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Email: info@nmmip.org
Toll Free : 1-844-728-7896
TTY: 1-844-728-7987
FAX (Claims): 1-620-792-7053
FAX (Premium Billing & Enrollment): 1-620-793-1199
New Mexico Medical Insurance Pool

New Mexico Medical Insurance Pool

"When no one else will help, we're there."
  • Home
  • About Us
    • Who We Are
    • Who We Serve
    • Pool Contact Information
  • I Need Health Coverage
    • Benefits & Eligibility
    • What Benefits are Covered?
    • 2021 Rate Tables
    • Do I Qualify for LIPP?
    • Applications
    • 2020 Medicare Carve-Out Plan
  • Resources for Members
    • 2021 Open Enrollment
    • Policy Book
    • Summary of Benefits
    • Additional Resources
  • Transparency
    • Statistics Packs
    • Financial Audits
    • Board of Directors
    • Statute
    • Plan of Operation
    • Contact Us
  • RFP
    • Actuarial RFP
    • Statute
  • Carriers
    • Direct Premium Survey

Forms

Automatic Payment Form

Click Here

Automatic Payment Form (Spanish)

Click Here

PHI Release Authorization Form

Click Here

Termination Request Form

Click Here

Non-Tobacco User Affidavit

Click Here

Non-Tobacco User Affidavit (Spanish)

Click Here

For further information and assistance regarding Forms please contact Customer Service at 1-844-728-7896.

New Mexico Medical Insurance Pool

The New Mexico Medical Insurance Pool (NMMIP) was established by the 1987 New Mexico State Legislature.

The Pool was created to provide access to health insurance coverage to residents of New Mexico who are denied health insurance and considered uninsurable.

Executive Services

  • 1-866-622-4711
  • info@nmmip.org
  • www.nmmip.org

  • 1223 St Francis Dr. Ste. B.
    Santa Fe, NM 87505

Administrator

  • 1-844-728-7896
  • info@nmmip.org
  • www.benefitmanagementllc.com

  • P.O. Box 1090
    2015 16th St.
    Great Bend, KS 67530

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