NM State Health Plan Pays $353 Million To Providers

GSD Secretary Ken Ortiz

STATE News:

SANTA FE — The New Mexico General Services Department, through its health care plan for state and local government workers and their dependents, paid nearly $353 million to medical providers in fiscal year 2020, GSD Secretary Ken Ortiz announced Tuesday.

GSD’s group health plan, managed by the department’s Risk Management Division, is the largest employer-based medical benefits pool in the state, covering nearly 58,000 New Mexicans in dozens of communities.

“GSD’s plan is a critical part of the state’s health care infrastructure,” Ortiz said. “The plan covers government employees across the state and pays hundreds of hospitals and other medical providers to serve those employees and their families.”

Ortiz said the reimbursement rates paid by the health plan are considerably higher than those of Medicaid and Medicare, the health care programs for low-income people and older Americans.

“Those higher rates are especially critical to medical providers in smaller communities,” Ortiz said.

The health plan covers about 38,500 state employees and dependents, as well as nearly 19,500 local government workers and their dependents.

The local employees covered by the plan include workers with more than 135 public bodies, including 24 counties, four colleges and universities, and 59 cities, towns and villages. Some of the smaller local public bodies have as few as one covered employee.

“Without GSD’s group health plan, the local entities would struggle to afford the same high-quality level of benefits on the commercial market,” Ortiz said.

State law permits, but doesn’t require, participation in the plan by local public bodies.

GSD’s group health plan is self-insured and is funded by premiums paid by employers and employees.

“Being self-insured allows the pool to operate efficiently, with over 95 cents of every premium dollar collected going directly to hospitals and other medical providers,” said Mark Tyndall, director of GSD’s Risk Management Division.

State and local employees in the benefits pool choose from health care coverage provided by Presbyterian Health Plan, Blue Cross and Blue Shield of New Mexico and Cigna. GSD also offers dental, vision, life and disability coverage.

The New Mexico General Services Department is committed to providing high-quality, cost-effective and on-time services that support the success of our fellow agencies in government.

GSD’s divisions provide services in facilities management, purchasing, risk management, health care and other employee benefits, transportation, construction management and printing. GSD is a government leader in addressing climate change through its green buildings project, purchase of electric vehicles, construction of EV charging stations and other initiatives. Learn more about GSD at www.generalservices.state.nm.us and follow on Twitter @NmGeneral.

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