Senate Bill376 (SB376) modifies contribution percentage for state employee’s health benefits and authorizes  the Secretary of Health Care Authority to use funds appropriated from the Health Care Affordability Fund to reduce or eliminate premiums for certain government employees. 

 Senate Bill 376 (SB376) makes modifications to the state contribution for health insurance to read: “E. Except as found in Subsection  H, “effective July 1, 2025 , the group insurance contributions of the state or any of its executive, judicial or legislative departments, including agencies, boards or commissions, shall be eighty percent of the cost of insurance. 
The exception listed above states: “H. An employer shall pay one hundred percent of the employee group insurance contributions due and payable on or after July 1, 2016 for an employee who is injured while performing a public safety function or duty and, as a result of the injury, is placed on approved workers' compensation leave”. This language is found in Subsection H of Section 1, Section 10-7-4 NMSA 1978 (being Laws 1941, Chapter 188, Section 1.
In a cost containment effort paragraph, Subparagraph K, new language provides: “If a state agency that is responsible for providing state employee health benefits under the Health Care Purchasing Act establishes a reference-based pricing program for in-network or out-of-network hospital services, hospitals subject to the program shall not charge or collect from a member of the health benefit plan an amount in addition to the maximum payment established by the secretary of health care authority, except that a hospital may charge an amount for cost-sharing that is authorized by the terms of the member's health benefit plan”.
Other new language states: “When the secretary of health care authority submits the health care authority's annual budget request to the legislature, the secretary shall include a budget request for purchasing state employee health benefits that reflects actuarially sound rate adjustments.  Beginning July 1, 2025, the secretary shall set actuarially sound rates sufficient to cover projected claims, subject to legislative appropriation. The secretary of health care authority shall establish a program to make state health benefit premiums more affordable for certain employees using appropriations from the health care affordability fund.  The secretary shall establish a system for determining eligibility for the program and may annually update program eligibility and contribution criteria. "
In Section 2, Subparagrph B, and in relation to the Health Care Affordability Fund, new language provides that the purpose of the Fund is to “cover a portion or all of the net premium health benefit contributions for state employees enrolled in health benefit plans covered by the Health Care Purchasing Act who do not qualify for medicaid and have a modified adjusted gross income up to two hundred fifty percent of the federal poverty level; “ and to “over a portion or all of the net premiums for members of the New Mexico national guard who qualify for a federal TRICARE reserve select policy”.



 

 Amended February 25, 2025 in STBTC
STBTCa/SB376: The Senate Tax,Business and Transportation Committee amends Senate Bill 376 as follows:

“ On page 8, strike lines 10 through 15 and insert in lieu thereof: "(5)  cover a portion or all of the net premium health benefit contributions for state employees enrolled in health benefit plans covered by the Health Care Purchasing Act who do not qualify for medicaid and: (a)  have a modified adjusted gross income up to two hundred fifty percent of the federal poverty level; or (b)  purchase employee-only coverage and receive an annual salary from the state of fifty thousand dollars ($50,000) or less;"

 

 Committee Substitute March 07, 2025 in SFC
SFCacs/ SB376: The Senate Finance Committee makes several changes requiring maximum benefits for the least cost and “M.  When the secretary of health care authority submits the health care authority's annual budget request to the legislature, the secretary shall include a budget request for purchasing state employee health benefits that has actuarially sound rates for the following fiscal year beginning July 1, 2025, the secretary shall set actuarially sound rates sufficient to cover projected claims, subject to legislative appropriation.  By September 1 of each year, the projected actuarially sound rate adjustment for the following fiscal year, subject to legislative appropriation, shall be communicated to the local public bodies who are part of the state employee health benefit program.” 
The reference to “actuarially sound rates for the following year”is new language
A new paragraph “O” under Section 1 is to read: 
“O.  By July 1, 2026, the health care authority shall ensure that state employees are provided the opportunity to purchase a variety of health benefit plans with varying plan designs and cost-sharing options. "
Also, under Section 2, B, paragraph 5 will now read, “(5)  cover a portion or all of the net premium health benefit contributions for state employees enrolled in health benefit plans covered by the Health Care Purchasing Act who do not qualify for medicaid and: (a)  have a modified adjusted gross income up to two hundred fifty percent of the federal poverty level; or (b)  purchase employee-only coverage and receive an annual salary from the state of fifty thousand dollars ($50,000) or less; “.