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We ensure that New Mexicans attain their highest level of health by providing whole-person, cost-effective, accessible, and high-quality health care and safety-net services.
Health Care Coverage Innovations – HCAF
- Reduce premiums and out-of-pocket health care costs for New Mexicans who qualify for coverage on BeWell, the state’s Health Insurance Marketplace;
- Reduce premiums for small businesses and their employees;
- Provide resources for planning, design and implementation of health care coverage initiatives for uninsured New Mexico residents; and
- Provide resources for administration of state health care coverage initiatives for uninsured New Mexico residents.
The Fund and its programs are administered by the New Mexico Health Care Authority (HCA).
Programs
- Health Insurance Marketplace Affordability Program
- New Mexico Premium Assistance
- Turquoise Plans
- Clear Cost Plans
- Medicaid Transition Premium Relief
- Native American Premium Assistance
- Small Business Health Insurance Premium Relief Initiative
Rules
Resources
Plan/Program Year 2026: Materials
2026 Plan Year Marketplace Affordability Program
- 2026 Plan Year Health Insurance Marketplace Affordability Program – Policy & Procedure Manual
- 2026 Plan Year Supplemental SOPA Template (Excel download)
- Final PY26 Clear Cost Plan Requirements
- Final PY26 Clear Cost Plan Designs (Excel download)
2026 Plan Year DACA Coverage Program
**NEW** Updated: 2026 DACA Coverage Program: Notice of Program Guidance
2026 Plan Year Small Business Health Insurance Premium Relief
- Jan 2026 – June 2026 Small Business Program Guidance
- HCAF Bulletin 2025-002: Premium Reduction Percentage for Coverage Jul 1 – Dec 31, 2025
- PY25 Small Business Reporting Template – Monthly (Excel download)
- PY25 Small Business FAQs for Jul 1 – Dec 31, 2025
Plan/Program Year 2025: Materials
Final 2025 Health Insurance Marketplace Affordability Program Guidance
- 2025 Plan Year Health Insurance Marketplace Affordability Program Policy and Procedures Manual FINAL
- 2025 Plan Year Marketplace Affordability Program FAQs for Issuers (Updated April 26, 2024)
- 2025 Plan Year BeWell Clear Cost Plan Requirements FINAL
- 2025 Plan Year BeWell Clear Cost Plan AV Calculator Screenshots FINAL (Downloads Excel File)
- Non-AVC Clear Cost Benefits Co-Pay Category (Downloads Excel File)
2025 DACA Coverage Bridge Initiative
- PY25 DACA Notice of Program Guidance – FINAL
- Template – PY25 DACA Coverage Bridge Initiative (Excel download)
2025 Plan Year Marketplace Affordability Program
For Insurance Carriers and Brokers
Video: Kickoff to PY25 – Updates to Health Care Affordability Fund
PY25 Kickoff – Updates to Health Care Affordability Fund (pdf presentation)
Small Business Health Insurance Premium Relief Initiative
- HCA Bulletin 2024-01 (January 2025-June 2025)
Plan/Program Year 2024: Materials
2024 Health Insurance Marketplace Affordability Program Guidance
- 2024 Plan Year Health Insurance Marketplace Affordability Program Policy and Procedures Manual (FINAL)
- 2024 Plan Year Marketplace Affordability Program FAQs for Issuers (Updated May 10, 2023)
- 2024 Plan Year Supplemental SOPA Template (Downloads Excel file)
- 2024 Plan Year Standardized Health Plan Requirements
- 2024 Plan Year Standardized Health Plan AV Calculator Screenshots (Updated May 10, 2023) (Downloads Excel file)
2024 Plan Year Marketplace Affordability Program Bulletins
2024 Plan Year SOPA Reconciliation Guidance for Health Insurance Issuers
- Sep 2025 – PY24 SOPA Reconciliation Training Webinar
- Final PY24 SOPA Reconciliation Checklist (Excel download)
- Recap: SOPA Reconciliation Training – PY24 2nd Cycle Wednesday, September 3 | Meeting | Microsoft Teams
- PY24 SOPA Reconciliation Training Webinar Jan 2025
- PY24 SOPA Reconciliation Training-Jan 2025 (PowerPoint download)
- FINAL Plan Year 2024 SOPA Reconciliation Guidance
- Final PY24 Template A-Issuer and Plan Level SOPA (Excel download)
- Final PY24 Template B-Policy Level SOPA-Reconciliation (Excel download)
- Final PY24 Template C-SOPA Request for Reconsideration (Excel download)
- Final PY24 Attestation form A for EHB inclusion (Excel download)
- Final PY24 Attestation form B for EHB inclusion (Excel download)
Small Business Health Insurance Premium Relief Initiative
- PY24 Reconciliation Training Refresher – Small Business (video)
- FINAL PY24 Guidance – Small Business
- PY24 Annual Reconciliation Template – Small Business (Excel download)
- PY24 Annual Reconciliation Examples – Small Business (Excel download)
- PY24 Attestation Form – Small Business
Small Business Bulletins
- OSI Bulletin 2024-011 (July 2024-December 2024)
- OSI Bulletin 2024-010 (July 2024-December 2024)
- OSI Bulletin 2023-036 (January 2024-June 2024)
Plan/Program Year 2023: Materials
Health Insurance Marketplace Affordability Program Information for the 2023 Plan Year
2023 Health Insurance Marketplace Affordability Program Guidance
- 2023 Plan Year Health Insurance Marketplace Affordability Program Policy and Procedures Manual
- Marketplace Affordability Program FAQ for Issuers (Updated April 4, 2022)
- Bulletin 2022-022 – MAP Payment Process
- How reporting income changes after Open Enrollment could affect Turquoise Plan eligibility
Final 2023 Plan Year SOPA Reconciliation Guidance for Health Insurance Issuers
- Final SOPA Reconciliation Guidance (Version 2)
- OSI Responses to Carrier Questions Following Jan 2023 SOPA Reconciliation Training – Mar 2023
- Template A – Issuer and Plan Level SOPA
- Template B – Policy Level SOPA-Reconciliation
- Template C – SOPA Request for Reconsideration
- Attestation Form A – EHB Inclusion
- Attestation Form B – EHB Inclusion
- Attestation Form C – Simplified Methodology Forms
Small Business Health Insurance Premium Relief Initiative
OSI
- Bulletin 2023-10 (July 2023-December 2023)
- Bulletin 2022-018 (January 2023-June 2023)
- Bulletin 2022-006 (July 2022-December 2022)

