give up the opportunity to enroll in the health coverage provided by your employer for the upcoming year. You will not eligible for health coverage through your employer until the next open enrollment period.
You can choose to waive coverage during the open enrollment period by selecting the Waive Employer Coverage option. If you select this option, you will be asked to provide the reason why you want to give up employer-sponsored health coverage. You may be covered under another plan or you may be eligible for a government plan such as Medicaid.
If you waive coverage, you will be asked to verify this choice and then provide your electronic signature. If you do not have any health coverage and you still choose to waive your employer coverage, you may be subject to a tax penalty.
Once enrolled, the dependent will continue to be covered under the employee's health insurance until the plan's renewal date, or until a life change event is reported that makes the dependent eligible for a Special Enrollment Period.
First, it is important to note that the Employer needs to complete the renewal process for the group, or the health insurance coverage for the Employee will be cancelled.
If the group coverage has been renewed, Employees are auto-renewed when they meet both of the following conditions:
The health insurance coverage offered by your employer is considered affordable to you if your share of the annual premium for the lowest priced self-only plan is less than 9.5% of your household's combined annual income. If the employer-sponsored coverage offered to you is considered affordable and provides "minimum essential coverage," you will not be eligible for any tax credits to reduce the cost of the monthly premiums for a plan purchased through the individual marketplace. Of course, you can still purchase a plan from the marketplace at full price.
This is the amount your employer pays for a portion of your health insurance premium.. This contribution may or may not also apply to your dependent premiums.
You can add a dependent either during open enrollment or special enrollment by completing the Update Dependents step.
As part of the shopping experience on NMHIX, you are currently offered the opportunity to purchase dental coverage for your minor children only. Family dental coverage will be available for you to select in the near future. In the meantime, if you'd like to shop for dental coverage outside of NMHIX, click here for a list of dental insurance carriers in New Mexico.
The employee and all dependents must be enrolled in the same health insurance plan. Children can be enrolled in an additional plan for dental coverage.
There are two ways to see the details of your selected plans:
An e-signature is the electronic version of a handwritten signature and is a simple and legal way to give consent on electronic forms. When you enroll in the selected health care plan, you provide an e-signature by typing your name on the Enrollment screen.